Parecoxib improves the cognitive function of POCD rats via attenuating COX-2

OBJECTIVE

This study aims to explore the role of parecoxib in improving postoperative cognitive dysfunction (POCD) in rats, and to investigate the possible underlying mechanism.

MATERIALS AND METHODS

60 Sprague Dawley (SD) rats were randomly divided into the control group (n=20), the model group (n=20), and the para group (n=20). The Morris water maze test was conducted to detect the postoperative cognitive ability of rats. The hematoxylin-eosin (HE) staining was applied to observe the neuronal density in the hippocampus of rats. The TdT-mediated dUTP Nick-End Labeling (TUNEL) was used to detect the hippocampal apoptosis in rats. Meanwhile, relative levels of inflammatory factors in rat hippocampus were detected by enzyme-linked immunosorbent assay (ELISA), including interleukin-1β (IL-1β), IL-6, tumor necrosis factor-α (TNF-α), and prostaglandin E2 (PGE2). Furthermore, Western blot was conducted to detect the protein levels of cyclooxygenase-2 (COX-2), PGE2, EP1, and p-Akt in rat hippocampus.

RESULTS

Behavioral test results showed that the escape latency of rats in the para group was significantly shorter than that of the model group (p<0.05). Compared with the model group, rats in para group showed significantly longer time in target quadrant and more times across the platform, as well as higher Tn/Tn+Tf (p<0.05). In the control group, pathological changes of hippocampal neurons were slighter with rare apoptotic cells. Rats in model group showed great pathological lesions with abundant apoptotic neurons, which were markedly alleviated in the para group (p<0.05). Meanwhile, ELISA showed that the levels of IL-1β, IL-6, TNF-α, and PGE2 in the para group were remarkably lower than those of the model group (p<0.05). Expression levels of COX-2, PGE2, and EP1 in the para group were significantly lower than those of the model group (p<0.05). However, the expression level of p-Akt was significantly higher than the model group (p<0.05).

CONCLUSIONS

Parecoxib improves the cognitive function of POCD rats via inhibiting COX-2 overexpression in rat brain.

Applications of microbial co-cultures in polyketides production

Polyketides are a large group of natural biomolecules that are normally produced by bacteria, fungi and plants. These molecules have clinical importance due to their anti-cancer, anti-microbial, anti-oxidant and anti-inflammatory properties. Polyketides are biosynthesized from units of acyl-CoA by different polyketide synthases (PKSs), which display wide diversity of functional domains and mechanisms of action between fungi and bacteria. Co-culture of different micro-organisms can produce novel products distinctive from those produced during single cultures. This study compared the new polyketides produced in such co-culture systems and discusses aspects of the cultivation systems, product structures and identification techniques. Current results indicate that the formation of new polyketides may be the result of activation of previously silent PKSs genes induced during co-culture. This review indicated a potential way to produce pure therapeutic polyketides by microbial fermentation and a potential way to develop functional foods and agricultural products using co-co-culture of different micro-organisms. It also pointed out a new perspective for studies on the process of functional foods, especially those involving multiple micro-organisms.

[A multicentric study on clinical characteristics and antibiotic sensitivity in children with methicillin-resistant Staphylococcus aureus infection]

Objective: To investigate the clinical characteristics of pediatric methicillin-resistant Staphylococcus aureus (MRSA) infection and the antibiotic sensitivity of the isolates. Methods: The clinical data of children with MRSA infection and antibiotic sensitivity of the isolates from 11 children's hospitals in Infectious Diseases Surveillance of Paediatrics (ISPED) group of China between January 1, 2018 and December 31, 2018 were collected retrospectively. The children's general condition, high-risk factors, antimicrobial therapy and prognosis, differences in clinical disease and laboratory test results between different age groups, and differences of antibiotic sensitivity between community-acquired (CA)-MRSA and hospital-acquired (HA)-MRSA were analyzed. The t test and Wilcoxon rank sum test were used for statistical analysis of the quantitative data and Chi-square test were used for comparison of rates. Results: Among the 452 patients, 264 were males and 188 were females, aged from 2 days to 17 years. There were 233 cases (51.5%) in the ≤1 year old group, 79 cases (17.5%) in the>1-3 years old group, 29 cases (6.4%) in the >3-5 years old group, 65 cases (14.4%) in the >5-10 years old group, and 46 cases (10.2%) in the>10 years old group. The main distributions of onset seasons were 55 cases (12.2%) in December, 47 cases (10.4%) in February, 46 cases (10.2%) in November, 45 cases (10.0%) in January, 40 cases (8.8%) in March. There were 335 cases (74.1%) CA-MRSA and 117 (25.9%) cases HA-MRSA. Among all cases, 174 cases (38.5%) had basic diseases or long-term use of hormone and immunosuppressive drugs. During the period of hospitalization, 209 cases (46.2%) received medical interventions. There were 182 patients (40.3%) had used antibiotics (β-lactams, glycopeptides, macrolides, carbapenems, oxazolones, sulfonamides etc) 3 months before admission. The most common clinical disease was pneumonia (203 cases), followed by skin soft-tissue infection (133 cases), sepsis (92 cases), deep tissue abscess (42 cases), osteomyelitis (40 cases), and septic arthritis (26 cases), suppurative meningitis (10 cases). The proportion of pneumonia in the ≤1 year old group was higher than the >1-3 years old group,>3-5 years old group,>5-10 years old group,>10 years old group (57.5% (134/233) vs. 30.4% (24/79), 31.0% (9/29), 38.5% (25/65), 23.9% (11/46), χ(2)=17.374, 7.293, 7.410, 17.373, all P<0.01) The proportion of skin and soft tissue infections caused by CA-MRSA infection was higher than HA-MRSA (33.4% (112/335) vs. 17.9% (21/117), χ(2)=10.010, P=0.002), and the proportion of pneumonia caused by HA-MRSA infection was higher than CA-MRSA (53.0% (62/117) vs. 42.1% (141/335), χ(2)=4.166, P=0.041). The first white blood cell count of the ≤1 year old group was higher than that children > 1 year old ((15±8)×10(9)/L vs. (13±7)×10(9)/L, t=2.697, P=0.007), while the C-reactive protein of the ≤1 year old group was lower than the 1-3 years old group,>5-10 years old group,>10 years old group (8.00 (0.04-194.00) vs.17.00 (0.50-316.00), 15.20 (0.23-312.00), 21.79(0.13-219.00) mg/L, Z=3.207, 2.044, 2.513, all P<0.05), there were no significant differences in procalcitonin (PCT) between different age groups (all P>0.05). After the treatment, 131 cases were cured, 278 cases were improved, 21 cases were not cured, 12 cases died, and 10 cases were abandoned. The 452 MRSA isolates were all sensitive to vancomycin (100.0%), linezolid (100.0%), 100.0% resistant to penicillin, highly resistant to erythromycin (85.0%, 375/441), clindamycin (67.7%, 294/434), less resistant to sulfonamides (5.9%, 23/391), levofloxacin (4.5%, 19/423), gentamicin (3.2%, 14/438), rifampicin (1.8%, 8/440), minocycline (1.1%, 1/91). The antimicrobial resistance rates were not significantly different between the CA-MRSA and HA-MRSA groups (all P>0.05). Conclusions: The infection of MRSA is mainly found in infants under 3 years old. The prevalent seasons are winter and spring, and MRSA is mainly acquired in the community. The main clinical diseases are pneumonia, skin soft-tissue infection and sepsis. No MRSA isolate is resistant to vancomycin, linezolid. MRSA isolates are generally sensitive to sulfonamides, levofloxacin, gentamicin, rifampicin, minocycline, and were highly resistant to erythromycin and clindamycin. To achieve better prognosis. clinicians should initiate anti-infective treatment for children with MRSA infection according to the clinical characteristics of patients and drug sensitivity of the isolates timely and effectively.

