[Clinical features of patients with hypertrophic obstructive cardiomyopathy combining obstructive sleep apnea]

Objective: To investigate the clinical features of patients with hypertrophic obstructive cardiomyopathy (HOCM) combined with obstructive sleep apnea (OSA). Methods: From 2010 to 2018, a total of 299 patients who were diagnosed with hypertrophic cardiomyopathy and underwent sleep monitoring at Fuwai Hospital were retrospectively analyzed. General clinical features, data of echocardiography, and sleep breathing parameters were recorded. OSA was diagnosed by apnea-hypopnea index ≥ 5 events/hour. Clinical characteristics were compared between patients with and without OSA. Results: A total of 156 (52.2%) HOCM patients were diagnosed with OSA. Compared with patients without OSA, patients with OSA were older((54±10) years vs (45±14) years, P<0.001), had a higher body mass index ((27±3) kg/m(2) vs (25±3) kg/m(2), P<0.001), a higher prevalence of hypertension (54.4% (85/156) vs 21.0% (30/143), P<0.001), hyperlipidemia (37.2% (58/156) vs 13.3% (19/143), P<0.001) and smoking history (48.1% (75/156) vs 35.0% (50/143), P=0.022). Patients with OSA also had a higher incidence of New York Heart Association functional class Ⅱ or Ⅲ (P=0.017), atrial fibrillation (P=0.005), and higher levels of systolic and diastolic blood pressure, fast glucose and high-sensitive c-reactive protein (all P<0.001). Left ventricular end-diastolic diameter as well as ascending aorta diameter in patients with OSA were also greater than those without OSA (both P<0.001). Apnea-hypopnea index (AHI) value positively correlated with left ventricular end-diastolic diameter (r=0.346), ascending aorta diameter (r=0.357) and high-sensitive c-reactive protein (r=0.230) (all P<0.001). Conclusions: A high prevalence of OSA occurs in patients with HOCM. Severity of OSA correlates with cardiac remodeling and serum inflammatory factor level. As for HOCM patients, clinicians should actively monitor the sleep breathing parameters in order to recognize and treat potential OSA, thereby improving the prognosis of patients with HOCM.

STAT3-induced upregulation of lncRNA SNHG17 predicts a poor prognosis of melanoma and promotes cell proliferation and metastasis through regulating PI3K-AKT pathway

OBJECTIVE

Long noncoding RNAs (lncRNAs) have drawn increasing attention due to their critical roles in various diseases, including melanoma. In this study, we aimed to explore the potential roles and underlying mechanisms of Small nucleolar RNA host gene 17 (SNHG17) in the modulation of melanoma progression.

PATIENTS AND METHODS

The levels of SNHG17 in melanoma tissues and cells were determined using RT-PCR. The clinical significance of SNHG17 in melanoma patients was analyzed using Chi-square tests, Kaplan-Meier methods, and multivariate assays. MTT assays, transwell assay, and flow cytometry were carried out to explore the biological functions of SNHG17. The biological mechanism underlying up-regulation of SNHG17 was explored using ChIP analysis and luciferase reporter assays. The related proteins of the PI3K-AKT pathway were determined by Western blot.

RESULTS

High expressions of SNHG17 were observed in both melanoma tissues and cells. Up-regulation of SNHG17 in melanoma patients was associated with lymph node metastasis and tumor stage. Survival assays revealed that those patients with high SNHG17 expression had significantly shorter survival time. SNHG17 was also confirmed to be independently associated with overall survival of melanoma patients. Functional studies confirmed that the proliferation, migration, and invasion of melanoma cells were noticeably reduced by the down-regulation of SNHG17. Mechanistically, the up-regulation of SNHG17 was induced by STAT3. We also found that knockdown of SNHG17 resulted in the remarkable diminution in the phosphorylation levels of PI3K and AKT, suggesting that the activity of the PI3K-AKT pathway was suppressed.

CONCLUSIONS

STAT3-induced upregulation of SNHG17 contributed to the progression of melanoma by promoting the PI3K-AKT signaling.

MOTS-c improves osteoporosis by promoting the synthesis of type I collagen in osteoblasts via TGF-β/SMAD signaling pathway

OBJECTIVE

To investigate whether MOTS-c can regulate the synthesis of type I collagen in osteoblasts by regulating TGF-β/SMAD pathway, thereby improving osteoporosis.

MATERIALS AND METHODS

Viability of hFOB1.19 cells treated with MOTS-c was detected by CCK-8 assay. The mRNA and protein levels of TGF-β, SMAD7, COL1A1 and COL1A2 in hFOB1.19 cells were detected by quantitative Real-time polymerase chain reaction (qRT-PCR) and Western blot, respectively. We then changed expressions of TGF-β and SMAD7 by plasmids transfection to detect levels of COL1A1 and COL1A2 in hFOB1.19 cells by qRT-PCR and Western blot, respectively.

RESULTS

Cell viability was significantly increased after treatment of 1.0 μM MOTS-c for 24 h or 0.5 μM MOTS-c for 48 h in a time-dependent manner. The mRNA and protein expressions of TGF-β, SMAD7, COL1A1 and COL1A2 in hFOB1.19 cells were dependent on the concentration of MOTS-c. In addition, MOTS-c increased the expressions of COL1A1 and COL1A2, which were partially reversed by knockdown of TGF-β or SMAD7.

