Characteristics and Functions of MYB (v-Myb avivan myoblastsis virus oncogene homolog)-Related Genes in Arabidopsis thaliana

The MYB (v-Myb avivan myoblastsis virus oncogene homolog) transcription factor family is one of the largest families of plant transcription factors which plays a vital role in many aspects of plant growth and development. MYB-related is a subclass of the MYB family. Fifty-nine Arabidopsis thaliana MYB-related (AtMYB-related) genes have been identified. In order to understand the functions of these genes, in this review, the promoters of AtMYB-related genes were analyzed by means of bioinformatics, and the progress of research into the functions of these genes has been described. The main functions of these AtMYB-related genes are light response and circadian rhythm regulation, root hair and trichome development, telomere DNA binding, and hormone response. From an analysis of cis-acting elements, it was found that the promoters of these genes contained light-responsive elements and plant hormone response elements. Most genes contained elements related to drought, low temperature, and defense and stress responses. These analyses suggest that AtMYB-related genes may be involved in A. thaliana growth and development, and environmental adaptation through plant hormone pathways. However, the functions of many genes do not occur independently but instead interact with each other through different pathways. In the future, the study of the role of the gene in different pathways will be conducive to a comprehensive understanding of the function of the gene. Therefore, gene cloning and protein functional analyses can be subsequently used to understand the regulatory mechanisms of AtMYB-related genes in the interaction of multiple signal pathways. This review provides theoretical guidance for the follow-up study of plant MYB-related genes.

A Cost-Effective, Machine Learning-Based New Unified Risk-Classification Score (NU-CATS) for Patients with Endometrial Cancer

PURPOSE/OBJECTIVE(S)

Treatment for endometrial cancer (EC) with radiotherapy is increasingly guided by molecular risk classifications. Derived from genomic profiling of The Cancer Genome Atlas (TCGA) project, several EC risk classification systems, including ProMisE and Leiden/TransPORTEC, have been developed. However, the current systems were developed on a relatively homogeneous population. Black or African American (BOAA) patients have consistently been demonstrated to have worse stage-adjusted prognosis than Caucasians. Given this, we intended to develop a new unified risk classification system (NU-CATS) for EC patients using machine learning (ML) utilizing datasets with demographically diverse populations.

MATERIALS/METHODS

TCGA-Uterine Corpus Endometrial Carcinoma (n = 596), Memorial Sloan Kettering-Metastatic Events and Tropisms (MSK-MET, n = 1,315) and the American Association for Cancer Research Project Genomics Evidence Neoplasia Information Exchange (AACR-GENIE, n = 4,561) were used to identify genetic alterations and clinicopathological features, including age, race, stage, histologic grade and features, and distribution of metastatic disease. Software packages including Keras, Pytorch, and Scikit Learn were tested to build artificial neural networks (ANNs) with a binary output as either intra-abdominal metastatic lesions vs. non-metastatic. A 5-layered ANN (5-6-4-2-1) using 5 inputs ('age at surgery', 'histology', 'race', 'mismatch repair status' and 'TP53'). The optimal performing ANN was selected and cross validated. The weights and biases of the trained ANN were used to reconstruct the algorithm.

RESULTS

BOAA patients with EC have worse prognosis than Caucasians, adjusting for TP53 or POLE mutation status. TP53 is the most common gene differentially altered by race in EC. Over 75% of BOAA patients carry TP53 mutations as compared to approximately 40% of Caucasians. Older age is associated with an increasing likelihood of TP53 mutations, high risk histology, and distant metastasis. For patients above age 70, 91% of BOAA and 60% of Caucasian EC patients carry TP53 mutations. The NU-CATS that incorporates age, race, histology, mismatch repair (MMR) status, and TP53 mutation status showed 75% accuracy in prognosticating intra-abdominal metastasis. A higher NU-CATS (>50) is associated with about 2-fold increased risk of having positive pelvic or para-aortic lymph nodes (LNs) and distant. NU-CATS was shown to outperformed TransPORTEC model for estimating risk of FIGO Stage I/II disease progression and survival in BOAA EC patients.

CONCLUSION

Despite adjusting for molecular classification, race and age retain prognostic importance in EC. NU-CATS, a ML-based, cost-effective algorithm, incorporates diverse clinicopathologic and molecular variables of EC, and yields superior prognostication of the risk of nodal involvement, distant metastasis, disease progression, and overall survival as compared to other classification systems.

GlioPredictor: A Deep Learning Model for Identification of High-Risk Low-Grade Glioma toward Adjuvant Treatment Planning

PURPOSE/OBJECTIVE(S)

High-risk low-grade glioma (LGG) patients are recommended to undergo adjuvant radiotherapy whereas watchful waiting is recommended for low-risk LGG patients per the latest NCCN guidelines. Based on Radiation Therapy Oncology Group (RTOG) 9802, high-risk features include age >40 or subtotal resection (STR). However, in the era of molecular-based classification for tumors of central neural system, current risk classification criteria based on gross disease and patient demographics may be outdated. Here, we aim to develop a molecular-based glioma risk classification system (GlioPredictor) that could potentially facilitate identification of high-risk LGG patients.