PVDF-Modified Nafion Membrane for Improved Performance of MFC

Low power production and unstable power supply are important bottlenecks restricting the application of microbial fuel cells (MFCs). It is necessary to explore effective methods to improve MFC performance. By using molasses wastewater as fuel, carbon felt as an electrode, and the mixture of K3[Fe(CN)6] and NaCl as a catholyte, an MFC experimental system was set up to study the performance of MFCs with three different proton exchange membranes. A Nafion membrane was used as the basic material, and polyvinylidene fluoride (PVDF) and acetone-modified PVDF were used to modify it, respectively. The experimental results show that a PVDF-modified membrane can improve the water absorption effectively and, thus, make the MFC have greater power generation and better wastewater treatment effect. The acetone-modified PVDF can further improve the stability of output power of the MFC. When the acetone-modified PVDF was used to modify the Nafion membrane, the steady output voltage of the MFC was above 0.21 V, and the Chemical Oxygen Demand (COD) removal rate for molasses wastewater was about 66.7%, which were 96.3% and 75.1% higher than that of the MFC with the ordinary Nafion membrane. Membrane modification with acetone-modified PVDF can not only increase the output voltage of the MFC but also improve the stability of its output electrical energy.

[Ibrutinib treatment for 2 cases of relapsed/refractory autoimmune hemolytic anemia: a pilot study]

目的

探索伊布替尼治疗复发/难治原发性自身免疫性溶血性贫血（AIHA）的疗效及安全性。

方法

2例原发性AIHA患者多次复发，1例有脾切除史，经糖皮质激素、利妥昔单抗及多种免疫抑制药物治疗无效，诊断为复发/难治原发性AIHA。给予伊布替尼起始剂量280 mg/d（例1第3～8周加量到420 mg/d）治疗，观察疗效及安全性。

结果

例1治疗2周后脱离输血，HGB增长>20 g/L，获得部分疗效；10周后HGB 113 g/L伴有代偿性溶血实验室改变，获得完全缓解伴代偿性溶血状态（CRi）。例2治疗2周后脱离输血，HGB增长>20 g/L，获得部分疗效；6周后HGB 118 g/L伴有代偿性溶血实验室改变，获得CRi。2例患者分别随访16周和12周，已维持疗效14周和10周，未复发。伊布替尼治疗期间2例患者血液学不良反应轻，非血液学不良反应轻微。

结论

伊布替尼单药治疗复发/难治原发性AIHA有初步疗效，尚需规范的临床研究试验进一步验证其疗效及安全性。

Systematic review of hepatic arterial infusion chemotherapy versus sorafenib in patients with hepatocellular carcinoma with portal vein tumor thrombosis

BACKGROUND AND AIM

The prognosis of hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is very poor. This study aimed to evaluate hepatic arterial infusion chemotherapy (HAIC) versus sorafenib (SORF) in the treatment of HCC with PVTT.

METHODS

Studies were identified online in Embase and MEDLINE before October 31, 2019. The end-points were overall survival (OS), progression-free survival (PFS), disease control rate (DCR), and safety.

RESULTS

Six studies with 417 cases were included in this systematic review. Meta-analyses demonstrated that HAIC is superior to SORF with respect to OS (hazard ratio [HR]: 0.50, 95% confidence interval: 0.38-0.66, P < 0.001) and PFS (HR: 0.47, 95% confidence interval: 0.31-0.73, P = 0.001) irrespective of research territoriality and study quality. Our systematic review also demonstrated that HAIC is superior to SORF with respect to DCR. Subgroup analysis demonstrated that the advantage is more obvious in the treatment of types III-IV PVTT with respect to OS (HR: 0.29, P < 0.001) and PFS(HR: 0.39, P < 0.001). HAIC caused more grades 3-4 neutropenia (HR: 10.71), anemia (HR: 7.55), leukopenia (HR: 10.38), and thrombocytopenia (HR: 13.09) than SORF. However, HAIC caused fewer cases of grades 3-4 aspartate aminotransferase rising (HR: 0.21), diarrhea (HR: 0.14), and hand-foot syndrome (HR: 0.14) than SORF.

