Targeted inhibition of β-catenin by miR-320 and decreased MMP-13 expression in suppressing chondrocyte collagen degradation

OBJECTIVE

Wnt/β-catenin pathway plays a critical role in modulating embryonic development, cell growth, and differentiation. The over-expression of β-catenin activates this pathway and up-regulates expression of matrix metalloproteinase-13 (MMP-13), and promotes matrix degradation and occurrence of osteoarthritis (OA). This study aims to explore the effect of miR-320 expression in OA chondrocyte and underlying mechanisms.

PATIENTS AND METHODS

Chondrocyte tissues from OA patients and normal individuals were collected for the detection of expression levels of miR-320, β-catenin, MMP-13, and alpha-1 chain of type II collagen (COL2A1). Dual luciferase reporter assay was performed to test targeted regulation between miR-320 and β-catenin. IL-1β was used to simulate in vitro cultured chondrocytes, which were transfected with miR-320 mimic and/or si-β-catenin, followed by quantification of miR-320, β-catenin, MMP-13, and COL2A1.

RESULTS

In chondrocytes of OA patients, expression of microRNA (miR)-320 is decreased. Bioinformatics analysis revealed complementary binding sites between miR-320 and β-catenin. Compared to control group, increasing levels of β-catenin and MMP-13 expression with reduction of miR-320 and COL2A1 expressions were observed in OA chondrocytes. Transfection of miR-320 mimic and/or si-β-catenin depressed expression of β-catenin and MMP-13 inside chondrocytes, accompanied with elevation of COL2A1 expression.

CONCLUSIONS

MiR-320 expression in OA chondrocyte is decreased, accompanied with up regulation of β-catenin and MMP-13. MiR-320 can inhibit β-catenin and MMP-13 expressions, elevates COL2A1 expression, which provides novel insights for the treatment of osteoarthritis.

[Prediction model for survival in patients with biliary tract cancer: a development and validation study]

Objective: The aim of the present study was to investigate the survival rate and its prognostic factors for patients with biliary tract cancer, and then a prognostic risk prediction model was constructed to predict the survival probability of patients. Methods: A total of 14 005 patients with biliary tract cancer (including gallbladder cancer, extrahepatic bile duct cancer, and ampulla of Vater cancer), who were diagnosed between 2010 and 2015 in the US National Cancer Institute Surveillance, Epidemiology, and End Results Program (SEER) were included in the development cohort. The prognostic risk factors of biliary tract cancer were investigated using multivariate Cox regression models. The predictive nomograms were then constructed to predict the overall survival probability of 1, 3, and 5 years, and the predictive discrimination and calibration ability of the nomograms were further evaluated. Meanwhile, 11 953 patients who were diagnosed during 2004 to 2009 from SEER Program were then selected to validate the external predictive accuracy of the prediction models. Results: The 1, 3 and 5-year cumulative survival rates of patients with biliary tract cancer were 41.9%, 20.4% and 15.3%, respectively, in the development cohort. Age greater than 50 years, African Americans and Native Americans and Alaska Natives, higher T, N and M stage and poor histological differentiation grade were risk factors for death, while married status, Asia-Pacific Islanders, insured status and surgery on primary site were protective factors. Gender was not significantly associated with the overall survival. The C statistic of the prediction model was 0.73 (95%CI: 0.72-0.74), and the calibration curve showed that the interaction curves of predictive and actual survival rates of 1, 3 and 5 years were close to the 45 degree diagonal. Results in the validation cohort were similar with those in the construction cohort, with a C statistic of 0.70 (95%CI: 0.69-0.72), indicating high external applicability of the prediction model. Findings from gallbladder cancer, extrahepatic bile duct cancer, and ampulla of Vater cancer are in consistent with the overall biliary tract cancer. Conclusions: The survival rate of patients with biliary tract cancer is relatively poor, and the survival prediction model based on prognostic factors has high prediction accuracy. In the future, this prognostic prediction model could be applied to clinical practice to guide individualized treatment for patients with biliary tract cancer.