MATERIALS/METHODS

A total of 507 LGG cases from The Cancer Genome Atlas-low grade glioma (TCGA-LGG), and 1,309 cases from AACR GENIE v13.0 datasets were studied for genetic disparities between IDH1-wildtype and mutated cohorts, and varying age groups. Through a feature selection technique using genomic profiling and correlation analyses, features such as mutation status, copy number variations (CNVs), among other clinicopathologic features prognostic of IDH1 mutation status were selected as potential inputs to train an artificial neural networks (ANNs) that could predict IDH1 mutation status. Model performance was assessed using the area under the receiver operating characteristic curve (AUC). Memorial Sloan Kettering (MSK) dataset (n = 404) for LGG was used to cross-validate the trained ANN. The optimized ANN model has 6 layers with 6 input nodes, 20 hidden nodes, and a binary output layer. The weights and biases of the hidden layers of the best-performing model were retrieved and reconstructed to yield the GlioPredictor score-the predicted risk of progression for IDH1-wildtype LGG.

RESULTS

Over 81% of glioma patients age less than 40 have IDH1 mutation, as compared with 31% in those age above 60. Using age > 40 as a cutoff failed to identify high-risk IDH1-mutant LGG with early progression. IDH1 mutation is associated with decreased CNVs of EGFR (21 % vs. 3%), CDKN2A (20% vs. 6%) and PTEN (14% vs. 1.7%), and increased percentage of mutations for TP53 (15% vs. 63%), and ATRX (10% vs. 54%) (p<0.001). Using these molecular features, along with the patient's age, an ANN model with 6 layers and 20 hidden nodes can predict IDH1 mutation status with over 90% accuracy and AUC score over 0.91.

CONCLUSION

We have developed an ANN model that is capable of learning the prognostic features of LGG associated with an IDH1-mutated LGG cohort and using the features to predict high-risk patients from the IDH1-wildtype cohort. This ANN model facilitates the selection of LGG patients who could benefit from immediate adjuvant radiotherapy. Future work includes the integration of image features to improve the prediction performance of the GlioPredictor system.

Effects of long-term herbaceous plant restoration on microbial communities and metabolic profiles in coal gangue-contaminated soil

The soil microbial diversity in the gangue accumulation area is severely stressed by a variety of heavy metals, while the influence of long-term recovery of herbaceous plants on the ecological structure of gangue-contaminated soil is to be explored. Therefore, we analysed the differences in physicochemical properties, elemental changes, microbial community structure, metabolites and expression of related pathways in soils in the 10- and 20-year herbaceous remediation areas of coal gangue. Our results showed that phosphatase, soil urease, and sucrase activities of gangue soils significantly increased in the shallow layer after herbaceous remediation. However, in zone T1 (10-year remediation zone), the contents of harmful elements, such as Thorium (Th; 1.08-fold), Arsenic (As; 0.78-fold), lead (Pb; 0.99-fold), and uranium (U; 0.77-fold), increased significantly, whereas the soil microbial abundance and diversity also showed a significant decreasing trend. Conversely, in zone T2 (20-year restoration zone), the soil pH significantly increased by 1.03- to 1.06-fold and soil acidity significantly improved. Moreover, the abundance and diversity of soil microorganisms increased significantly, the expression of carbohydrates in soil was significantly downregulated, and sucrose content was significantly negatively correlated with the abundance of microorganisms, such as Streptomyces. A significant decrease in heavy metals was observed in the soil, such as U (1.01- to 1.09-fold) and Pb (1.13- to 1.25-fold). Additionally, the thiamin synthesis pathway was inhibited in the soil of the T1 zone; the expression level of sulfur (S)-containing histidine derivatives (Ergothioneine) was significantly up-regulated by 0.56-fold in the shallow soil of the T2 zone; and the S content in the soil significantly reduced. Aromatic compounds were significantly up-regulated in the soil after 20 years of herbaceous plant remediation in coal gangue soil, and microorganisms (Sphingomonas) with significant positive correlations with benzene ring-containing metabolites, such as Sulfaphenazole, were identified.

A Pilot Trial of Consolidation Bevacizumab after Hypo-Fractionated Concurrent Chemoradiotherapy in Patients with Unresectable Locally Advanced Non-Squamous Non-Small-Cell Lung Cancer

PURPOSE/OBJECTIVE(S)

To assess the feasibility of adding bevacizumab consolidation into hypo-fractionated concurrent chemoradiotherapy (hypo-CCRT) in patients with unresectable locally advanced non-squamous non-small cell lung cancer (LA-NS-NSCLC).

MATERIALS/METHODS

Eligible patients were treated with hypo-RT (40 Gy in 10 fractions) followed by hypo-boost (24-28 Gy in 6-7 fractions) combined with concurrent weekly chemotherapy. Patients completed the hypo-CCRT without≥G2 toxicities then received consolidation bevacizumab every 3 weeks for up to 1 year, or disease progression or unacceptable treatment related toxicities. The primary endpoint was the risk of G4 or higher hemorrhage. The secondary endpoint was progression-free survival (PFS), overall survival (OS), locoregional failure-free survival (LRFS), distant metastasis-free survival (DMFS) and objective response rate (ORR). All time-to-event endpoints (OS, PFS, LRFS and DMFS) were measured from the start of radiotherapy.

RESULTS

From December 2017 to July 2020, a total of 27 patients were analyzed with a median follow-up duration of 28.0 months. One patient (3.7%) developed G5 hemorrhage during bevacizumab consolidation. Besides, there were 7 patients (25.9%) had G3 cough and 3 patients (11.1%) had G3 pneumonitis. The ORR was 92.6% of the whole cohort. The median OS was 37.0 months (95% confidence interval, 8.9-65.1 months), the median PFS was 16.0 months (95% confidence interval, 14.0-18.0 months), the median LRFS was not reached and the median DMFS was 18.0 months.

CONCLUSION

This pilot study met its goal of demonstrating the tolerability of consolidation bevacizumab after hypo-CCRT. Further investigation of antiangiogenic and immunotherapy combinations in LA-NSCLC is warranted while G3 respiratory toxicities is worth considering.