CONCLUSIONS

This systematic review demonstrated that HAIC is superior to SORF in HCC with PVTT with respect to OS, PFS, and DCR, especially in HCC with types III-IV PVTT. HAIC caused more myelosuppression, whereas SORF is associated with diarrhea and hand-foot syndrome. Further randomized controlled trials are warranted.

The role of hsa_circ_0000285 in metastasis of hepatocellular carcinoma

Since this article has been suspected of research misconduct and the corresponding authors did not respond to our request to prove originality of data and figures, "The role of hsa_circ_0000285 in metastasis of hepatocellular carcinoma, by X.-J. Zhang, G. Cao, J. Fu, H.-J. Zhuang, J. Shi, published in Eur Rev Med Pharmacol Sci 2020; 24 (7): 3579-3585-DOI: 10.26355/eurrev_202004_20819-PMID: 32329832" has been withdrawn. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/20819.

Aspirin protects human coronary artery endothelial cells by inducing autophagy

Although the use of aspirin has substantially reduced the risks of cardiovascular events and death, its potential mechanisms have not been fully elucidated. In a previous study, we found that aspirin triggers cellular autophagy. In the present study, we aimed to determine the protective effects of aspirin on human coronary artery endothelial cells (HCAECs) and explore its underlying mechanisms. HCAECs were treated with oxidized low-density lipoprotein (ox-LDL), angiotensin II (Ang-II), or high glucose (HG) with or without aspirin stimulation. The expression levels of endothelial nitric oxide (NO) synthase (eNOS), p-eNOS, LC3, p62, phosphor-nuclear factor kappa B (p-NF-κB), p-p38 mitogen-activated protein kinase (p-p38 MAPK), and Beclin-1 were detected via immunoblotting analysis. Concentrations of soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) were measured via ELISA. NO levels were determined using the Griess reagent. Autophagic flux was tracked by tandem mRFP-GFP-tagged LC3. Results showed that aspirin increased eNOS level and reduced injury to the endothelial cells (ECs) caused by ox-LDL, Ang-II, and HG treatment in a dose-dependent manner. Aspirin also increased the LC3II/LC3I ratio, decreased p62 expression, and enhanced autophagic flux (autophagosome and autolysosome puncta) in the HCAECs. p-NF-κB and p-p38 mitogen-activated protein kinase inhibition, sVCAM-1 and sICAM-1 secretion, and eNOS activity promotion by aspirin treatment were found to be dependent on Beclin-1. These results suggested that aspirin can protect ECs from ox-LDL-, Ang-II-, and HG-induced injury by activating autophagy in a Beclin-1-dependent manner.

Status analysis and evaluation of the blood scrap rate from 2015-2017 for a blood center in China

OBJECTIVES

The objective of this study was to ascertain the current conditions and development in the past three years of clinical transfusion practice in Nanjing, Jiangsu province, China.

MATERIALS AND METHODS

Blood quality control practices and the blood production scrap rate from 2015-2017 were monitored and measured using different quality statistics and management tools.

RESULTS

The causes of unqualified and scrapped blood during blood collection and supply were analyzed and evaluated. The analysis of the key indices for blood component quality control showed that the qualified rate of FVIII activity (from fresh frozen plasma) was 54.55%, which failed to meet the threshold of 75%. Retrospective analysis of conventional blood scrapping factors showed that laboratory scraps accounted for the majority. The composition ratio of TTI screening results included ALT (31.91%), HBV (21.92%), TP (12.15%), NAT (10.78%), HCV (8.45%), and HIV (7.43%). Retrospective analysis of unconventional blood scrapping factors showed that the total unconventional blood depletion rate was 0.565%. Insufficient or small quantities of collected blood was the most important factor related to unconventional scrapping. The blood donor and blood hospital service satisfaction rates were over 95% and 90%, respectively, which achieved the quality target.

CONCLUSIONS

Nonconforming product control was proposed and determined as the urgent theme of the first QCC. It is necessary for blood stations to effectively control blood scrapping, which can reduce the cost of blood collection, protect the blood donation of unpaid blood donors, increase the rate of repeated blood donation, and improve blood safety.

[Orthodontic treatment in patients with periodontitis]

Patients with malocclusions and periodontitis need to conduct the orthodontic treatment based on good periodontal treatment. Combined orthodontic-periodontal treatment can improve occlusal relationship, effectively promote inflammation control and long-term stability.

[A prospective cohort study on blood pressure control and risk of ischemic stroke in patients with hypertension]

Objective: To explore the association between blood pressure control and risk of ischemic stroke (IS) in patients with hypertension. Methods: A total of 5 488 patients with hypertension from 60 communities were randomly selected from 101 communities in 8 streets of Nanshan District in Shenzhen City by using two-stage sampling method. The social demographic characteristics, behavior and life style, coronary heart disease and diabetes were collected and the physical condition, blood pressure and blood biochemical indexes were measured. From April 1, 2010 to August 31, 2017 as the follow-up period, the incidence of IS was annually collected by using telephone survey. Cox proportional hazard regression model was used to analyze the relationship between blood pressure control, systolic blood pressure (SBP), diastolic blood pressure (DBP) and the risk of IS. Results: The age of all patients was (58.50±12.14) years old, including 2 712 males (49.42%) and 3 112 patients with well-controlled blood pressure (56.71%). During the follow-up period, 358 new cases of IS were confirmed, and the incidence density was 1 346.27/100 000 person-years. Cox proportional hazard regression model analysis showed after adjusting for confounding factors, unstable blood pressure control, SBP≥150 mmHg (1 mmHg=0.133 kPa; compared with SBP<120 mmHg), and DBP≥95 mmHg (compared with DBP<80 mmHg) were associated with risk of IS. The HR (95%CI) was 1.29 (1.04, 1.59), 2.00 (1.26, 3.17) and 1.52 (1.01, 2.64), respectively. Subgroup analyses showed these associations only existed in female patients with hypertension. The HR (95%CI) was 1.39 (1.05, 1.85), 2.53 (1.41, 4.56) and 1.73 (1.00, 3.36), respectively. Conclusion: Unstable blood pressure control increases the risk of IS in female patients with hypertension.

