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Jiang L, Xu C, Bai Y, Liu A, Gong Y, Wang YP, Deng HW. AUTOSURV: INTERPRETABLE DEEP LEARNING FRAMEWORK FOR CANCER SURVIVAL ANALYSIS INCORPORATING CLINICAL AND MULTI-OMICS DATA. RESEARCH SQUARE 2023:rs.3.rs-2486756. [PMID: 37609286 PMCID: PMC10441464 DOI: 10.21203/rs.3.rs-2486756/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Accurate prognosis for cancer patients can provide critical information for optimizing treatment plans and improving life quality. Combining omics data and demographic/clinical information can offer a more comprehensive view of cancer prognosis than using omics or clinical data alone and can reveal the underlying disease mechanisms at the molecular level. In this study, we developed a novel deep learning framework to extract information from high-dimensional gene expression and miRNA expression data and conduct prognosis prediction for breast cancer and ovarian cancer patients. Our model achieved significantly better prognosis prediction than the conventional Cox Proportional Hazard model and other competitive deep learning approaches in various settings. Moreover, an interpretation approach was applied to tackle the "black-box" nature of deep neural networks and we identified features (i.e., genes, miRNA, demographic/clinical variables) that made important contributions to distinguishing predicted high- and low-risk patients. The identified associations were partially supported by previous studies.
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Xu JJ, Chen J, Liu YX, Song Y, Jiang L, Yan SD, Guo WY, Yao Y, Jia SD, Yuan DS, Wang PZ, Li JX, Zhao XY, Liu ZY, Yuan JQ. [The impact of LDL-C/HDL-C ratio on severity of coronary artery disease and 2-year outcome in patients with premature coronary heart disease: results of a prospective, multicenter, observational cohort study]. ZHONGHUA XIN XUE GUAN BING ZA ZHI 2023; 51:702-708. [PMID: 37460423 DOI: 10.3760/cma.j.cn112148-20230128-00043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Objective: To explore the relationship between low density lipoprotein cholesterol (LDL-C)/high density lipoprotein cholesterol (HDL-C) ratio with the severity of coronary artery disease and 2-yeat outcome in patients with premature coronary heart disease. Methods: This prospective, multicenter, observational cohort study is originated from the PROMISE study. Eighteen thousand seven hundred and one patients with coronary heart disease (CHD) were screened from January 2015 to May 2019. Three thousand eight hundred and sixty-one patients with premature CHD were enrolled in the current study. According to the median LDL-C/HDL-C ratio (2.4), the patients were divided into two groups: low LDL-C/HDL-C group (LDL-C/HDL-C≤2.4, n=1 867) and high LDL-C/HDL-C group (LDL-C/HDL-C>2.4, n=1 994). Baseline data and 2-year major adverse cardiovascular and cerebrovascular events (MACCE) were collected and analyzed in order to find the differences between premature CHD patients at different LDL-C/HDL-C levels, and explore the correlation between LDL-C/HDL-C ratio with the severity of coronary artery disease and MACCE. Results: The average age of the low LDL-C/HDL-C ratio group was (48.5±6.5) years, 1 154 patients were males (61.8%); the average age of high LDL-C/HDL-C ratio group was (46.5±6.8) years, 1 523 were males (76.4%). The number of target lesions, the number of coronary artery lesions, the preoperative SNYTAX score and the proportion of three-vessel coronary artery disease in the high LDL-C/HDL-C group were significantly higher than those in the low LDL-C/HDL-C group (1.04±0.74 vs. 0.97±0.80, P=0.002; 2.04±0.84 vs. 1.85±0.84, P<0.001; 13.81±8.87 vs. 11.70±8.05, P<0.001; 36.2% vs. 27.4%, respectively, P<0.001). Correlation analysis showed that there was a significant positive correlation between LDL-C/HDL-C ratio and preoperative SYNTAX score, the number of coronary artery lesions, the number of target lesions and whether it was a three-vessel coronary artery disease (all P<0.05). The 2-year follow-up results showed that the incidence of MACCE was significantly higher in the high LDL-C/HDL-C group than that in the low LDL-C/HDL-C group (6.9% vs. 9.1%, P=0.011). There was no significant difference in the incidence of all-cause death, cardiac death, myocardial infarction, stroke, revascularization and bleeding between the two groups. Cox multivariate regression analysis showed that the LDL-C/HDL-C ratio has no correlation with 2-year MACCE, death, myocardial infarction, revascularization, stroke and bleeding events above BARC2 in patients with premature CHD. Conclusion: High LDL-C/HDL-C ratio is positively correlated with the severity of coronary artery disease in patients with premature CHD. The incidence of MACCE of patients with high LDL-C/HDL-C ratio is significantly higher during 2 years follow-up; LDL-C/HDL-C ratio may be an indicator for evaluating the severity of coronary artery disease and long-term prognosis in patients with premature CHD.