Sarcopenia as a Predictor of Neoadjuvant Therapy-Related Toxicity in Esophageal Squamous Cell Carcinoma Patients

PURPOSE/OBJECTIVE(S)

Sarcopenia, characterized by loss of muscle mass, plays a critical role in patients with esophageal squamous cell cancer (ESCC). Preoperative chemoradiotherapy and immunotherapy in ESCC patients has been reported to improve survival. Therefore, we sought to evaluate the predictive value of preoperative sarcopenia for toxicity and pathological tumor response to neoadjuvant therapy (NAT) in ESCC patients.

MATERIALS/METHODS

A retrospective analysis was performed using a prospectively collected patient cohort of an academic cancer center diagnosed with cT2-4N0-3M0 ESCC between 2019-2022 and treated with neoadjuvant chemoradiotherapy ± pembrolizumab. Sarcopenia was assessed by skeletal muscle index at the third lumbar vertebra in computed tomography scans before NAT (men: 43cm²/m² for body mass index (BMI) < 25kg/m², 53cm²/m² for BMI≥25 kg/m²; women: 41cm²/m²). Logistic regression was performed to assess the association between sarcopenia and preoperative therapy-related toxicity and tumor response.

RESULTS

The study included 59 locally advanced ESCC patients (53 male and 6 female), 48 (81.4%) in the non-sarcopenia group, and 11 (18.6%) in the sarcopenia group. Mean age at diagnosis was 62±8 years. Mean BMI at diagnosis was 22.13±2.85 kg/m². 19 patients (32.2%) were stage ⅢA, 25 patients (42.4%) were ⅢB, 15 patients (25.4%) were ⅣA. No significant differences were found between both groups regarding sex, age, BMI, and clinical stage. Acute grade ≥3 toxicity occurred significantly more frequently in the sarcopenia group (54.5% vs. 22.9%, p = 0.045), which mainly included leukopenia, neutropenia, anemia and thrombocytopenia. The discontinuation of NAT owing to toxicity occurred in 8 patients (13.5%), which was significantly associated with sarcopenia (p = 0.003). All patients proceeded to surgery and 33 patients (55.9%) had a pathological complete response (pCR). Univariate analysis revealed no significant association between sarcopenia and pCR (p = 0.071).

CONCLUSION

Among patients with locally advanced EC, sarcopenia is not a predictor of poor NAT response, but it is strongly associated with discontinuation of NAT due to toxicity.

Clinical application of laparoscopic continuous interposition jejunostomy with double-tract anastomosis and esophagogastric anastomosis: a retrospective study

OBJECTIVE

The aim of this study was to compare the early clinical outcomes of laparoscopic-assisted proximal gastrectomy with continuous interposition of jejunal cis-peristaltic dual-channel anastomosis and esophagogastric anastomosis.

PATIENTS AND METHODS

A retrospective analysis of 130 patients who underwent laparoscopic-assisted radical resection of proximal gastric cancer in the Department of Gastrointestinal Surgery at the Affiliated Hospital of Chengde Medical College between June 2018 and October 2022 was conducted. Continuous interposition jejunal double-channel anastomosis (double-tract anastomosis) was used in 71 patients and esophagogastric anastomosis (esophagogastrostomy) in 59 patients. The basic clinical data, preoperative and postoperative clinical test indexes, postoperative complications and improvement of symptoms compared to preoperative ones, basic nutritional status and Visick classification of esophageal reflux symptoms at 6 months after surgery were compared between the two groups. Postoperative contrast images of patients in the continuous interposition jejunal double-tract group were collected and analyzed for the ratio of contrast agent remaining in the stomach to that remaining in the small intestinal channel.

RESULTS

A total of 130 cases meeting the criteria were included in this study, including 71 cases involving the double-tract (DT) anastomosis method and 59 cases involving the esophagogastrostomy (EG) anastomosis method. There was no significant difference in preoperative information and perioperative safety between the two groups. Visick score of the DT group was significantly better than that of the EG group.

CONCLUSIONS

Double-tract jejunal anastomosis can effectively improve esophageal reflux symptoms after proximal gastrectomy. At the same time, its anastomotic method also improves the nutritional status in the short term compared to the esophagogastric anastomosis and is a more ideal procedure for reconstructing the digestive tract after proximal gastrectomy.

Boosting Ion Conductivities: Light-Modulated Azobenzene-Based Ionic Liquids in Vertical Nanochannels

Exploring stimuli-responsive ion-conductive materials is a challenging task, but it has gained increasing attention because of their enormous potential applications in actuators, sensors, and smart electronics. Here, we demonstrate a distinctive photoresponsive ion-conductive device that utilizes azobenzene-based ionic liquids ([AzoCnMIM][Br], where n = 2, 6, and 10), confined in nanochannels of anodic aluminum oxide (AAO) templates for photoisomerization. The structure of [AzoCnMIM][Br] comprises photoresponsive and hydrophobic azobenzene moieties, hydrophilic imidazolium cations, and negatively charged bromide ions. Therefore, [AzoCnMIM][Br] can form micelles and exhibit photoresponsive ion conductivities. The nanochannels of AAO templates exhibit a confinement effect on the formation of azobenzene-based ionic liquid micelles due to the pore size, thereby preventing the formation of larger micelles that could lead to a decrease in conductivity. Consequently, the ion conductivities of the azobenzene-based ionic liquids are higher in the nanochannels of the AAO templates. The effects of the length of carbon chains on the azobezene-based ionic liquids and the pore size of the AAO templates have also been investigated. Additionally, through irradiation with UV/vis light, [AzoCnMIM][Br] can undergo reversible isomerization, thereby reversibly changing the sizes of the micelles and subsequently altering the ion conductivities.