[Characteristics of methadone maintenance treatment clinic patients and influencing factors for HBsAg positivity based on Bayesian network model]

Objective: To understand the characteristics and explore the influencing factors of HBsAg positivity in methadone maintenance treatment (MMT) clinic patients. Methods: A face to face interview and medical record review were conducted in 1 040 patients at three MMT clinics in Guangxi from September to November in 2014. The questionnaire information included general demographic characteristics, drug use history, MMT status, sexual behaviors, and health status, etc. Blood samples were collected from the patients at the same time for the detections of the level of HBsAg, anti-HBs and anti-HCV. By using χ(2) test, unconditional logistic regression model and Bayesian network model the influencing factors for HBsAg positivity in MMT clinic patients and the complex network relationship among these factors were explored. Results: A total of 1 031 MMT clinic patients were surveyed, the HBsAg positive rate was 11.35% (117/1 031). The anti-HCV positive rate was 71.77% (740/1 031), among the anti-HCV positive patients, the HBsAg positive rate was 10.27% (76/740). After adjusting for the confounding factors, anti-HBs positive persons might not be HBsAg positive (OR=0.05, 95%CI: 0.03-0.09), and anti-HCV positive persons might not be HBsAg positive too (OR=0.30, 95%CI: 0.17-0.52) compared with anti-HBs negative and anti-HCV negative persons, respectively. The persons with family history of hepatitis B virus infection were more likely to be HBsAg positive compared those with no such family history (OR=5.30, 95%CI: 2.68-10.52). Bayesian network model analysis results showed that family history of hepatitis B virus infection and anti-HBs were directly related with HBsAg positivity. Anti-HCV, intravenous drug use in the past three months and other drug using during treatment were indirectly related with HBsAg positivity. Conclusions: Anti-HBs, family history of hepatitis B virus infection, anti-HCV, intravenous drug use in past three months and other drug use during treatment were related with the HBsAg positivity in MMT clinic patients. So, it is necessary to enhance health education, improve health awareness and decrease high risk behaviors to reduce the rate of HBV infection.

Detection of multiple hypervirulent Klebsiella pneumoniae strains in a New York City hospital through screening of virulence genes

OBJECTIVES

The 'hypervirulent' variant of Klebsiella pneumoniae (hvKp) is a predominant cause of community-acquired pyogenic liver abscess in Asia, and is an emerging pathogen in Western countries. hvKp infections have demonstrated 'metastatic' dissemination in immunocompetent hosts, an unusual mode of infection associated with severe complications. Two cases alerted us to the possible presence of hvKp at our hospital, both involving elderly Hispanic males who presented with recurrent fever, bacteraemia, epigastric pain and liver abscesses/phlegmon, thus prompting an assessment of hvKp prevalence.

METHODS

A surveillance of K. pneumoniae blood, body fluid and wound isolates was conducted using real-time PCR to detect virulence-associated genes (uni-rmpA, iucA and peg344). Positive isolates were further characterized by wzi gene sequencing to determine capsular types (K-type) and by multilocus sequence typing and pulsed-field gel electrophoresis to determine strain relatedness.

RESULTS

Four-hundred and sixty-three K. pneumoniae isolates, derived from 412 blood, 21 body fluids and 30 abdominal wound specimens, were screened over a 3-year period. Isolates included 98 multidrug-resistant strains. Eighteen isolates from 17 patients, including two from the index patient, screened positive for all three virulence genes. Sixteen of 18 positive isolates had K-types associated with hvKp, and isolates from different patients were unrelated strains, indicating likely community acquisition. Of 13 patients with significant morbidity, five died; eight patients had co-existing hepatobiliary disease, and six had diabetes mellitus.

CONCLUSIONS

Multiple strains of hvKp are emerging in New York City and are associated with high mortality relative to multidrug-resistant and classical Klebsiella infections. Co-existing hepatobiliary disease appears to be a potential risk factor for these infections.

[Physiological and pathological effects of nitric oxide and nitric oxide synthase in oral cavity]

Nitric oxide (NO) is a short-lived free radical which is not only involved in regulating many physiological processes of the body, but also closely related to many diseases. Nitric oxide synthase (NOS) is the key enzyme for NO production. NOS exists as three distinct isoforms, the endothelial NOS (eNOS), neuronal NOS (nNOS) and inducible NOS (iNOS). It has been found that nNOS and eNOS were expressed in normal pulp tissues, periodontal tissues and salivary glands, and the NO produced from nNOS and eNOS was involved in their physiological functions. NO and iNOS are involved in the occurrence and development of pulpitis, periodontitis, salivary gland disease and oral cancer. This review focuses on the physiological and pathological effects of NO and different subtypes of NOS in oral cavity.

MRI Signal Intensity and Electron Ultrastructure Classification Predict the Long-Term Outcome of Skull Base Chordomas

BACKGROUND AND PURPOSE

MR imaging is a useful and widely used evaluation for chordomas. Prior studies have classified chordomas into cell-dense type and matrix-rich type according to the ultrastructural features. However, the relationship between the MR imaging signal intensity and ultrastructural classification is unknown. We hypothesized that MR imaging signal intensity may predict both tumor ultrastructural classification and prognosis.

MATERIALS AND METHODS

Seventy-nine patients with skull base chordomas who underwent 95 operations were included in this retrospective single-center series. Preoperative tumor-to-pons MR imaging signal intensity ratios were calculated and designated as ratio on T1 FLAIR sequence (R_T1), ratio on T2 sequence (R_T2), and ratio on enhanced T1 FLAIR sequence (R_EN), respectively. We assessed the relationships among signal intensity ratios, ultrastructural classification, and survival.

RESULTS

Compared with the matrix-rich type group, the cell-dense type chordomas showed lower R_T2 (cell-dense type: 1.90 ± 0.38; matrix-rich type: 2.61 ± 0.60 P < .001). The model of predicting cell-dense type based on R_T2 had an area under the curve of 0.83 (95% CI, 0.75-0.92). In patients without radiation therapy, both progression-free survival (P = .003) and overall survival (P = .002) were longer in the matrix-rich type group than in the cell-dense type group. R_EN was a risk factor for progression-free survival (hazard ratio = 10.24; 95% CI, 1.73-60.79); R_T2 was a protective factor for overall survival (hazard ratio  = 0.33; 95% CI, 0.12-0.87); and R_EN was a risk factor for overall survival (hazard ratio = 4.76; 95% CI, 1.51-15.01).