Cell migration and osteo/odontogenesis stimulation of iRoot FS as a potential apical barrier material in apexification

AIM

To investigate the in vitro biological effects of a nanoparticle bioceramic material, iRoot Fast Set root repair material (iRoot FS), on the proliferation, migration and osteo/odontogenic differentiation of human stem cells from the apical papilla (hSCAP), and to further explore the mechanism involved in osteo/odontogenic induction of iRoot FS.

METHODOLOGY

hSCAP were isolated and characterized in vitro. iRoot FS conditioned medium were prepared and used to treat hSCAP, while using mineral trioxide aggregate (MTA) conditioned medium as the positive control and regular medium as the negative control. MTT assay and BrdU labelling assay were performed to determine cell proliferation. Wound healing assay and transwell assay were conducted to evaluate cell migration. The osteo/odontogenic differentiation of hSCAP was evaluated by qPCR, Western blot and Alizarin red S staining. Wnt inhibitor was used for downregulating the expression level of β-catenin of hSCAP.

RESULTS

The cell proliferation of hSACP in the iRoot FS group was not significantly different compared with the control groups. The cell migration of hSCAP in the iRoot FS group was significantly increased than the MTA and negative control groups (P < 0.01). The expression levels of osteo/odontogenic markers and mineralization nodule formation of hSCAP in the iRoot FS group were significantly elevated (P < 0.01). Furthermore, iRoot FS enhanced the osteo/odontogenic differentiation of hSCAP by activating Wnt/β-catenin signalling.

CONCLUSIONS

iRoot FS promoted the cell migration of hSCAP and enhanced their oseto/odontogenesis potential via the Wnt/β-catenin pathway without cytotoxicity. iRoot FS had satisfactory biological properties and has potential to be used as an apical barrier in apexification or as a coronal sealing material in regenerative endodontic treatment.

Free fatty acids mediates human umbilical vein endothelial cells inflammation through toll-like receptor-4

OBJECTIVE

To investigate the role of Toll-like receptor-4 (TLR4) in the free fatty acids (FFAs) induced human umbilical vein endothelial cells (HUVECs) inflammation and to explore the underlying mechanisms.

MATERIALS AND METHODS

HUVECs and HEK293 cell lines were obtained from Shanghai Type Culture Collection. Cell counting kit-8 (CCK8) and flow cytometry (FCM) were performed to examine the cell viability and apoptosis rate of HUVECs induced by FFAs treatments with or without infection of toll-like receptor-4 interference (TLR4i) adenovirus. Enzyme-linked immunosorbent assay (ELISA) was performed to evaluate the inflammatory cytokines release. Quantitative polymerase chain reaction (qPCR) and Western Blot (WB) were used to test the molecular mechanisms of inflammation.

RESULTS

FFAs induced inflammatory responses in HUVECs via modulating the TLR4 receptor complex. TLR4i adenovirus interference increased cell viability and decreased cell apoptosis rate. FFAs treatments significantly increased the expressions of inflammatory cytokines interleukin-6 (IL-6), interleukin-8 (IL-8), C-C motif chemokine ligand 5 (CCL5) and CXC chemokine ligand 10 (CXCL10), while TLR4i adenovirus interference significantly reduced these cytokines levels. TLR4-mediated myeloid differential protein-88 (MyD88) expression activating the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and inhabiting kappa B kinase-beta (IKK-β). TLR4i adenovirus interference decreased the expressions of these genes at both mRNA level and protein level.

CONCLUSIONS

TLR4 mediates FFAs induced inflammatory responses in HUVECs. TLR4 interference in HUVECs significantly reduces the inflammatory cytokines expression, decreases the cell apoptosis rate and increases cell viability.

