A Nomogram for Predicting Cancer-Specific Survival of Patients with Gastrointestinal Stromal Tumors

Background

The aim of this study was to construct a nomogram to predict the prognosis of patients with gastrointestinal stromal tumor (GIST).

Material/Methods

We enrolled 4086 GIST patients listed in the SEER database from 1998 to 2015. They were separated to 2 groups: an experimental group (n=2862) and a verification group (n=1224). A nomogram was constructed by using statistically significant prognostic factors.

Result

A nomogram that included age, sex, marital status, tumor location, grade, SEER stage, tumor size, and surgical management was developed. It can be used to predict overall survival (OS), while adding AJCC 7^th TNM stage can predict cancer-specific survival (CSS). The C-index used to forecast OS and CSS nomograms was 0.778 (95% CI, 0.76–0.79) and 0.818 (95% CI, 0.80–0.84), respectively.

Conclusions

The nomogram can effectively predict 3- and 5-year CSS in patients with GIST, and its use can improve clinical practice.

MSIsensor-pro: Fast, Accurate, and Matched-normal-sample-free Detection of Microsatellite Instability

Microsatellite instability (MSI) is a key biomarker for cancer therapy and prognosis. Traditional experimental assays are laborious and time-consuming, and next-generation sequencing-based computational methods do not work on leukemia samples, paraffin-embedded samples, or patient-derived xenografts/organoids, due to the requirement of matched normal samples. Herein, we developed MSIsensor-pro, an open-source single sample MSI scoring method for research and clinical applications. MSIsensor-pro introduces a multinomial distribution model to quantify polymerase slippages for each tumor sample and a discriminative site selection method to enable MSI detection without matched normal samples. We demonstrate that MSIsensor-pro is an ultrafast, accurate, and robust MSI calling method. Using samples with various sequencing depths and tumor purities, MSIsensor-pro significantly outperformed the current leading methods in both accuracy and computational cost. MSIsensor-pro is available at https://github.com/xjtu-omics/msisensor-pro and free for non-commercial use, while a commercial license is provided upon request.

PPLS/D: Parallel Pareto Local Search Based on Decomposition

Pareto local search (PLS) is a basic building block in many metaheuristics for a multiobjective combinatorial optimization problem. In this paper, an enhanced PLS variant called parallel PLS based on decomposition (PPLS/D) is proposed. PPLS/D improves the efficiency of PLS using the techniques of parallel computation and problem decomposition. It decomposes the original search space into L subregions and executes L parallel processes searching in these subregions simultaneously. Inside each subregion, the PPLS/D process is guided by a unique scalar objective function. PPLS/D differs from the well-known two phase PLS in that it uses the scalar objective function to guide every move of the PLS procedure in a fine-grained manner. In the experimental studies, PPLS/D is compared against the basic PLS and a recently proposed PLS variant on the multiobjective unconstrained binary quadratic programming problems and the multiobjective traveling salesman problems with, at most, four objectives. The experimental results show that regardless of whether the initial solutions are randomly generated or generated by heuristic methods, PPLS/D always performs significantly better than the other two PLS variants.

[The humor characteristics of young epileptic patients and its correlation with depression]

Objective: To explore the characteristics of humor in young adult epileptic patients and examine the relationship between humor and depression. Methods: We recruited 55 young adult epileptic patients who visited outpatient clinic of the Department of Neurology of Yijishan Hospital of Wannan Medical College between October 2018 and March 2019 and 44 healthy controls to complete the multidimensional humor scale (MSHS), humor style questionnaire (HSQ) and Beck depression scale-Ⅱ (BDI-Ⅱ), and compared their differences between the two groups. Results: The results showed that the young adult patients with epilepsy (PWEs) were affected in humor creation, coping with humor and the totally scores of MSHS. The scores of humor creation, coping with humor and the totally scores of MSHS in the young epilepsy patients were 25.3±5.9, 16.7±5.0 and 61±10, which were significantly lower than those in the control group 29.8±6.1, 21.1±2.6 and 71±8. As for the humor style, self-defeating humor scores in PWEs were higher than controls 14±5 vs 9±3, and the self-enhancing humor scores were lower than controls 18±7 vs 23±6. The scores of BDI-Ⅱ in PWEs were significantly higher than those of normal controls 13±7 vs 6±4. Pearson's correlation test showed that the scores of BDI-Ⅱ were negatively correlated with humor creation, coping with humor, the totally scores of MSHS and self-enhancing humor scores (r=-0.566--0.721, P<0.05), while it was positively correlated with self-defeating humor scores (r=0.818, P<0.05). Among the clinically relevant factors, the scores of BDI-Ⅱ were correlated with seizure control and gender. Multiple stepwise linear regression showed that coping with humor, self-defeating and self-enhancing humor scores were closely related with depression in young epileptic adults. Conclusion: The young adults with epilepsy are affected in sense of humor and humor style, which are closely related with depression.