Identification of Brassica rapa BrEBF1 homologs and their characterization in cold signaling

EIN3-binding F-box 1 (EBF1) is involved in cold tolerance in Arabidopsis; however, its exact roles in cold signaling in Brassica rapa remain uncertain. Herein, we demonstrated that EBF1 homologs are highly conserved in Brassica species, but their copy numbers are diverse, with some motifs being species specific. Cold treatment activated the expression of EBF1 homologs BrEBF1 and BrEBF2 in B. rapa; however, their expression schemas were diverse in different cold-resistant varieties of the plant. Subcellular localization analysis revealed that BrEBF1 is a nuclear-localized F-box protein, and cold treatment did not alter its localization but induced its degradation. BrEBF1 overexpression enhanced cold tolerance, reduced cold-induced ROS accumulation, and enhanced MPK3 and MPK6 kinase activity in Arabidopsis. Our study revealed that BrEBF1 positively regulates cold tolerance in B. rapa and that BrEBF1-regulated cold tolerance is associated with ROS scavenging and MPK3 and MPK6 kinase activity through the C-repeat binding factor pathway.

Smart Temperature-Gating and Ion Conductivity Control of Grafted Anodic Aluminum Oxide Membranes

Over the past few decades, stimuli-responsive materials have been widely applied to porous surfaces. Permeability and conductivity control of ions confined in nanochannels modified with stimuli-responsive materials, however, have been less investigated. In this work, we demonstrate the permeability and conductivity control of ions confined in nanochannels of anodic aluminum oxide (AAO) templates modified with thermo-responsive poly(N-isopropylacrylamide) (PNIPAM) brushes. By surface-initiated atom transfer radical polymerization (SI-ATRP), PNIPAM brushes are successfully grafted onto the hexagonally packed cylindrical nanopores of AAO templates. The surface hydrophilicities of the membranes can be reversibly altered because of the lower critical solution temperature (LCST) behavior of the PNIPAM polymer brushes. From electrochemical impedance spectroscopy (EIS) analysis, the temperature-gating behaviors of the AAO-g-PNIPAM membranes exhibit larger impedance changes than those of the pure AAO membranes at higher temperatures because of the aggregation of the grafted PNIPAM chains. The reversible surface properties caused by the extended and collapsed states of the polymer chains are also demonstrated by dye release tests. The smart thermo-gated and ion-controlled nanoporous membranes are suitable for future smart membrane applications.

Risk factors of lymph node metastasis in patients with T1 stage colorectal cancer-a retrospective cohort study based on the Surveillance, Epidemiology, and End Results database

Background

Patients with T1 stage early colorectal cancer (CRC) can be treated with radical surgery or endoscopic surgery. Endoscopic surgery has a number of advantages, including minimal trauma and a rapid recovery. However, it cannot remove regional lymph nodes to assess whether there is lymph node metastasis. Thus, the analysis of the risk factors of lymph node metastasis in patients with T1 stage CRC is of great significance in the selection of appropriate treatment methods. Although previous studies have explored the risk factors for lymph node metastasis in T1 stage CRC patients, the number of cases were relatively insufficient, and further exploration is necessary.

Methods

A total of 2,085 patients who had been pathologically diagnosed with CRC from 2015 to 2017 from the Surveillance, Epidemiology, and End Results (SEER) database. Among the patients, 324 had lymph node metastasis. A multivariate logistic regression analysis was conducted to analyze the risk factors of lymph node metastasis in patients with T1 stage CRC. Next, we established a prediction model to predict lymph node metastasis in patients with T1 stage CRC.

Results

The results of the multivariate logistic regression analysis showed that age at diagnosis, rectosigmoid cancer, poorly differentiated or undifferentiated tumor cells, and distant metastasis were independent factors of lymph node metastasis in patients with T1 stage CRC (P<0.05). This study used the R4.0.3 statistical software for the statistical analysis. The data set was randomly divided into a training set and verification set. The training set comprised 1,460 patients, and the verification set comprised 625 patients. The area under the receiver operating characteristic curve (AUC) of the training set was 0.675 [95% confidence interval (CI): 0.635-0.714], and the AUC of the verification set was 0.682 (95% CI: 0.617-0.747). In the validation set, the model was tested by the Hosmer-Lemeshow Goodness-of-Fit Test (χ²=4.018, P=0.855), and the results showed that the model was reliable at predicting lymph node metastasis in patients with T1 stage CRC.

Conclusions

For CRC patients with high risk factors of lymph node metastasis, endoscopic physicians should carefully evaluate the advantages and disadvantages of the endoscopic surgery before deciding whether to perform this surgery.

Association between the systemic immune inflammation index and recurrence or metastasis after interventional therapy in patients with primary liver cancer- a retrospective cohort study

Background

The systemic immune inflammation index has been used to evaluate the prognosis of patients with a variety of malignant tumors. However, studies were limited in primary liver cancer (PLC) patients. This study aimed to investigate the association between the systemic immune inflammation index and recurrence or metastasis after interventional therapy in patients with PLC.

Methods

From January 2016 to December 2017, 272 patients with PLC admitted to the 941st Hospital of PLA Joint Logistics Support Force were retrospectively collected. All patients received interventional treatment, there were no residual lesions after interventional treatment. The patients were followed up for 5 years to monitor the rates of recurrence or metastasis. The patients were divided into a recurrence or metastasis group (n=112) and a control group (n=160). The differences in clinical features between the 2 groups were compared, and the predictive value of systemic immune inflammation index on recurrence or metastasis after interventional treatment in patients with PLC was analyzed.