MicroRNA-338 inhibits proliferation, migration, and invasion of gastric cancer cells by the Wnt/β-catenin signaling pathway

OBJECTIVE

Emerging evidence suggests aberrant microRNAs (miRNAs) expression is involved in cancer development through multiple. Although miR338 has shown to have tumor suppression ability and anti-migration effects in some cancers, its regulatory role and molecular mechanism in the development of gastric cancer cells yet remains little known. This work aims to investigate miR-338 in regulating Wnt/β-catenin pathway in epithelial-mesenchymal transition (EMT) in gastric cancers.

MATERIALS AND METHODS

Human gastric cancer cells were transfected with either miR-338 mimic or erythropoietin-producing hepatocellular (Eph)A2-targeting siRNA. The biological function of miR-338 in gastric cancer cells was investigated using a MTT assay and invasion assay. Western blot assay was used to measure the levels of EphA2, GSK-3β, phospho-GSK-3βSer9, c-Myc, E-cadherin, Vimentin, and β-catenin of at protein level.

RESULTS

Our data showed that miR-338 inhibited proliferation, migration and invasion of human gastric cancer cells. miR-338 affected the Wnt/β-catenin pathway by increasing p-GSK-3βSer9 and decreasing GSK-3βSer9 and c-Myc at protein levels. EphA2 protein level was downregulated and positively correlated with EMT markers. Both silencing of EphA2 and transfection with miR-338 mimic resulted in the up-regulation of the EMT molecular marker E-cadherin and down-regulation of Vimentin and β-catenin at protein levels.

CONCLUSIONS

This study indicated that miR-338 is a potential tumor suppressor in gastric cancer and miR-338 inhibited EMT of gastric cancer cells through deactivation of Wnt/β-catenin signaling targeting at EphA2.

Current status of scoliosis school screening: targeted screening of underserved populations may be the solution

OBJECTIVES

The growing body of evidence documenting the effectiveness of brace treatment for scoliosis has renewed interest in potential benefits of early detection through school screening. We aimed to assess the prevalence and identify barriers of screening. We hypothesized that school screening is more frequent in schools that have a nurse on staff compared to schools without nurse on staff.

STUDY DESIGN

A questionnaire survey.

METHODS

All schools located in four counties in Louisiana, United States of America comprising the New Orleans metropolitan area between September 2015 and January 2016 were contacted by phone to assess rates of scoliosis screening, report the availability of a school nurse, and specify barriers if screening was not performed.

RESULTS

Two hundred and ninety-one schools responded to the survey including 152 public, 30 charter, and 109 private schools (101 had religious affiliation). A staff nurse was available in 180 schools (61.8%). Only 21 schools (7.2%) performed scoliosis screening. The majority were charter schools (11 schools), while six were private and four were public (P < 0.0001). Of these 21 schools, 16 (76.2%) had a nurse on staff while five schools did not (P = 0.16). Lack of a referral pathway in the event of a positive screen was the most common barrier to performing scoliosis screening.

CONCLUSION

Scoliosis screening is infrequent in the examined school districts. Efforts to support school screening can facilitate clear referral pathways for schools in the event of a positive screen. These findings suggest a potential need for different pathway of scoliosis screening. Pediatricians and family physicians can assist with scoliosis screening during the annual visit. While universal screening is overburdensome and likely unnecessary, targeted screening of underserved populations may prove to be beneficial. Further investigation should include assessment of the economic viability of targeted screening programs.

LEVEL OF EVIDENCE

IV.

RNA binding activates RIG-I by releasing an autorepressed signaling domain

The retinoic acid-inducible gene I (RIG-I) innate immune receptor is an important immunotherapeutic target, but we lack approaches for monitoring the physical basis for its activation in vitro. This gap in our understanding has led to confusion about mechanisms of RIG-I activation and difficulty discovering agonists and antagonists. We therefore created a novel fluorescence resonance energy transfer-based method for measuring RIG-I activation in vitro using dual site-specific fluorescent labeling of the protein. This approach enables us to measure the conformational change that releases the signaling domain during the first step of RIG-I activation, making it possible to understand the role of stimulatory ligands. We have found that RNA alone is sufficient to eject the signaling domain, ejection is reversible, and adenosine triphosphate plays but a minor role in this process. These findings help explain RIG-I dysfunction in autoimmune disease, and they inform the design of therapeutics targeting RIG-I.