[Hepatocellular carcinoma-derived exosomal miRNA expression and its clinical value]

The early diagnosis and effective treatment of hepatocellular carcinoma (HCC) still remains a difficult problem that plagues the medical community. Exosomes are microvesicles with a diameter of 40~100 nm, and contains proteins, lipids and nucleic acids (mRNAs, lncRNAs, circRNAs, and microRNAs). They serve as an information exchange carrier, and play an important role in regulating and controlling the biomolecular function to maintain the stability of the intracellular environment. The function of exosomes in HCC includes intercellular communication, neoangiogenesis, cancer cell metastasis and multidrug resistance, which mediates the transformation of microRNAs (miRNA) and regulate the microenvironment of tumor progression, and then affect the pathophysiological behavior of cancer cells. Exosome-derived miRNA can be used for HCC monitoring or potential specific markers of early diagnosis. In addition, with the development and application prospects it could be a therapeutic goal for HCC. This paper summarizes the recent progress in the study of HCC-derived exosomal miRNA.

[Abnormal expression of Wnt3a and inhibiting role of its molecular-targeted intervening in hepatocellular carcinoma]

Objective: To investigate the Wnt3a expression in tissues of HCC and its gene knockout on effects of HepG2 cell proliferation or xenograft tumor growth. Methods: Hepatic Wnt3a expressions in 87 HCC and their matched surrounding tissues were observed by tissue microarray and immunohistochemistry for analyzing its clinicopathological characteristics; Wnt3a-knockout HepG2 cell lines were established by Crispr/cas9-sgRNA system and genomic cleavage efficiency was verified at gene level by surveyor assay. The relative proteins were confirmed by Western blotting; Cell Counting Kit-8 assay was used to examine cell proliferation after knocking-out Wnt3a successfully, and the nude mice HepG2 cell xenograft tumors delete that the relationship between Wnt3a and HCC growth. Results: The positive Wnt3a with brown staining particles was mainly distributed in cytosol and membrane of hepatocytes. The incidence of hepatic Wnt3a expression in cancerous tissues (95.4%) was significantly higher (χ (2) = 47.754, P < 0.001) than that in their surrounding tissues (49.4%). The high Wnt3a expression was 70.1% in the HCC and only 14.9% in the surrounding tissues. High Wnt3a expression was associated with poorly-differentiated grade, liver cirrhosis, HBV infection, portal vein invasion, TNM stage and 5-year survival rate. After knocked-out by Crispr/cas9-sgRNA system successfully, Wnt3a expression was down-regulated significantly at gene or protein level. Key molecule β-catenin in cytoplasma was obviously inhibited. HepG2 cell lines proliferation was suppressed in time-dependent manner. The nude mice HepG2 cell xenograft tumors confirmed that the knock-out of Wnt3a could significantly supressed HCC growth with slower speed (t = 6.418, P < 0.001), smaller volume(869.4 ± 222.5 mm(3) vs 355.0 ± 99.9 mm(3), t = 5.168, P < 0.001), and lighter weight (0.88 ± 0.20 g vs 0.35 ± 0.11 g, t = 5.628, P < 0.001)compared with the control group. Conclusion: Abnormal expression of Wnt3a could be expected as a promising target for HCC gene therapy.

