Health-related quality of life with pembrolizumab monotherapy in patients with previously treated advanced microsatellite instability high/mismatch repair deficient endometrial cancer in the KEYNOTE-158 study

OBJECTIVE

Pembrolizumab demonstrated a clinically meaningful objective response rate in patients with previously treated, advanced MSI-H/dMMR endometrial cancer in the multicohort phase 2 KEYNOTE-158 study (ClinicalTrials.gov, NCT02628067). We present health-related quality of life (HRQoL) results for these patients.

METHODS

This analysis included patients from cohorts D (endometrial cancer with any MSI status) and K (any MSI-H/dMMR solid tumor except colorectal) who had previously treated, advanced MSI-H/dMMR endometrial cancer. Patients received pembrolizumab 200 mg Q3W for 35 cycles. EORTC QLQ-C30 and EQ-5D-3L questionnaires were administered at baseline, at regular intervals during treatment, and 30 days after treatment discontinuation. Pre-specified exploratory analyses included changes from baseline to week 9 in QLQ-C30 global health status (GHS)/QoL and EQ-5D-3L visual analog scale (VAS) score for all patients and by best overall response.

RESULTS

84 of 90 enrolled patients completed ≥1 HRQoL questionnaire and were included in the analysis. QLQ-C30 and EQ-5D-3L compliance rates were 90% and 94%, respectively, at baseline, and 92% and 93% at week 9. Mean (95% CI) QLQ-C30 GHS/QoL scores improved from baseline to week 9 by 6.08 (0.71-11.46) points in the overall population, with greater improvement in patients who achieved complete or partial response (11.67 [5.33-18.00]-point increase). Mean (95% CI) EQ-5D-3L VAS scores improved by 6.00 (2.25-9.75) points in the overall population and 9.11 (5.24-12.98) points in patients with CR/PR.

CONCLUSIONS

Pembrolizumab maintained or improved HRQoL in patients with previously treated, advanced MSI-H/dMMR endometrial cancer, further supporting efficacy and safety results from KEYNOTE-158 and pembrolizumab use in this setting.

Observation of supersymmetry and its spontaneous breaking in a trapped ion quantum simulator

Supersymmetry (SUSY) helps solve the hierarchy problem in high-energy physics and provides a natural groundwork for unifying gravity with other fundamental interactions. While being one of the most promising frameworks for theories beyond the Standard Model, its direct experimental evidence in nature still remains to be discovered. Here we report experimental realization of a supersymmetric quantum mechanics (SUSY QM) model, a reduction of the SUSY quantum field theory for studying its fundamental properties, using a trapped ion quantum simulator. We demonstrate the energy degeneracy caused by SUSY in this model and the spontaneous SUSY breaking. By a partial quantum state tomography of the spin-phonon coupled system, we explicitly measure the supercharge of the degenerate ground states, which are superpositions of the bosonic and the fermionic states. Our work demonstrates the trapped-ion quantum simulator as an economic yet powerful platform to study versatile physics in a single well-controlled system.

Quantum Simulation of the Two-Dimensional Weyl Equation in a Magnetic Field

Quantum simulation of 1D relativistic quantum mechanics has been achieved in well-controlled systems like trapped ions, but properties like spin dynamics and response to external magnetic fields that appear only in higher dimensions remain unexplored. Here we simulate the dynamics of a 2D Weyl particle. We show the linear dispersion relation of the free particle and the discrete Landau levels in a magnetic field, and we explicitly measure the spatial and spin dynamics from which the conservation of helicity and properties of antiparticles can be verified. Our work extends the application of an ion trap quantum simulator in particle physics with the additional spatial and spin degrees of freedom.