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Winiarski B, Gheysen J, Pyka G, Hannard F, Arseenko M, Villanova J, Brinek A, Chirazi A, Jiang L, Simar A. Correlative Microscopy Discovers Self-Healing of AM-Build Al-Mg Alloy. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2023; 29:1981-1982. [PMID: 37612913 DOI: 10.1093/micmic/ozad067.1026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
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Zhang S, He CF, Cai XZ, Jiang L, Wu XW, Jin Y, Mei LY. [Comparative study of surgical effects on patients with mixed deafness and otosclerosis with different air bone conduction differences]. ZHONGHUA ER BI YAN HOU TOU JING WAI KE ZA ZHI = CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY 2023; 58:666-671. [PMID: 37455111 DOI: 10.3760/cma.j.cn115330-20230616-00283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Objective: To analyze the surgical efficacy of patients with mixed hearing loss and otosclerosis with different air bone gap (ABG) before surgery, and to provide reference for the prognosis evaluation of otosclerosis surgery. Methods: The clinical data of 108 cases(116 ears) of otosclerosis who had undergone stapes fenestration technique artificial stapes implantation in Xiangya Hospital of Central South University from November 2013 to May 2020 and had mixed hearing loss before surgery were collected, including 71 women(76 ears)and 37 men (40 ears), with an average age of 38.5 years. According to preoperative pure tone audiometry ABG, they were divided into three groups: group S, 15 dB≤ABG<31 dB, a total of 39 ears; group M, 31 dB≤ABG<46 dB, a total of 58 ears; and group L, ABG≥46 dB, 19 ears in total. The hearing outcomes of three groups of patients at 6-12 months after surgery were compared and analyzed using SPSS 24.0 statistical software. Results: A total of 3 patients (group S: 2 cases; group L: 1 case) experienced severe sensorineural hearing loss after surgery and were not included in the statistical analysis. After surgery, the pure tone hearing threshold of patients with otosclerosis in each group was significantly improved compared to before surgery, with an average air conduction threshold improvement of(21.6±13.4) dB. The difference between before and after surgery was statistically significant(t=17.13, P<0.01). The average bone conduction threshold improved by(3.7±7.6) dB, and the difference was statistically significant before and after surgery(t=5.20, P<0.01). The postoperative ABG was(18.3±9.3) dB, which was significantly reduced compared to preoperative(36.2±8.6)dB. Among the three groups of patients, the L group had the highest improvement in air conduction threshold[(29.9±10.8)dB], while the S group had the lowest improvement[(15.7±11.4)dB]. There was no statistically significant difference in post operative pure tone hearing thresholds between the three groups(P>0.05). The postoperative ABG in group S was the smallest[(16.5±9.0)dB], while in group L, the postoperative ABG was the largest[(20.5±10.0)dB]. Compared with group S, group M and group L still had a large residual ABG at 2 000 Hz after surgery. The bone conduction threshold of both S and M groups improved to some extent after surgery compared to before (P<0.01). Conclusions: Surgery can benefit patients with mixed hearing loss and otosclerosis with different preoperative ABG. Patients with small preoperative ABG have better surgical results and ideal ABG closure at all frequencies after surgery. Patients with large preoperative ABG can significantly increase the gas conduction threshold during surgery, but certain frequencies of ABG may still be left behind after surgery. The improvement effect of surgery on bone conduction threshold is not significant. Patients should be informed of treatment methods such as hearing aids based on their actual situation for selection.
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Liu T, Jiang L, Bai Q, Wu S, Yu X, Wu T, Wang J, Zhang X, Li H, Zhao K, Wang L. CLDN6 Suppresses Migration and Invasion of MCF-7 and SKBR-3 Breast Cancer Cells by Blocking the SMAD/Snail/MMP-2/9 Axis. Bull Exp Biol Med 2023; 175:376-381. [PMID: 37566248 DOI: 10.1007/s10517-023-05871-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Indexed: 08/12/2023]
Abstract
The study examined the mechanisms of action of signal protein claudin 6 (CLDN6) on migration and invasion of breast cancer cell lines MCF-7 and SKBR-3. To this end, the signal proteins SMAD were blocked with their inhibitor SB431542, the genes CLDN6 and SNAIL were knocked down with short hairpin RNAs, and MMP2 and MMP9 were inhibited with TIMP-1. Expressions of MMP2 and MMP9 mRNAs were evaluated by reverse transcription PCR, Expressions of MMP-2, MMP-9, E-cadherin, N-cadherin, and vimentin were examined by Western blotting. Migration and invasion were analyzed by scratch test and Matrigel invasion assay. SB431542 inhibited expression of MMP2 and MMP9 in both cell lines. Single use of SB431542 inhibited expression of MMP-2/MMP-9 and corresponding mRNAs, but subsequent silencing of CLDN6 gene reversed this effect. TIMP-1 reversed down-regulation of E-cadherin, upregulation of N-cadherin and vimentin, facilitation of migration and invasion evoked by CLDN6 knocking down. Silencing of SNAIL gene inhibited migration and invasion, upregulated the expression of E-cadherin, and down-regulated expression of MMP2, MMP 9, N-cadherin, and vimentin. Thus, CLDN6 suppresses the epithelial-mesenchymal transition, migration, and invasion via blocking SMAD/Snail/MMP-2/9 signaling pathway in MCF-7 and SKBR-3 cancer cell lines.
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Abratenko P, Andrade Aldana D, Anthony J, Arellano L, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barr G, Barrow J, Basque V, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhattacharya M, Bishai M, Blake A, Bogart B, Bolton T, Book JY, Camilleri L, Caratelli D, Caro Terrazas I, Cavanna F, Cerati G, Chen Y, Conrad JM, Convery M, Cooper-Troendle L, Crespo-Anadón JI, Del Tutto M, Dennis SR, Detje P, Devitt A, Diurba R, Djurcic Z, Dorrill R, Duffy K, Dytman S, Eberly B, Ereditato A, Evans JJ, Fine R, Finnerud OG, Foreman W, Fleming BT, Foppiani N, Franco D, Furmanski AP, Garcia-Gamez D, Gardiner S, Ge G, Gollapinni S, Goodwin O, Gramellini E, Green P, Greenlee H, Gu W, Guenette R, Guzowski P, Hagaman L, Hen O, Hicks R, Hilgenberg C, Horton-Smith GA, Irwin B, Itay R, James C, Ji X, Jiang L, Jo JH, Johnson RA, Jwa YJ, Kalra D, Kamp N, Karagiorgi G, Ketchum W, Kirby M, Kobilarcik T, Kreslo I, Leibovitch MB, Lepetic I, Li JY, Li K, Li Y, Lin K, Littlejohn BR, Louis WC, Luo X, Mariani C, Marsden D, Marshall J, Martinez N, Martinez Caicedo DA, Mason K, Mastbaum A, McConkey N, Meddage