Variations in submicron aerosol liquid water content and the contribution of chemical components during heavy aerosol pollution episodes in winter in Beijing

The aerosol liquid water content (ALWC) of submicron particles (PM₁) was calculated in this work by three methods based on the aerosol physical and chemical properties measurement campaigns in winter in Beijing, including (a) the PM₁ volume difference between the ambient and dry states by applying the particle number size distribution and particle hygroscopicity measurement; (b) the thermodynamic equilibrium model (ISORROPIA II) based on the chemical composition; and (c) the κ-Köhler theory of chemical composition with a volume mixing scheme. The three methods agreed well with reasonable uncertainties. The ALWC showed an exponential trend depending on the relative humidity (RH), and an abundant ALWC was also favored by the high PM₁ mass loading. The contribution of different chemical component to the ALWC was evaluated by the κ-Köhler method, which revealed that during the measurement, the inorganics and organics could contribute to ~80% and ~20%, respectively, under ambient RH conditions, with the largest contributor of ammonium nitrate. When the RH was above 85%, the mass concentration of ALWC was comparable to, or even larger than, that of the dry PM₁.

Gaussian Belief Propagation for Solving Network Utility Maximization with Delivery Contracts

Classical network utility maximization (NUM) models fail to capture network dynamics, which are of increasing importance for modeling network behaviors. In this paper, we consider the NUM with delivery contracts, which are constraints to the classical model to describe network dynamics. This paper investigates a method to distributively solve the given problem. We first transform the problem into an equivalent model of linear equations by dual decomposition theory, and then use Gaussian belief propagation algorithm to solve the equivalent issue distributively. The proposed algorithm has faster convergence speed than the existing first-order methods and distributed Newton method. Experimental results have demonstrated the effectiveness of our proposed approach.

Low-temperature microstructural studies on superconducting CaFe2As2

Undoped CaFe₂As₂ (Ca122) can be stabilized in two slightly different non-superconducting tetragonal phases, PI and PII, through thermal treatments. Upon proper annealing, superconductivity with a T_c up to 25 K emerges in the samples with an admixture of PI and PII phases. Systematic low-temperature X-ray diffraction studies were conducted on undoped Ca122 samples annealed at 350 °C over different time periods. In addition to the diffraction peaks associated with the single-phase aggregation of PI and PII, a broad intermediate peak that shifts with annealing time was observed in the superconducting samples only. Our simulation of phase distribution suggests that the extra peak is associated with the admixture of PI and PII on the nanometer scale. High-resolution transmission electron microscopy confirms the existence of these nano-scale phase admixtures in the superconducting samples. These experimental results and simulation analyses lend further support for our conclusion that interfacial inducement is the most reasonable explanation for the emergence of superconductivity in undoped Ca122 single crystals.

[The association between plasma levels of 20 amino acids and risk of diabetes]

Objective: To investigate the association between the plasma levels of 20 amino acids and the risk of diabetes in middle-aged and elderly population. Methods: This study was a part of the Chinese multi-provincial cohort study conducted in communities of Shougang. In 2007 and 2012, the population was investigated for diabetes and other risk factors. Blood samples collected from 475 people were tested for various amino acid levels by liquid chromatography-tandem mass spectrometry. A multivariate logistic regression analysis was used to analyze the association between plasma amino acid levels and diabetes risk. Results: The age of the selected population at baseline was (58.7±6.3) years, and the blood glucose level at baseline was (5.68±1.34) mmol/L. Among them, 56 (11.79%) subjects were diabetes. Multivariate logistic regression analyses showed that after adjusting for age, gender, body mass index, systolic blood pressure and dyslipidemia, individuals with plasma branched-chain amino acid (valine, leucine and isoleucine) and cysteine in the highest tertile levels were at high risk of diabetes with the ORs of 3.61 (95% CI 1.48-8.80), 3.27 (95% CI 1.34-7.99), 2.46 (95% CI 1.04-5.84) and 2.09 (95% CI 1.02-4.27), respectively. After 5 years' followed up, 5.73% (24/419) subjects developed diabetes. Compared with those in the lowest tertile, individuals with plasma branched-chain amino acid (total concentration), phenylalanine, and tyrosine levels at baseline in the highest tertile had 3.69 times, 3.61 times and 4.14 times higher risk to develop new diabetes, respectively. In contrast, individuals with plasma glycine level in the highest tertile had only 76% (OR 0.24, 95% CI 0.06-0.91) risk for the development of diabetes compared with those with plasma glycine level in the lowest tertile. Conclusions: The increase in plasma branched-chain amino acid and cysteine levels is significantly associated with an increase in incident diabetes. Subjects with higher levels of branched-chain amino acids and aromatic amino acids (phenylalanine, tyrosine) had a significantly higher risk of developing new-onset diabetes, while those with higher glycine levels had a significantly lower risk of developing diabetes in 5 years.