CONCLUSIONS

The difference in MR imaging signal intensity in chordomas can be explained by electron microscopic features. Both signal intensity ratios and electron microscopic features may be prognostic factors.

The role of hsa_circ_0000285 in metastasis of hepatocellular carcinoma

OBJECTIVE

The importance of circular RNAs in malignant tumors causes more attention in researchers. Hepatocellular carcinoma (HCC) is one of the most ordinary malignant tumors. Hsa_circ_0000285 was explored to identify how it functions in the metastasis of HCC.

PATIENTS AND METHODS

Real Time-quantitative Polymerase Chain Reaction (RT-qPCR) was utilized to detect hsa_circ_0000285 expression in HCC patients' tissues. Hsa_circ_0000285 lentivirus and shRNA was constructed for the transfection of HCC cells. Wound healing assay, transwell assay, and Matrigel assay were conducted to identify the function of hsa_circ_0000285 in HCC cells. Furthermore, mechanism assays were performed to uncover the interaction between hsa_circ_0000285 and miR-599.

RESULTS

Hsa_circ_0000285 was significantly higher-expressed in HCC samples compared to that in adjacent samples. The migrated length of HCC cells was reduced after hsa_circ_0000285 was silenced, while the migrated length of HCC cells was increased after hsa_circ_0000285 was overexpressed. Moreover, the number of migrated and invaded HCC cells was reduced after hsa_circ_0000285 was silenced, while the number of migrated and invaded HCC cells was increased after hsa_circ_0000285 was overexpressed. Moreover, RT-qPCR results revealed that miR-599 was downregulated via overexpression of hsa_circ_0000285, while miR-599 was upregulated via knockdown of hsa_circ_0000285. Further experiments showed that miR-599 was a direct target of hsa_circ_0000285 in HCC.

CONCLUSIONS

Hsa_circ_0000285 could enhance cell metastasis of HCC by targeting miR-599 and might be a potential therapeutic target in HCC.

[Influential factors related to the long-term effect of periodontal-orthodontic treatment in patients with aggressive periodontitis and malocclusion]

Objective: To investigate the influential factors related to the long-term effect of periodontal-orthodontic treatment in patients with aggressive periodontitis (AgP). Methods: A retrospective analysis was conducted in 25 AgP patients, who have received periodontal-orthodontic treatment in Peking University School and Hospital of Stomatology. Changes in the ratio of the residual alveolar bone height (RBH) was measured at three time points: baseline (T0), post orthodontic treatment (T1), and the last re-visit 3 years after orthodontic treatment (T2). Root abnormity was evaluated by observing periapical radiographs, and its relationship with alveolar bone loss after orthodontic treatment was analyzed. A multi-level analysis on factors related to the clinical outcome (alveolar bone height change) was performed. Results: Totally 693 teeth of 25 patients at T0 and T1 and 368 teeth of 14 patients at T2 were investigated. During the periodontal-orthodontic treatment, the RBH was mainly influenced by root abnormity (estimation value -2.392), tooth position (estimation value for upper teeth vs. lower teeth 3.139, and anterior teeth vs. posterior teeth -3.469) and the baseline RBH at T0 (estimation value -0.391) (P<0.05). Teeth with root abnormity, teeth in mandibular and anterior area, and teeth with higher RBH showed less change in T1-T0 RBH values. In the long-term follow-up, RBH was mainly influenced by tooth position (estimation value for upper teeth vs. lower teeth 3.735, and anterior teeth vs. posterior teeth -5.318), the baseline RBH and probing depth (PD) at T0. Teeth in mandibular and anterior area, teeth with higher RBH (estimation value -0.498) and PD (estimation value -1.594) (P<0.05) showed less change in T0-T2 RBH values. Conclusions: During orthodontic treatment, teeth with abnormal root, lower teeth, anterior teeth, and teeth with high RBH were unfavorable factors for bone gain. In the long-term observation, lower teeth, anterior teeth, teeth with high RBH and PD at first visit were unfavorable factors for bone gain.

European Position Paper on Rhinosinusitis and Nasal Polyps 2020

The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise . The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com.

[The value of laryngoscopy and MRI in diagnosis and management of pharyngolaryngeal venous malformations]

Objective:To investigate the value of laryngoscopy and MRI in diagnosis and management of pharyngolaryngeal venous malformations（VMs）, and to provide reliable evidences for clinical application. Method:The clinical data of 73 patients with pharyngolaryngeal VMs was analyzed retrospectively. Laryngoscopy and MRI were detected before treatment. The involved anatomic sites and the volume of VMs were calculated by Mimics version 20.0. Result:No significant difference was found in the detection rate of VMs between laryngoscopy and MRI（P>0.05）. The most common sites involved in pharyngolaryngeal VMs were the tongue base（37.0%）, followed by epiglottis（35.6%） and pyriform sinus（32.9%）. The volume of pharyngolaryngeal VMs ranged from 0.75 cm³to 76.33 cm³, with an average volume of （17.43±6.28） cm³. Conclusion:Laryngoscopy and MRI have their own advantages in diagnosing of pharyngolaryngeal VMs. Thus a combination which provides more information to formulate reasonable treatment plan has great diagnosing value. When treating with facial and cervical VMs, routine laryngoscopy is recommended to screen and to evaluate the laryngopharyngeal involvement.