V, Miller K, Mills J, Mogan A, Mohayai T, Mooney M, Moor AF, Moore CD, Mora Lepin L, Mousseau J, Mulleriababu S, Naples D, Navrer-Agasson A, Nayak N, Nebot-Guinot M, Nowak J, Nunes M, Oza N, Palamara O, Pallat N, Paolone V, Papadopoulou A, Papavassiliou V, Parkinson HB, Pate SF, Patel N, Pavlovic Z, Piasetzky E, Ponce-Pinto ID, Pophale I, Prince S, Qian X, Raaf JL, Radeka V, Rafique A, Reggiani-Guzzo M, Ren L, Rochester L, Rodriguez Rondon J, Rosenberg M, Ross-Lonergan M, Rudolf von Rohr C, Scanavini G, Schmitz DW, Schukraft A, Seligman W, Shaevitz MH, Sharankova R, Shi J, Snider EL, Soderberg M, Söldner-Rembold S, Spitz J, Stancari M, John JS, Strauss T, Sword-Fehlberg S, Szelc AM, Tang W, Taniuchi N, Terao K, Thorpe C, Torbunov D, Totani D, Toups M, Tsai YT, Tyler J, Uchida MA, Usher T, Viren B, Weber M, Wei H, White AJ, Williams Z, Wolbers S, Wongjirad T, Wospakrik M, Wresilo K, Wright N, Wu W, Yandel E, Yang T, Yates LE, Yu HW, Zeller GP, Zennamo J, Zhang C. First Measurement of Quasielastic Λ Baryon Production in Muon Antineutrino Interactions in the MicroBooNE Detector. PHYSICAL REVIEW LETTERS 2023; 130:231802. [PMID: 37354393 DOI: 10.1103/physrevlett.130.231802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/07/2023] [Accepted: 04/28/2023] [Indexed: 06/26/2023]
Abstract
We present the first measurement of the cross section of Cabibbo-suppressed Λ baryon production, using data collected with the MicroBooNE detector when exposed to the neutrinos from the main injector beam at the Fermi National Accelerator Laboratory. The data analyzed correspond to 2.2×10^{20} protons on target running in neutrino mode, and 4.9×10^{20} protons on target running in anti-neutrino mode. An automated selection is combined with hand scanning, with the former identifying five candidate Λ production events when the signal was unblinded, consistent with the GENIE prediction of 5.3±1.1 events. Several scanners were employed, selecting between three and five events, compared with a prediction from a blinded Monte Carlo simulation study of 3.7±1.0 events. Restricting the phase space to only include Λ baryons that decay above MicroBooNE's detection thresholds, we obtain a flux averaged cross section of 2.0_{-1.7}^{+2.2}×10^{-40} cm^{2}/Ar, where statistical and systematic uncertainties are combined.
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Luo P, Hu W, Xu R, Wang Y, Li X, Jiang L, Chang S, Wu D, Li G, Dai Y. Enabling early detection of knee osteoarthritis using diffusion-relaxation correlation spectrum imaging. Clin Radiol 2023:S0009-9260(23)00224-6. [PMID: 37336674 DOI: 10.1016/j.crad.2023.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/11/2023] [Accepted: 05/23/2023] [Indexed: 06/21/2023]
Abstract
AIM To present a technique that enables detection of early stage OA of the knee using diffusion-relaxation correlation spectrum imaging (DR-CSI). MATERIALS AND METHODS Fifty-five early osteoarthritis patients (OA, Kellgren-Lawrence [KL] score 1 to 2; mean age, 56.4 years) and 49 healthy volunteers (mean age, 56.7 years) were underwent magnetic resonance imaging (MRI) with T2-mapping and DR-CSI techniques. Maps of mean apparent diffusion coefficient (ADC), T2 relaxation time and volume fraction Vi for DR-CSI compartment i (A, B, C, D) sensitivity, specificity, and positive and negative likelihood ratio (PLR, NLR) were assessed to determine the diagnostic accuracy for detection of early-stage degeneration of knee articular cartilage. The structural abnormalities of articular cartilage were evaluated using modified Whole-Organ MR Imaging Scores (WORMS). RESULTS All intra- and interobserver agreements for DR-CSI compartment volume fractions and modified WORMS of cartilage were excellent. Early OA versus the controls had higher VC, lower VA and VB (p<0.001), but comparable VD (p>0.05). VA, VB and VC had a moderate association with WORMS. No significant correlation was identified between VD and WORMS. VC had better ability than VA,VB, VD, T2 and ADC to discriminate early OA patients from healthy controls (area under the curve, 0.898). Sensitivity, specificity, PLR, and NLR of VC with a cut-off value of 29.9% were 81.8% (95% confidence interval [CI], 69.1-90.9%), 95.9% (86-99.5%), 20.05% (5.13-78.34%), and 0.19% (0.11-0.33%). CONCLUSIONS DR-CSI compartment volume fractions may be sensitive indicators for detecting early-stage degeneration in knee articular cartilage.
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Liu AN, Shen HQ, Xu CF, Jiang L, Shao J, Shu Q, Fu JF, Ni Y. [Characteristics of serum bile acids among healthy children in Zhejiang province]. ZHONGHUA ER KE ZA ZHI = CHINESE JOURNAL OF PEDIATRICS 2023; 61:509-514. [PMID: 37312461 DOI: 10.3760/cma.j.cn112140-20230127-00056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To characterize the serum bile acid profiles of healthy children in Zhejiang Province. Methods: A cross-sectional study was conducted on 245 healthy children who underwent imaging and laboratory biochemical tests during routine physical examinations at the Children's Hospital of Zhejiang University School of Medicine from January 2020 to July 2022. Overnight fasting venous blood samples were collected, and the concentrations of 18 individual bile acids in the serum were accurately quantitated using tandem mass spectrometry. The concentration difference of bile acid were compared between different genders and to explore the correlation between age and bile acid levels. Used the Mann-Whitney U test for intergroup comparison and Spearman test to correlation analysis. Results: A total of 245 health children with a age of 10 (8, 12) years including 125 boys and 120 girls. There were no significant differences in levels of total bile acids, primary and secondary bile acids, free and conjugated bile acids between the two gender groups (all P>0.05). The serum concentrations of ursodeoxycholic acid and glycoursodeoxycholic acid in girls were significantly higher than those in boys (199.0 (66.9, 276.5) vs. 154.7 (49.3, 205.0) nmol/L, 274.0 (64.8, 308.0) vs. 181.0 (43.8, 209.3) nmol/L, Z=2.06, 2.71, both P<0.05). The serum taurolithocholic acid in both boys and girls were positively correlated with age (r=0.31, 0.32, both P<0.05). The serum chenodeoxycholic acid and glycochenodeoxycholic acid in the boys group were positively correlated with age (r=0.20, 0.23, both P<0.05), whereas the serum tauroursodeoxycholic acid in the girls group was negatively correlated with age (r=-0.27, P<0.05), and the serum cholic acid was positively correlated with age (r=0.34, P<0.05). Conclusions: The total bile acid levels are relatively stable in healthy children in Zhejiang province. However, individual bile acids showed gender differences and were correlated with age.