[Association between long-term blood pressure change and the incidence of cardiovascular diseases: a population-based cohort study]

Objective: To explore the association between long-term changes in blood pressure (BP) levels and the incidence of cardiovascular diseases (CVD). Methods: A total of 5 752 participants, who participated baseline examination in 1992-1993 and re-examination in 2007, were followed up till December 31, 2013 according to the study protocol of the Chinese Multi-provincial Cohort Study. Participants were stratified by baseline BP and re-examination BP and cross-combined into 9 subgroups. The 20-year incidence of acute cardiovascular events, acute coronary heart disease (CHD) and acute stroke events were analyzed and association between disease incidence and 15-year changes in BP were determined using the competing risk regression model. Results: (1) There were 523 CVD events (170 CHD, 373 stroke) during the 20 years follow up. The number of participants with baseline systolic blood pressure (SBP)/diastolic blood pressure (DBP) of <130/80 mmHg (1 mmHg=0.133 kPa), 130-139/80-89 mmHg, and hypertension were 2 892 (50.3%), 1 328 (23.1%) and 1 532 (26.6%), respectively. (2) Among participants with baseline SBP of 130-139 mmHg or DBP of 80-89 mmHg, 870 (65.5%) progressed to hypertension and 279 (21.0%) maintained at the same stratum over a 15-year follow up period. (3) After adjustment for age, sex, body mass index, smoking status, diabetes, total cholesterol, and high-density lipoprotein cholesterol at baseline, participants maintained SBP/DBP at 130-139/80-89 mmHg had a higher risk of developing acute cardiovascular events, CHD and stroke with the hazard ratios (HR) and 95% confidence interval (95%CI) of 2.04 (1.16, 3.57), 3.29 (1.30, 8.35) and 1.63 (0.80, 3.33), compared with those who maintained their SBP < 130 mmHg and DBP <80 mmHg. Participants whose BP increased from 130-139/80-89 mmHg to hypertension over the follow up period had 2.81-fold (1.84, 4.29), 3.17-fold (1.43, 7.03) and 2.71-fold (1.65, 4.44) higher risk for the incidence of acute cardiovascular events, CHD, and stroke, respectively, compared with participants who maintained their SBP <130 mmHg and DBP <80 mmHg. Conclusions: Participants with SBP/DBP of 130-139/80-89 mmHg have a high long-term risk for progression to hypertension. Sustained exposure to SBP/DBP of 130-139/80-89 mmHg or higher increases the risk of CVD incidence, and our results highlight the importance of early prevention for participants with this BP stratum.

Label‑free quantitative proteomics and bioinformatics analyses of alcoholic liver disease in a chronic and binge mouse model

As a significant cause of mortality and morbidity, alcoholic liver disease (ALD) has been widely investigated. However, little is known about the underlying metabolic mechanisms involved in the complicated pathological processes of ALD. The present study used label‑free quantitative proteomics and bioinformatics analyses to investigate the differentially expressed proteins (DEPs) and their functions in the livers of alcohol‑feed (AF) and control pair‑feed (PF) mice. As a result, 87 upregulated DEPs and 133 downregulated DEPs were identified in AF liver tissues compared with PF livers. Gene ontology and Kyoto encyclopedia of genes and genomes bioinformatics analyses demonstrated that the DEPs were significantly enriched in 'protein binding', 'metabolism', 'signal conduction' and 'immune response'. The expression of several core proteins including thyroid hormone receptor interactor 12 (TRIP12), NADH dehydrogenase (ubiquinone)1 α subcomplex, assembly factor 3 (NDUFAF3) and guanine monophosphate synthetase (GMPS) was validated by reverse transcription‑quantitative polymerase chain reaction (RT‑qPCR) in a larger series of samples. The RT‑qPCR results confirmed that TRIP12, NDUFAF3 and GMPS genes were significantly differentially expressed in between the AF and PF samples. These results extend our understanding of the molecular mechanisms underlying the occurrence and development of ALD. The present study indicated that the majority of DEPs serve vital roles in multiple metabolic pathways and this extends our knowledge of the molecular mechanisms involved in the occurrence and progression of ALD.