[Analysis of genotypes, EEG and phenotypes of tuberous sclerosis complex patients]

Objective: Tuberous sclerosis complex (TSC) is a multi-system disease with TSC1 and TSC2 genes as the pathogenic genes. The purpose of our study was to analyze the gene mutation in patients with TSC with epilepsy as the main clinical manifestation. The relationship between genotype and phenotype, scalp EEG in patients was analyzed. Methods: The peripheral blood was extracted from 43 patients and their families. TSC gene was detected by second-generation sequencing. Long-term video EEG monitoring and MRI examination were performed to determine the onset area, seizure type and location of nodules. Results: 39 patients had TSC gene mutation, 4 patients did not detect the gene mutation.11 had TSC1 mutations and 28 had TSC2 mutations. 22 mutations were de novo. Patients with TSC2 mutations had earlier seizure and more nodules than patients with TSC1 mutations, but no significant difference in intelligence and spasm were observed. 28 patients had focal origin of scalp EEG, of which 85.7% of TSC2 mutations patients had focal origin. Conclusions: Patients of TSC2 mutations always has an early onset age. Although MRI shows multiple nodules, the onset of EEG is mainly focal origin.

[Analysis of related factors of secondary pulmonary infection in children with tracheobronchial foreign body]

Objective:To analyze the secondary pulmonary infection and the distribution of pathogenic bacteria in children with tracheobronchial foreign body, and to guide the clinical treatment. Method:The clinical data of 197 children with tracheobronchial foreign bodies confirmed by rigid bronchoscopy were reviewed. According to the clinical manifestations and signs, blood routine, chest CT and airway endocrine pathogen distribution, the secondary pulmonary infection was analyzed. Result:Seventy-five of 197 children with foreign bodies in tracheobronchial had secondary pulmonary infections. Among them, 32 cases of airway endocrine cultured pathogenic bacteria, mainly including Streptococcus pneumoniae and Haemophilus influenzae. Children with long preoperative history, fever, and with a history of using antibiotics are more likely to have secondary pulmonary infections. Conclusion:The duration of disease history, preoperative fever and the use of antibiotics are related to secondary pulmonary infection. The third generation of cephalosporins can effectively control the infection.

MiR-1203 is involved in hepatocellular carcinoma metastases and indicates a poor prognosis

Non-coding RNAs, especially miRNAs, have been shown to be important regulators in multiple human diseases, including malignant tumors, congenital disease, and autoimmune disease. In this study, we screened the metastasis-associated miRNAs in hepatocellular carcinoma (HCC). Based on the miRNA microarray screening, miR-1203 was confirmed to be the most significant miRNA and was also highly associated with HCC metastases. Bioinformatics prediction indicated direct binding of miR-1203 in SOCS3, which was also confirmed by a dual luciferase reporter assay, resulting in suppression of SOCS3. Increased miR-1203 also promoted invasion of HCC cells through suppressing SOCS3, while no effect on cell proliferation or apoptosis was detected. Circulating expression of miR-1203 and SOCS3 might serve as a predictor of metastases and poor prognosis in HCC patients. In conclusion, miR-1203 might promote HCC metastasis by decreasing SOCS3. MiR-1203 predicts a poor outcome in HCC patients and thus might serve as a potential therapeutic target for the prevention of HCC.

[Expression of CD45 in newly diagnosed multiple myeloma and the relationship with prognosis]

目的

观察CD45在初诊多发性骨髓瘤（MM）患者中的表达，探讨其与MM疗效和预后的关系。

方法

回顾性分析2010年1月至2017年1月河南省人民医院收治的130例初诊MM患者骨髓异常浆细胞中CD45的表达情况，对CD45⁺与CD45⁻患者的疗效和预后进行比较。

结果

①130例初诊MM患者中CD45⁺组33例（25.38%），CD45⁻组97例（74.62%）。②CD45⁺组和CD45⁻组的客观缓解率（ORR）分别为33.33%和64.95%，差异有统计学意义（P=0.002）；以硼替佐米为基础方案治疗的患者，CD45⁺组和CD45⁻组的ORR分别为35.71%和66.25%，差异有统计学意义（P=0.005）。③130例MM患者的中位无进展生存（PFS）时间为33.3（95%CI 6.0~69.0）个月，中位总生存（OS）时间为36.3（95%CI 6.0~78.0）个月，CD45⁺组与CD45⁻组的中位PFS时间分别为29.8（95%CI 10.0~59.0）个月和34.5（95%CI 6.0~69.0）个月，差异有统计学意义（χ²=14.59，P<0.001），中位OS时间分别为32.5（95%CI 10.0~68.0）个月和37.6（95%CI 6.0~78.0）个月，差异有统计学意义（χ²=11.42，P=0.001）；接受硼替佐米的患者中，CD45⁺组与CD45⁻组的中位PFS分别为30.3（95%CI 10.0~59.0）个月和36.3（95%CI 6.0~69.0）个月，差异有统计学意义（χ²=14.75，P=0.001）。中位OS时间分别为34.0（95%CI 10.0~68.0）个月和39.5（95%CI 6.0~78.0）个月，差异有统计学意义（χ²=10.62，P=0.001）。④Cox风险回归模型分析显示血肌酐≥176.8 µmol/L[HR=2.723（95%CI 1.744~6.723），P=0.001]、CD45阳性[HR=1.330（95%CI 1.067~1.804），P=0.008]，LDH ≥ 220 IU/L[HR=1.308（95%CI 1.160~2.417），P=0.015]是独立于其他临床指标的预后危险因素。

结论

CD45阳性是MM患者的预后不良因素。硼替佐米不能改善CD45⁺MM患者的不良预后。

P5497The gender paradox in non-ST-segment elevation acute coronary syndrome: an outdated paradigm or a persistent reality-an analysis of contemporary practice from an integrate health care system

Introduction

Although sex related differences in Non-ST-Segment elevation (NSTEMI) acute coronary syndrome (ACS) have been well delineated in the past, there is a paucity of data from contemporary practice on the evolutions of this paradox and its clinical practice implications.

Purpose

We hypothesized that in the era of guideline driven contemporary practice, and in the setting of an integrated heath care model, gender related differences in care and outcomes would be marginal at best if no altogether absent.

Methods

We utilized data from an integrated health care system to identify 4099 patients with NSTEMI-ACS (1531 women; 2561 men). The patients were stratified by gender and a comparative analysis was performed on guideline directed medical therapy, revascularization strategy and major adverse cardiac events between the two groups.