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Jin A, Xu H, Gao X, Sun S, Yang Y, Huang X, Wang X, Liu Y, Zhu Y, Dai Q, Bian Q, Jiang L. ScRNA-Seq Reveals a Distinct Osteogenic Progenitor of Alveolar Bone. J Dent Res 2023; 102:645-655. [PMID: 37148259 DOI: 10.1177/00220345231159821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023] Open
Abstract
The metabolism and remodeling of alveolar bone are the most active among the whole skeletal system, which is related to the biological characteristics and heterogeneity of the bone mesenchymal stromal cells (MSCs). However, there is a lack of systematic description of the heterogeneity of MSC-derived osteoblastic lineage cells as well as their distinct osteogenic differentiation trajectory of alveolar bone. In this study, we constructed a single-cell atlas of the mouse alveolar bone cells through single-cell RNA sequencing (scRNA-seq). Remarkably, by comparing the cell compositions between the alveolar bone and long bone, we uncovered a previously undescribed cell population that exhibits a high expression of protocadherin Fat4 (Fat4+ cells) and is specifically enriched around alveolar bone marrow cavities. ScRNA-seq analysis indicated that Fat4+ cells may initiate a distinct osteogenic differentiation trajectory in the alveolar bone. By isolating and cultivating Fat4+ cells in vitro, we demonstrated that they possess colony-forming, osteogenic, and adipogenic capabilities. Moreover, FAT4 knockdown could significantly inhibit the osteogenic differentiation of alveolar bone MSCs. Furthermore, we revealed that the Fat4+ cells exhibit a core transcriptional signature consisting of several key transcription factors, such as SOX6, which are involved in osteogenesis, and further demonstrated that SOX6 is required for the efficient osteogenic differentiation of the Fat4+ cells. Collectively, our high-resolution single-cell atlas of the alveolar bone reveals a distinct osteogenic progenitor that may contribute to the unique physiological characteristics of alveolar bone.
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Wang MP, Xi XM, Zhu B, Lou R, Jiang Q, He Y, Jiang L. [Dose-response association between fluid overload and hospital mortality in patients with sepsis]. ZHONGHUA NEI KE ZA ZHI 2023; 62:513-519. [PMID: 37096277 DOI: 10.3760/cma.j.cn112138-20220516-00377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
Objective: To investigate dose-response associations between fluid overload (FO) and hospital mortality in patients with sepsis. Methods: The current cohort study was prospective and multicenter. Data were derived from the China Critical Care Sepsis Trial, which was conducted from January 2013 to August 2014. Patients aged≥18 years who were admitted to intensive care units (ICUs) for at least 3 days were included. Fluid input/output, fluid balance, fluid overload (FO), and maximum FO (MFO) were calculated during the first 3 days of ICU admission. The patients were divided into three groups based on MFO values: MFO<5%L/kg, MFO 5%-10%L/kg, and MFO≥10% L/kg. Kaplan-Meier analysis was used to predict time to death in hospital in the three groups. Associations between MFO and in-hospital mortality were evaluated via multivariable Cox regression models with restricted cubic splines. Results: A total of 2 070 patients were included in the study, of which 1 339 were male and 731 were female, and the mean age was (62.6±17.9) years. Of 696 (33.6%) who died in hospital, 968 (46.8%) were in the MFO<5%L/kg group, 530 (25.6%) were in the MFO 5%-10%L/kg group, and 572 (27.6%) were in the MFO≥10%L/kg group. Deceased patients had significantly higher fluid input than surviving patients during the first 3 days [7 642.0 (2 874.3, 13 639.5) ml vs. 5 738.0 (1 489.0, 7 153.5)ml], and lower fluid output [4 086.0 (1 367.0, 6 354.5) ml vs. 6 130.0 (2 046.0, 11 762.0) ml]. The cumulative survival rates in the three groups gradually decreased with length of ICU stay, and they were 74.9% (725/968) in the MFO<5% L/kg group, 67.7% (359/530) in the MFO 5%-10%L/kg group, and 51.6% (295/572) in the MFO≥10%L/kg group. Compared with the MFO<5%L/kg group, the MFO≥10%L/kg group had a 49% increased risk of inhospital mortality (HR=1.49, 95%CI 1.28-1.73). For each 1% L/kg increase in MFO, the risk of in-hospital mortality increased by 7% (HR=1.07, 95% CI 1.05-1.09). There was a"J-shaped"non-linear association between MFO and in-hospital mortality with a nadir of 4.1% L/kg. Conclusion: Higher and lower optimum fluid balance levels were associated with an increased risk of in-hospital mortality, as reflected by the observed J-shaped non-linear association between fluid overload and inhospital mortality.
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Dai Q, Sun S, Jin A, Gong X, Xu H, Yang Y, Huang X, Wang X, Liu Y, Gao J, Gao X, Liu J, Bian Q, Wu Y, Jiang L. Osteoblastic RAR Inhibition Causes VAD-Like Craniofacial Skeletal Deformity. J Dent Res 2023; 102:667-677. [PMID: 37036085 DOI: 10.1177/00220345231151691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023] Open
Abstract
Retinoid signaling disorders cause craniofacial deformity, among which infants with maternal vitamin A deficiency (VAD) exhibited malformation of the eye, nose, palate, and parietal and jaw bone. Previous research uncovered the pathogenesis of eye defect and cleft palate of VAD in mice, but the studies on craniofacial skeletal deformity met obstacles, and the cell/lineage and underlying mechanism remain unclear. The retinoic acid receptor (RAR) is the key transcription factor in retinoid signaling, but individual knockout cannot simulate pathway inhibition. Here, we conditionally expressed dominant-negative RARα mutation (dnRARα) in osteoblasts to specifically inhibit the transcription activity of RAR in mice, which mimics the craniofacial deformities caused by VAD in clinical cases: hypomineralization of cranial bones, mandibular deformity, and clavicular hypoplasia. Furthermore, we performed 3-dimensional reconstruction based on micro-computed tomography and confirmed the abnormalities in the shape, size, and ossification of craniofacial bones due to osteoblastic RAR inhibition. Histological analysis indicated that inhibition of RAR in osteoblasts impaired both bone formation and bone resorption, which was confirmed by transcriptome sequencing of the calvaria. Furthermore, mechanism investigation showed that inhibition of RAR in osteoblasts directly decreased osteoblast differentiation in a cell-autonomous manner by impairing osteogenic gene transcription and also inhibited osteoclast differentiation via osteoblast-osteoclast crosstalk by impairing Rankl transcription. In summary, osteoblastic RAR activity is critical to craniofacial skeletal development, and its dysfunction leads to skeletal deformities mimicking VAD craniofacial defects, providing a new insight for VAD pathogenesis.