Small form factor, flexible, dual-modality handheld probe for smartphone-based, point-of-care oral and oropharyngeal cancer screening

Oral cancer is a growing health issue in low- and middle-income countries due to betel quid, tobacco, and alcohol use and in younger populations of middle- and high-income communities due to the prevalence of human papillomavirus. The described point-of-care, smartphone-based intraoral probe enables autofluorescence imaging and polarized white light imaging in a compact geometry through the use of a USB-connected camera module. The small size and flexible imaging head improves on previous intraoral probe designs and allows imaging the cheek pockets, tonsils, and base of tongue, the areas of greatest risk for both causes of oral cancer. Cloud-based remote specialist and convolutional neural network clinical diagnosis allow for both remote community and home use. The device is characterized and preliminary field-testing data are shared.

Propionate alleviates high-fat diet-induced lipid dysmetabolism by modulating gut microbiota in mice

AIMS

The aims were to examine whether oral sodium propionate supplementation regulate lipid metabolism through modulating gut microbiota.

METHODS AND RESULTS

ICR male mice (26·98 ± 0·30 g) were randomly assigned to three groups (n = 10) and fed control diet (Con), high-fat diet (HFD) and HFD plus propionate (Pro) respectively. In this study, we found that HFD increased the weight of final body, inguinal white adipose tissues (iWAT), epididymal white adipose tissue (eWAT) and perirenal white adipose tissue (pWAT), as well as the adipocyte mean area of iWAT and eWAT in mice (P < 0·05), whereas sodium propionate treatment reduced the weight of iWAT and pWAT as well as adipocyte mean area of iWAT in mice fed a HFD (P < 0·05). Moreover, in the iWAT, the mRNA expression of lipogenesis genes, including peroxisome proliferator activated receptor γ, acetyl-CoA carboxylase and carnitine palmitoyl transferase-1β, was upregulated by HFD challenge (P < 0·05), and the elevation of these genes was nearly reversed to the level of control diet-fed mice by sodium propionate treatment. Meanwhile, sodium propionate treatment increased the hormone-sensitive lipase mRNA expression in the iWAT of HFD-fed mice (P < 0·05). High-throughput pyrosequencing of the 16S rRNA demonstrated that sodium propionate treatment significantly recovered the gut microbiota dysbiosis in HFD-fed mice, including the richness and diversity of microbiota and the ratio of Firmicutes to Bacteroidetes. Furthermore, the HFD-induced reductions in colonic levels of butyrate and valerate were reversed by sodium propionate treatment, which also normalized the serum LPS level seen in HFD-fed mice to the levels of the control diet-fed mice.

CONCLUSIONS

Collectively, these results indicated that sodium propionate treatment could improve lipid metabolism in HFD-fed mice, and the potential mechanisms might be via regulating gut microbiota.

SIGNIFICANCE AND IMPACT OF THE STUDY

We demonstrated for the first time that oral sodium propionate significantly improved HFD-induced dysbiosis of gut microbiota, indicating that the mitigative effect of propionate for HFD-induced lipid dysmetabolism might be mediated by gut microbiota in mice.