Results

Compared with the control group (8.12%), the proportion of patients with ≥2 lesions in the recurrence or metastasis group (19.64%) was significantly increased (P=0.005); the proportion of patients with vascular invasion was significantly increased in the recurrence or metastasis group (10.71% vs. 4.38%, P=0.044); albumin decreased significantly in the recurrence or metastasis group (39.69±6.17 vs. 41.69±6.82 g/L, P=0.014); neutrophils (%) were significantly increased in the recurrence or metastasis group (0.70±0.08 vs. 0.64±0.08, P<0.001); lymphocytes (%) were significantly reduced in the recurrence or metastasis group (0.25±0.06 vs. 0.30±0.06, P<0.001); and platelet count was significantly increased in the recurrence or metastasis group (179.22±39.52 vs. 160.81±34.13 10⁹/L, P<0.001). The systemic immune inflammation index was significantly increased in the recurrence or metastasis group (535.23±174.05 vs. 357.84±120.21, P<0.001). Systemic immune inflammation index was valuable in predicting recurrence or metastasis, and the area under the curve was 0.795 (95% CI: 0.742-0.848, P<0.001). Systemic immune inflammation index >405.08 was an independent risk factor of recurrence or metastasis [relative risk (95% CI: 1.878-5.329), P=0.000].

Conclusions

Elevated systemic immune inflammation index is associated with recurrence or metastasis after interventional therapy in patients with PLC.

[Investigate of the etiology and prevention status of liver cirrhosis]

Objective: To investigate the etiology, prevention and treatment status, and their corresponding regional differences of the patients with liver cirrhosis in China, in order to provide scientific basis for the development of diagnosis and control strategies in China. Methods: Clinical data of patients diagnosed with liver cirrhosis for the first time through January 1, 2018 to December 31, 2020 from 50 hospitals in seven different regions of China were collected and analyzed retrospectively, and the difference of etiology, treatment, and their differences in various regions were analyzed. Results: A total of 11 861 cases with liver cirrhosis were included in the study. Thereinto, 5 093 cases (42.94%) were diagnosed as compensated cirrhosis, and 6 768 cases (57.06%) had decompensated cirrhosis. Notably, 8 439 cases (71.15%) were determined as chronic hepatitis B-caused cirrhosis, 1 337 cases (11.27%) were alcoholic liver disease, 963 cases (8.12%) were chronic hepatitis C, 698 cases (5.88%) were autoimmune liver disease, 367 cases (3.09%) were schistosomiasis, 177 cases (1.49%) were nonalcoholic fatty liver, and 743 cases (6.26%) of other types of liver disease. There were significant differences in the incidence of chronic hepatitis B, chronic hepatitis C, alcoholic liver disease, fatty liver, schistosomiasis liver disease, and autoimmune liver disease among the seven regions (P<0.001). Only 1 139 cases (9.60%) underwent endoscopic therapy, thereinto, 718 cases (6.05%) underwent surgical therapy, and 456 cases (3.84%) underwent interventional therapy treatment. In patients with compensated liver cirrhosis, 60 cases (0.51%) underwent non-selective β receptor blockers(NSBB), including 59 cases (0.50%) underwent propranolol and 1 case (0.01%) underwent carvedilol treatment. In patients with decompensated liver cirrhosis, 310 cases (2.61%) underwent NSBB treatment, including 303 cases (2.55%) underwent propranolol treatment and 7 cases (0.06%) underwent carvedilol treatment. Interestingly, there were significant differences in receiving endoscopic therapy, interventional therapy, NSBB therapy, splenectomy and other surgical treatments among the seven regions (P<0.001). Conclusion: Currently, chronic hepatitis B is the main cause (71.15%) of liver cirrhosis in several regions of China, and alcoholic liver disease has become the second cause (11.27%) of liver cirrhosis in China. The three-level prevention and control of cirrhosis in China should be further strengthened.

Model construction and risk analysis of the lncRNA genes associated with the prognosis of esophageal adenocarcinoma with immune infiltration

Background

Our study analyzed the immune infiltration of esophageal adenocarcinoma (EAC) tumor cells and identified long non-coding ribonucleic acid (lncRNA) genes to construct a prognostic model of EAC to evaluate the survival prognosis of patients and explore potential therapeutic targets.

Methods

The data of 89 patients with EAC, including 11 normal tissue samples and 78 EAC of tumor tissue samples, were downloaded from The Cancer Genome Atlas public database. Perl script and R software were used to run the code, conduct the statistical analysis, calculate the risk coefficients of the patients, and conduct the Cox regression analysis, immune-related lncRNA survival analysis, risk analysis, principal component analysis (PCA), and receiver operating characteristic (ROC) curve analysis.

Results

We screened and identified 19 prognostic biomarkers, including LINC01612, AC008443.2, and LINC02582, allocated the patients into high- and low-risk groups, and found significant differences in the prognosis between the high- and low-risk groups using the Kaplan-Meier survival analysis (P<0.001). A ROC curve was used to evaluate the feasibility of the prognostic model for EAC, and we found that the model had high predictability (area under the curve =0.964). A PCA analysis was performed of the complex transcriptome sequencing data and other cubes to transform the data into a 3-dimensional space constructed by feature vectors.

Conclusions

Our study effectively screened and identified the lncRNA genes related to the immune infiltration of EAC and successfully constructed a prognostic model. In total, 19 potential diagnostic and therapeutic target genes, including LINC01612, AC008443.2, and LINC02582, were identified that have certain significance in guiding the clinical treatment of EAC patients.

