Resveratrol Pretreatment Inhibits Myocardial Apoptosis in Rats Following Coronary Microembolization via Inducing the PI3K/Akt/GSK-3β Signaling Cascade

Purpose

Coronary microembolization (CME) is associated with progressive cardiac dysfunction, myocardial inflammation, and apoptosis. Resveratrol (RES) has a considerable role in cardioprotection. However, the contribution and possible mechanisms of RES in CME have not been clearly understood.

Methods

In the current study, 40 SD rats were randomly selected and categorized into various groups including CME, CME + resveratrol (CME + RES), CME + resveratrol+ LY294002 (CME + RES + LY), and sham groups (10 animals in each group). The inert plastic microspheres (42 μm) were injected into the rats’ left ventricle for developing the CME model. Then resveratrol (25 mg/kg/d) was given to the rats in the CME + RES and CME + RES + LY groups for one week before CME induction. Furthermore, LY294002 (10 mg/kg) was intraperitoneally injected into the rats of the CME + RES + LY group 0.5 hours before CME modeling. The cardiac functions, serum levels of myocardial injury biomarkers, myocardial histopathology, and mRNA and proteins associated with myocardial apoptosis were all assessed 12 hours after surgery.

Results

The results revealed that resveratrol pretreatment alleviated the CME-induced myocardial damage by improving cardiac dysfunction, and lowering the serum level of myocardial injury biomarkers, myocardial microinfarct size, and cardiomyocyte apoptotic index. Pretreatment with resveratrol reduced the level of proteins and mRNAs associated with the pro-apoptosis in myocardial tissues and increased the levels of proteins and mRNAs associated with the anti-apoptosis. Moreover, the combined treatment of resveratrol and LY294002 reversed the observed protective effects.

Conclusion

Resveratrol can inhibit cardiomyocyte apoptosis, thus attenuating the CME-induced myocardial injury by triggering the PI3K/Akt/GSK-3β cascade.

The Economic Burden of Alzheimer's Disease in Zhejiang Province

BACKGROUND

The World Alzheimer Report has described and predicted the economic burden of Alzheimer's disease (AD) patients in detail for four consecutive years. There was a large-scale national survey in China launched by Professor Jianping Jia in 2015, but it did not adequately represent the average economic burden of AD patients in Zhejiang Province.

OBJECTIVE

To investigate the economic burden and main factors influencing Alzheimer's disease (AD) in Zhejiang Province.

METHODS

We recruited 830 patients from 10 cities in Zhejiang Province, evaluated their per capita and total cost related to AD treatment and care in 2017, and analyzed the main factors affecting economic burden from the perspective of demographic characteristics and disease severity.

RESULTS

In 2017, per capita cost of AD was 114,343.7 yuan, while the total cost was 27.53 billion yuan, accounting for 0.77% of Zhejiang Province's GDP (5176.8 billion yuan). Total cost, direct medical cost, and indirect cost have different correlations with age, education level, type of work, marital status, comorbidity, and disease severity.

CONCLUSION

The economic burden of AD in Zhejiang Province is heavy, similar to the national burden, and interventions based on demographic characteristics and disease severity can help reduce it.

Intra-arterial chemoembolization with chemotherapy for unresectable locally advanced rectal cancer: a case report and literature review

Preoperative intra-arterial chemoembolization has been successfully applied in many malignant tumors but is rarely reported in patients with locally advanced rectal cancer (LARC). Herein we report a 69-year-old female diagnosed as rectal adenocarcinoma by endoscopic biopsy and the clinical stage was cT4aN2M0, IIIB. After computed tomography (CT) and magnetic resonance imaging (MRI) examinations, the neoplasm was considered unresectable. Then neoadjuvant chemoradiotherapy was recommended to the patient after multidisciplinary treatment. Due to the financial situation and physical condition, the patient only chose chemotherapy for preoperative treatment. During the first time of the mFOLFOX6 regimen, the patient had severe side effects of vomiting, despite tropisetron being routinely given. Then we recommended regional intra-arterial chemoembolization combined with CAPEOX regimen for conversion treatment. After intra-arterial chemoembolization with oxaliplatin and 3 months of chemotherapy with CAPEOX regimen, CT and MRI were performed again to re-evaluate the local condition. Images showed distinct remission in the tumor area, and its surrounding lymph nodes were reduced in number and volume. Also, the tumor had shrunk distinctly with a negative circumferential resection margin (CRM). We concluded that the tumor was converted into a resectable one, and the patient met the conditions for the operation. The fact indicates that it is effective in creating good operative conditions for LARC by adding intra-arterial chemotherapy to the standard treatment.

Strategies and Structure Feature of the Aboveground and Belowground Microbial Community Respond to Drought in Wild Rice (Oryza longistaminata)

BACKGROUND

Drought is global environmental stress that limits crop yields. Plant-associated microbiomes play a crucial role in determining plant fitness in response to drought, yet the fundamental mechanisms for maintaining microbial community stability under drought disturbances in wild rice are poorly understood. We make explicit comparisons of leaf, stem, root and rhizosphere microbiomes from the drought-tolerant wild rice (Oryza longistaminata) in response to drought stress.

RESULTS

We find that the response of the wild rice microbiome to drought was divided into aboveground-underground patterns. Drought reduced the leaf and stem microbial community diversity and networks stability, but not that of the roots and rhizospheres. Contrary to the aboveground microbial networks, the drought-negative response taxa exhibited much closer interconnections than the drought-positive response taxa and were the dominant network hubs of belowground co-occurrence networks, which may contribute to the stability of the belowground network. Notably, drought induces enrichment of Actinobacteria in belowground compartments, but not the aboveground compartment. Additionally, the rhizosphere microbiome exhibited a higher proportion of generalists and broader habitat niche breadth than the microbiome at other compartments, and drought enhanced the proportion of specialists in all compartments. Null model analysis revealed that both the aboveground and belowground-community were governed primarily by the stochastic assembly process, moreover, drought decreased 'dispersal limitation', and enhanced 'drift'.

CONCLUSIONS

Our results provide new insight into the different strategies and assembly mechanisms of the above and belowground microbial community in response to drought, including enrichment of taxonomic groups, and highlight the important role of the stochastic assembly process in shaping microbial community under drought stress.