Hierarchical SnS2/SnO2 nanoheterojunctions with increased active-sites and charge transfer for ultrasensitive NO2 detection

SnS2 nanosheets with unique properties are excellent candidate materials for fabricating high-performance NO2 gas sensors. However, serious restacking and aggregation during sensor fabrication have greatly impacted the sensing response. In this study, flower-like hierarchical SnS2 was prepared by a simple microwave method and partially thermally oxidized to form hierarchical SnS2/SnO2 nanocomposites to further improve the sensing performance at low operating temperature. The fabricated SnS2/SnO2 sensor exhibited ultrahigh response (resistance ratio = 51.1) toward 1 ppm NO2 at 100 °C, roughly 10.2 times higher than that of pure SnS2 nanoflowers. The excellent and enhanced NO2 sensing performances of hierarchical SnS2/SnO2 nanocomposites were attributed to the novel hierarchical structure of SnS2 and the nanoheterojunction between SnS2 and the ultrafine SnO2 nanoparticles. The SnS2/SnO2 sensors also exhibited excellent selectivity and reliable repeatability. The simple fabrication of high performance sensing materials may facilitate the large-scale production of NO2 gas sensors.

Simultaneous Bayesian Clustering and Feature Selection Through Student's ${t}$ Mixtures Model

In this paper, we proposed a generative model for feature selection under the unsupervised learning context. The model assumes that data are independently and identically sampled from a finite mixture of Student's distributions, which can reduce the sensitiveness to outliers. Latent random variables that represent the features' salience are included in the model for the indication of the relevance of features. As a result, the model is expected to simultaneously realize clustering, feature selection, and outlier detection. Inference is carried out by a tree-structured variational Bayes algorithm. Full Bayesian treatment is adopted in the model to realize automatic model selection. Controlled experimental studies showed that the developed model is capable of modeling the data set with outliers accurately. Furthermore, experiment results showed that the developed algorithm compares favorably against existing unsupervised probability model-based Bayesian feature selection algorithms on artificial and real data sets. Moreover, the application of the developed algorithm on real leukemia gene expression data indicated that it is able to identify the discriminating genes successfully.

[Trends in 30-day case fatality rate in patients hospitalized due to acute myocardial infarction in Beijing, 2007-2012]

Objective: To understand the distribution and trends in 30-day coronary heart disease (CHD) case fatality rate in patients hospitalized due to acute myocardial infarction (AMI) in Beijing during 2007-2012. Methods: The clinical data of patients hospitalized due to AMI in Beijing from 1 January 2007 to 31 December 2012 were collected from "The Cardiovascular Disease Surveillance System in Beijing" . A total of 77 943 local patients aged ≥25 years were hospitalized due to AMI in Beijing during the this period. After excluding duplicate records and validation for the completeness and accuracy of the records, the clinical characteristics of the patients and 30-day CHD case fatality rate in the patients were analyzed. Trends in 30-day CHD case fatality rate in the patients were analyzed with Poisson regression models. Results: The age-standardized average 30-day CHD case fatality rate was 9.7% in the 77 943 patients. During this period, a decreasing trend was observed in 30-day CHD case fatality rate after adjusting for age and gender (P<0.001). The age-standardized 30-day CHD case fatality rate decreased by 16.0%, from 10.8% in 2007 to 9.0% in 2012. The decreases of 30-day CHD case fatality rates were noted in both men and women, whereas 30-day CHD case fatality rate was higher in women (14.1%) than in men (7.6%) after adjusting for age. During this period, the proportion of ST-segment elevation myocardial infarction (STEMI) decreased, while the proportion of non-ST-segment elevation myocardial infarction (NSTEMI) increased with year. A significant decline (20.1%) in 30-day case fatality rate of STEMI was found, but no decline was found for 30-day mortality rate of NSTEMI. Conclusion: A decreasing trend in 30-day CHD case fatality rate was observed in the patients aged ≥25 years and hospitalized due to AMI in Beijing during 2007-2012, indicating the improvement in short-term prognosis of patients hospitalized due to AMI. Our findings highlight the urgent need to improve the treatment for woman and NSTEMI patients.