CONCLUSIONS

MOTS-c could promote osteoblasts to synthesize type I collagen via TGF-β/SMAD pathway.

Effusion attenuates the effect of synovitis on radiographic progression in patients with hand osteoarthritis: a longitudinal magnetic resonance imaging study

An exploratory study to determine the role of effusion, i.e., fluid in the joint, in pain, and radiographic progression in patients with hand osteoarthritis. Distal and proximal interphalangeal joints (87 patients, 82% women, mean age 59 years) were assessed for pain. T2-weighted and Gd-chelate contrast-enhanced T1-weighted magnetic resonance images were scored for enhanced synovial thickening (EST, i.e., synovitis), effusion (EST and T2-high signal intensity [hsi]) and bone marrow lesions (BMLs). Effusion was defined as follows: (1) T2-hsi > 0 and EST = 0; or 2) T2-hsi = EST but in different joint locations. Baseline and 2-year follow-up radiographs were scored following Kellgren-Lawrence, increase ≥ 1 defined progression. Associations between the presence of effusion and pain and radiographic progression, taking into account EST and BML presence, were explored on the joint level. Effusion was present in 17% (120/691) of joints, with (63/120) and without (57/120) EST. Effusion on itself was not associated with pain or progression. The association with pain and progression, taking in account other known risk factors, was stronger in the absence of effusion (OR [95% CI] 1.7 [1.0–2.9] and 3.2 [1.7–5.8]) than in its presence (1.6 [0.8–3.0] and 1.3 [0.5–3.1]). Effusion can be assessed on MR images and seems not to be associated with pain or radiographic progression but attenuates the association between synovitis and progression.

Key Points • Effusion is present apart from synovitis in interphalangeal joints in patients with hand OA. • Effusion in finger joints can be assessed as a separate feature on MR images. • Effusion seems to be of importance for its attenuating effect on the association between synovitis and radiographic progression.

[Application and efficacy of the adjustment on left ventricular electrical delay and the distance between right and left ventricular pacing polar in optimizing the left ventricular pacing polar]

Objective: To investigate the application and efficacy of left ventricular (LV) electrical delay (LVED) and the distance of right ventricular(RV) pacing polar to LV(DRLV) in optimizing LV pacing polar. Methods: Heart failure (HF) patients who implanted cardiac resynchronization therapy (CRT) device with a LV quadripolar lead from January 2014 to January 2018 at General Hospital of Northern Theater Command were enrolled in the study. Measurements of LVED and DRLV of each polar of the lead were performed in patients with HF who underwent CRT with LV quadripolar lead. The principle in turn for polar selecting used for clinical LV pacing was the pacing polar: (1)without phrenic nerve stimulation(PNS); (2)with appropriate capture threshold; (3)not located in apical; (4)with maximal LVED; (5)with maximal DRLV. The LV pacing polar was selected for CRT according to the procedure. The distribution of target veins implanted with LV quadripolar lead were calculated. The percentage of biventricular pacing at 6-month follow-up was recorded. The following indexes were compared before and 6-month after surgery, including QRS duration, LV end-systolic volume(LVESV), LV ejection fraction(LVEF), LV end-diastolic dimension(LVEDD), 6 minute walking distance(6MWD), New York Heart Association(NYHA) class. The efficacy and echocardiographic efficacy of CRT was evaluated. Results: There were twenty-nine HF patients enrolled. The mean age of enrolled patients was(61.7±7.6)years old, nineteen (66%)of them were male. There were seventeen(59%) patients diagnosed as dilated cardiomyopathy and twelve(41%) patients as ischemic cardiomyopathy. All patients were successfully implanted with LV quadripolar lead into target veins, and all four pacing sites were also in target veins. Target veins were located in lateral veins in 15 patients (52%), anterior veins in 2 patients (7%), posterior veins in 11 patients (38%), and lateral branches of great cardiac veins in 1 patient (3%). After 6-month of follow-up, the percentage of biventricular pacing was greater than 95%.There were nineteen(66%) patients optimized LV pacing polar by the largest LVED and four (14%) patients by the DRLV. Of the 29 patients, 5(17%) patients used D1 as the pacing polar, 5(17%) patients used M2 as the pacing polar, 7(24%) patients used M3 as the pacing polar, and 12(41%) patients used P4 as the pacing polar. The pacing polars (D1, M2) of traditional bipolar lead were used in 10(34%) patients, and the LV quadripolar lead specific pacing polars (M3, P4) were used in 19(66%) patients.Compared to a LV quadripolar lead, the LV pacing polar (M3, P4) selected in 19(66%) patients were not achievable with the traditional LV bipolar lead (D1, M2). Preoperative QRS duration, LVESV, LVEF, LVEDD, 6MWD and NYHA class were (171±24)ms, (231±79)ml, (28±5)%, (74±11)mm, (294±103)m, (3.2±1.0)class and the postoperative 6-month were (130±12)ms, (158±73)ml, (36±10)%, (66±12)mm, (371±86)m, (1.9±0.5)class. These indexes were significantly improved after 6 months operation(P<0.001). 97% and 83% patients were responders of CRT as assessed by 6-month efficacy and echocardiographic efficacy. Conclusion: The maximal LVED and DRLV can be used to select LV pacing polar with a high rate of CRT response rate.