Experimental Realization of the Rabi-Hubbard Model with Trapped Ions

Quantum simulation provides important tools in studying strongly correlated many-body systems with controllable parameters. As a hybrid of two fundamental models in quantum optics and in condensed matter physics, the Rabi-Hubbard model demonstrates rich physics through the competition between local spin-boson interactions and long-range boson hopping. Here, we report an experimental realization of the Rabi-Hubbard model using up to 16 trapped ions and present a controlled study of its equilibrium properties and quantum dynamics. We observe the ground-state quantum phase transition by slowly quenching the coupling strength, and measure the quantum dynamical evolution in various parameter regimes. With the magnetization and the spin-spin correlation as probes, we verify the prediction of the model Hamiltonian by comparing theoretical results in small system sizes with experimental observations. For larger-size systems of 16 ions and 16 phonon modes, the effective Hilbert space dimension exceeds 2^{57}, whose dynamics is intractable for classical supercomputers.

Analysis of effects of laryngopharyngeal reflux disease and proton pump inhibitor treatment on Eustachian tube function in patients with obstructive sleep apnea hypopnea

OBJECTIVE

This study aims to explore the effects of laryngopharyngeal reflux disease (LPRD) and proton pump inhibitor (PPI) treatment on Eustachian tube function in patients with obstructive sleep apnea (OSA).

METHODS

The Eustachian tube score-7 (ETS-7) was observed before and after PPI treatment in the control group, OSA only group, and OSA + LPRD group.

RESULTS

Age, sex, smoking history, and drinking history showed no differences among 3 groups (P > .05). The body mass index (BMI) in the control group was lower than that in other groups (P < .017). Before PPI treatment, the abnormality rate of ETS-7 in the OSA + LPRD group statistically differed from that in the control group and the OSA only group (P < .017). After PPI treatment, the abnormality rate of ETS-7 in the OSA + LPRD group exhibited no significant differences compared with that in the control group and the OSA only group (P > .017), and it declined remarkably compared with that before PPI treatment (75% vs 35%, χ² = 13.334, P = .001). Moreover, the multivariate analysis revealed that only LPRD had an independent correlation with the abnormality of ETS-7 (OR = 1.245, 95% CI: 1.759-6.861, P = .000).

CONCLUSION

In view of its high incidence in OSA patients, LPRD may be a considerable factor for the high incidence of abnormality rate of ETS-7 in OSA patients, and PPI therapy is of significant value in improving Eustachian tube function in OSA patients with LPRD.

Study of the intentional replantation procedure used to treat a tooth with a palatogingival groove: A case report

In order to clarify the prognosis of intentional replantation used for palatogingival groove treatment for long-term follow-up observation, the case of a patient with a maxillary lateral incisor with palatogingival groove was investigated. The intentional replantation was carried out to preserve the tooth. The periodontal pocket and the apical bone defect were almost completely repaired at 12-month follow-up. However, the infection was reoccurred after 25-month follow-up examinations. The infected tooth was extracted, of which the root was investigated by histological analysis. Therefore, the reason of the replant failure and the pathways of bacterial infection was investigated.

Key words:Palatogingival groove, intentional tooth replantation, bacterial infection, maxillary lateral incisor.

Decreased nasal nitric oxide levels: A potential marker of decreased olfactory discrimination in chronic rhinosinusitis

Objective

This study aimed to investigate the association of nasal nitric oxide and olfactory function.

Method

A cross-sectional study was performed in 117 adults, including 91 patients with chronic rhinosinusitis and 26 healthy controls. Scores on the 22-item Sino-Nasal Outcomes Test, Lund-Mackay scale and Lund-Kennedy scale were recorded to assess severity of disease. All participants were screened for common inhaled and food allergens. Nasal nitric oxide and fractional exhaled nitric oxide testing, acoustic rhinometry and anterior rhinomanometry testing were performed to measure nasal function. The validated Sniffin’ Sticks test battery was used to assess olfactory function.

Results

Higher nasal nitric oxide was an independent protective factor for odour discrimination and odour threshold in participants with chronic rhinosinusitis after adjusting for age, gender, drinking, smoking, 22-item Sino-Nasal Outcomes Test, Lund-Mackay score, Lund-Kennedy score, immunoglobulin E and the second minimal cross-sectional area by acoustic rhinometry. Nasal nitric oxide also showed high discrimination in predicting impaired odour discrimination. In addition, nasal nitric oxide was lower in older participants, those with higher Lund-Mackay or Lund-Kennedy scores and higher with elevated total serum immunoglobulin E concentrations above a threshold of 0.35 kU/l.