Stable cycling of Prussian blue/Zn battery in a nonflammable aqueous/organic hybrid electrolyte

Although rechargeable aqueous batteries are attracting increasing attention in recent years due to high safety, low cost, high power density and environmental friendliness, the aqueous batteries suffer from limited cycle life due to a narrow electrochemical window of the aqueous electrolytes, severe side reaction and instability of electrode materials in aqueous electrolytes. In this work, we propose a hybrid aqueous electrolyte with a mixed solvent of water and acetonitrile (ACN), which exhibits a wide electrochemical window, high ionic conductivity, and nonflammability. An aqueous battery with an iron hexacyanoferrate (FeHCF) cathode, Zn anode and H₂O/ACN hybrid electrolyte shows a high capacity of 69.1 mA h g^-1 at 10C (89.5% relative to that at 1C) and an extremely long cycle life with 51.4% capacity retention after 19 000 cycles at 10C. The excellent cycling performance of the aqueous FeHCF/Zn batteries can be attributed to the reduced water activity and extended electrochemical window because of the strong hydrogen-bonding interaction between ACN and H₂O. Besides, the large particle size and good crystallization of FeHCF can inhibit its dissolution in the aqueous electrolyte which further improves cycling performance. This work will shed light on the design of safe aqueous batteries for applications in large-scale energy storage.

Characterizing the impact of high temperature during grain filling on phytohormone levels, enzyme activity and metabolic profiles of an early indica rice variety

Global warming results in high temperature stress (HTS), which presents severe challenges worldwide for modern agricultural production and will have significant impacts on the yield and quality of crops. Accumulation of photosynthetic products, activity of enzymes involved in sucrose-starch metabolism, phytohormone levels and metabolic profiling using LC-MS were analysed in the flag leaves and/or developing grains subjected to HTS during the grain-filling stage of an indica rice. HTS induced significant yield loss and reduced the grain quality, with lower amylose content. HTS reduced photosynthetic product accumulation in flag leaves and reduced starch accumulation in developing grains, compared to growth under normal temperatures. The activity of enzymes related to sucrose-starch metabolism were dis-regulated in developing grains grown under high temperature (HT). Moreover, phytohormone homeostasis in flag leaves and developing grains was also dramatically disturbed by HT. Metabolic profiling detected many metabolites with remarkably different relative fold abundances at different time points in the developing grain at HT versus normal temperatures, these metabolites were enriched in several HTS response pathways. The change in phytohormone ratio and auxin level might be associated with the reduction in photosynthetic products and their translocation, and ultimately with reduced starch accumulation in the developing grain. The detected metabolites might have different roles in response to the HTS in developing grain at different development stages. These results provide a theoretical reference and basis for future rice production towards higher quality and yield when grown under HTS.

Personalized 0D-1D multiscale hemodynamic modeling and wave dynamics analysis of cerebral circulation for an elderly patient with dementia

Senile dementia is associated with pronounced alterations in cerebral circulation. A fundamental understanding of intracranial hemodynamics and wave dynamics is essential for assessing dementia risk. Recent findings suggest that higher carotid artery wave intensity (WI) can predict future cognitive impairments in the elderly. However, wave power (WP) is more advantageous for assessing the risk of cognitive impairment and dementia because of its conservative form, which allows quantification of detailed WP distribution among the entire cerebrovascular network. Unfortunately, intracranial hemodynamics and wave dynamics in elderly patients with dementia remain poorly understood due to ethical issues and technical challenges. In this paper, we proposed a novel and easily achievable personalized methodology for the 0D-1D model of cerebral circulation using widely available clinical data on transcranial Doppler ultrasonography velocity, cerebral artery anatomy from magnetic resonance imaging, and brachial artery pressure. Using the proposed model, we simulated the cerebral blood flows and compared the wave dynamics between a healthy elderly subject and one living with dementia. Moreover, we performed a variance-based global sensitivity analysis to quantify the model-predicted WI and WP sensitivity to the uncertainties of model inputs. This provided more precise information for model personalization and further insights into the wave dynamics of cerebral circulation. In conclusion, the proposed personalized model framework provides a practical approach for patient-specific modeling and WI/WP analysis of cerebral circulation through noninvasive clinical data. The wave dynamics features of higher WI and lower WP in cerebral arteries may be an invaluable biomarker for assessing dementia risk.

Effects of Ink Formulation on Construction of Catalyst Layers for High-Performance Polymer Electrolyte Membrane Fuel Cells

Rational design of catalyst layers in a membrane electrode assembly (MEA) is crucial for achieving high-performance polymer electrolyte membrane fuel cells. Establishing a clear understanding of the property (catalyst ink)-structure (catalyst layer)-performance (MEA) relationship lays the foundation for this rational design. In this work, a synergistic approach was taken to correlate the ink formulation, the microstructure of catalyst layers, and the resulting MEA performance to establish such a property-structure-performance relationship. The solvent composition (n-PA/H₂O mixtures) demonstrated a strong influence on the performance of the MEA fabricated with an 830-EW (Aquivion) ionomer, especially polarization losses of cell activation and mass transport. The performance differences were studied in terms of how the solvent composition affects the catalyst/ionomer interface, ionomer network, and pore structure of the resulting catalyst layers. The ionomer aggregates mainly covered the surface of catalyst aggregates acting as oxygen reduction reaction active sites, and the aggregate sizes of the ionomer and catalyst (revealed by ultrasmall angle X-ray scattering and cryo-transmission electron microscopy) were dictated by tuning the solvent composition, which in turn determined the catalyst/ionomer interface (available active sites). In n-PA/H₂O mixtures with 50∼90 wt % H₂O, the catalyst agglomerates could be effectively broken up into small aggregates, leading to enhanced kinetic activities. The boiling point of the mixed solvents determined the pore structure of ultimate catalyst layers, as evidenced by mercury porosimetry and scanning electron microscopy. For mixed solvents with a higher boiling point, the catalyst-ionomer aggregates in the ink tend to agglomerate during the solvent evaporation process and finally form larger catalyst-ionomer aggregates in the ultimate catalyst layer, resulting in more secondary pores and thus lower mass transport resistance. Both the enlarged catalyst/ionomer interface and appropriate pore structure were achieved with the catalyst layer fabricated from an n-PA/H₂O mixture with 90 wt % H₂O, leading to the best MEA performance.