'Where and how do you buy medicines?' A pilot survey of consumption strategies among the public in Sweden

Background

Substandard and falsified (SF) medical products are a major danger to public health. They affect every region of the world, and have been identified in all major therapeutic categories. Studies from medicine, pharmacology, law and public health dominate this research area with a focus on the supply side. However, the spread of SF medical products cannot be fully understood without information about the demand side or a sociocultural perspective on market formation. The aim of this short report is to present findings from a pilot study that examines the attitudes of the Swedish public regarding consumption of medicines.

Methods

We conducted a pilot survey in 2016 ‘Where and how do you buy medicines?’ using LimeSurvey, an open-source online survey software. In total 155 respondents completed the survey.

Results

The majority of respondents turn to doctors within healthcare for prescription-only medicines (POM). Simultaneously, some respondents would consider buying POMs without prior contact with experts even if medicines may come from unsafe sources.

Conclusions

There is a tendency that people move away from formal healthcare towards an unregulated market. In parallel, people’s approach to doctors becomes more personalized and pragmatic than in former patriarchal relationships. Risk becomes a negotiable concept.

Viral Load Dynamics in Sputum and Nasopharyngeal Swab in Patients with COVID-19

Coronavirus disease 2019 (COVID-19) has caused a global pandemic associated with substantial morbidity and mortality. Nasopharyngeal swabs and sputum samples are generally collected for serial viral load screening of respiratory contagions, but temporal profiles of these samples are not completely clear in patients with COVID-19. We performed an observational cohort study at Renmin Hospital of Wuhan University, which involved 31 patients with confirmed COVID-19 with or without underlying diseases. We obtained samples from each patient, and serial viral load was measured by real-time quantitative polymerase chain reaction. We found that the viral load in the sputum was inclined to be higher than samples obtained from the nasopharyngeal swab at disease presentation. Moreover, the viral load in the sputum decreased more slowly over time than in the nasopharyngeal group as the disease progressed. Interestingly, even when samples in the nasopharyngeal swab turned negative, it was commonly observed that patients with underlying diseases, especially hypertension and diabetes, remained positive for COVID-19 and required a longer period for the sputum samples to turn negative. These combined findings emphasize the importance of tracking sputum samples even in patients with negative tests from nasopharyngeal swabs, especially for those with underlying conditions. In conclusion, this work reinforces the importance of sputum samples for SARS-CoV-2 detection to minimize transmission of COVID-19 within the community.

Synthesis of mesoscale ordered two-dimensional π-conjugated polymers with semiconducting properties

Two-dimensional materials with high charge carrier mobility and tunable band gaps have attracted intense research effort for their potential use in nanoelectronics. Two-dimensional π-conjugated polymers constitute a promising subclass because the band structure can be manipulated by varying the molecular building blocks while preserving key features such as Dirac cones and high charge mobility. The major barriers to the application of two-dimensional π-conjugated polymers have been the small domain size and high defect density attained in the syntheses explored so far. Here, we demonstrate the fabrication of mesoscale ordered two-dimensional π-conjugated polymer kagome lattices with semiconducting properties, Dirac cone structures and flat bands on Au(111). This material has been obtained by combining a rigid azatriangulene precursor and a hot dosing approach, which favours molecular diffusion and eliminates voids in the network. These results open opportunities for the synthesis of two-dimensional π-conjugated polymer Dirac cone materials and their integration into devices.

MiR-126-3p suppresses the growth, migration and invasion of NSCLC via targeting CCR1

OBJECTIVE

MicroRNA (miRNA) plays vital roles in the development of different cancers. In the current work, we explored the function of miR-126-3p in the growth and metastasis of non-small-cell lung cancer (NSCLC) cell in vitro and in vivo.

PATIENTS AND METHODS

The expressions of miR-126-3p in NSCLC cell lines were assessed using the quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) assay. 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT), colony formation, wound healing and transwell invasion were applied to reveal the role of miR-126b-3p on NSCLC cell growth, migration and invasion. The expressions of epithelial-mesenchymal transition (EMT) associated markers (E-cadherin and N-cadherin) were assessed by immunofluorescence staining. The Xenograft model and lung metastasis model were applied to explore the impact of miR-126-3p on the growth and aggressiveness of NSCLC cell in vivo.

RESULTS

MiR-126-3p was significantly down-regulated in NSCLC cell lines and tissues. The up-regulation of miR-126-3p inhibited the growth, colony formation, migration and invasion of NSCLC cell. Furthermore, the xenograft model indicated that miR-126-3p suppressed NSCLC cell growth and lung metastasis by targeting chemokine (C-C motif) receptor 1 (CCR1). In addition, we demonstrated that the over-expression of CCR1 rescued the inhibitory effects of miR-126-3p on NSCLC cells growth, migration and invasion. Finally, knocked-down of CCR1 was able to mimic the inhibitory effects of miR-126-3p on the progression of NSCLC cell.

CONCLUSIONS

These findings indicate that miR-126-3p plays an important role in the growth, migration and invasion of NSCLC by targeting CCR1.