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Wang TT, Cao QY, Zhang ZP, Guo YB, Cui L, Zhang Y, Zhang Y, Wang MP, Jiang L. [The predictive value of warning scores for intensive care unit admission in coronavirus disease 2019 patients]. ZHONGHUA NEI KE ZA ZHI 2023; 62:433-437. [PMID: 37032140 DOI: 10.3760/cma.j.cn112138-20220414-00277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
To evaluate the predictive value of early warning scores for intensive care unit (ICU) admission in patients with coronavirus disease 2019 (COVID-19). For COVID-19 patients who were admitted to Shijiazhuang People's Hospital from January 2021 to February 2021, national early warning score (NEWS), national early warning score 2 (NEWS2), rapid emergency medicine score (REMS), quick sepsis-related organ failure (qSOFA), altered consciousness, blood urea nitrogen, respiratory rate, blood pressure, and age-65 (CURB-65) were used to evaluate the inpatient condition and the predictive value for ICU admission. A total of 368 patients were included, and 32 patients (8.7%) were transferred to the ICU. The median age was 49.0 (34.0,61.0) years. The scores of NEWS, NEWS2, REMS, and CURB-65 were 1 (0, 2), 1 (0, 2), 4 (2, 6) and 0 (0, 1), respectively. The receiver operating characteristic (ROC) cure (AUC) was used to evaluate the predictive value in detecting patients who are at risk of being transferred to the ICU. Area under the ROC AUC of NEWS was 0.756, sensitivity 65.6%, and specificity 71.3%. ROC AUC of NEWS2 was 0.732, sensitivity 62.5%, and specificity 61.3%. ROC AUC of REMS was 0.787, sensitivity 84.4%, and specificity 64.6%. ROC AUC of CURB-65 was 0.814, sensitivity 81.3%, and specificity 76.8%. The predictive value of NEWS and NEWS2 combined with age were significantly improved. The ROC AUC of NEWS combined with age was 0.885, sensitivity 85.1%, and specificity 75.0%. The ROC AUC of NEWS2 combined with age was 0.883, sensitivity 84.2%, and specificity 75.0%. NEWS and NEWS2 combined with age can be used as a predictive tool for whether COVID-19 patients will be admitted to the ICU.
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Jiang L, Jiang S, Luo Q. 88P Quantitative CT parameters in predicting the degree of risk of solitary pulmonary nodules. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00343-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
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Chen Y, Tu L, Jiang L, Ji HX. [Analysis of serum CA125 and related influencing factors in silicosis patients with pulmonary heart disease]. ZHONGHUA LAO DONG WEI SHENG ZHI YE BING ZA ZHI = ZHONGHUA LAODONG WEISHENG ZHIYEBING ZAZHI = CHINESE JOURNAL OF INDUSTRIAL HYGIENE AND OCCUPATIONAL DISEASES 2023; 41:209-212. [PMID: 37006147 DOI: 10.3760/cma.j.cn121094-20211115-00563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
Objective: To analyze the serum carbohydrate antigen 125 (CA125) level and its influencing factors in male silicosis patients with pulmonary heart disease. Methods: In October 2021, data of 38 male patients with simple silicosis (silicosis group), 28 cases of silicosis with pulmonary heart disease (pulmonary heart disease group), and 27 healthy controls (control group) in the same age group were collected in inpatient and outpatient of Nanjing Occupational Disease Prevention and Control Hospital from January 2017 to December 2020. The serum CA125 levels of the three groups were compared, and the correlation between disease-related indexes and serum CA125 in silicosis patients with pulmonary heart disease was analyzed, as well as the influencing factors of pulmonary heart disease and serum CA125 levels in silicosis patients. Results: The serum CA125 level[ (19.95±7.52) IU/ml] in pulmonary heart disease group was higher than that in silicosis group[ (12.98±6.35) IU/ml] and control group[ (9.17±5.32) IU/ml] (P<0.05). There was no significant difference in serum CA125 level between the silicosis group and the control group (P>0.05). Serum CA125 levels were positively correlated with blood uric acid and fasting blood glucose in silicosis patients with pulmonary heart disease (r=0.39, 0.46, P<0.05). Serum CA125 level was a risk factor for silicosis patients with pulmonary heart disease (OR=1.13, 95%CI: 1.02-1.24, P<0.05). Dust exposure time, lactate dehydrogenase and smoking history were positively correlated with serum CA125 level in silicosis patients (P<0.05) . Conclusion: The serum CA125 level of male silicosis patients with pulmonary heart disease is significantly increased, and the level of CA125 is correlated with the level of fasting blood glucose and blood uric acid.