[Effect of malleostapedotomy procedure on 17 cases of congenital middle ear malformation]

Objective: To conclude the clinical features and the postoperative efficacy of congenital middle ear malformation treated with Malleostapedotomy (MS), and to explore the security and effectiveness of MS surgery. Methods: The clinical data of 17 patients (18 ears) with congenital middle ear malformation undergoing MS procedure were analyzed. There were 10 males (11 ears) and 7 females (7 ears), aged from 7 to 48 years. The imaging examination, pure-tone audiometry, intraoperative findings and postoperative hearing improvement of these patients were analyzed and summarized, and software SPSS23.0 was used for statistical analysis. Rusults All the 17 patients (18 ears) presented with hearing loss since childhood on the affected sides. Preoperative high resolution CT (HRCT) of the temporal bone revealed definite malformations in 9 ears (6 ears with incus long process dysplasia and 3 ears with anterior and posterior crus dysplasia). Before surgery, the mean bone conductive hearing threshold at 500, 1 000, 2 000 and 4 000 Hz was (15.6±10.2) dB HL, the mean air conductive hearing threshold was (60.6±9.7) dB HL, and the mean air-bone gap was (45.0±8.9) dB. During the surgery, all 18 ears were found to be accompanied by absence or hypoplasia of incus long process. 12 ears had stapes fixation, 6 ears had oval window atresia. All patients were treated with MS procedure by using Piston. The patients were followed up for 3 months to 1 year. The mean bone conductive hearing threshold was (14.7±8.8) dB HL. The mean air conductive hearing threshold was (37.7±11.6) dB HL, and the mean air-bone gap was (23.0±8.0) dB. There were statistically significant differences in the mean air conductive hearing threshold and mean air-bone gap before and after surgery (P<0.05). While there were no statistically significant differences in the mean bone conductive hearing threshold before and after surgery (P=0.550). Conclusions: MS procedure is safe and reliable in patients with congenital middle ear malformation of incus long process dysplasia, stapes fixation or oval window atresia. HRCT is useful in evaluating the major deformity of ossicular chain and facial nerve deformity. However, it is not enough to evaluate the joint of incus-stapes and oval window atresia. MS surgery in middle ear malformation requires advanced surgical experience and skills. The hearing improvement can be significant, even though some air-bone gap after surgery exist.

P–757 The risk of aspirin and prednisone using in women with antithyroid antibodies undergoing assisted reproductive technology

Study question

Is it safe using aspirin (A) and prednisone (P) before pregnancy among women with antithyroid antibodies (ATAbs) undergoing assisted reproductive technology?

Summary answer

Combination therapy of aspirin and prednisone didn’t improve likelihood of clinical pregnancy, but increased miscarriage rate.

What is known already

Compared with women with negative-ATAb, women with positive-ATAb had a lower live birth rate and a higher miscarriage rate. Insufficient evidence existed to determine whether aspirin and prednisone therapy improved the success of pregnancy following assisted reproductive technology (ART) in ATAb-positive euthyroid women. Aspirin and prednisone were used frequently in clinical practice, but the use of these medicines before pregnancy during ART process is still controversial, and the risks of these medicines were not well understood.

Study design, size, duration

A prospective study involving 268 women with unexplained reason for infertility who tested positive for antithyroperoxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb) were being treated for infertility at the Second Affiliated Hospital of Zhejiang University School of Medicine, Ningbo Women and Children’s Hospital and People’s Hospital of Jinhua from October 2017 to July 2020. Their TSH level ranged from 0.35–4.0mIU/ml and they all underwent fresh embryo transfer.

Participants/materials, setting, methods

Overall, a total of 268 ATAb-positive women were divided 2 groups: group A: no treatment; B: A+P. Both medicines were used in the lowest effective dose. Between the two groups, we measured oocytes retrieved, fertilization rate, high-quality embryo rate, blastulation rate, cleavage rate,implantation rate, likelihood of clinical pregnancy and miscarriage rate. Kruskal-Wallis test was used in nonnormally distributed variables, and the χ2 test or Fisher exact test was used to compare categorical variables.

Main results and the role of chance

A total of 268 infertile women with unexplained reason who tested positive for TPOAb and/or TgAb were recruited in our study. According to assignment, they were divided into two groups. All women in different groups had the similar age, BMI, number of miscarriage and duration of infertility. Levels of FSH, AMH, TSH, FT4, FT3, fibrinogen and d-dimer were similar in all groups. The use of A+P reduced cleavage rate (F = 23.982, P &lt; 0.001) and implantation rate (F = 4.388, P = 0.036). The fertilization rate (P = 0.407), high-quality embryo rate (P = 0.208) and blastulation rate (P = 0.157) were not influenced by the use of medication. In this study, likelihood of clinical pregnancy (P = 0.066) did not change significantly after therapy, and miscarriage rate (P = 0.042) increased after medical treatment.

Limitations, reasons for caution

Firstly, Aspirin is just one representation of anticoagulation therapy, so additional consideration of low molecular heparin should also be considered. Secondly, further randomized controlled trials of aspirin and prednisone alone are needed.

Wider implications of the findings: In this study, use of A+P showed no positive effect, and reduced cleavage rate and implantation rate, while increased miscarriage rate. So, the use of medication for interfile women should be cautious.

Trial registration number

n/a

Chloride sensing by WNK1 regulates NLRP3 inflammasome activation and pyroptosis

The NLRP3 inflammasome mediates the production of proinflammatory cytokines and initiates inflammatory cell death. Although NLRP3 is essential for innate immunity, aberrant NLRP3 inflammasome activation contributes to a wide variety of inflammatory diseases. Understanding the pathways that control NLRP3 activation will help develop strategies to treat these diseases. Here we identify WNK1 as a negative regulator of the NLRP3 inflammasome. Macrophages deficient in WNK1 protein or kinase activity have increased NLRP3 activation and pyroptosis compared with control macrophages. Mice with conditional knockout of WNK1 in macrophages have increased IL-1β production in response to NLRP3 stimulation compared with control mice. Mechanistically, WNK1 tempers NLRP3 activation by balancing intracellular Cl- and K+ concentrations during NLRP3 activation. Collectively, this work shows that the WNK1 pathway has a critical function in suppressing NLRP3 activation and suggests that pharmacological inhibition of this pathway to treat hypertension might have negative clinical implications.

CDH11 Regulates Adhesion and Transcellular Migration of Tongue Squamous Cell Carcinoma

Purpose

CDH11, as a member of cadherins, mediates homotypic cell adhesion. Some studies have shown that CDH11 plays an important role in the development of tumors, especially in the processes of tumor invasion and metastasis. While features of CDH11 in tongue squamous cell carcinoma (TSCC) are still indeterminate, the purpose of the present study is to explore the role of CDH11 in TSCC.

Methods

The expression of cadherin gene in a TSCC cell line with high metastatic potential (LN4) and the parental CAL27 were examined both in the TCGA database and in collected clinical samples, further verified by quantitative real-time PCR. The effects of CDH11 on the proliferation, apoptosis, migration, invasion and adhesion were tested in appropriate ways after CDH11 was overexpressed in TSCC cells.