[Evaluation of CT angiography vascular localization combined with refined three-dimensional printing in guiding the resection and reconstruction of complex oral cancer]

Objective: To evaluate the effect of vascular localization using computerized tomography angiography (CTA) combined with refined three dimensional (3D) printing in guiding the resection and reconstruction of complex oral cancer. Methods: From December 2013 to July 2017, the clinical data of 30 patients with complex oral cancer enrolled in the Hunan Cancer Hospital were retrospectively analyzed. 15 patients received CTA+ 3D assisted surgery, while the other 15 patients underwent traditional surgery. In CTA+ 3D assisted surgery group, CT and Magnetic Resonance Imaging (MRI) data were combined with CTA to print refined solid 3D model and surgical guide plate. The preoperative and intraoperative virtual surgical system and the operative experience were combined for preoperative evaluation and surgery. In traditional surgery group, preoperative evaluation and surgery were performed according to imaging data and surgeons' clinical experience. Operative time, intraoperative blood loss, hospital stay and local recurrence rate were compared between the two groups. Results: In CTA+ 3D assisted surgery group, one patient gave up surgical treatment after intuitively watching the lesion through the 3D model, and the remaining 14 patients underwent surgery as planned. All the 15 patients in traditional surgery group received surgery. But the preoperative plans of three patients were temporarily and passively modified due to insufficient preoperative evaluation. The average intraoperative blood loss was(320.1±27.2)ml in CTA+ 3D assisted surgery group and(430.2±30.3)ml in traditional surgery group. Mean operation time was(440.3±19.2)min and(552.2±23.3)min, respectively. Mean hospitalization time was (20.4±3.2)d and (25.1±3.7)d, respectively. The differences were all statistically significant (all P<0.05). 1 year and 3 years local recurrence rates were 9.1% and 28.6% in CTA+ 3D assisted surgery group, as well as 14.3% and 50.4% in traditional surgery group with statistical significance (P<0.05). Conclusion: For complex oral cancer patients with difficulty in opening the mouth or postoperative recurrence, CTA vascular localization combined with fine 3D printing technology has significant advantages in the surgical process, surgical effect and postoperative evaluation index compared with traditional method using imaging data and clinical experience.

[Analysis of prognostic factors for hyperamylasemia following pancreaticoduodenectomy]

Objective: To investigate the prognostic factors of hyperamylasemia following pancreaticoduodenectomy (PD) . Methods: Clinical data of 359 patients were collected prospectively who underwent PD by the same group at Changhai Hospital of Navy Medical University from January 2017 to June 2018.There were 212 males and 147 females.The median age was 63 years old (range: 23 to 82 years old) .According to whether the patient's serum amylase was greater than 120 U/L at 0 or 1 day after surgery,the patients were divided into hyperamylasemia group and non-hyperamylasemia group. Univariate analysis and multivariate analysis were used to find out the prognostic factors of hyperamylasemia after PD. Results: Of the 359 patients, 238 cases (66.3%) developed hyperamylasemia.The incidence rate of clinically related pancreatic fistula (15.1% vs.2.5%, P<0.01) , grade B/C post pancreatectomy hemorrhage (8.8% vs. 2.5%, P<0.01) , and surgical site infection (9.2% vs. 3.3%, P=0.04) was significantly higher in the hyperamylasemia group.The severity of complications (CD grade≥Ⅲ: 11.3% vs.4.1%, P=0.023) and postoperative hospital stay (11 days vs. 9 days, P=0.001) were higher in the hyperamylasemia group.In the multivariate analysis, the main pancreatic duct diameter (MPD) ≤3 mm (OR=4.469, 95% CI: 2.563-7.793, P<0.01) , pathological type of disease (pancreatic cancer or pancreatitis) (OR=0.230, 95% CI: 0.122-0.436, P<0.01) and soft texture of pancreas (OR=3.297, 95%CI: 1.930-5.635, P<0.01) were independent prognostic factors for hyperamylasemia. Conclusions: Post-PD hyperamylasemia increased the incidence and severity of postoperative complications after PD.MPD≤3 mm, soft texture of pancreas and pathological type of disease were independent prognostic factors of hyperamylasemia.