Substandard and falsified medical products are a global public health threat. A pilot survey of awareness among physicians in Sweden

Background

Substandard and falsified medical products are a public health threat, primarily associated with low- and middle-income countries. Today, the phenomenon also exists in high-income countries. Increased Internet access has opened a global market. Self-diagnosis and self-prescription have boosted the market for unregulated websites with access to falsified medicines.

Aim

To describe the state of knowledge and experience on SF medical products among emergency physicians (EPs) and general practitioners (GPs) in Sweden.

Methods

An online survey with anonymous answers from 100 EPs and 100 GPs. Physicians were recruited from TNS SIFO’s medical database. The term in the survey was ‘illegal and falsified medicines’ which was common in Sweden at that time. It corresponds well with the term ‘substandard and falsified medical products’ that the WHO launched shortly after our data collection. We report our results with this term.

Results

In Sweden, 78.5% of the physicians had heard the term ‘illegal and falsified medicines’ and 36.5% had met patients they suspected had taken it. Physicians lacked awareness of the use of the reporting system and wanted more knowledge about how to deal with patients who have possibly used falsified medicines.

Conclusions

To meet the public health threat of SF medical products, physicians need more knowledge.

Preventive intraperitoneal hyperthermic perfusion chemotherapy for patients with T4 stage colon adenocarcinoma

BACKGROUND

Hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to be an effective treatment for peritoneal tumors; whether preventive HIPEC after radical resection for T4 stage colon adenocarcinoma could decrease peritoneal recurrence remains unknown. The aim of the present study was to compare peritoneal recurrence and short-term survival in patients with T4 stage colon adenocarcinoma undergoing HIPEC plus adjuvant chemotherapy or adjuvant chemotherapy alone following surgery.

METHODS

We retrospectively reviewed T4 stage colon adenocarcinoma patients who had radical tumor resection at our institution between January 2014 and January 2019. Clinical data were extracted from the database at our institution, and patient survival and long-term complications were assessed through repeated outpatient examinations and telephone interviews.

RESULTS

A total of 352 patients were included in this study; 157 patients received postoperative HIPEC plus adjuvant chemotherapy (HIPEC group), 195 patients received adjuvant chemotherapy alone (conventional chemotherapy group). Forty-one (26.1%) patients in the HIPEC group had a peritoneal recurrence and the peritoneum was the first site of tumor recurrence in 6 (14.6%) of them. However, 73 (37.4%) patients experienced peritoneal recurrence in the conventional group, and the peritoneum was the first site of tumor recurrence in 25 (34.2%) (p = 0.019). Disease-free survival in the HIPEC group at 1 and 3 years was 93.3% and 61.1%, respectively, versus 89.3% and 51.7% in the conventional chemotherapy group (p = 0.038). Overall survival in the HIPEC group at 1 and 3 years was 100.0% and 82.7%, respectively, versus 100.0% and 76.9% in the conventional chemotherapy group (p = 0.420). The two groups did not differ with respect to severe complications.

CONCLUSIONS

Preventive HIPEC after radical surgery may decrease peritoneal recurrence and promote disease-free survival for T4 stage colon adenocarcinoma. Large-scale randomized controlled studies are needed to confirm the results of our study.

FRI0014 A PUTATIVE ROLE OF IGF-1R ON THE PATHOGENESIS OF GOUT THROUGH BINDING TO TRANSCRIPTION FACTORS

Background:

Recent studies showed that SNPs on IGF-1/IGF-1R were highly associated with hyperuricemia and gout [1,2]. It was shown that the IGF-1/IGF-1R signaling pathway played a role in regulating the serum urate level. By modulating the uric acid transporters, IGF-1/IGF-1R influenced the resorption and secretion of uric acid. However, we demonstrated that the increased activation of IGF1R could activate the mTOR pathway, leading to a higher inflammatory response upon pathogen stimulation [3]. This finding indicates that IGF-1/IGF1-R has a role in inflammation, which could results in gout. The IGF-1/IGF-1R pathway may have an overall influence on both urate transporters and inflammatory pathways. it was shown that IGF-1R was not only expressed on the cell surface, but could also internalize into the nucleus and recruit RNA polymerase, regulating the expression of other transcription factors[4]. These transcription factors have been shown to regulate inflammation and have been predicted to bind promoter regions of urate transporters [5]

Objectives:

To unveil how the IGF-1/IGF1-R associates with hyperuricemia and gout by studying the IGF-1R SNP rs6598541.

Methods:

To assess the influence of the SNP to IGF1-R, the protein expression of IGF-1R on the cell surface was identified by flow cytometry in different genotypes. Additionally, we measured the in vitro immune response of PBMCs with different genotypes upon exposure to MSU and/or LPS. To estimate the overall influence of the SNP on the immune response, we analyzed the SNP’s function on transcription factors.

Results:

We observed an enhanced inflammatory response in the homozygous genotype with the risk alleles upon LPS and/or MSU stimulation, indicative of a higher risk for gout. However, the IGF-1R surface expression level was comparable between different genotypes. Furthermore, in epigenetic analysis, we found that rs6598541 located in an enhancer region, which is bound by c-FOS, c-JUN and other transcription factors. In recent years, c-FOS and c-JUN have been shown to regulate inflammatory responses.