Results

Among the 22 cadherin genes, CDH11 was one of the most obviously inhibited genes in LN4 cells as compared with the parental cells. Overexpression of CDH11 did not show a significant effect on cell proliferation, apoptosis, stemness, migration and invasion ability of TSCC cells themselves, but it increased the adhesion of TSCC cells with human oral epithelial cells and decreased their ability to pass through human oral epithelial cells (HOECs) for migration.

Conclusion

The results indicated that CDH11 plays as a tumor suppressor in tongue squamous cell carcinoma by inhibiting the invasion and migration of tongue cancer cells. CDH11 may serve as an effective clinical target for new tongue cancer treatments.

[Clinical and experimental study of late postoperative opacification of hydrophilic acrylic intraocular lenses]

Objective: To analyze the cause of late postoperative opacification of hydrophilic acrylic intraocular lenses (IOLs) and the effect of IOL replacement surgery. Methods: This retrospective case series study comprised 15 eyes of 15 patients who were diagnosed as late postoperative opacification of hydrophilic acrylic IOLs from January 2019 to June 2020 at Qingdao Eye Hospital of Shandong First Medical University. The clinical data of patients were reviewed, and two IOLs were examined by scanning electron microscopy and energy dispersive X-ray spectroscopy. The intraoperative and postoperative complications of IOL replacement surgery were evaluated, and best corrected visual acuity was compared before and after surgery. Preoperative and postoperative data were compared using the paired t test. Results: The interval between the first IOL implantation and the detection of IOL opacification in 15 patients was (27.3±5.9) months. All the 15 patients had unilateral IOL opacification, and 9 patients had hypertension. Glycosylated hemoglobin A1c was significantly higher than the normal value in 4 of the 10 patients who underwent cataract surgery at our hospital. Confocal microscopy disclosed coralliform deposits on the superficial IOL optic. Scanning electron microscopy and energy dispersive X-ray spectroscopy showed the presence of calcium and phosphorus crystals in the opacification region of IOLs. Visual acuity in all 13 eyes receiving IOL exchange was significantly improved from 1.03±0.64 (logarithm of the minimum angle of resolution) to 0.39±0.21 (P<0.05). Posterior capsule rupture (4 eyes), new IOL implanted in the ciliary sulcus (3 eyes) and zonule breaking (1 eye) occurred during IOL replacement. Conclusions: IOL opacification is related with the IOL material and calcium ion concentration on the IOL surface. IOL replacement surgery can improve visual acuity safely and effectively. (Chin J Ophthalmol, 2021, 57: 512-518).

miR-1307-5p regulates proliferation and apoptosis of chondrocytes in osteoarthritis by specifically inhibiting transforming growth factor beta-induced gene

OBJECTIVE

To explore the effect of miR-1307-5p which specifically inhibits transforming growth factor beta-induced gene (TGFBI) on the biologic behavior of osteoarthritis (OA) chondrocytes.

METHODS

We detected miR-1307-5p and TGFBI expression in the cartilage tissue specimens of OA patients and mice, respectively. RNA22 was applied to predict the target gene of miR-1307-5p, and we further verified the relationship by performing a dual luciferase reporter experiment. Enzyme-linked immunosorbent assay was used to measure the expression of matrix metalloproteinase inhibitor-1 (TIMP-1), interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in the culture medium of mouse chondrocytes. Quantitative reverse transcription-polymerase chain reaction and western blot were used to measure the expression of Bax and Bcl-2. MTT method was applied to detect the proliferation activity of chondrocytes, while flow cytometry was implemented to detect the apoptosis of chondrocytes.

RESULTS

The expression of miR-1307-5p in cartilage tissue specimens of OA patients was up-regulated, while TGFBI expression was down-regulated. Compared with normal mice cartilage tissue specimens, the expression of miR-1307-5p in cartilage tissue specimens of OA mouse was increased, while TGFBI expression was decreased (both P<0.05). The results of the dual luciferase reporter experiment showed that TGFBI was a target gene of miR-1307-5p. In cell experiments, compared with the normal group, TIMP-1 and Bcl-2 expression, and cell proliferation activities in all model groups were decreased. IL-1β, IL-6, TNF-α, Bax expression, and cell apoptosis rates were increased (all P<0.05). Compared with the blank group, TIMP-1 and Bcl-2 expression, and cell proliferation activities in the miR-1307-5p inhibitor group and the TGFBI group were increased, while IL-1β, IL-6, TNF-α, and Bax expression, and cell apoptosis rates were decreased (all P<0.05). The changes in all indicators in the miR-1307-5p mimic group were opposite to those of the miR-1307-5p inhibitor group (all P<0.05). There were no significant differences concerning all indicators between the blank group and the NC group, and between the blank group and the miR-1307-5p mimic + TGFBI group (all P>0.05).

CONCLUSION

The suppression of miR-1307-5p expression can increase TGFBI expression, promoting the proliferation of chondrocytes in OA mice, while inhibiting their apoptosis.

[Japan narrow-band imaging Expert Team type 2B colorectal cancer: consistency between endoscopic prediction and pathological diagnosis]

OBJECTIVE

To explore the potential factors that affect the accuracy of endoscopic diagnosis for Japan narrow-band imaging (NBI) Expert Team (JNET) type 2B colorectal lesions.

OBJECTIVE

The clinical data were collected from 261 patients with JNET type 2B colorectal lesions diagnosed in Nanfang Hospital between July, 2018 and July, 2021. We analyzed the macroscopic type, size, location or pit pattern classification of the lesions for their potential influence of the diagnostic accuracy of JNET type 2B lesions.

OBJECTIVE

The 261 lesions included 91 low-grade intramucosal neoplasia lesions (34.9%), 132 high-grade intramucosal neoplasia lesions (50.6%), 13 submucosal invasive cancer lesions (5.0%), and 25 deep submucosal invasive cancer lesions (9.6%). The coincidence rate between endoscopic prediction and pathological diagnosis of these lesions was 55.6% (145/ 261). The macroscopic type and size of the lesions were significantly associated with the diagnostic accuracy of JNET type 2B lesions (P < 0.001). There was a significant difference in the diagnostic accuracy among the lesions with different pit pattern types (P < 0.001).

OBJECTIVE

Both the macroscopic type and size affect the accuracy of endoscopic diagnosis of JNET type 2B colorectal lesions. JNET classification combined with pit pattern types can have better accuracy in predicting the pathological diagnosis of these lesions.