Regulatory Mechanisms of Soft Palate Development and Malformations

Orofacial clefting is the most common congenital craniofacial malformation, appearing in approximately 1 in 700 live births. Orofacial clefting includes several distinct anatomic malformations affecting the upper lip and hard and soft palate. The etiology of orofacial clefting is multifactorial, including genetic or environmental factors or their combination. A large body of work has focused on the molecular etiology of cleft lip and clefts of the hard palate, but study of the underlying etiology of soft palate clefts is an emerging field. Recent advances in the understanding of soft palate development suggest that it may be regulated by distinct pathways from those implicated in hard palate development. Soft palate clefting leads to muscle misorientation and oropharyngeal deficiency and adversely affects speech, swallowing, breathing, and hearing. Hence, there is an important need to investigate the regulatory mechanisms of soft palate development. Significantly, the anatomy, function, and development of soft palatal muscles are similar in humans and mice, rendering the mouse an excellent model for investigating molecular and cellular mechanisms of soft palate clefts. Cranial neural crest-derived cells provide important regulatory cues to guide myogenic progenitors to differentiate into muscles in the soft palate. Signals from the palatal epithelium also play key roles via tissue-tissue interactions mediated by Tgf-β, Wnt, Fgf, and Hh signaling molecules. Additionally, mutations in transcription factors, such as Dlx5, Tbx1, and Tbx22, have been associated with soft palate clefting in humans and mice, suggesting that they play important regulatory roles during soft palate development. Finally, we highlight the importance of distinguishing specific types of soft palate defects in patients and developing relevant animal models for each of these types to improve our understanding of the regulatory mechanism of soft palate development. This knowledge will provide a foundation for improving treatment for patients in the future.

The shape change index (SCI) of inferior vena cava (IVC) measuring by transabdominal ultrasound to predict the presence of septic shock in intensive care unit (ICU) patients

OBJECTIVE

This study is designed as prospective and observational research of patients with sepsis. It was carried out in the intensive care unit (ICU). We investigated the shape change index (SCI) of inferior vena cava (IVC) measured with trans-abdominal ultrasound to detect the signs of septic shock. The aim of this research was to find the most effective tool in predicting shock in patients compared with that of other parameters such as brain natriuretic peptide (BNP), lactate, variation index of inferior vena cava IVC-VI, and extravascular lung water index (EVLWI).

PATIENTS AND METHODS

We suppose that SCI can be used as the safest and most sensitive tool in the early recognition of septic dysfunction. The observational study was conducted in the Department of ICU, Shandong Provincial Hospital Affiliated to Shandong University from January 2016 to December 2017. SCI of IVC, serum lactate, BNP, IVC-VI, and EVLWI concentrations were measured in 30 sepsis patients. All studied biomarkers were analyzed and contrasted according to the score of the Sequential Organ Failure Assessment (SOFA). Pearson correlation analysis was analyzed to statistic the relationship between variables.

RESULTS

We showed the correlation of BNP value, lactic acid value, IVC-VI, EVLWI, and SCI of IVC in sick patients suffering septic shock. Positive correlation was observed in the BNP value, lactic acid value, IVC-VI, EVLWI, and SCI of IVC (r=0.447, p=0.013; r=0.484, p=0.007; r=0.423, p=0.023; r=0.638, p<0.001; r=0.599, p<0.001; respectively). However, the SCI and EVLWI showed a stronger correlation with the SOFA than the others. SCI of IVC, as estimated by transabdominal ultrasound, was more accurate than the other commonly used non-invasive predictors. EVLWI, as an accurate and classical predictor, was an invasive predictor. SCI of IVC was faster, more convenient and safer than the other.

CONCLUSIONS

SCI of IVC was faster, more convenient and safer than the other commonly used non-invasive predictors. Early recognition and diagnosis of sepsis may improve patient outcome.