CXD101 and nivolumab in patients with metastatic microsatellite-stable colorectal cancer (CAROSELL): a multicentre, open-label, single-arm, phase II trial

BACKGROUND

Patients with microsatellite stable (MSS) colorectal carcinoma (CRC) do not respond to immune checkpoint inhibitors. Preclinical models suggested synergistic anti-tumour activity combining CXD101 and anti-programmed cell death protein 1 treatment; therefore, we assessed the clinical combination of CXD101 and nivolumab in heavily pre-treated patients with MSS metastatic CRC (mCRC).

PATIENTS AND METHODS

This single-arm, open-label study enrolled patients aged 18 years or older with biopsy-confirmed MSS CRC; at least two lines of systemic anticancer therapies (including oxaliplatin and irinotecan); at least one measurable lesion; Eastern Cooperative Oncology Group performance status of 0, 1 or 2; predicted life expectancy above 3 months; and adequate organ and bone marrow function. Nine patients were enrolled in a safety run-in study to define a tolerable combination schedule of CXD101 and nivolumab, followed by 46 patients in the efficacy assessment phase. Patients in the efficacy assessment cohort were treated orally with 20 mg CXD101 twice daily for 5 consecutive days every 3 weeks, and intravenously with 240 mg nivolumab every 2 weeks. The primary endpoint was immune disease control rate (iDCR).

RESULTS

Between 2018 and 2020, 55 patients were treated with CXD101 and nivolumab. The combination therapy was well tolerated with the most frequent grade 3 or 4 adverse events being neutropenia (18%) and anaemia (7%). Immune-related adverse reactions commonly ascribed to checkpoint inhibitors were surprisingly rare although we did see single cases of pneumonitis, hypothyroidism and hypopituitarism. There were no treatment-related deaths. Of 46 patients assessable for efficacy, 4 (9%) achieved partial response and 18 (39%) achieved stable disease, translating to an immune disease control rate of 48%. The median overall survival (OS) was 7.0 months (95% confidence interval 5.13-10.22 months).

CONCLUSIONS

The primary endpoint was met in this phase II study, which showed that the combination of CXD101 and nivolumab, at full individual doses in the treatment of advanced or metastatic MSS CRC, was both well tolerated and efficacious.

Involvement of NO and Ca2+ in the enhancement of cold tolerance induced by melatonin in winter turnip rape (Brassica rapa L.)

As a multifunctional phytohormone, melatonin (Mel) plays pivotal roles in plant responses to multiple stresses. However, its mechanism of action remains elusive. In the present study, we evaluated the role of NO and Ca²⁺ signaling in Mel enhanced cold tolerance in winter turnip rape. The results showed that the NO content and concentration of intracellular free Ca²⁺ ([Ca²⁺]_cyt) increased by 35.42% and 30.87%, respectively, in the leaves of rape seedlings exposed to cold stress. Compared with those of the seedlings in cold stress alone, the NO content and concentration of [Ca²⁺]_cyt in rape seedlings pretreated with Mel increased further. In addition, the Mel-mediated improvement of cold tolerance was inhibited by L-NAME (a NO synthase inhibitor), tungstate (a nitrate reductase inhibitor), LaCl₃ (a Ca²⁺ channel blocker), and EGTA (a Ca²⁺ chelator), and this finding was mainly reflected in the increase in ROS content and the decrease in osmoregulatory capacity, photosynthetic efficiency and antioxidant enzyme activities, and expression levels of antioxidant enzyme genes. These findings suggest that NO and Ca²⁺ are necessary for Mel to improve cold tolerance and function synergistically downstream of Mel. Notably, the co-treatment of Mel with L-NAME, tungstate, LaCl₃, or EGTA also inhibited the Mel-induced expression of MAPK3/6 under cold stress. In conclusion, NO and Ca²⁺ are involved in the enhancement of cold tolerance induced by Mel through activating the MAPK cascades in rape seedlings, and a crosstalk may exist between NO and Ca²⁺ signaling.

Regulation of pollen tube growth by cellular pH and ions

Tip growth of the pollen tube is a model system for the study of cell polarity establishment in flowering plants. The tip growth of the pollen tube displays an oscillating pattern corresponding to cellular ion and pH dynamics. Therefore, cellular pH and ions play an important role in pollen growth and development. In this review, we summarized the current advances in understanding the function of cellular pH and ions in regulating pollen tube growth. We analyzed the physiological roles and underlying mechanisms of cellular pH and ions, including Ca²⁺, K⁺, and Cl^-, in regulating pollen tube growth. We further examined the function of Ca²⁺ in regulating cytoskeletons, small G proteins, and cell wall development in relation to pollen tube growth. We also examined the regulatory roles of cellular pH in pollen tube growth as well as pH regulation of ion flow, cell wall development, auxin signaling, and cytoskeleton function in pollen. In addition, we assessed the regulation of pollen tube growth by proton pumps and the maintenance of pH homeostasis in the trans-Golgi network by ion transporters. The interplay of ion homeostasis and pH dynamics was also assessed. We discussed the unanswered questions regarding pollen tube growth that need to be addressed in the future.