Conclusion

Higher nasal nitric oxide is associated with better odour discrimination in chronic rhinosinusitis and is modulated by age, degree of allergy and severity of chronic rhinosinusitis.

Clinical significance of the cognition-related pathogenic proteins in plasma neuronal-derived exosomes among normal cognitive adults over 45 years old with olfactory dysfunction

OBJECTIVES

Exosomal Phospho-Tau-181(P-T181-tau), Total tau (T-tau), and amyloid-β peptide 42 (Aβ42) have been proved the capacity for the amnestic mild cognitive impairment (MCI) and the diagnosis of Alzheimer's disease (AD). This study aimed to explore the cognitive function and the levels of P-T181-tau, T-tau, and Aβ42 in neuronal-derived exosomes (NDEs) extracted from plasma in normal cognitive adults over 45 years old with olfactory dysfunction.

METHODS

A cross-sectional survey of 29 participants aged over 45 was conducted. Plasma exosomes were isolated, precipitated, and enriched by immuno-absorption with anti- L1 cell adhesion molecule (L1CAM) antibody. NDEs were characterized by CD81, and extracted NDE protein (P-T181-tau, T-tau, and Aβ42) biomarkers were quantified by enzyme-linked immunosorbent assay (ELISAs). Olfactory performance was assessed by Sniffin' Sticks and cognitive performance was assessed by Montreal Cognitive Assessment (MoCA).

RESULTS

There was no significant difference between adults with olfactory dysfunction and without olfactory dysfunction regarding the cognitive function as measured by MoCA and all the participants showed normal cognition. Adults with olfactory dysfunction showed a higher concentration of P-T181-tau in plasma NDEs than did adults without olfactory dysfunction (P = 0.034). Both the levels of P-T181-tau (r = - 0.553, P = 0.003) and T-tau (r = - 0.417, P = 0.034) negatively correlated with the odor identification scores. In addition, the level of T-tau negatively correlated with MoCA scores (r = - 0.597, P = 0.002). The levels of P-T181-tau (r = - 0.464, P = 0.022) and T-tau (r = - 0.438, P = 0.032) negatively correlated with the delayed recall scores.

CONCLUSIONS

This study demonstrated that cognition-related pathogenic proteins including P-T181-tau in plasma NDEs were significantly increased in adults over 45 years old with olfactory dysfunction before the occurrence of cognitive impairment. The impaired odor identification and the delayed recall function were highly associated with the increased levels of P-T181-tau and T-tau in plasma NDEs.

417 Initial Choice of Imaging Investigation for Patients Presenting with Acute Pancreatitis: Should MRCP Be First Line in Selected Patients?

Introduction

Current guidelines for acute pancreatitis advocate abdominal ultrasound (AUS) as the first-line imaging investigation to identify if gallstones are the cause of pancreatitis. However, many patients have a history of cholecystectomy or present with known gallstones and deranged liver function tests (LFTs). In these patients, magnetic resonance cholangiopancreatography (MRCP) is indicated due to its higher sensitivity and specificity for detecting choledocholithiasis.

Method

This retrospective audit reviewed all consecutive patients who presented to the surgical assessment unit with acute pancreatitis over one month. Their past surgical history, bloods and imaging were reviewed.

Results

Of the 30 patients, seventeen (57%) had no previous cholecystectomy or known gallstones, nine (30%) had previous cholecystectomy and eight (27%) had known gallstones, seven (88%) of which presented with deranged LFTs. Of the seventeen patients who should have had AUS first (n = 17), thirteen (76%) had AUS first, none had MRCP first and four (24%) had computerised tomography (CT) first. Of the patients in whom MRCP was indicated first-line (n = 13), seven (54%) had AUS first, none had MRCP first, four (31%) had CT first and two (15%) went straight to endoscopic retrograde cholangiopancreatography having had recent outpatient MRCPs. In the seven patients in whom MRCP was indicated but AUS was performed first, six (86%) underwent subsequent MRCP.