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Ji Y, Xie R, Wu C, Liu X, Zhang X, Jiang L. Cost-effective carbon-based amine adsorbents for carbon capture: Equilibrium, kinetics and selectivity. J CO2 UTIL 2023. [DOI: 10.1016/j.jcou.2023.102422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Sotirchos V, Zhan C, Haghani L, Zhao K, Alexander E, Jiang L, Marinelli B, Silk M, Yarmohammadi H, Ziv E, Sofocleous C, Solomon S, Erinjeri J. Abstract No. 252 Comparison of Perioperative and Procedure Room Times Between Moderate Sedation and Monitored Anesthesia Care in Interventional Radiology. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Bazhenova L, Chih-Hsin Yang J, Wang M, Mitchell P, Camidge DR, Fang J, Nian W, Chiu CH, Zhou J, Zhao Y, Su WC, Yang TY, Zhu V, Millward M, Fan Y, Huang WT, Cheng Y, Jiang L, Zheng L, Janne P. OA01.07 Sunvozertinib in NSCLC Patients with EGFR Exon20 Insertion Mutations. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Chen Y, Zhu P, Xu JJ, Song Y, Jiang L, Gao LJ, Chen J, Song L, Gao Z, Liu HB, Yang YJ, Gao RL, Xu B, Yuan JQ. [Clinical features and long-term prognosis of diabetic patients with low or intermediate complexity coronary artery disease post percutaneous coronary intervention]. ZHONGHUA XIN XUE GUAN BING ZA ZHI 2023; 51:143-150. [PMID: 36789593 DOI: 10.3760/cma.j.cn112148-20220601-00432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Objective: To investigate the clinical features and long-term prognostic factors of diabetic patients with low or intermediate complexity coronary artery disease (CAD) post percutaneous coronary intervention (PCI). Methods: This was a prospective, single-centre observational study. Consecutive diabetic patients with SYNTAX score (SS)≤32 undergoing PCI between January and December 2013 in Fuwai hospital were included in this analysis. The patients were divided into two groups based on SS, namely SS≤22 group and SS 23-32 group. Multivariate Cox regression analysis was performed to identify independent factors related to poor 5-year prognosis. The primary outcomes were cardiac death and recurrent myocardial infarction, the secondary outcomes were all cause death and revascularization. Results: Of the 3 899 patients included in the study, 2 888 were men (74.1%); mean age was 59.4±9.8 years. There were 3 450 patients in the SS≤22 group and 449 patients in the SS 23-32 group. Compared with SS≤22 group, the incidence of revascularization was higher in SS 23-32 group (18.9% (85/449) vs. 15.2% (524/3450), log-rank P=0.019). There was no significant difference in all-cause death, cardiac death and recurrent myocardial infarction between the two groups (log-rank P>0.05). Multivariate Cox regression analysis showed that age (HR=1.05, 95%CI 1.02-1.08, P<0.001), chronic obstructive pulmonary disease (HR=3.12, 95%CI 1.37-7.07, P=0.007) and creatinine clearance rate (CCr)<60 ml/min (HR=3.67, 95%CI 2.05-6.58, P<0.001) were independent risk factors for 5-year cardiac death, while left ventricular ejection fraction (HR=0.94, 95%CI 0.91-0.96, P<0.001) was a protective factor. Previous PCI (HR=2.04, 95%CI 1.38-3.00, P<0.001), blood glucose level≥11.1 mmol/L on admission (HR=2.49, 95%CI 1.32-4.70, P=0.005) and CCr<60 ml/min (HR=1.85, 95%CI 1.14-2.99, P=0.012) were independent risk factors for 5-year recurrent myocardial infarction. The SS of 23-32 was independently associated with risk of revascularization (HR=1.54, 95%CI 1.09-2.16, P=0.014), after adjusting for residual SS. Residual SS was not a risk factor for 5-year prognosis. Conclusions: In diabetic patients with low-or intermediate complexity CAD, SS 23-32 is associated with increased risk of 5-year revascularization; the clinical characteristics of the patients are associated with the long-term mortality and recurrent myocardial infarction, but not related to revascularization.
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Piribauer M, Jiang L, Kostov T, Parr M, Steidel S, Bizjak DA, Steinacker JM, Diel P. Combinatory in vitro effects of the β2-agonists salbutamol and formoterol in skeletal muscle cells. Toxicol Lett 2023; 378:10-18. [PMID: 36822333 DOI: 10.1016/j.toxlet.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 02/25/2023]
Abstract
β2-agonists are used for the treatment of bronchoconstriction, but also abused in doping. Beside an ergogenic activity β2-agonists may have also anabolic activity. Therefore, we investigated the anabolic activity and associated molecular mechanisms of Salbutamol (SAL) and Formoterol (FOR) alone, as well as in combination in C2C12 myotubes. In differentiated C2C12 cells, dose-dependent effects of SAL and FOR (alone/in combination) on myotube diameter, myosin heavy chain (MHC) protein expression and the mRNA expression of genes involved in hypertrophy were analyzed. β2-adrenoceptor 2 (ADRB2), androgen receptor (AR) and estrogen receptor (ER) inhibitors, as well as dexamethasone (Dexa) were co-incubated with the β2-agonists and myotube diameter was determined. SAL and FOR treatment significantly induced hypertrophy and increased MHC expression and the mRNA expression of Igf1, mTOR, PIk3r1 and AMpKa2. In contrast to an ER inhibitor, the ADRB2 and AR inhibitors, as well as Dexa antagonized FOR and SAL induced hypertrophy. Combined treatment with SAL and FOR resulted in significant additive effects on myotube diameter and MHC expression. Future clinical studies are needed to prove this effect in humans and to evaluate this finding with respect to antidoping regulations.