Conclusion:

The risk allele of rs6598541 is associated with a higher inflammatory response, which might be the key factor for gout. Because of the location of the SNP, it might explain the function of IGF-1R in gout, and the pathogenesis might be modulated through transcription factors. According to the recent study, intracellular IGF-1R could act as a transcription factor regulating other transcription factors expression, like c-JUN. Additionally, c-JUN has been shown to regulate inflammatory responses. It is tempting to speculate that IGF-1R regulates transcription factors expression and leads to an overall immune responses, which influence the risk of gout.

References:

[1]Kottgen, A., et al.,Genome-wide association analyses identify 18 new loci associated with serum urate concentrations.Nat Genet, 2013.45(2): p. 145-54.

[2]Mannino, G.C., et al.,The polymorphism rs35767 at IGF1 locus is associated with serum urate levels.Sci Rep, 2018.8(1): p. 12255.

[3]Bekkering, S., et al.,Metabolic Induction of Trained Immunity through the Mevalonate Pathway.Cell, 2018.172(1-2): p. 135-146.e9.

[4]Aleksic, T., et al.,Nuclear IGF1R Interacts with Regulatory Regions of Chromatin to Promote RNA Polymerase II Recruitment and Gene Expression Associated with Advanced Tumor Stage.Cancer Res, 2018.78(13): p. 3497-3509.

[5]Granet, C., W. Maslinski, and P. Miossec,Increased AP-1 and NF-kappaB activation and recruitment with the combination of the proinflammatory cytokines IL-1beta, tumor necrosis factor alpha and IL-17 in rheumatoid synoviocytes.Arthritis Res Ther, 2004.6(3): p. R190-8.

Disclosure of Interests:

Ruiqi Liu: None declared, Orsi Gaal: None declared, Viola Klück: None declared, Tania Crisan: None declared, Stephanie Fanucchi: None declared, Musa Mhlanga: None declared, Leo Joosten Consultant of: SAB member of Olatec Therapeutics LLC

Effects of environment and breed on growth performance and meat quality of fattening pigs

Meat quality is not only influenced by breed but also rearing environment. The aim of this study was to evaluate the influence of different housing environments on growth performance, carcase traits, meat quality, physiological response pre-slaughter and fatty acid composition in two pig breeds. A total of 120 growing pigs at 60–70 days of age were arranged in a 2 × 2 factorial design with the breeds (Duroc × Landrace × Large White [D × L × LW] and Duroc × Landrace × Min pig [D × L × M]) and environmental enrichment (barren concrete floor or enriched with straw bedding) as factors. Each treatment was performed in triplicate with ten pigs per replicate. The pigs housed in the enriched environment exhibited a higher average daily gain, average daily feed intake, saturated fatty acid percentage and backfat depth than the pigs reared in the barren environment. Plasma cortisol levels were lower and growth hormone higher in enriched compared to barren pens. The D × L × M pigs showed lower cooking loss compared with the D × L × LW pigs. Moreover, the D × L × M pigs exhibited poor growth performance but had a better water-holding capacity. Only carcase traits and meat quality interaction effects were observed. We concluded that an enriched environment can reduce pre- slaughter stress and improve the growth performance of pigs and modulate the fatty acid composition of pork products.

P-type laser-doped WSe2/MoTe2 van der Waals heterostructure photodetector

Van der Waals heterostructures (vdWHs) based on two-dimensional (2D) materials are being studied extensively for their prospective applications in photodetectors. As the pristine WSe₂/MoTe₂ heterostructure is a type I (straddling gap) structure, it cannot be used as a photovoltaic device theoretically, although both WSe₂ and MoTe₂ have excellent photoelectric properties. The Fermi level of p-doped WSe₂ is close to its valence band. The p-doped WSe₂/MoTe₂ heterostructure can perform as a photovoltaic device because a built-in electric field appears at the interface between MoTe₂ and p-doped WSe₂. Here, a 633 nm laser was used for scanning the surface of WSe₂ in order to obtain the p-doped WSe₂. x-ray photoelectron spectroscopy (XPS) and electrical measurements verified that p-type doping in WSe₂ is produced through laser treatment. The p-type doping in WSe₂ includes substoichiometric WO_x and nonstoichiometric WSe_x. A photovoltaic device using p-doped WSe₂ and MoTe₂ was successfully fabricated. The band structure, light-matter reactions, and carrier-transport in the p-doped WSe₂/MoTe₂ heterojunction were analyzed. The results showed that this photodetector has an on/off ratio of ≈10⁴, dark current of ≈1 pA, and response time of 72 μs under the illumination of 633 nm laser at zero bias (V _ds = 0 V). The proposed p-doping method may provide a new approach to improve the performance of nanoscale optoelectronic devices.