Retromer stabilizes transient membrane insertion of L2 capsid protein during retrograde entry of human papillomavirus

Retromer, a cellular protein trafficking complex, sorts human papillomaviruses (HPVs) into the retrograde pathway for transport of HPV to the nucleus during virus entry. Here, we conducted a protein modulation screen to isolate four artificial transmembrane proteins called traptamers that inhibit different steps of HPV entry. By analyzing cells expressing pairs of traptamers, we ordered the trafficking steps during entry into a coherent pathway. One traptamer stimulates ubiquitination of the L2 capsid protein or associated proteins and diverts incoming virus to the lysosome, whereas the others act downstream by preventing sequential passage of the virus through retrograde compartments. Complex genetic interactions between traptamers revealed that a cell-penetrating peptide (CPP) on L2 mediates transient insertion of L2 into the endosome membrane, which is stabilized by retromer-L2 binding. These results define the retrograde entry route taken by HPV and show that retromer can play a role in CPP-mediated membrane insertion.

The correlation between tissue Doppler imaging and N-terminal pro-brain natriuretic peptide concentration during left ventricular diastolic function recovery after coronary artery bypass grafting

OBJECTIVE

This study aims to evaluate the changes in left ventricular diastolic function after coronary artery bypass grafting through tissue Doppler imaging (TDI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration and the correlation between the two.

PATIENTS AND METHODS

A total of 133 patients who underwent coronary artery bypass grafting between January 2016 and December 2018 were included in this study. Echocardiography and NT-proBNP concentration were reviewed pre-operation, 1 month post-operation, and 3-6 months post-operation. The transmitral peak flow velocity (E) of the mitral valve was measured at each of the three-time points using spectral Doppler imaging. The mitral annulus displacement (Ea peak and Aa peak) was then measured at each of the time points using TDI, and the E/Ea ratio was calculated. Subsequently, the correlation of the E value, Ea value, and E/Ea ratio with NT-proBNP concentration was statistically analyzed.

RESULTS

The data obtained at the three-time points were compared with the respective concentrations of NT-proBNP. Multiple linear regression analysis revealed a correlation between NT-proBNP concentration and E value, Ea value, and E/Ea ratio.

CONCLUSIONS

Left ventricular diastolic function gradually recovered at 1 month and 3-6 months after coronary artery bypass grafting. There was a correlation between TDI-related values and NT-proBNP concentration.

Effects of mindfulness decompression therapy combined with transcranial magnetic stimulation in generalized anxiety disorder

OBJECTIVE

To explore the clinical effects of mindfulness decompression therapy combined with transcranial magnetic stimulation in generalized anxiety disorder.

METHODS

In the present prospective study, ninety-two patients with generalized anxiety disorder were randomly divided into two groups, with 46 cases in each group. On the basis of drug treatment, patients in the control group received transcranial magnetic stimulation, and patients in the research group were treated with mindfulness decompression therapy combined with transcranial magnetic stimulation. The total effective rate, anxiety degree (evaluated by the Hamilton Anxiety Scale (HAMA) score), severity of condition (evaluated by the clinical global impression (CGI) score), comfort degree score (Psychology, physiology, environment, social culture), neuroelectrophysiological parameters and sleep quality (Pittsburgh sleep quality index (PSQI) factors) before and after treatment were compared between the two groups.

RESULTS

After treatment, the research group had higher total effective rate than that of the control group (P<0.05); the HAMA score and CGI score of two groups were both decreased, and the research group decreased much more than the control group (P<0.05); mismatch negativity (MMN) latency, target N2 latency and target P3 latency of two groups were all decreased, MMN amplitude and none-target P2 amplitude were both increased, and the research group improved much more than the control group (P<0.05); the scores of social comfort, environmental comfort, physiological comfort and psychological comfort of two groups were all increased, and the corresponding scores of the research group were all higher than those of the control group (P<0.05); PSQI scores of two groups were all decreased, and the research group had lower PSQI scores than the control group (P<0.05).

CONCLUSION

Mindfulness decompression therapy combined with transcranial magnetic stimulation effectively relieve anxiety symptoms and improve comfort degree and sleep quality in patients with generalized anxiety disorder.

Mechanism of Mitophagy and Its Role in Sepsis Induced Organ Dysfunction: A Review

Autophagy, an evolutionarily conserved process, plays an important role in maintaining cellular homeostasis under physiological and pathophysiological conditions. It is widely believed that mitochondria influence the development of disease by regulating cellular metabolism. When challenged by different stimuli, mitochondria may experience morphological disorders and functional abnormalities, leading to a selective form of autophagy-mitophagy, which can clear damaged mitochondria to promote mitochondrial quality control. Sepsis is a complex global problem with multiple organ dysfunction, often accompanied by manifold mitochondrial damage. Recent studies have shown that autophagy can regulate both innate and acquired immune processes to protect against organ dysfunction in sepsis. Sepsis-induced mitochondrial dysfunction may play a pathophysiological role in the initiation and progression of sepsis-induced organ failure. Mitophagy is reported to be beneficial for sepsis by eliminating disabled mitochondria and maintaining homeostasis to protect against organ failure. In this review, we summarize the recent findings and mechanisms of mitophagy and its involvement in septic organ dysfunction as a potential therapeutic target.

Mechanism of Mitophagy and Its Role in Sepsis Induced Organ Dysfunction: A Review

Autophagy, an evolutionarily conserved process, plays an important role in maintaining cellular homeostasis under physiological and pathophysiological conditions. It is widely believed that mitochondria influence the development of disease by regulating cellular metabolism. When challenged by different stimuli, mitochondria may experience morphological disorders and functional abnormalities, leading to a selective form of autophagy-mitophagy, which can clear damaged mitochondria to promote mitochondrial quality control. Sepsis is a complex global problem with multiple organ dysfunction, often accompanied by manifold mitochondrial damage. Recent studies have shown that autophagy can regulate both innate and acquired immune processes to protect against organ dysfunction in sepsis. Sepsis-induced mitochondrial dysfunction may play a pathophysiological role in the initiation and progression of sepsis-induced organ failure. Mitophagy is reported to be beneficial for sepsis by eliminating disabled mitochondria and maintaining homeostasis to protect against organ failure. In this review, we summarize the recent findings and mechanisms of mitophagy and its involvement in septic organ dysfunction as a potential therapeutic target.