Conclusions

MRCP should be considered the first line imaging investigation for patients presenting with acute pancreatitis and a history of cholecystectomy or known gallstones with deranged LFTs, as AUS rarely prevents the need for subsequent MRCP.

416 Hyperlipasaemia In an Adult Hospital Population: A Retrospective Audit Demonstrating A High Proportion of Non-Pancreatic Causes of a Diagnostically Raised Lipase

Introduction

Serum lipase is considered to be a more specific test than amylase for acute pancreatitis, and a rise of over three times the laboratory upper limit of normal (ULN) is considered diagnostic. This single-centre retrospective audit assessed the accuracy of a raised lipase in confirming acute pancreatitis.

Method

All patients with a raised lipase (&gt;78 U/L) admitted over one month were reviewed. Patients whose lipase was measured &gt;48 hours after admission were excluded. Cross-sectional imaging and discharge summaries were reviewed to determine the cause of hyperlipasaemia. Receiver Operator Characteristics (ROC) analysis was performed to determine the most accurate cut-off value for diagnosing acute pancreatitis.

Results

Ninety-nine patients were included. The most common causes of raised lipase (&gt;78 U/L) were pancreatitis (37%), hepatobiliary (15%), gastroduodenal (8%) and renal (8%) disease. In patients with a lipase &gt;234 U/L (3xULN, n = 46), the most common causes were pancreatitis (70%), drugs (9%), hepatobiliary (9%), gastroduodenal (4%) and renal (4%) disease. ROC analysis showed lipase to have an area under the curve (AUC) of 0.89 (95% CI 0.84-0.96, p &lt; 0.0001). Using the laboratory cut-off of 234 U/L (3xULN), lipase had a sensitivity, specificity, and positive likelihood ratio (PLR) of 86.5%, 77.4% and 3.8. Increasing the lipase cut-off did not improve the specificity without compromising the sensitivity of the test.

Conclusions

A lipase cut-off of 3xULN is an appropriate cut-off for a biochemical diagnosis of acute pancreatitis. However, up to 30% of patients with lipase values above this cut-off may have alternative diagnoses that should be considered.

Experimental Realization of Multi-ion Sympathetic Cooling on a Trapped Ion Crystal

Trapped ions are one of the leading platforms in quantum information science. For quantum computing with large circuit depth and quantum simulation with long evolution time, it is of crucial importance to cool large ion crystals at runtime without affecting the internal states of the computational qubits, thus the necessity of sympathetic cooling. Here, we report multi-ion sympathetic cooling on a long ion chain using a narrow cooling beam focused on two adjacent ions, and optimize the choice of the cooling ions according to the collective oscillation modes of the chain. We show that, by cooling a small fraction of ions, cooling effects close to the global Doppler cooling limit can be achieved. This experiment therefore demonstrates an important enabling step for quantum information processing with large ion crystals.

MiR-182 inhibits oxidative stress and epithelial cell apoptosis in lens of cataract rats through PI3K/Akt signaling pathway

OBJECTIVE

The aim of this study was to investigate the influences of micro ribonucleic acid (miR)-182 on oxidative stress and epithelial cell apoptosis in the lens of cataract rats through the phosphatidylinositol 3-hydroxy kinase/protein kinase B (PI3K/Akt) pathway.

MATERIALS AND METHODS

A total of 36 Sprague-Dawley rats were randomly assigned into three groups, including normal group (n=12), model group (n=12), and miR-182 mimics group (n=12). Rats in normal group were first normally fed. After establishing the cataract model, rats in model group were intraperitoneally injected with normal saline. Meanwhile, rats in miR-182 mimics group were intraperitoneally injected with miR-182 mimics. At 7 d after operation, materials were sampled. The expressions of B-cell lymphoma 2 (Bcl-2) and Bcl-2 associated X protein (Bax) were detected via immunofluorescence. The protein expressions of PI3K and Akt were detected using Western blotting. Moreover, the expression level of miR-182 was measured via qPCR. Cell apoptosis was evaluated using terminal deoxynucleotidyl transferase (TdT) dUTP nick-end labeling (TUNEL). In addition, the content of superoxide dismutase (SOD) and malondialdehyde (MDA) was determined using enzyme-linked immunosorbent assay (ELISA).