Cell cycle-related and expression-elevated protein in tumor overexpression is associated with proliferation behaviors and poor prognosis in non-small-cell lung cancer

The cell cycle‐related and expression‐elevated protein in tumor (CREPT) is overexpressed in several human malignancies. However, the clinical relevance of CREPT expression and its biological role in non‐small‐cell lung cancer (NSCLC) remains unclear. In this study, we detected the expression of CREPT in both NSCLC tissues and cell lines by immunohistochemistry, Western blot analysis, and RT‐PCR. The correlation between CREPT expression and clinicopathologic features was analyzed in 271 NSCLC patients. The prognostic value of CREPT expression was evaluated by Kaplan–Meier analysis and Cox regression analysis. CREPT was overexpressed in Calu‐1 cell lines by using plasmid vector and its biological function was explored both in vitro and in vivo. We found that CREPT was significantly overexpressed in NSCLC compared with paired adjacent non‐tumor tissues, and the expression level of CREPT was correlated with tumor differentiation, lymph node metastasis, and clinical stage. Kaplan–Meier analysis showed that the recurrence‐free survival and overall survival of high CREPT expression groups were significantly shorter than those of the low CREPT expression group. Multivariate analysis identified that CREPT might be an independent biomarker for the prediction of NSCLC prognosis. Overexpression of CREPT increased cell proliferation and enhanced the migration and invasion ability of Calu‐1 cells (a human NSCLC cell line with relative low CRPET expression) in vitro. Moreover, CREPT overexpression promoted tumor growth in a nude mice model. These results suggest that CREPT is closely relevant to the proliferation of NSCLC cells and it might be a potential prognostic marker in NSCLC patients.

[Impact of different intervention models on adherence to secondary prevention therapies in patients with acute coronary syndrome]