Results

There were significant difference in pharmacologic treatment, catheter based interventions and surgical revascularizations strategies. Underutilization of guideline directed medical therapy was demonstrated in women specifically vis a vis angiotensin converting enzyme inhibitor (ACE-I) (p=0.0014), statins (p=0.0001), and antiplatelet therapy: clopodigrel (p=0.0004), prasugrel (p=0.0012), and ticagrelor (p=0.03). Additionally, clear differences emerged in percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) options despite similarities in high risk status at index presentation by well validated risk algorithms. Specifically, men were more likely to undergo PCI (p=0.021) and CABG (p<0.001) than women. Finally, women had a greater incidence of bleeding complications (p=0.0003) and stroke (p=0,038).

Conclusions

There were treatment disparities in pharmacologic interventions, catheter based interventions, surgical revascularization access and clinical outcomes among patients with NSTEMI-ACS. The persistence of this gender paradox in contemporary practice and despite increasing education and awareness should potentiate further public policy initiatves as well as reinforce the need for geneder specific guidelines

P4348Early assessment of left ventricular function by layer-specific strain and its relationship to pulsatile arterial load in patients with coronary slow flow

Background

Previous studies reported controversial Left ventricular (LV) function impairment and pathophysiology in patients with coronary slow flow (CSF). Greater arterial load has been shown to increase aortic impedance and endothelial shear stress, potentially affecting coronary anatomy and function. We investigated LV systolic function by a new layer-specific strain technology and assessed the association between pulsatile arterial load and contractility.

Methods and results

A total of 70 patients with CSF and 50 controls with normal coronary angiography were included in the study. Layer-specific longitudinal and circumferential strains were assessed from endocardium, mid-myocardium and epicardium (GLS-endo, GLS-mid, GLS-epi and GCS-endo, GCS-mid, GCS-epi) by two-dimensional speckle tracking imaging (2D-STI). Pulsatile arterial load was estimated by indexed arterial compliance (ACI). Layer-specific GLS showed a decreasing gradient from the endocardium to the epicardium in both controls and CSF group. GLS-endo and GLS-mid in CSF group were significantly lower than the control group (all P<0.05). Layer-specific longitudinal strain showed a good correlation with the number of affected coronary arteries (all P<0.05) and the mean thrombolysis in myocardial infarction frame count (TFC) (all P<0.05). ACI was lower in CSF patients (P=0.005) and ACI was correlated negatively with layer-specific GLS (all P<0.05).

Conclusion

Layer-specific evaluation of the LV provides an understanding of the layer-specific properties of the LV wall and the possible process of the LV impairment in patients with CSF. Greater pulsatile arterial load, as manifested by a lower ACI, is coupled with worse LV longitudinal function in CSF patients.

P4376Circumferential ascending aortic strain in healthy adults aged 24 to 75 years

Background

Two-dimensional speckle-tracking echocardiography (2D-STE) for the measurement of circumferential ascending thoracic aortic strain (CAAS) in healthy adults is not elucidated. We aimed to establish normal adult STE-derived CAAS and to evaluate associations with age, gender and other physiologic parameters.

Methods

One hundred eighty-one healthy subjects aged 24–75 were prospectively gathered and examined with two-dimensional echocardiography. The global peak CAAS was the parameter used, and an average of six segments of arterial wall deformation was calculated. The corrected CAAS was calculated as the global CAAS/pulse pressure (PP). Aortic stiffness (β2) index was assessed according to ln(Ps/Pd)/CAAS.

Results

We included 171 healthy subjects (age 44.3±10.9 years, 50% female, CAAS16.0±6.9%). The CAAS was independently predicted by age (β=−0.387, P<0.001), and gender (β=−2.701, P=0.001). The corrected CAAS was independently predicted by age (β=−0.009, P<0.001), SAC (β=−0.206, P<0.001) and gender (β=−0.068, P=0.001). The β2 index was independently predicted by age (β=0.136, P<0.001), and PP (β=0.059, P=0.007).

Conclusion

CAAS using 2D-STE can be performed on a clinical basis and may become an important method for the assessment of aortic mechanical parameter. Age, gender and LV afterload-related variables were the most import determinants of 2D-STE global CAAS. Therefore, these factors should be taken into account for strain interpretation in clinical practice.

[Clinical research of HLA-haploidentical peripheral hematopoietic stem cell transplantation following reduced intensity conditioning regimen with hematological malignancy patients over 50 years old]

目的

分析减低剂量预处理单倍型外周血造血干细胞移植（RIC-haplo-PBSCT）治疗50岁以上恶性血液肿瘤患者的疗效。

方法

18例50岁以上恶性血液肿瘤患者纳入研究，男8例，女10例，中位年龄52（50~66）岁；急性髓系白血病（AML）8例，慢性髓性白血病（CML）2例，骨髓增生异常综合征（MDS）5例，急性淋巴细胞白血病（ALL）2例，急性NK细胞白血病（ANKL）1例；采用FAB+ATG（氟达拉滨+阿糖胞苷+白消安+兔抗人胸腺细胞免疫球蛋白）减低剂量预处理方案，输注供者高剂量非去T细胞外周血造血干细胞（PBSC），应用强化移植物抗宿主病（GVHD）预防方案及感染防控措施。

结果

16例患者在移植后15 d获得完全供者嵌合，其中1例在移植后1个月发生移植排斥，其余2例在移植后15 d为混合嵌合并于移植后1个月发生移植排斥。急性GVHD发生率为61.1%（95%CI 49.6%~72.6%），Ⅱ~Ⅳ度急性GVHD发生率为35.4%（95%CI 21.1%~49.7%），Ⅲ/Ⅳ度急性GVHD发生率为13.8%（95%CI 4.7%~22.9%）。2年慢性GVHD累积发生率为38.2%（95%CI 25.5%~50.9%），未发生广泛型慢性GVHD。中位随访14.5（3~44）个月，2年总生存率、无病生存率分别为72.6%（95%CI 60.1%~85.1%）、63.7%（95%CI 49.2%~78.2%），2年累积复发率为31.2%（95%CI 16.5%~45.9%），2年非复发死亡率为12.5%（95%CI 4.2%~20.8%）。

结论

RIC-haplo-PBSCT治疗50岁以上恶性血液肿瘤患者可获得较好的疗效。

The relationship of platelet to lymphocyte ratio and neutrophil to monocyte ratio to radiographic grades of knee osteoarthritis

OBJECTIVE

Accumulating data show that platelet to lymphocyte ratio (PLR) and neutrophil to monocyte ratio (NMR) undergo changes during inflammation in various diseases; however, the clinical features remain unclear in knee osteoarthritis (OA) patients. The purpose of our study was to evaluate PLR and NMR in knee OA patients, and assess their relationship to knee OA's radiographic grades.