RESULTS

Compared with normal group, both model group and miR-182 mimics group exhibited significantly up-regulated expression level of Bax and down-regulated expression of Bcl-2 (p<0.05). MiR-182 mimics group had markedly lower expression level of Bax and higher expression level of Bcl-2 than model group (p<0.05). Western blotting results demonstrated that the protein expression levels of PI3K and Akt in model and miR-182 mimics groups were considerably higher than those in normal group (p<0.05). Meanwhile, their protein expression levels in miR-182 mimics group were significantly higher than those in model group (p<0.05). In comparison with normal group, the expression level of miR-182 was markedly up-regulated in both model group and miR-182 mimics group (p<0.05). Moreover, its expression level in miR-182 mimics group was considerably higher than that in model group (p<0.05). TUNEL-positive cells increased significantly in both model group and miR-182 mimics group when compared with normal group (p<0.05). However, they were remarkably reduced in miR-182 mimics group when compared with model group (p<0.05). Compared with normal group, model and miR-182 groups exhibited substantially decreased SOD content and increased MDA content (p<0.05).

CONCLUSIONS

MiR-182 inhibits oxidative stress and epithelial cell apoptosis in the lens of cataract rats by activating the PI3K/Akt signaling pathway.

736 Optimal Time for Cholecystectomy After ERCP

Introduction

Recent research on the management of cholecystolithiasis with co-existing choledocholithiasis suggests performing cholecystectomy within 24 hours after ERCP has favourable outcomes. However, this target can be difficult to achieve in the NHS due to limited resources.

Method

This retrospective study includes 444 patients who underwent successful ERCP before cholecystectomy. We examined the impact of the duration of ERCP to cholecystectomy and post ERCP complications on operative difficulty and patient outcomes. We also report on gallstone related readmissions and rate of retained stones.

Results

The median duration from ERCP to cholecystectomy was 75 days, with a 14% readmission rate between their first successful ERCP and cholecystectomy.

Our analysis showed a statistically significant negative correlation between ERCP-to-cholecystectomy duration and postoperative stay. Readmissions increased with time, but this did not reach statistical significance. The occurrence of post ERCP complications significantly increased postoperative stay and the open conversion rate.

Conclusions

In contrast to recent research, our analysis suggests that early cholecystectomy post ERCP is not associated with better outcome. However, the impact of gallstone related readmissions needs further analysis. Post ERCP complication could serve as a predictor for operative difficulty and longer postoperative stay. It should be considered when planning the cholecystectomy.

[Analysis of clinical characteristics of 481 HBV-related liver cirrhotic patients with low viral load]