Mechanism of Mitophagy and Its Role in Sepsis Induced Organ Dysfunction: A Review

Autophagy, an evolutionarily conserved process, plays an important role in maintaining cellular homeostasis under physiological and pathophysiological conditions. It is widely believed that mitochondria influence the development of disease by regulating cellular metabolism. When challenged by different stimuli, mitochondria may experience morphological disorders and functional abnormalities, leading to a selective form of autophagy-mitophagy, which can clear damaged mitochondria to promote mitochondrial quality control. Sepsis is a complex global problem with multiple organ dysfunction, often accompanied by manifold mitochondrial damage. Recent studies have shown that autophagy can regulate both innate and acquired immune processes to protect against organ dysfunction in sepsis. Sepsis-induced mitochondrial dysfunction may play a pathophysiological role in the initiation and progression of sepsis-induced organ failure. Mitophagy is reported to be beneficial for sepsis by eliminating disabled mitochondria and maintaining homeostasis to protect against organ failure. In this review, we summarize the recent findings and mechanisms of mitophagy and its involvement in septic organ dysfunction as a potential therapeutic target.

MicroRNA-182 is a potential biomarker for prognosis of gastric cancer: A protocol for meta-analysis and bioinformatics analysis

BACKGROUND

Being the second leading cause of cancer death in the world, gastric cancer is a common malignant tumor in digestive system. Most patients were diagnosed in advanced stage and had poor prognosis. In recent years, related studies have displayed that MicroRNA-182 (miRNA-182) can promote the proliferation, infiltration, metastasis and drug resistance of tumor cells, so it can be used as a new molecular marker for the early diagnosis, prognosis, and treatment of tumors. However, the expression and prognosis of miRNA-182 in gastric cancer are not clear. Therefore, this study conducted a meta-analysis to further clarify the relationship between the expression of miRNA-182 in gastric cancer and prognosis. In addition, a bioinformatics analysis was adopted to further analyze the possible molecular mechanism of miRNA-182, so as to provide a theoretical basis for the diagnosis, treatment, and prognosis of patients suffering from gastric cancer.

METHODS

The following electronic databases were searched on computer: Wanfang, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, the Chongqing VIP Chinese Science and Technology Periodical Database, PubMed, Embase, and Web of Science databases. The retrieval time is set to build the database until April 2021. Combined hazard ratios (HRs) and 95% confidence intervals (95% CIs) were used to evaluate the effects of miRNA-182 on the prognosis of gastric cancer. Stata 16.0 software was applied for the meta-analysis. The expression of miRNA-182 in gastric cancer was analyzed by Gene Expression Omnibus database and The Cancer Genome Atlas database. The survival curve of miRNA-182 differential expression was analyzed by OncomiR. The target genes of miRNA-182 were predicted by TargetScan, miRBase, miRTarBase, starBase V2.0, and miRWalk. The target genes were obtained by the intersection of Wayne diagram. DAVID database was used for gene ontology (GO) and Kyoto encyclopedia of genes and genomes enrichment analysis. STRING database and Cytoscape were applied to construct Protein-protein interaction network to obtain key genes (hub gene). The expression of hub gene in gastric cancer was analyzed by gene expression profiling interactive analysis. The survival curve between hub gene and prognosis of gastric cancer was drawn by Kaplan-Meier Plotter database. TIMER database was used to analyze the relationship between hub gene expression and immune cell infiltration in gastric cancer.

RESULTS

The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.

CONCLUSION

This study provides high-quality evidence support for the expression of miRNA-182 and the prognosis of gastric cancer. Through bioinformatics analysis, we further discussed the mechanism of miRNA-182 in gastric cancer and the understanding of related pathways.

OSF REGISTRATION NUMBER

DOI 10.17605/OSF.IO/EHJ6X.

Dexmedetomidine reduces the incidence of postoperative delirium after cardiac surgery: a meta-analysis of randomized controlled trials

Background

The role of dexmedetomidine in preventing postoperative delirium (POD) after cardiac surgery remains controversial because of several recent trials with negative results. We aimed to perform an updated meta-analysis of randomized controlled trials (RCTs) to clarify this controversy.

Methods

RCTs investigating the perioperative administration of dexmedetomidine in cardiac surgery were retrieved from PubMed, Web of Science, and the Cochrane library until August,27,2020. Two researchers independently screened the literature, collected the data and evaluated the bias risk of the included studies. The meta-analysis was performed with the RevMan 5.3.

Results

A total of 15 studies including 2813 patients were included in the study. A pooled result showed that dexmedetomidine could reduce the risk of POD in adult population underwent cardiac surgery (OR 0.56, 95%CI 0.36–0.89, P = 0.0004, I² = 64%). The subgroup analysis demonstrated that the protective effect of dexmedetomidine was only present in the patients injected with dexmedetomidine after surgery but not from the start of surgery, in the adult patients without specific age limitation but not in the elderly, and in the studies in comparison with other sedatives but not with placebo. There were no statistical differences when analyzing the secondary outcomes including hypotension (OR 1.13; 95% CI 0.54–2.37, P < 0.00001, I² = 85%), bradycardia (OR 1.72; 95% CI 0.84–3.53, P = 0.04, I² = 58%) and atrial fibrillation (OR 0.87; 95% CI 0.70–1.08, P = 0.43, I² = 0).

Conclusions

Dexmedetomidine can reduce the incidence of POD compared to other sedatives and opioids after cardiac surgery in adult patients. The proper population and timing for perioperative use of dexmedetomidine after cardiac surgery remain to be further investigated.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12871-021-01370-1.

Oxygen-rich PdSnCu nanocrystals with particle connection features as enhanced catalysts for ethanol oxidation reaction

Most electrocatalysts show a high mass and special activity during the ethanol oxidation reaction, but those still suffer from limited stability, finite renewable capability and poor anti-poisoning durability. Furthermore, the reliable structure and appropriate composition of catalysts are fairly associated with the electrocatalysis performance. Herein, we report the development of trimetallic Pd₆₁Sn₃₄Cu₅nanocrystals (NCs) whose rough surfaces are rich in step atoms and coupled with abundant of SnO_xand CuO, which may effectively boost reaction activity and rapidly remove carbonaceous intermediate, respectively. Under the tuning on the composition, the defect rich Pd₆₁Sn₃₄Cu₅NCs exhibit elevated electrocatalysis activity and durability for ethanol oxidation reaction with an optimized mass activity (1.26 AmgPd-1) and specific activity (10.6 mA cm^-2), which is about 2.21 and 2.58 times greater than that of the commercial Pd/C catalyst (0.57 AmgPd-1and 4.1 mA cm^-2).