A bioinformatics framework to identify the biomarkers and potential drugs for the treatment of colorectal cancer

Colorectal cancer (CRC), a common malignant tumor, is one of the main causes of death in cancer patients in the world. Therefore, it is critical to understand the molecular mechanism of CRC and identify its diagnostic and prognostic biomarkers. The purpose of this study is to reveal the genes involved in the development of CRC and to predict drug candidates that may help treat CRC through bioinformatics analyses. Two independent CRC gene expression datasets including The Cancer Genome Atlas (TCGA) database and GSE104836 were used in this study. Differentially expressed genes (DEGs) were analyzed separately on the two datasets, and intersected for further analyses. 249 drug candidates for CRC were identified according to the intersected DEGs and the Crowd Extracted Expression of Differential Signatures (CREEDS) database. In addition, hub genes were analyzed using Cytoscape according to the DEGs, and survival analysis results showed that one of the hub genes, TIMP1 was related to the prognosis of CRC patients. Thus, we further focused on drugs that could reverse the expression level of TIMP1. Eight potential drugs with documentary evidence and two new drugs that could reverse the expression of TIMP1 were found among the 249 drugs. In conclusion, we successfully identified potential biomarkers for CRC and achieved drug repurposing using bioinformatics methods. Further exploration is needed to understand the molecular mechanisms of these identified genes and drugs/small molecules in the occurrence, development and treatment of CRC.

Otoacoustic emission and its application in anesthesia

OBJECTIVE

An otoacoustic emission (OAE) is a low-level sound emitted by the cochlea. OAEs are able to objectively evaluate the auditory perception and reflect the functional status of the auditory system. With the characteristics of non-invasiveness, high reliability, and easy manipulation, OAEs have gained wide popularity in clinical audiology and anesthesiology. This review aims to summarize the application of OAE in anesthesia.

MATERIALS AND METHODS

This study collected data from the databases Web of Science-Clarivate Analytics, PubMed, and Google Scholar in English, covering research in the last 40 years. The keywords were defined as anesthesia, cochlea, OAEs, distortion product otoacoustic emissions, transient evoked otoacoustic emissions, bispectral index, auditory evoked potentials, and depth of anesthesia. Documents that matched defined keywords were selected and reviewed.

RESULTS

Research showed that the types and doses of anesthetic drugs impacted OAEs. Ketamine-based anesthesia has a greater effect on OAE sensitivity over time compared to isoflurane. A higher dose of ketamine-xylazine significantly reduced the amplitude of OAEs. According to those characteristics, OAEs could be used as an objective evaluation method for the effect of anesthetics and have great potential to be applied for anesthetic drug dose control during surgery. OAEs also have been used to detect the cochlear function during anesthesia, which may cause irreversible damage to the cochlea.

CONCLUSIONS

Studies reported that OAEs have been used in anesthesia. However, the existing studies have mainly focused on the influence of anesthetic types or dosages on OAEs. Considering the characteristics of OAEs, such as a convenient measurement, less susceptibility to interference, and fast detection speed, the application of OAE has a great potential in the anesthesia field.

[Efficacy comparison among high risk factors questionnaire and Asia-Pacific colorectal screening score and their combinations with fecal immunochemical test in screening advanced colorectal tumor]