[Robotic hilar cholangiocarcinoma radical resection compared with laparotomy in prognosis]

Objective: To compare the long term and short term outcomes between robotic and open surgery for hilar cholangiocarcinoma radical resection. Methods: This is a single-center and retrospective case-control study. Patients underwent hilar cholangiocarcinoma radical resection between January 2016 and December 2016 at Department of Hepatobiliary Surgery of the General Hospital of the Chinese People's Liberation Army were included. Safety, effectiveness and long-term prognosis of tumors were evaluated. Patients were divided into robotic hilar cholangiocarcinoma radical surgery group (robotic group, n=16) and open hepatic hilar cholangiocarcinoma radical surgery group (open group, n=31) . All cases were confirmed by pathology histological. Age, gender, histology, resection margin status, extent of surgical resection, disease-free survival (DFS) , and overall survival (OS) were retrospectively collected and analyzed.In the follow-up cohort, the primary outcome was patient death and the secondary outcome was tumor recurrence. Continuous variables were expressed as means and medians and were compared using the Student t test if normally distributed or Wilcoxon-Mann-Whitney test for nonparametric variables. Discrete variables were expressed as frequency and percentages and χ(2) or Fisher exact test, when appropriate, were used for comparisons. Kaplan-Meier curves were used to calculate the probability of survival and comparisons were performed using log-rank test. Results: In this study, compared with the open group, the robotic group had a longer operation time ( (338±71) minutes vs. (256±56) minutes, t=4.251, P=0.001) , but the intraoperative blood loss was less (100 ml vs. 200 ml, Z=121.50, P=0.040) , the gastric tube removal time was earlier (3 days vs. 4 days, Z=136.0, P=0.011) , and the postoperative hospital stay was shorter (9 days vs. 12 days, Z=144.50, P=0.040) , and the difference was statistically significant.There was no significant difference in the blood transfusion rate, R0 resection rate, and tumor size between the two groups.The recurrence rates in the robotic group and open surgery were 53.3% and 67.0%, respectively (χ(2)=1.04, P=0.307) .The median survival time of the robotic group and the open group was 22.0 months and 25.0 months. There was no significant difference in the overall survival rate between the two groups (P>0.05) . Conclusion: Compared with laparotomy, robotic HCC radical resection could have an equivalence or non-inferiority approach with acceptable long-term outcome.

[Analysis of trends on smoking prevalence and its risk factors in Shaanxi province 2007-2015]

Objective: To analyze the trend of smoking prevalence and its risk factors among adults in Shaanxi province from 2007 to 2015. Methods: We used data from China Chronic Disease and Risk Factor Surveillance in 2007, 2010, 2013 and 2015. The current smoking prevalence and trends of the four surveys were calculated. Its risk factors were analyzed by multivariate logistic regression from each survey and then from all pooled data of the three surveys. Results: The number of participants in 2007, 2010, 2013 and 2015 was 1 542, 3 000, 10 166 and 6 330, respectively. The current smoking prevalence dropped from 34.34% in 2007 to 26.22% in 2013, but increased to 28.33% in 2015 (trend χ(2) test: Z=2.53, P=0.01). The results from four pooled data showed that the current smoking prevalence of men was higher than that of women (OR=75.03, 95%CI: 63.57-88.55). The current smoking prevalence of people aged 45-59 was higher than that of people aged 18-44 (OR=1.28, 95%CI: 1.15-1.41). In addition, the current smoking prevalence of those who were educated for 7-9 years and more than 9 years were higher than those who were educated for less than 6 years (people with education for 7-9 years OR=1.44, 95%CI: 1.29-1.61; people with education >9 years OR=1.43, 95%CI: 1.26-1.63). The current smoking prevalence of the single was lower than those of married/cohabitants (OR=0.54, 95%CI: 0.37-0.77). The current smoking prevalence of retirees were lower than those of employees (OR=0.46, 95%CI: 0.38-0.57) and smoking prevalence of alcohol drinkers were higher than those of non-drinkers (OR=2.92, 95%CI: 2.67-3.19). Conclusion: From 2007 to 2015, the current smoking prevalence of Shaanxi population was high and the trends remained stable. It is necessary to strengthen smoking control and health education for men, people over 45 years old, people with education level 7 years and above, and working personnel in Shaanxi province.

High throughput, efficacious gene editing & genome surveillance in Chinese hamster ovary cells

Chinese hamster ovary (CHO) cells are a common tool utilized in bioproduction and directed genome engineering of CHO cells is of great interest to enhance recombinant cell lines. Until recently, this focus has been challenged by a lack of efficacious, high throughput, and low-cost gene editing modalities and screening methods. In this work, we demonstrate an improved method for gene editing in CHO cells using CRISPR RNPs and characterize the endpoints of Cas9 and ZFN mediated genetic engineering. Furthermore, we validate sequence decomposition as a cost effective, rapid, and accurate method for assessing mutants and eliminating non-clonal CHO populations using only capillary sequencing.

Silencing of TPD52 inhibits proliferation, migration, invasion but induces apoptosis of pancreatic cancer cells by deactivating Akt pathway

Pancreatic cancer (PC) is a complex and multifactorial human malignancy with a low survival rate. Tumor protein D52 (TPD52) was abnormally expressed in several cancers and participated in tumorigenesis. However, the oncogenic effect of TPD52 on PC remains unknown. In the present study, after transfecting AsPC-1 and PANC-1 cells with NC or sh-TPD52, the CCK-8 assay, Hoechst staining, western blot, transwell assay, flow cytometry were used to examine the cell proliferation, migration, invasion and apoptosis. qRT-PCR results confirmed that the expression of TPD52 was significantly increased in PC cells, especially AsPC-1 and PANC-1 cells. The present study revealed that silencing of TPD52 significantly suppressed the proliferation, migration and invasion, but induced apoptosis of AsPC-1 and PANC-1 cells in vitro by dephosphorylating Akt at Ser473. Conversely, SC79, an Akt activator, could partially reverse the anti-metastatic effects of sh-TPD52, accompanied by the reactivating of Akt pathway. Additional in vivo studies are warranted to elucidate that knockdown of TPD52 could inhibit tumor growth in PC mice models. These findings suggested that TPD52 might be a novel therapeutic target for PC treatment.