[Discussion on implementation of public health standards adopted in centers for disease control and prevention]

As the most important phase in standardization activity, implementation saves as the essence. CDC in China are the major institutions undertaking disease control and prevention. Implementing the standards of public health provides technical basis for CDC to complete the task of disease control and prevention. In the study, spot conversation and questionnaire were used to investigate the implementation of standards on public health in CDC. Results showed that the staff of CDC got to know the standards through the Internet. The departments of CDC which conducted training and sent staff to attend training courses accounted for 50.00%(25/50) and 34.00%(17/50), respectively. State mandatory rule is still the main reason for relevant departments to implement the standards of the public health. Government promotion activities facilitate the implementation of Standards, and the degree of familiarity with Standards affects the implementation as well. The paper summarizes the existing problems, such as the lack of coordination between departments of public health at provincial level or below, lack of access to standards, and the need to strengthen the training of the standard implementation etc. It puts forward some suggestions to strengthen the implementation of public health Standards.

Observation of second sound in graphite at temperatures above 100 K

Wavelike thermal transport in solids, referred to as second sound, is an exotic phenomenon previously limited to a handful of materials at low temperatures. The rare occurrence of this effect restricted its scientific and practical importance. We directly observed second sound in graphite at temperatures above 100 kelvins by using time-resolved optical measurements of thermal transport on the micrometer-length scale. Our experimental results are in qualitative agreement with ab initio calculations that predict wavelike phonon hydrodynamics. We believe that these results potentially indicate an important role of second sound in microscale transient heat transport in two-dimensional and layered materials in a wide temperature range.

Electronic structure of multiferroic BiFeO3: Electron energy-loss spectroscopy and first-principles study

The electronic structure of BiFeO₃ has been investigated by using electron energy loss spectrum and first-principle calculations. Assignments of the individual interband transitions have been accomplished by comparing the interband transition energy with the calculated PDOS. The DOS is mainly divided into two regions, the hybridized region of O 2p with Fe 3p in the valence band and that of O 2p hybridized with Bi 6p in the conduction band. From the simulation of high energy-loss near-edge structure, the core-hole effect is believed to be more significant. The feature groups for the experimental spectra of O K-edge and Fe L_2,3-edge are consistent with simulation results.

Regulatory T cells are an important prognostic factor in breast cancer: a systematic review and meta-analysis

The clinical relevance of regulatory T cell (Treg) infiltration in breast cancer (BC) remains controversial, and no recent meta-analysis has been published on this subject. Our aim was to identify the precise relationship between Tregs and the prognosis and clinic-pathological features of BC. Eligible articles were identified with a MEDLINE database search over a period up to March 2015. Our meta-analysis was performed using STATA software 11.0 and Review Manager 5.3. The correlations between Treg infiltration and clinico-pathological features and BC prognosis were analyzed. Subgroup and sensitivity analyses, as well as meta-regression, were conducted. Eighteen published studies (including 8,562 patients) were eligible. Overall survival (OS) and disease-, recurrence-, and progression-free survival (DFS/RFS/PFS) were correlated with Treg infiltration (OR=2.03 (95% CI, 1.40-2.95; P=0.000) and 1.48 (95% CI, 1.00-2.19; P=0.050), respectively), including 3-, 5-, and 10-year mortality rates. In addition, low Treg infiltration was present in estrogen receptor (ER)-positive tumors (P=0.000), progesterone receptor (PR)-positive tumors (P=0.003), Her2-negative tumors (P=0.000) and histological grade I/II tumors (P=0.001). No publication bias was observed with the exception of OS. Subgroup analysis suggested that the mortality rate of the high Treg infiltration subgroup was increased compared with the low Treg infiltration subgroup among ER-positive patients. Treg infiltration indicated a poorer prognosis for BC and is related to ER, PR, and Her2 status and histological grade. Thus, Treg infiltration could help predict outcomes and guide clinical therapy.

Dual antiplatelet therapy reduced stroke risk in high-risk patients with transient ischaemic attack assessed by ABCD3-I score

BACKGROUND AND PURPOSE

Several clinical trials have demonstrated that dual antiplatelet therapy (DAPT) benefited patients with transient ischaemic attack (TIA) with an ABCD2 score ≥4. The present study aimed to investigate whether the ABCD3-I score could be a more appropriate tool for selection of patients with TIA to receive DAPT in real-world settings.