Objective: To investigate the effects of high risk factors questionnaire (HRFQ), Asia-Pacific colorectal screening (APCS) score and their combinations with fecal immunochemical test (FIT) in screening advanced colorectal neoplasia, in order to provide an evidence for further optimization of cancer screening program. Methods: A retrospective cohort study method was used to summarize and analyze the results of colorectal tumor screening in Jiashan County, Zhejiang Province from March 2017 to July 2018. Those with severe diseases that were not suitable for colonoscopy and those with mental and behavioral abnormalities who can not cooperate with the screening were excluded. Those who met any one or more of the followings in the HRFQ questionnaire were classified as high-risk people of HRFQ: (1) first-degree relatives with a history of colorectal cancer; (2) subjects with a history of cancer or any other malignant tumor; (3) subjects with a history of intestinal polyps; (4) those with two or more of the followings: chronic constipation (constipation lasted for more than 2 months per year in the past two years), chronic diarrhea (diarrhea lasted for more than 3 months in the past two years, and the duration of each episode was more than one week), mucus and bloody stools, history of adverse life events (occurring within the past 20 years and causing greater trauma or distress to the subject after the event), history of chronic appendicitis or appendectomy, history of chronic biliary disease or cholecystectomy. In this study, those who were assessed as high risk by HRFQ were recorded as "HRFQ (+)", and those who were not at high risk were recorded as "HRFQ (-)". The APCS questionnaire provided risk scores based on 4 risk factors including age, gender, family history and smoking: (1) age: 2 points for 50-69 years old, 3 points for 70 years old and above; (2) gender: 1 point for male, 0 point for women; (3) family history: 2 points for first-degree relatives suffering from colorectal cancer; (4) smoking: 1 point for current or past smoking, 0 point for non-smokers. The population was divided into low-risk (0-1 point), intermediate-risk (2-3 points), and high-risk (4-7 points). Those who were assessed as high risk by APCS were recorded as "APCS (+)", and those with intermediate and low risk were recorded as "APCS (-)". The hemoglobin threshold for a positive FIT was set to 100 μg/L. Those who were assessed as high risk by APCS with positive FIT were recorded as "APCS+FIT (+)". Those who were assessed as high risk by APCS with negative FIT, those who were assessed by APCS as low-middle risk with positive FIT, and those who were assessed by APCS as low-middle with negative FIT were all recorded as "APCS+FIT(-)". Observation indicators in this study were as follows: (1) the screening compliance rate of the cohort and the detection of advanced colorectal tumors; (2) positive predictive value, negative predictive value, sensitivity and specificity of HRFQ and APCS and their combination with FIT for screening advanced colorectal tumors; (3) comparison of the detection rate between HRFQ and APCS questionnaire for different colorectal lesions. Using SPSS 21.0 software, the receiver operating characteristic (ROC) curve was drawn to evaluate the clinical value of HRFQ and APCS combined with FIT in screening advanced colorectal tumors. Results: From 2017 to 2018 in Jiashan County, a total of 53 268 target subjects were screened, and 42 093 people actually completed the questionnaire, with a compliance rate of 79.02%. A total of 8145 cases underwent colonoscopy. A total of 3607 cases among HRFQ positive population (5320 cases) underwent colonoscopy, and the colonoscopy compliance rate was 67. 80%; 8 cases were diagnosed with colorectal cancer and 88 cases were advanced colorectal adenoma. A total of 2977 cases among APCS positive population (11 942 cases) underwent colonoscopy, and the colonoscopy compliance rate was 24.93%; 17 cases were diagnosed with colorectal cancer and 148 cases were advanced colorectal adenoma. The positive rate of HRFQ screening was lower than that of APCS [12.6% (5320/42 093) vs. 28.4% (11 942/42 093), χ²=3195. 547, P<0.001]. In the FIT positive population (6223 cases), a total of 4894 cases underwent colonoscopy, and the colonoscopy compliance rate was 78.64%; 34 cases were diagnosed with colorectal cancer and 224 cases were advanced adenoma. The positive predictive values of HRFQ and APCS and their combination with FIT for screening advanced colorectal tumors were 2.67%, 5.54%, 5.44%, and 8.56%; negative predictive values were 94.89%, 96.85%, 96.11% and 96.99%; sensitivity was 29.27%, 50.30%, 12.20 % and 39.02%; specificity was 55.09%, 64.03%, 91.11% and 82.51%, respectively. The ROC curves constructed by HRFQ, APCS, FIT, HRFQ+FIT and APCS+FIT indicated that APCS+FIT presented the highest efficacy in screening advanced colorectal tumors (AUC: 0.608, 95%CI: 0.574-0.642). The comparison of the detection rates of different colorectal lesions between HRFQ and APCS questionnaires showed that there were no significant differences in detection rate of inflammatory polyps and hyperplastic polyps between the two questionnaires (both P>0.05). However, as compared to HRFQ questionnaire, APCS questionnaire had higher detection rates in non-advanced adenomas [26.10% (777/2977) vs. 19.43% (701/3607), χ²=51.228, P<0.001], advanced adenoma [4.97% (148/2977) vs. 2.44% (88/3607), χ²=30.249, P<0.001] and colorectal cancer [0.57% (17 /2977) vs. 0.22% (8/3607), χ²=5.259, P=0.022]. Conclusions: APCS has a higher detection rate of advanced colorectal tumors than HRFQ. APCS combined with FIT can further improve the effectiveness of advanced colorectal tumor screening.

Decidual mesenchymal stem/stromal cells from preeclamptic patients secrete endoglin, which at high levels inhibits endothelial cell attachment invitro

INTRODUCTION

In preeclampsia (PE), inadequate remodelling of spiral arterioles in the decidua basalis causes oxidative stress and subsequent increased release of antiangiogenic soluble endoglin (sENG) into the maternal circulation. Decidual mesenchymal stem/stromal cells (DMSCs) reside adjacent to endothelial cells in this vascular niche. Surprisingly, DMSCs express membrane-bound ENG (CD105). PE-affected DMSCs (PE-DMSCs) are abnormal and due to reduced extravillous invasion, more of them are present, but the significance of this is not known.

METHODS

DMSCs were isolated and characterised from normotensive control and severe-PE placentae. Extracellular vesicle (EV) types, shed microvesicles (sMV) and exosomes, were isolated from DMSC conditioned media (DMSC_CM), respectively. Secretion of ENG by DMSCs was assessed by ELISA of DMSC_CM, with and without EV depletion. The effects of reducing ENG concentration, by blocking antibody, on human umbilical vein endothelial cell (HUVEC) attachment were assessed by xCELLigence real-time functional assays.

RESULTS

ENG was detected in DMSC_CM and these levels significantly decreased when depleted of exosomes and sMV. There was no significant difference in the amount of ENG secreted by control DMSCs and PE-DMSCs. Blocking ENG in concentrated DMSC_CM, used to treat HUVECs, improved endothelial cell attachment.

DISCUSSION

In normotensive pregnancies, DMSC secretion of ENG likely has a beneficial effect on endothelial cells. However, in PE pregnancies, shallow invasion of the spiral arterioles exposes more PE-DMSC derived sources of ENG (soluble and EV). The presence of these PE-DMSCs in the vascular niche contributes to endothelial cell dysfunction.

Fractal Permeability Model of Newtonian Fluids in Rough Fractured Dual Porous Media

Based on the statistical self-similar fractal characteristics of the microstructure of porous media, the total flow rate and permeability of Newtonian fluids in the rough fracture network and rough matrix pores are derived, respectively. According to the connection structure between fractures and pores, the permeability analysis model of fluids in a matrix-embedded fracture network is established. The comparison between the predicted values of the model and the experimental data shows that the predicted values of the permeability of the rough fracture network and the rough matrix pores decrease with the increase in the relative roughness of the fractures and matrix pores, and are lower than the experimental data. Meanwhile, the predicted total flow rate of a rough fractured dual porous media is lower than that of a smooth fractal model and experimental data. In addition, it is also found that the larger the average inclination angle and the relative roughness of the fracture network, the smaller the permeability of the fractured dual porous media, and the relative roughness of the fracture network has a far greater influence on fluid permeability in the fractured dual porous media than the relative roughness of the matrix pores.