Visible colorimetric dosimetry of UV and ionizing radiations by a dual-module photochromic nanocluster

Radiation dosimeters displaying conspicuous response of irradiance are highly desirable, owing to the growing demand of monitoring high-energy radiation and environmental exposure. Herein, we present a case of dosimetry based on a discrete nanocluster, [Th6(OH)4(O)4(H2O)6](TPC)8(HCOO)4∙4DMF∙H2O (Th-SINAP-100), by judiciously incorporating heavy Th6 polynuclear centers as radiation attenuator and organic linkers as photo-responsive sensor. Interestingly, dual-module photochromic transitions upon multiple external stimuli including UV, β-ray, and γ-ray are integrated into this single material. The striking color change, and more significantly, the visible color transition of luminescence in response to accumulating radiation dose allow an on-site quantitative platform for naked-eye detection of ionization radiations over a broad range (1-80 kGy). Single crystal X-ray diffraction and density functional theory calculations reveal that the dual-module photochromism can be attributed to the π(TPC) → π*(TPC) intermolecular charge transfer driven by enhanced π-π stacking interaction between the adjacent TPC moieties upon irradiation.

Senkyunolide I attenuates hepatic ischemia/reperfusion injury in mice via anti-oxidative, anti-inflammatory and anti-apoptotic pathways

BACKGROUND

Senkyunolide I (SEI)exerts considerable protective effects in various disease models, but its effect on hepatic ischemia-reperfusion (I/R) injury remains unknown. This research aimed to investigate the effect of SEI in a murine model of hepatic I/R injury.

METHODS

With modified liver I/R murine model, low, medium and high doses of SEI were injected intraperitoneally after operation. After 6 h of reperfusion, the blood and liver were collected. Serum ALT and AST were detected by automatic analyzer, while liver injury was evaluated by HE staining. High-dose SEI was selected to further explore its impacts on oxidative stress, inflammatory responses and apoptosis induced by hepatic I/R. The pharmacological effect of SEI was also compared with a positive control, glutathione (GSH). We used ELISA to detect serum TNF-α, IL-1 β and IL-6, special kit to explore activities of SOD and GSH-Px, and the content of MDA, and western blotting to detect HO-1, Bax and Bcl-2 levels, and to perceive expressions and phosphorylations of NF- κB p65 and p38/ERK/JNK in liver tissues. Apoptosis in liver tissue was evaluated by TUNEL. The antioxidative effect of SEI was further investigated using the HuCCT1 cells stimulated with H₂O₂ and the role of SEI on regulation of Nrf-2/HO-1 was determined.

RESULTS

200 mg/kg of SEI was optimal dose for treating liver I/R injury. Elevated ALT, AST and histopathological injury in I/R liver was attenuated by SEI administration, similarly to GSH. Serum TNF-α, IL-1β, and IL-6 were reduced in liver I/R mice treated with SEI, and in liver tissues, phosphorylation of p65 NF-κB and MAPK kinases (p38, ERK, JNK), were inhibited. SEI reduced the MDA content, but increased HO-1 level and enhanced SOD and GSH-Px activities. Apoptosis of liver tissues was decreased, while SEI inhibited Bax and elevated Bcl-2 expression. In in vitro experiments, H₂O₂ reduced the survival rate of HuCCT1 cells, which was protected by SEI administration. SEI reduced the ROS and MDA content. The transportation of Nrf-2 into the nucleus was enhanced and HO-1 expression was upregulated.

CONCLUSIONS

SEI attenuates hepatic I/R injury in mice via anti-oxidative, anti-inflammatory and anti-apoptotic pathways.

The Protection of User Preference Privacy in Personalized Information Retrieval: Challenges and Overviews

This paper reviews a large number of research achievements relevant to user privacy protection in an untrusted network environment, and then analyzes and evaluates their application limitations in personalized information retrieval, to establish the conditional constraints that an effective approach for user preference privacy protection in personalized information retrieval should meet, thus providing a basic reference for the solution of this problem. First, based on the basic framework of a personalized information retrieval platform, we establish a complete set of constraints for user preference privacy protection in terms of security, usability, efficiency, and accuracy. Then, we comprehensively review the technical features for all kinds of popular methods for user privacy protection, and analyze their application limitations in personalized information retrieval, according to the constraints of preference privacy protection. The results show that personalized information retrieval has higher requirements for users’ privacy protection, i.e., it is required to comprehensively improve the security of users’ preference privacy on the untrusted server-side, under the precondition of not changing the platform, algorithm, efficiency, and accuracy of personalized information retrieval. However, all kinds of existing privacy methods still cannot meet the above requirements. This paper is an important study attempt to the problem of user preference privacy protection of personalized information retrieval, which can provide a basic reference and direction for the further study of the problem.

Kallistatin alleviates heart failure in rats by inhibiting myocardial inflammation and apoptosis via regulating sirt1

OBJECTIVE

Heart failure (HF) is the loss of myocardial structure and function caused by various congenital or acquired heart diseases. This study explored the new target of treatment of HF by investigating the effect of Kallistatin (KS) on inflammation and apoptosis of myocardial tissue in HF rats.

MATERIALS AND METHODS

We used doxorubicin to induce rat HF, and determined the success rate of modeling by detecting changes in rat heart weight and body weight, cardiac function and histology. We used two different doses (1 mg/kg, 2 mg/kg) of KS intraperitoneally injected rats and detected changes in inflammation and apoptosis of rat myocardial tissue by enzyme-linked immunosorbent assay (ELISA), Reverse Transcription-Polymerase Chain Reaction (RT-PCR) and immunohistochemical staining. Changes in the expression of sirt1 were also detected. In addition, we cultured rat myocardial cell line, H9c2 cells, and used siRNA-sirt1 to inhibit sirt1 in H9c2 cells to clarify the mechanism of KS regulating myocardial cells.

RESULTS

The body weight of HF rats treated with KS decreased while the heart weight increased. KS has also been found to reduce the concentration of brain natriuretic polypeptide (BNP) in rat serum. The results of echocardiography showed that KS effectively relieved the cardiac function of HF rats. Inflammatory factors (interleukin (IL)-1β, IL-6, IL-8 and tumor necrosis factor (TNF)-α) and pro-apoptotic molecules (caspase3/9 and Bax) in the serum and myocardial tissue of rats treated with KS were also significantly reduced. The inhibition of sirt1 in H9c2 cells significantly reduced the anti-apoptotic effect of KS on H9c2 cells.

CONCLUSIONS

KS reduces the inflammation and apoptosis of myocardial tissue in HF rats by promoting the expression of sirt1, thereby alleviating HF-induced myocardial injury.