Objective: To evaluate the impact of different intervention models on adherence to secondary prevention therapies in patients with acute coronary syndrome (ACS). Methods: This multi-center cross-sectional study collected data from 34 hospitals covering 22 provinces in China. Hospitals were randomly divided into four groups: control group(routine treatment and care), promotional calendar group (routine treatment and care plus giving propaganda desk calendar to patients), education group (routine treatment and care add patients education by nurses) and combined intervention group (promotional calendar and education).At least 90 patients with ACS were consecutively enrolled from each involved hospital from April 15, 2012 to June 30, 2013. To reduce the impact of uneven distribution of inter-group variables on the results, 1∶1∶1∶1 propensity score matching method was used. The drug usage for secondary prevention and prognosis wasobtainedat 6 months after hospital discharge. Results: (1) A total of 3 391 patients were selected and 2 244 patients were included for the final analysisafter propensity score analysis. (2) At 6 months after discharge, the adherence rates of antiplatelet, statins, angiotensin converting enzyme inhibitor(ACEI)/angiotensin Ⅱ receptor blocker(ARB), β-blocker and the combination of 4 medications were similar between control group and promotional calendar group (all P>0.016).The adherence rates of antiplatelet and statins were 97.0% (526/542) and 91.0% (493/542) in the education group, 3.7% and 5.5% higher than in the control group (both P<0.016). The adherence rates of statins,ACEI/ARB and combined medication were 91.0% (496/545), 68.3% (372/545) and 53.2% (290/545) in the combined intervention group,significantly higher than in the control group (5.5%,8.3% and 9.6%, all P<0.016). (3) Poisson regression analysis showed that the adherence of antiplatelet drugs in the education group was 3.4%(OR=1.034, 95%CI 1.007-1.060,P<0.05) and 3.5%(OR=1.035, 95%CI 1.007-1.063, P<0.05) higher than in the control group and the promotional calendar group, and the statins adherence rate was 5.5%(OR=1.055, 95%CI 1.012-1.101,P<0.05) higher than in the control group. The antiplatelet drug adherence rates in the combined intervention group were 3.0% (OR=1.030, 95%CI 1.002-1.058,P<0.05) and 3.1% (OR=1.031, 95%CI 1.003-1.060,P<0.05) higher than in the control group and the promotional calendar group, respectively, and statin adherence was 6.1% (OR=1.061, 95%CI 1.017-1.107,P<0.01) higher than in the control group. The adherence rates of ACEI/ARB in combined intervention group were respectively 15.4%(OR=1.154, 95%CI 1.057-1.259, P<0.01),20.0%(OR=1.200, 95%CI 1.096-1.314, P<0.01) and 25.5%(OR=1.255, 95%CI 1.142-1.380, P<0.01) higher than in the control group, promotional calendar group and education group. The adherence rates of combined medication in combined intervention group were respectively 21.6%(OR=1.216, 95%CI 1.079-1.371, P<0.01),21.5%(OR=1.215, 95%CI 1.077-1.371, P<0.01) and 27.8%(OR=1.278, 95%CI 1.126-1.450, P<0.01) higher than in the control group, promotional calendar group and education group. (4) At 6 months after discharge, the control rates of blood pressure (<140/90 mmHg,1 mmHg=0.133 kPa) in the education group were significantly higher than in the control group and promotional calendar group (78.7% (398/506) vs. 70.2%(373/531) and 71.1% (354/498) , all P<0.016),and the control rates of blood pressure in combined intervention group were higher than in the control group and promotional calendar group (78.2% (376/481) vs. 70.2%(373/531) and 71.1% (354/498) , all P<0.016).The rehospitalization rates were 7.0% (39/561) in the promotional calendar group, and 7.6% (42/561) in the education group, both significantly higher than in the control group (3.8% (21/561), all P<0.016).The rate of the low density lipoprotein cholesterol<2.07 mmol/L and the rate for all-cause mortality were similar among groups (all P>0.016) . Conclusion: Post-discharge medication adherence in ACS patients can be enhanced by either promotional calendaror nurses education strategy, and the efficacy is better by nurse education as compared with promotional calendar, the combination of both methods can further increase the post-discharge medication adherence rates in ACS patients.

CircRNA_100782 regulates pancreatic carcinoma proliferation through the IL6-STAT3 pathway

Circular RNAs (circRNAs) are a novel class of noncoding RNAs that play an important role in cancer. However, the mechanisms by which circRNAs regulate gene expression in pancreatic ductal adenocarcinoma (PDAC) remain unclear. This study seeks to elucidate the role that circRNAs play in the proliferation of PDAC cells. On the basis of previous studies of circRNA expression profiles in PDAC, we found that the circRNA_100782 was markedly upregulated in PDAC tissue. Functional experiments revealed that circRNA_100782 down-regulation inhibited BxPC3 cell proliferation and colony formation. Loss-of-function studies showed that knockdown of circRNA_100782 inhibited cell proliferation by downregulating the microRNA-124 (miR-124) target genes interleukin-6 receptor (IL6R) and signal transducer and activator of transcription 3 (STAT3). Overexpression of miR-124 also inhibited BxPC3 cell proliferation by reducing the expression of IL6R and STAT3, which was consistent with the result of silencing circRNA_100782. In addition, luciferase assay revealed that miR-124 was a direct target of circRNA_100782. Silencing STAT3 inhibited BxPC3 cell proliferation and colony formation. Cell viability was reduced in BxPC3 cells treated with si-circRNA_100782 and miR-124 mimic, and this effect could be attenuated by activating STAT3. In vivo study validated that circRNA_100782 knockdown suppressed BxPC3 xenografts in nude mice. Taken together, these results suggest that circRNA_100782 regulates BxPC3 cell proliferation by acting as miR-124 sponge through the IL6–STAT3 pathway.