METHODS

A retrospective study on 132 adult knee OA patients and 162 healthy controls (HC) was performed. All clinical characteristics of the knee OA patients were obtained from their medical records. PLR and NMR were compared between knee OA patients and HC by non-parametric tests. Correlations of PLR and NMR with Kellgren-Lawrence (KL) classification (KL grade 2, KL grade 3, and KL grade 4) were also analyzed through a Spearman correlation test. Ordinal polytomous logistic regression was used to determine independent factors influencing radiographic grades of knee OA patients.

RESULTS

PLR was increased significantly in knee OA patients, while a statistical difference in NMR was not observed. However, PLR was not relevant to KL grades, while NMR was negatively correlated with these (r = -0.330, P < 0.01) and was independently associated with KL grades of knee OA.

CONCLUSION

PLR could reflect the inflammation response of knee OA. NMR emerged as an independent factor and could be used as a potential marker indicating the severity of knee OA.

Piezo1 channels are mechanosensors in human fetoplacental endothelial cells

STUDY QUESTION

Does the shear stress sensing ion channel subunit Piezo1 have an important mechanotransduction role in human fetoplacental endothelium?

SUMMARY ANSWER

Piezo1 is present and functionally active in human fetoplacental endothelial cells, and disruption of Piezo1 prevents the normal response to shear stress.

WHAT IS KNOWN ALREADY

Shear stress is an important stimulus for maturation and function of placental vasculature but the molecular mechanisms by which the force is detected and transduced are unclear. Piezo1 channels are Ca²⁺-permeable non-selective cationic channels which are critical for shear stress sensing and maturation of murine embryonic vasculature.

STUDY DESIGN, SAMPLES/MATERIALS, METHODS

We investigated the relevance of Piezo1 to placental vasculature by studying human fetoplacental endothelial cells (FpECs) from healthy pregnancies. Endothelial cells were isolated from placental cotyledons and cultured, for the study of tube formation and cell alignment to shear stress. In addition, human placental arterial endothelial cells were isolated and studied immediately by patch-clamp electrophysiology.

MAIN RESULTS AND THE ROLE OF CHANCE

The synthetic Piezo1 channel agonist Yoda1 caused strong elevation of the intracellular Ca²⁺ concentration with a 50% effect occurring at about 5.4 μM. Knockdown of Piezo1 by RNA interference suppressed the Yoda1 response, consistent with it being mediated by Piezo1 channels. Alignment of cells to the direction of shear stress was also suppressed by Piezo1 knockdown without loss of cell viability. Patch-clamp recordings from freshly isolated endothelium showed shear stress-activated single channels which were characteristic of Piezo1.

LIMITATIONS, REASONS FOR CAUTION

The in vitro nature of fetoplacental endothelial cell isolation and subsequent culture may affect FpEC characteristics and PIEZO1 expression. In addition to Piezo1, alternative shear stress sensing mechanisms have been suggested in other systems and might also contribute in the placenta.

WIDER IMPLICATIONS OF THE FINDINGS

These data suggest that Piezo1 is an important molecular determinant of blood flow sensitivity in the placenta. Establishing and manipulating the molecular mechanisms regulating shear stress sensing could lead to novel therapeutic strategies to improve blood flow in the placenta.

LARGE-SCALE DATA

Not applicable.

STUDY FUNDING/COMPETING INTEREST(S)

LCM was funded by a Clinical Research Training Fellowship from the Medical Research Council and by the Royal College of Obstetricians and Gynaecologists, and has received support from a Wellcome Trust Institutional Strategic Support Fund. JS was supported by the Wellcome Trust and a BHF Intermediate Research Fellowship. HJG, CW, AJH and PJW were supported by PhD Studentships from BHF, BBSRC and the Leeds Teaching Hospitals Charitable Foundation respectively. All authors declare no conflict of interest.

Complement alternative pathway activation associated with pulmonary hypertension in lupus nephritis patients

Pulmonary hypertension occurs in systemic lupus erythematosus (SLE) for several reasons, such as vasculopathy. Previous studies have indicated that the excessive activation of the complement alternative pathway might be involved in the pathogenesis of lupus nephritis, especially in the absence of factor H or its functional impairment. However, the clinical and pathological significance of the alternative complement activation in lupus nephritis patients with pulmonary hypertension remains elusive. The data on patients with pulmonary hypertension and non-pulmonary hypertension lupus nephritis were retrospectively analyzed in our centre. Major plasma levels of complement components were evaluated. The depositions of Bb, C3d and C5b-9 in the lung specimens of pulmonary hypertension combined with SLE patients were detected by immunofluorescence staining. Among 352 lupus nephritis cases, 24 were diagnosed with pulmonary hypertension and 328 with non-pulmonary hypertension. Higher levels of Bb and lower levels of factor H were detected in the pulmonary hypertension group in comparison with the negative group (P = 0.049, P = 0.024, respectively). Pulmonary hypertension was a risk factor for renal outcome as deduced by the log-rank and Cox test for survival analysis. C3d, C5b-9 and Bb were found to be positive in lung specimens of lupus nephritis patients with pulmonary hypertension. We concluded that activation of the complement alternative pathway may be involved in the pathogenesis of pulmonary hypertension in lupus nephritis.