Contralesional Structural Plasticity in Different Molecular Pathologic Subtypes of Insular Glioma

Neuroplasticity may preserve neurologic function in insular glioma, thereby improving prognosis following resection. However, the anatomic and molecular bases of this phenomenon are not known. To address this gap in knowledge, the present study investigated contralesional compensation in different molecular pathologic subtypes of insular glioma by high-resolution three-dimensional T1-weighted structural magnetic resonance imaging. A total of 52 patients with insular glioma were examined. We compared the gray matter volume (GMV) of the contralesional insula according to histological grade [low-grade glioma (LGG) and high-grade glioma (HGG)] and molecular pathology status [isocitrate dehydrogenase (IDH) mutation, telomerase reverse-transcriptase (TERT) promoter mutation, and 1p19q codeletion] by voxel-based morphometry (VBM). A cluster of 320 voxels in contralesional insula with higher GMV was observed in glioma with IDH mutation as compared to IDH wild-type tumors by region of interest-based VBM analysis (family-wise error-corrected at p < 0.05). The GMV of the entire contralesional insula was also larger in insular glioma patients with IDH mutation than in patients with wild-type IDH. However, there was no association between histological grade, TERT promoter mutation, or 1p19q codeletion and GMV in the contralesional insula. Thus, IDH mutation is associated with greater structural compensation in insular glioma. These findings may be useful for predicting neurocognitive and functional outcomes in patients undergoing resection surgery.

Pioneering Iodine-125-Labeled Nanoscale Covalent Organic Frameworks for Brachytherapy

Brachytherapy has been clinically used for the treatment of malignant solid tumors. However, the classic therapeutic radioactive ¹²⁵I seed must be surgically implanted directly into tumors. To avoid the surgery and prevent irrational radioactive distribution, radioiodine-loaded nanomaterials are ever-developing for brachytherapy. Hence, it is still a notable challenge to obtain an advanced material that simultaneously incorporates features of high radiolabeling rate, short labeling time, good radiolabeling stability, and long tumor retention time. Covalent organic frameworks (COFs), which are crystalline polymers with ordered pores, are widely applied in guest delivery of drugs based on their high porosity and modifiable skeleton. Herein, we developed a functionalized nanoscale PEG-COF-Ag material, which could rapidly capture radioiodine reaching a 94% radiolabeling yield in 30 s. In addition, more than 95% ¹²⁵I was maintained after 24 h in PBS (phosphate-buffered saline) as well as in serum and over 90% for nearly 1 week. PEG-COF-Ag-¹²⁵I (¹²⁵I-COF) demonstrated excellent cancer cell killing performance in vitro, and further experiments in vivo revealed a long tumor retention time and effective tumor treatment during the radiotherapy. The results indicate that radioiodine-labeled PEG-COF-Ag could be potentially applied in brachytherapy with a promising therapeutic effect.

LINC00114 promoted nasopharyngeal carcinoma progression and radioresistance in vitro and in vivo through regulating ERK/JNK signaling pathway via targeting miR-203

OBJECTIVE

Nasopharyngeal carcinoma (NPC) is a malignancy and is prone to distant metastasis and radioresistance. Long non-coding RNAs (lncRNAs) play vital roles in human cancers. The purpose of this study was to explore the role and the action mechanism of intergenic lncRNA (LINC00114) in NPC.

MATERIALS AND METHODS

The expression of LINC00114 and microRNA-203 (miR-203) was measured by quantitative real-time polymerase chain reaction (qRT-PCR). NPC cells were exposed to X-ray as radiation treatment. Cell proliferation, migration, cell survival fraction and apoptosis were assessed by 3-(4, 5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT), transwell, colony formation, and flow cytometry assays, respectively. The expression of Cleaved-cas-3, Cleaved-cas-9, phosphor-ERK (p-ERK) and phosphor-JNK (p-JNK) was quantified by Western blot. The interaction between miR-203 and LINC00114 was predicted by bioinformatics tool microRNA.org and verified by dual-luciferase reporter assay. Tumor formation assay in nude mice was conducted to examine the role of LINC00114 in vivo.

RESULTS

LINC00114 was upregulated in serums from NPC patients, tissues and cell lines of NPC. LINC00114 knockdown inhibited proliferation, migration, and radioresistance of NPC cells. MiR-203 was a target of LINC00114, and miR-203 inhibition eliminated the effects of LINC00114 knockdown. Besides, the extracellular signal-regulated kinases (ERK)/c-Jun N-terminal kinases (JNK) pathway was inactivated by LINC00114 knockdown but recovered by miR-203 inhibition. Moreover, LINC00114 knockdown suppressed tumor growth and radioresistance in vivo.

CONCLUSIONS

LINC00114 contributed to NPC development and radioresistance through the regulation of ERK/JNK signaling pathway and the mediation of miR-203, suggesting that LINC00114 was a promising biomarker to defense NPC progression and radioresistance.

Prediction of Lower Grade Insular Glioma Molecular Pathology Using Diffusion Tensor Imaging Metric-Based Histogram Parameters

Objectives

To explore whether a simplified lesion delineation method and a set of diffusion tensor imaging (DTI) metric-based histogram parameters (mean, 25th percentile, 75th percentile, skewness, and kurtosis) are efficient at predicting the molecular pathology status (MGMT methylation, IDH mutation, TERT promoter mutation, and 1p19q codeletion) of lower grade insular gliomas (grades II and III).

Methods

40 lower grade insular glioma patients in two medical centers underwent preoperative DTI scanning. For each patient, the entire abnormal area in their b-non (b0) image was defined as region of interest (ROI), and a set of histogram parameters were calculated for two DTI metrics, fractional anisotropy (FA) and mean diffusivity (MD). Then, we compared how these DTI metrics varied according to molecular pathology and glioma grade, with their predictive performance individually and jointly assessed using receiver operating characteristic curves. The reliability of the combined prediction was evaluated by the calibration curve and Hosmer and Lemeshow test.

Results

The mean, 25th percentile, and 75th percentile of FA were associated with glioma grade, while the mean, 25th percentile, 75th percentile, and skewness of both FA and MD predicted IDH mutation. The mean, 25th percentile, and 75th percentile of FA, and all MD histogram parameters significantly distinguished TERT promoter status. Similarly, all MD histogram parameters were associated with 1p19q status. However, none of the parameters analyzed for either metric successfully predicted MGMT methylation. The 25th percentile of FA yielded the highest prediction efficiency for glioma grade, IDH mutation, and TERT promoter mutation, while the 75th percentile of MD gave the best prediction of 1p19q codeletion. The combined prediction could enhance the discrimination of grading, IDH and TERT mutation, and also with a good fitness.

Conclusions

Overall, more invasive gliomas showed higher FA and lower MD values. The simplified ROI delineation method presented here based on the combination of appropriate histogram parameters yielded a more practical and efficient approach to predicting molecular pathology in lower grade insular gliomas. This approach could help clinicians to determine the extent of tumor resection required and reduce complications, enabling more precise treatment of insular gliomas in combination with radiotherapy and chemotherapy.