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Adnouni M, Jiang L, Zhang X, Zhang L, Pathare PB, Roskilly A. Computational modelling for decarbonised drying of agricultural products: Sustainable processes, energy efficiency, and quality improvement. J FOOD ENG 2023. [DOI: 10.1016/j.jfoodeng.2022.111247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abratenko P, Andrade Aldana D, Anthony J, Arellano L, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barr G, Barrow J, Basque V, Bathe-Peters L, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhattacharya M, Bishai M, Blake A, Bogart B, Bolton T, Book JY, Camilleri L, Caratelli D, Caro Terrazas I, Cavanna F, Cerati G, Chen Y, Conrad JM, Convery M, Cooper-Troendle L, Crespo-Anadón JI, Del Tutto M, Dennis SR, Detje P, Devitt A, Diurba R, Dorrill R, Duffy K, Dytman S, Eberly B, Ereditato A, Evans JJ, Fine R, Finnerud OG, Foreman W, Fleming BT, Foppiani N, Franco D, Furmanski AP, Garcia-Gamez D, Gardiner S, Ge G, Gollapinni S, Goodwin O, Gramellini E, Green P, Greenlee H, Gu W, Guenette R, Guzowski P, Hagaman L, Hen O, Hicks R, Hilgenberg C, Horton-Smith GA, Irwin B, Itay R, James C, Ji X, Jiang L, Jo JH, Johnson RA, Jwa YJ, Kalra D, Kamp N, Karagiorgi G, Ketchum W, Kirby M, Kobilarcik T, Kreslo I, Leibovitch MB, Lepetic I, Li JY, Li K, Li Y, Lin K, Littlejohn BR, Louis WC, Luo X, Manivannan K, Mariani C, Marsden D, Marshall J, Martinez N, Martinez Caicedo DA, Mason K, Mastbaum A, McConkey N, Meddage V, Miller K, Mills J, Mogan A, Mohayai T, Mooney M, Moor AF, Moore CD, Mora Lepin L, Mousseau J, Mulleriababu S, Naples D, Navrer-Agasson A, Nayak N, Nebot-Guinot M, Nowak J, Nunes M, Oza N, Palamara O, Pallat N, Paolone V, Papadopoulou A, Papavassiliou V, Parkinson HB, Pate SF, Patel N, Pavlovic Z, Piasetzky E, Ponce-Pinto ID, Pophale I, Prince S, Qian X, Raaf JL, Radeka V, Reggiani-Guzzo M, Ren L, Rochester L, Rodriguez Rondon J, Rosenberg M, Ross-Lonergan M, Rudolf von Rohr C, Scanavini G, Schmitz DW, Schukraft A, Seligman W, Shaevitz MH, Sharankova R, Shi J, Smith A, Snider EL, Soderberg M, Söldner-Rembold S, Spitz J, Stancari M, St John J, Strauss T, Sword-Fehlberg S, Szelc AM, Tang W, Taniuchi N, Terao K, Thorpe C, Torbunov D, Totani D, Toups M, Tsai YT, Tyler J, Uchida MA, Usher T, Viren B, Weber M, Wei H, White AJ, Williams Z, Wolbers S, Wongjirad T, Wospakrik M, Wresilo K, Wright N, Wu W, Yandel E, Yang T, Yates LE, Yu HW, Zeller GP, Zennamo J, Zhang C. First Constraints on Light Sterile Neutrino Oscillations from Combined Appearance and Disappearance Searches with the MicroBooNE Detector. PHYSICAL REVIEW LETTERS 2023; 130:011801. [PMID: 36669216 DOI: 10.1103/physrevlett.130.011801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
We present a search for eV-scale sterile neutrino oscillations in the MicroBooNE liquid argon detector, simultaneously considering all possible appearance and disappearance effects within the 3+1 active-to-sterile neutrino oscillation framework. We analyze the neutrino candidate events for the recent measurements of charged-current ν_{e} and ν_{μ} interactions in the MicroBooNE detector, using data corresponding to an exposure of 6.37×10^{20} protons on target from the Fermilab booster neutrino beam. We observe no evidence of light sterile neutrino oscillations and derive exclusion contours at the 95% confidence level in the plane of the mass-squared splitting Δm_{41}^{2} and the sterile neutrino mixing angles θ_{μe} and θ_{ee}, excluding part of the parameter space allowed by experimental anomalies. Cancellation of ν_{e} appearance and ν_{e} disappearance effects due to the full 3+1 treatment of the analysis leads to a degeneracy when determining the oscillation parameters, which is discussed in this Letter and will be addressed by future analyses.
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Liu T, Jiang L, Bai Q, Wu S, Yu X, Wu T, Wang J, Zhang X, Li H, Zhao K, Wang L. CLDN6 suppresses migration and invasion via blocking SMADs/Snail/MMP-2/9 axis in MCF-7 and SKBR-3 cell lines. Bull Exp Biol Med 2023. [DOI: 10.47056/0365-9615-2023-175-3-360-366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Wang MP, Jiang L, Zhu B, Lou R, He Y, Jiang Q, Xi XM. [Association between fluid balance and clinical outcomes in sepsis patients with identified subtypes]. ZHONGHUA YI XUE ZA ZHI 2022; 102:3756-3762. [PMID: 36517425 DOI: 10.3760/cma.j.cn112137-20220516-01068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Objective: To identify clinical subphenotypes of sepsis by clinical variables, and the association between fluid balance (FB) and outcomes in sepsis patients with different subphenotypes. Methods: Data were derived from China Critical Care Sepsis Trial. A total of 2 075 patients were included in the study, with a mean age of (62.5±17.4) years, 1 362 (65.6%) were male, 713 (34.3%) were female. In-hospital mortality was the primary outcome. Clinical variables were entered into the latent profile analysis (LPA) model which was used to identify the subphenotypes of sepsis. Multivariable logistic regression model was used to explore the association of FB on the first 2 days admitted to ICU and in-hospital mortality. Results: Total of 687 (33.1%) patients died in the hospital. Four subphenotypes of sepsis were identified by the PLA model: 1 421 (68.5%) patients were identified as profile 1, which was characterized by the lowest in-hospital mortality (28.3%, 402/1 421) and was considered as the baseline subphenotype; profile 2 was characterized by multiple organ dysfunction(232, 11.2%); profile 3 was characterized by respiratory dysfunction (196, 9.4%) and profile 4 was characterized by kidney injury/failure (226, 10.9%). Profile 2 showed the highest in-hospital mortality (54.3%, 126/232), followed by profile 4 (39.4%, 89/226), profile 3 (35.7%, 70/196). Profile 2 had the highest FB of 68.5(34.7, 89.4)ml/kg on day 1 and decreased rapidly to 29.4(13.6, 49.8) ml/kg on day 2. Multivariable analysis showed that for every 10 ml/kg of FB increased on the first 48 hours admitted to ICU, the risk of in-hospital mortality decreased 14% (OR=0.86, 95%CI: 0.81-0.97) in profile 2, and increased 4% (OR=1.04, 95%CI:1.02-1.07) in profile 4. However, there were no significant association between FB on the fist 2 days admitted to ICU and the risk of in-hospital mortality in profile 1 (OR=1.06, 95%CI: 0.94-1.19)and in profile 3 (OR=0.99, 95%CI: 0.94-1.05). Conclusions: Four subphenotypes of sepsis were identified according to the clinical variables, which showed different characteristics, distributions, outcomes and responses to fluid balance.