[Analysis on chronic diseases and risk factors of adult residents in Shaanxi province]

Objective: To explore the prevalence of chronic diseases and related risk factors in Shaanxi province. Methods: Multi-stage stratified cluster random sampling was used to collect the sample from permanent residents in 10 national surveillance points in Shaanxi province in 2015. Behavioral risk factors (smoking, drinking, diet and physical activity) were investigated by face-to-face interviews and biological risk factors (BMI, blood pressure, blood glucose and blood lipid) were collected by physical measurements and laboratory tests. Designed weight, no response weight and post hierarchical weight were taken into account in the data analysis. Binary logistic regression models were used to examine the pair-wise associations among 8 risk factors. Results: A total of 6 174 persons were included in the analysis. The following weighted prevalence were noticed in Shaanxi province in 2015, that including current smoking as 28.19%, harmful use of alcohol as 6.20%, inadequate intake of vegetables and fruits as 55.62%, physical inactivity as 19.56%, overweight and obesity as 46.82%, hypertension as 31.12%, raised fasting blood glucose as 4.27%, and raised total cholesterol as 20.96%. Eight risk factors were found to be associated with each other. The mean numbers of risk factors were 2.41 per male and 1.85 per female, 1.94 per urban resident and 2.28 per rural resident. Conclusions: Risk factors for chronic diseases among adults aged 18 or older were more than the national levels in Shaanxi province in 2015. Male and rural residents presented more risk factors than their counterparts. Correlations between risk factors implied that a combined package of interventions was needed to reduce these risk factors.

LncRNA SNHG8 participates in the development of endometrial carcinoma through regulating c-MET expression by miR-152

OBJECTIVE

To investigate the possible function and mechanism of lncRNA SNHG8 in the pathogenesis of endometrial carcinoma.

PATIENTS AND METHODS

We utilized qRT-PCR to detect the expression of SNHG8 in 60 cases of endometrial carcinoma and 25 cases of normal endometrium; after that, the endometrial carcinoma cell lines were screened. SNHG8 was transfected into endometrial carcinoma cells by Lipofectamine and the proliferative activity of cells was detected by cell counting kit-8 (CCK-8) assay. Bioinformatics methods were used to detect the target microRNA. miR-152 is predicted to bind to SNHG8 and target genes of c-MET. Luciferase reporter assay was performed to detect the relative luciferase activity between miR-152 and c-MET, SNHG8. The interactions between SNHG8, miR-152, and c-MET were further verified by transfection of miR-152 mimics, miR-152 mimics + OE-SNHG8, SNHG8 siRNA, and SNHG8 siRNA + miR-152 inhibitor.

RESULTS

SNHG8 expression in endometrial carcinoma tissue was significantly higher than that in normal endometrium. After transfection with SNHG8 siRNA, the cell viability of AN3CA cells decreased, whereas the activity of Ishikawa was increased after transfection with SNHG8 overexpression plasmid. Bioinformatics predictions and dual luciferase reporter assay illustrated that SNHG8 was bound to miR-152 and miR-152 targeted on c-MET. In addition, miR-152 mimics inhibited the expression of c-MET, and the inhibitory effect was reversed after SNHG8 overexpression. Silencing SNHG8 reduced c-MET expression, and c-MET expression was reversed after addition of miR-152 inhibitor.

CONCLUSIONS

SNHG8 is highly expressed in endometrial carcinoma, and SNHG8 targets c-MET through miR-152 to regulate the proliferation of endometrial cancer cells.

Curcumin alleviates isoproterenol-induced cardiac hypertrophy and fibrosis through inhibition of autophagy and activation of mTOR

OBJECTIVE

Curcumin has been reported to possess cardioprotective effects. However, the potential molecular mechanism of curcumin is still not clear. The aim of the present study was to investigate the role of curcumin in regulating autophagy and mammalian target of rapamycin (mTOR) signaling in isoproterenol-induced cardiac hypertrophy and fibrosis in the rat.

MATERIALS AND METHODS

Rats model of cardiac hypertrophy and fibrosis was induced by isoprenaline (5 mg/kg/day, subcutaneous injection), which were treated with or without curcumin (200 mg/kg/day, intragastric administration). Masson's trichrome staining was performed to investigate the effect of curcumin on fibrosis of cardiac hypertrophy rat. The expression of hypertrophic and fibrosis markers was determined by RT-qPCR. The protein expression of autophagic markers, mTOR, and phosphorylated-mTOR (p-mTOR) was performed by Western blotting.