Objective: To analyze the clinical characteristics of HBV-related liver cirrhotic patients with low viral load. Methods: A retrospective analysis on 481 inpatients with HBV-related cirrhosis with low viral load [HBV DNA≤2 000 IU/ml (10(4) copies/ml)] general condition, virological indicators, liver function-related indicators, complications, and incidence of complications were analyzed. The t-test was used to compare the average measurement data, and the χ (2) test was used to compare the count data. Results: 481 cases were mainly male (male/female: 324/157), aged 20-83 (53.31 ± 11.67) years old. Han nationality accounted for 71.518%. 386 cases were HBsAg positive. 391 cases were HBeAg positive, and 140 cases were HBV DNA positive. The average value of bilirubin, albumin, alanine aminotransferase, aspartate aminotransferase, platelets, and prothrombin were 50.59 ± 91.25 (μmol/L), 33.68 ± 7.5 (g/L), and 60.66 ± 106.95(U/L), 63.37 ± 86.19(U/L), 106.65 ± 83.22(×10(9)/L), 68.82% ± 25.33%, respectively. CTP class A/B/C had 220/150/111 cases. The average values of CTP, MELD, APRI and FIB-4 were 7.61 ± 2.58, 10.98 ± 5.79, 2.34 ± 3.56, 6.91 ± 8.04, respectively. The overall incidence of complications in HBV-related cirrhotic patients with low viral load, HBV DNA negative, HBV DNA positive, HBsAg negative, and HBsAg positive were 80.0%, 82.7%, 73.6%, 85.3%, and 78.8%, respectively. Among them, 283 cases (58.84%), 197 cases (55.77%), 86 cases (61.43%), 52 cases (54.74%) and 231 cases (59.84%) were of hypersplenism, and 267 cases (55.51%), 197 cases (55.77%), 70 cases (50.00%), 56 cases (58.95%), and 211 cases (54.66%) were of esophagogastric varices. There were 59 cases (12.27%), 48 cases (14.08%), 11 cases (7.86%), 12 cases (12.63%), and 47 cases (12.18%) of rupture of esophageal and gastric varices, respectively. 202 cases (42.00%), 147 cases (43.11%), 55 cases (39.29%), 42 cases (44.21%), and 160 cases (41.45%) were of ascites, respectively. 17 cases (3.53%), 12 cases (3.52%), 5 cases (3.5%), 2 cases (2.11%), 15 (3.89%) cases were of hepatic encephalopathy, respectively. There were 6 cases (1.25%), 3 cases (0.88%), 3 cases (2.14%), 0 cases (0%), 6 cases (1.55%) of liver cancer. 29 cases (6.03%), 21 cases (6.16%), 8 cases (5.71%), 9 cases (9.47%) and 20 cases (5.18%) were of portal vein thrombosis. Compared with the overall incidence of complications, 341 HBV DNA-negative patients and 95 HBsAg-negative patients still had higher incidence of complications. The patients were grouped by age, and in < 40 years old, 40-50 years old, and > 50 years old, the overall complications were 80.8% in 42 cases, 76.8% in 116 cases and 81.7% in 227 cases, and the difference was not statistically significant. Conclusion: HBV infection patients with low viral load, and those whose HBsAg has disappeared, are still at risk of developing liver cirrhosis and even serious complications, and whether such population need antiviral therapy and benefit from it deserves further research.

Forensic Analysis of 105 Autopsy Cases of Psychiatric Patients

Abstract

Objective To provide reference for medical and health services and forensic expertise, the causes and manners of death of psychiatric patients were analyzed retrospectively. Methods A total of 105 autopsy cases of psychiatric patients accepted and settled by Institute of Forensic Science of Criminal Investigation Police University of China from 2004 to 2019 were collected. The cases were divided into four groups： disease death, suicidal death, accidental death and homicidal death. The common causes of death of each group were statistically analyzed and the differences in age, disease duration, body mass index （BMI） and gender among the groups were assessed. Results Of the 105 cases, 60 were male and 45 were female, the course of psychosis was （12.9±10.4） years, the age of the deceased was （51.3±11.4） years, and 61.0% was schizophrenic. There were 50 cases （47.6%） in the disease death group, in which the psychiatric patients were the oldest and had the longest course of psychosis and lowest BMI. Pulmonary thromboembolism, respiratory infections, and cardiogenic disease were the most common causes of death in the group. There were 26 accidental deaths （24.8%）, among which traffic accidents were the most common cause of death. There were 15 homicidal deaths （14.3%）, all of which were male, with craniocerebral injury being the most common cause of death. There were 14 suicidal deaths （13.3%）. In suicidal death group, the age of the deceased was the youngest, the course of psychosis was the shortest and falling from the height was the most common way to commit suicide. Conclusion Understanding the common causes of death of psychiatric patients may contribute to developing measures to reduce the mortality rate of the population. It is necessary to investigate the age, course of psychosis and gender of the deceased when assessing the manner of death.

Silencing of lncRNA XIST suppresses proliferation and autophagy and enhances vincristine sensitivity in retinoblastoma cells by sponging miR-204-5p

OBJECTIVE

Retinoblastoma (RB) is the most prevalent intraocular malignancy in childhood. Long non-coding RNAs (lncRNAs) have been found as critical oncogenic drivers and tumor suppressor in RB. The aim of the present work was to investigate the impact and mechanism of XIST on RB cell autophagy and vincristine (VCR) sensitivity.