METHODS

We derived data from the TIA database of The First Affiliated Hospital of Zhengzhou University. The predictive outcome was ischaemic stroke at 90 days. The additive interaction effect was presented by the attributable proportion due to interaction. Kaplan-Meier curves were plotted to present cumulative stroke rates in different risk categories with monotherapy and DAPT. Cox proportional hazards regression was used to determine risk factors associated with stroke.

RESULTS

Among 785 patients, the mean (SD) age was 56.95 (12.73) years and 77 patients (9.8%) had an ischaemic stroke at 90 days. A total of 55.8% of patients (attributable proportion due to interaction; 95% confidence interval, 20.8%-90.9%) were attributed to additive interaction of ABCD3-I score and antiplatelet therapy. Kaplan-Meier curves showed a significant difference between patients receiving monotherapy and DAPT in high-risk patients with TIA (P = 0.021). DAPT reduced 90-day stroke risk in high-risk patients with TIA as assessed independently by ABCD3-I score (adjusted hazard ratio, 0.43; 95% confidence interval, 0.20-0.92, P = 0.031). The benefit did not exist in low- and medium-risk patients by ABCD3-I score (patients with ABCD2 score ≥ 4 or <4).

CONCLUSIONS

High-risk patients with TIA assessed by ABCD3-I score received the most pronounced clinical benefit from early use of DAPT in real-world clinical experience.

Point-of-care, smartphone-based, dual-modality, dual-view, oral cancer screening device with neural network classification for low-resource communities

Oral cancer is a growing health issue in a number of low- and middle-income countries (LMIC), particularly in South and Southeast Asia. The described dual-modality, dual-view, point-of-care oral cancer screening device, developed for high-risk populations in remote regions with limited infrastructure, implements autofluorescence imaging (AFI) and white light imaging (WLI) on a smartphone platform, enabling early detection of pre-cancerous and cancerous lesions in the oral cavity with the potential to reduce morbidity, mortality, and overall healthcare costs. Using a custom Android application, this device synchronizes external light-emitting diode (LED) illumination and image capture for AFI and WLI. Data is uploaded to a cloud server for diagnosis by a remote specialist through a web app, with the ability to transmit triage instructions back to the device and patient. Finally, with the on-site specialist's diagnosis as the gold-standard, the remote specialist and a convolutional neural network (CNN) were able to classify 170 image pairs into 'suspicious' and 'not suspicious' with sensitivities, specificities, positive predictive values, and negative predictive values ranging from 81.25% to 94.94%.

Phonon localization in heat conduction

Nondiffusive phonon thermal transport, extensively observed in nanostructures, has largely been attributed to classical size effects, ignoring the wave nature of phonons. We report localization behavior in phonon heat conduction due to multiple scattering and interference events of broadband phonons, by measuring the thermal conductivities of GaAs/AlAs superlattices with ErAs nanodots randomly distributed at the interfaces. With an increasing number of superlattice periods, the measured thermal conductivities near room temperature increased and eventually saturated, indicating a transition from ballistic to diffusive transport. In contrast, at cryogenic temperatures the thermal conductivities first increased but then decreased, signaling phonon wave localization, as supported by atomistic Greenșs function simulations. The discovery of phonon localization suggests a new path forward for engineering phonon thermal transport.

Automatic classification of dual-modalilty, smartphone-based oral dysplasia and malignancy images using deep learning

With the goal to screen high-risk populations for oral cancer in low- and middle-income countries (LMICs), we have developed a low-cost, portable, easy to use smartphone-based intraoral dual-modality imaging platform. In this paper we present an image classification approach based on autofluorescence and white light images using deep learning methods. The information from the autofluorescence and white light image pair is extracted, calculated, and fused to feed the deep learning neural networks. We have investigated and compared the performance of different convolutional neural networks, transfer learning, and several regularization techniques for oral cancer classification. Our experimental results demonstrate the effectiveness of deep learning methods in classifying dual-modal images for oral cancer detection.