RESULTS

Isoprenaline treatment significantly up-regulated the mRNA expression of hypertrophic (ANP and MYH7) and fibrotic (procollagen I and III) markers in the hearts from rats. All of these markers were reversed by curcumin treatment in isoproterenol-treated rats. Histological analysis showed that curcumin attenuated the interstitial fibrosis of heart triggered by isoproterenol. Moreover, isoproterenol significantly reduced the mRNA levels of mTOR and the protein expression of p-mTOR. However, isoprenaline caused a significant induction of the mRNA levels of LC3 and Beclin-1 and the protein expression of LC3-II and Beclin-1, as well as LC3-II/I ratio. Curcumin abolished these isoprenaline-mediated changes in mTOR/autophagy signaling pathway.

CONCLUSIONS

Our data demonstrated that curcumin targeted mTOR/autophagy axis could attenuate cardiac hypertrophy and fibrosis in a rat model.

Dynamic monitoring of HER2 amplification in circulating DNA of patients with metastatic colorectal cancer treated with cetuximab

PURPOSE

Cetuximab (CTX) has been used to treat metastatic colorectal cancer (mCRC) with wild-type (wt) RAS and BRAF genes. Meanwhile HER2 amplification reportedly denoted CTX-resistant mCRC tumors. We investigated whether monitoring of HER2 amplification in circulating DNA allowed early detection of mCRC progression and CTX resistance.

METHODS

mCRC, who progressed after CTX treatments between July 2015 and January 2018.

RESULTS

Of the 36 patients, 5 (13.9%) exhibited dynamic fluctuations of HER2 amplification in plasma in the course of CTX treatment, of whom 2 were positive for HER2 amplification in matched tumor specimens at baseline (per FISH). All 5 primary sites were left side: 3 rectums and 2 descending colon. HER2 ratio fluctuations in circulating DNA not only reflected changes in tumor volume, but their obvious increases presaged CT-documented progress by an average lead time of 2 months. Interestingly, progression-free survival did not significantly differ between these 5 patients and those without HER2 amplification (HR 1.06, 95% CI 0.40-2.77, P = 0.909).

CONCLUSION

Plasma HER2 amplification detected by ddPCR changed over time and predicted resistance to CTX, by an average lead time of 2 months. Further study is needed to validate our findings.

Seven Novel and Three Known Mutations in FOXL2 in 10 Chinese Families with Blepharophimosis Syndrome

BACKGROUND

Blepharophimosis syndrome (BPES) is characterized by eyelid malformation with occasional premature ovarian failure. Mutations in FOXL2 underlie a fraction of BPES cases.

OBJECTIVE

We aimed to investigate the genetic basis of BPES in 26 Chinese families that included 78 patients.

METHODS

We performed ophthalmological examinations on each family member. We used Sanger sequencing to screen FOXL2 exons and their flanking sequences. We also performed bioinformatics studies, structural modeling and pathogenicity evaluations on all identified variations. Literature was reviewed and genotype-phenotype correlation analysis was performed.

RESULTS

The patients had typical manifestations of BPES. Ten mutations were identified in ten of the twenty-six families. Among these, seven were novel mutations. These included the six truncating mutations, p.Glu69*, p.Gly256Glyfs*14, p.Ala14Serfs*135, p.Pro333Profs*200, p.Pro290Leufs*70, and p.Pro157Profs*91, and one missense mutation, p.Tyr59Cys. The mutations were scattered within the gene, and no mutational hotspots were found. Genotype-phenotype correlation analysis showed that frameshift or nonsense mutations were correlated with type I BPES, while in-frame or missense mutations were associated with type II BPES.

CONCLUSION

We report the largest BPES cohort in China thus far as well as seven novel mutations in FOXL2. The identification of novel mutations has not only expanded the mutational spectrum of the gene (which is valuable for mutation detection-based screening) but also suggests that most mutations within the Chinese population may not have been characterized yet.

The application of dexmedetomidine combined with dezocine in thoracoscopic radical resection of lung cancer and its effect on awakening quality of patients

OBJECTIVE

The paper aims to explore the application of dexmedetomidine combined with dezocine in thoracoscopic radical resection of lung cancer and its effect on the awakening quality.

PATIENTS AND METHODS

122 patients undergoing thoracoscopic radical resection of lung cancer in The Affiliated Hospital of Qingdao University from April 2009 to January 2012 were selected as the subjects of the study. Among them, 68 patients were anesthetized with dexmedetomidine combined with dezocine as a study group, 54 patients with midazolam combined with fentanyl as a control group. The onset of anesthetic, operation time, awakening time, extubation time, and recovery time was compared. The mean arterial pressure (MAP), central venous pressure (CVP), and heart rate (HR) were compared before anesthesia (t0), at extubation (t1), 10 min after extubation (t2), and when patients left anesthesia recovery room (t3). The postoperative sedation score (Ramsay), modified the objective pain score (MOPS), and the pediatric anesthesia emergence delirium (PAED) score were compared at the time of the postoperative awakening (b1), 30 min after awakening (b2), 1 hour after awakening (b3), and 3 hours after awakening (b4).

RESULTS

There was no significant difference in MAP, CVP, and HR between the study group and the control group at t0 (p > 0.05). The scores of PAED at b3 and b4 in the study group were lower than those in the control group (p < 0.05).

CONCLUSIONS

The anesthesia effect of dexmedetomidine combined with dezocine in thoracoscopic radical resection of lung cancer is better and safer than other drugs, and it can produce good sedation and analgesic effect.