MATERIALS AND METHODS

The levels of XIST and miR-204-5p were assessed by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Western blot analysis was used for the determination of related protein levels. Cell proliferation and IC50 value of VCR were detected using the 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay. Flow cytometry was performed to evaluate cell apoptosis. The activities of caspase-3 and caspase-9 were identified using a corresponding assay kit. The direct interaction between XIST and miR-204-5p was confirmed using Dual-Luciferase reporter assay. Xenograft model was established to observe the effect of XIST on RB in vivo.

RESULTS

Our data indicated that XIST was highly expressed in RB tissues and cell lines. XIST knockdown weakened the proliferation and autophagy and enhanced VCR sensitivity in RB cells. XIST acted as a molecular sponge of miR-204-5p. Moreover, the regulatory effects of XIST silencing on RB cell proliferation, autophagy and VCR sensitivity were mediated by miR-204-5p. Additionally, XIST silencing weakened tumor growth and enhanced VCR sensitivity in vivo through up-regulating miR-204-5p.

CONCLUSIONS

Our current study suggested that XIST silencing suppressed RB progression and promoted VCR sensitivity in vitro and in vivo at least partially by acting as a miR-204-5p sponge, highlighting a powerful therapeutic strategy for RB treatment.

[The role and mechanism of NORAD in proliferation and apoptosis of mouse mesangial cells induced by high glucose]

Objective: To uncover the role and mechanism of non-coding RNA-activated by DNA damage (NORAD) in proliferation and apoptosis of mouse mesangial cells induced by high glucose. Methods: SV40-MES-13 cells were divided into high glucose group and low glucose group according to the concentration of glucose in the culture medium. After 24 hours of treatment, SV40-MES-13 cells were transfected with si-NORAD and si-Toll-like receptor (TLR4), and real-time fluorescence quantitative PCR (qRT-PCR) was used to detect the expression of NORAD and TLR4. NORAD, TLR4 overexpression plasmids and small interfering RNA were transfected into SV40-MES-13 cells respectively. Cell counting kit (CCK-8) assay, 5-ethynyl-2'-deoxyuridine (EdU) assay and flow cytometry were performed to determine the results of cell proliferation and apoptosis. Luciferase activity and their mRNA levels were detected after cotransfection of pGL3-NORAD WT and miR-520h mimics or pGL3-TLR4 WT and miR-520h mimics. After cotransfection of si-NORAD and miR-520h inhibitors, TLR4 overexpression plasmids and miR-520h mimics, and cotransfection of si-TLR4 and miR-520h inhibitors, the levels of NORAD, miR-520h and TLR4, as well as cell proliferation were detected to verify the regulatory relationship among them. Results: NORAD and TLR4 were upregulated in SV40-MES-13 cells in high glucose group (1.65±0.08 vs 1.00±0.06, P=0.003; 1.96±0.09 vs 1.01±0.07, P=0.001). Overexpression of NORAD and TLR4 promoted the proliferative ability (1.34±0.04 vs 0.85±0.04, P=0.001; 1.33±0.02 vs 0.82±0.03, P<0.001) and inhibited the apoptosis in SV40-MES-13 cells (0.45±0.03 vs 0.94±0.06, P=0.001; 0.51±0.05 vs 0.99±0.03, P=0.001). The dual-luciferase reporter gene assay showed that miR-520h was confirmed to bind to NORAD and TLR4. The expression of NORAD and miR-520h affected each other, and miR-520h mimics reduced the expression of TLR4. The expression of TLR4 in cotransfected NORAD small interference RNA and miR-520h inhibitor was higher than that in NORAD small interference RNA alone (0.74±0.03 vs 0.55±0.03, P=0.014). Cotransfection of miR-520h mimics and TLR4 overexpression plasmids increased cell proliferation compared with miR-520h mimics alone (0.73±0.01 vs 0.61±0.02, P=0.007). Cotransfection of miR-520h inhibitors and TLR4 small interference RNA reduced cell proliferation compared with miR-520h inhibitors alone (1.31±0.04 vs 1.55±0.04, P=0.013). Conclusions: The regulatory loop NORAD/miR-520h/TLR4 promotes the proliferative ability and inhibits apoptosis in glomerular mesangial cells induced by high glucose.