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Shi A, Li L, Yang D, Min Y, Jiang L, Dong X, Deng W, Yu H, Yu R, Zhao J. 98P First-line atezolizumab/durvalumab plus platinum-etoposide combined with radiotherapy in extensive-stage small cell lung cancer. IMMUNO-ONCOLOGY AND TECHNOLOGY 2022. [DOI: 10.1016/j.iotech.2022.100202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Yi JR, Li ZN, Xie HQ, Chen BM, Jiang L, Qian LX, Xu HG, Li SR, Lei ZZ, Chen JD, Zhou J. [Effects and mechanism of human umbilical vein endothelial cells-derived exosomes on wound healing in diabetic rabbits]. ZHONGHUA SHAO SHANG YU CHUANG MIAN XIU FU ZA ZHI 2022; 38:1023-1033. [PMID: 36418259 DOI: 10.3760/cma.j.cn501225-20220622-00254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: The investigate the effects and mechanism of exosomes derived from human umbilical vein endothelial cells (HUVECs) on wound healing in diabetes rabbits. Methods: The experimental research methods were used. The primary vascular endothelial cells (VECs) and human skin fibroblasts (HSFs) were extracted from skin tissue around ulcer by surgical excision of two patients with diabetic ulcer (the male aged 49 years and the female aged 58 years) admitted to Xiangya Third Hospital of Central South University in June 2019. The cells were successfully identified through morphological observation and flow cytometry. The HUVEC exosomes were extracted by ultracentrifugation and identified successfully by morphological observation, particle size detection, and Western blotting detection. Twenty female 3-month-old New Zealand rabbits were taken to create one type 2 diabetic full-thickness skin defect wound respectively on both sides of the back. The wounds were divided into exosomes group and phosphate buffer solution (PBS) group and treated accordingly, with 20 wounds in each group, the time of complete tissue coverage of wound was recorded. On PID 14, hematoxylin-eosin staining or Masson staining was performed to observe angiogenesis or collagen fiber hyperplasia (n=20). The VECs and HSFs were co-cultured with HUVEC exosomes for 24 h to observe the uptake of HUVEC exosomes by the two kinds of cells. The VECs and HSFs were divided to exosome group treated with HUVEC exosomes and PBS group treated with PBS to detect the cell proliferation on 4 d of culture with cell count kit 8, to detect and calculate the cell migration rate at 24 and 48 h after scratch by scratch test, to detect the cell migration number at 24 h of culture with Transwell test, and to detect the mRNA expressions of nuclear factor-erythroid 2-related factor 2 (NRF2) and transcription activating factor 3 (ATF3) by real time fluorescence quantitative reverse transcription polymerase chain reaction. Besides, the number of vascular branches and vascular length were observed in the tube forming experiment after 12 h of culture of VECs (n=3). The VECs and HSFs were taken and divided into PBS group and exosome group treated as before, and NRF2 interference group, ATF3 interference group, and no-load interference group with corresponding gene interference. The proliferation and migration of the two kinds of cells, and angiogenesis of VECs were detected as before (n=3). Data were statistically analyzed with analysis of variance for repeated measurement, one-way analysis of variance, independent sample t test, and least significant difference test. Results: The time of complete tissue coverage of wound in exosome group was (17.9±1.9) d, which was significantly shorter than (25.2±2.3) d in PBS group (t=4.54, P<0.05). On PID14, the vascular density of wound in PBS group was significantly lower than that in exosome group (t=10.12, P<0.01), and the collagen fiber hyperplasia was less than that in exosome group. After 24 h of culture, HUVEC exosomes were successfully absorbed by VECs and HSFs. The proliferative activity of HSFs and VECs in exosome group was significantly higher than that in PBS group after 4 d of culture (with t values of 54.73 and 7.05, respectively, P<0.01). At 24 and 48 h after scratch, the migration rates of HSFs (with t values of 3.42 and 11.87, respectively, P<0.05 or P<0.01) and VECs (with t values of 21.42 and 5.49, respectively, P<0.05 or P<0.01) in exosome group were significantly higher than those in PBS group. After 24 h of culture, the migration numbers of VECs and HSFs in exosome group were significantly higher than those in PBS group (with t values of 12.31 and 16.78, respectively, P<0.01). After 12 h of culture, the mRNA expressions of NRF2 in HSFs and VECs in exosome group were significantly higher than those in PBS group (with t values of 7.52 and 5.78, respectively, P<0.05 or P<0.01), and the mRNA expressions of ATF3 were significantly lower than those in PBS group (with t values of 13.44 and 8.99, respectively, P<0.01). After 12 h of culture, the number of vascular branches of VECs in exosome group was significantly more than that in PBS group (t=17.60, P<0.01), and the vascular length was significantly longer than that in PBS group (t=77.30, P<0.01). After 4 d of culture, the proliferation activity of HSFs and VECs in NRF2 interference group was significantly lower than that in PBS group and exosome group (P<0.05 or P<0.01); the proliferation activity of HSFs and VECs in ATF3 interference group was significantly higher than that in PBS group (P<0.05 or P<0.01) and significantly lower than that in exosome group (P<0.05 or P<0.01). At 24 and 48 h after scratch, the migration rates of HSFs and VECs in ATF3 interference group were significantly higher than those in PBS group (P<0.05 or P<0.01) and significantly lower than those in exosome group (P<0.05 or P<0.01). At 24 and 48 h after scratch, the migration rates of HSFs and VECs in NRF2 interference group were significantly lower than those in PBS group and exosome group (P<0.05 or P<0.01). After 24 h of culture, the migration numbers of VECs and HSFs in ATF3 interference group were significantly more than those in PBS group (P<0.05) and significantly less than those in exosome group (P<0.05 or P<0.01); the migration numbers of VECs and HSFs in NRF2 interference group were significantly less than those in PBS group and exosome group (P<0.01). After 12 h of culture, the vascular length and number of branches of VECs in NRF2 interference group were significantly decreased compared with those in PBS group and exosome group (P<0.01); the vascular length and number of branches of VECs in ATF3 interference group were significantly increased compared with those in PBS group (P<0.01) and were significantly decreased compared with those in exosome group (P<0.01). Conclusions: HUVEC exosomes can promote the wound healing of diabetic rabbits by promoting the proliferation and migration of VECs and HSFs, and NRF2 and ATF3 are obviously affected by exosomes in this process, which are the possible targets of exosome action.
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