[Comparison of two quantitative methods of endobronchial ultrasound real-time elastography for evaluating intrathoracic lymph nodes]

Objective: To compare the clinical value of two quantitative methods in analyzing endobronchial ultrasound real-time elastography (EBUS-RTE) images for evaluating intrathoracic lymph nodes. Methods: From January 2014 to April 2014, EBUS-RTE examination was performed in patients who received EBUS-TBNA examination in Shanghai Chest Hospital. Each intrathoracic lymph node had a selected EBUS-RTE image. Stiff area ratio and mean hue value of region of interest (ROI) in each image were calculated respectively. The final diagnosis of lymph node was based on the pathologic/microbiologic results of EBUS-TBNA, pathologic/microbiologic results of other examinations and clinical following-up. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were evaluated for distinguishing malignant and benign lesions. Results: Fifty-six patients and 68 lymph nodes were enrolled in this study, of which 35 lymph nodes were malignant and 33 lymph nodes were benign. The stiff area ratio and mean hue value of benign and malignant lesions were 0.32±0.29, 0.62±0.20 and 109.99±28.13, 141.62±17.52, respectively, and statistical differences were found in both of those two methods (t=-5.14, P<0.01; t=-5.53, P<0.01). The area under curves was 0.813, 0.814 in stiff area ratio and mean hue value, respectively. The optimal diagnostic cut-off value of stiff area ratio was 0.48, and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 82.86%, 81.82%, 82.86%, 81.82% and 82.35%, respectively. The optimal diagnostic cut-off value of mean hue value was 126.28, and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 85.71%, 75.76%, 78.95%, 83.33% and 80.88%, respectively. Conclusion: Both the stiff area ratio and mean hue value methods can be used for analyzing EBUS-RTE images quantitatively, having the value of differentiating benign and malignant intrathoracic lymph nodes, and the stiff area ratio is better than the mean hue value between the two methods.

[Effects of trabecular metal augments for the reconstruction of Paprosky type Ⅲ acetabulum bone defects]

Objective: To investigate the methods and short-time clinical results of reconstruction of Paprosky type Ⅲ acetabulum bone defects by using tantalum augments. Methods: A total of 17 patients (17 hips) with Paprosky type Ⅲ acetabulum bone defects, treated with tantalum augments in revision of total hip arthroplasty at Department of Orthopedics Surgery in General Hospital of Chinese People's Liberation Army were retrospectively analyzed from March 2014 to May 2016.There were 6 males and 11 females aged from 23 to 74 years with an average of (50.2±16.3) years. Tantalum augments or TM-Cup augment (the cup-on-cup technique) were used to reconstruct the defects.The TM-Cup augment was the tantalum revision cup which was removed titanium ring. The cup-on-cup technique combined TM-Cup augment and biological acetabulum cup. Augments were served as the nonresorptive structural allograft in revision of total hip arthroplasty. Harris hip score was used to evaluate clinical effects. The vertical position of the rotation center was measured and analyzed. Radiographic assessments of the acetabular components were performed by DeLee-Charnley and the Anderson criteria and recorded postoperative complications. Results: All the patients were followed up from 3 to 29 months with an average of (16.2±5.4) months, tantalum augments and biological acetabulum cup were used in 13 patients, the TM-Cup augment and biological acetabulum cup were used in 4 patients. At the time of the latest follow-up, the mean Harris hip score increased compared to preoperatively (86.8±8.3 vs. 30.0±12.0) (t=12.78, P<0.01), the average vertical location of the center of rotation was decreased ((25.3±9.8) mm vs.(47.6±10.5)) mm (t=4.95, P<0.01). All the tantalum augments and biological acetabulum cups were stable, there were no infection, dislocation and other complications. Conclusions: The use of tantalum augments could be considered as an effective management of Paprosky type Ⅲ defects providing good clinical and radiographic outcomes in the short term.The cup-on-cup technique which was used in reconstruction of severe superior-invagination acetabular bone defects and restoration relatively normal center of rotation had special application value.