Prognostic value of olfactory evoked potentials in patients with post-infectious olfactory dysfunction

PURPOSE

Prognostic assessment of patients with post-infectious olfactory dysfunction (PIOD) poses a challenge for clinicians. While there have been some studies on the prognostic factors of PIOD focusing on demographic factors, the aim of this study was to investigate whether event-related potentials (ERPs) could be used as a new predictor of olfactory recovery in PIOD.

METHODS

This was a retrospective study involving patients who underwent olfactory examinations using Sniffin' Sticks test before treatment and after 1 year of follow-up. The responder group was defined by an increase of threshold-discrimination-identification (TDI) score of ≥ 6 points. All patients underwent ERP examination and the amplitude and latency of each wave of ERPs were recorded before treatment.

RESULTS

A total of 61 patients (age 47.50 ± 11.04 years, 27 males) were analyzed. The presence of olfactory ERPs (oERPs) was greater in the responder group than in the non-responder group (P = 0.007), while that of trigeminal ERPs (tERPs) did not differ between the two groups (P = 0.346). Logistic-regression analyses showed that factors associated with improvement of subjective olfactory function were duration (OR, 1.604; 95% CI, 1.062-2.423; P = 0.025), initial threshold (odds ratio [OR], 0.043; 95% confidence interval [CI], 0.004-0.439; P = 0.008), and latency of N1 in oERPs (OR, 1.007; 95% CI, 1.001-1.013; P = 0.021).

CONCLUSION

Our study shows that duration of OD, initial threshold, and latency of N1 in oERPs were associated with olfactory improvement in PIOD patients, which may provide guidance for clinicians.

[The value of intraoperative monitoring of cerebral oxygen saturation on postoperative cognitive function in elderly patients undergoing cardiac surgery]

Objective: To investigate the effect of cerebral oxygen saturation (rSO₂) on postoperative cognitive dysfunction (POCD) in elderly patients undergoing cardiac anesthesia. Methods: Retrospective analysis was performed on 113 elderly patients (age 65-89) underwent cardiac surgery in Peking University International Hospital from June 2017 to December 2019, 67 male and 46 female patients were included. All operations were performed under general anesthesia, cardiopulmonary bypass, rSO₂ and other relevant monitoring. Statistical analysis of the elderly patients with complications, cardiac surgery history, time of CPB, baseline value of rSO₂ (rSO_{2 baseline}), lowest intraoperative value of rSO₂ (rSO_{2 min}), time of operation, length of stay in CCU, length of hospital stay; Preoperative and postoperative NSE values; number of postoperative POCD and postoperative deaths were recorded. All data were obtained from the medical records system and anesthesia information system of Peking University International Hospital and risk factors related to POCD were analyzed by Logistic regression. Results: POCD occurred in 19 patients (16.8%), and also, intraoperative rSO₂ decreased by more than 30% over the baseline. The variance of rSO₂ (rSO_{2 baseline}-rSO_{2 min}) in POCD group and non-POCD group was (18.0±2.7) and (6.6±2.3), the variance of NSE (NSE _{after surgery}-NSE _{before surgery}) was (31.3±9.7) and (9.5±3.0) μg/L, respectively. The differences were statistically significant (t=18.35, 17.70, all P<0.05). rSO₂ variability was positively correlated with NSE variability (r=0.697, P<0.05). Logistic regression analysis showed that the variation degree of rSO₂ [OR(95%CI)was 0.374(0.059-1.895)]、 patients combined with diabetes mellitus [OR(95%CI)was 0.493 (0.041-1.812), history of stroke [OR(95%CI)was 0.325 (0.084-0.917)] and atrial fibrillation [OR(95%CI)was 0.176 (0.091-0.943)] were the risk factors for POCD. Conclusion: POCD can be predicted by monitoring the decline range of rSO₂ intraoperatively. rSO₂ is recommended as a routine monitoring item for elderly patients undergoing cardiac surgery.