Estimates of the effects of physical activity on osteoporosis using multivariable Mendelian randomization analysis

This study estimates causality of physical activity (PA) on bone mineral density (BMD) by conducting multivariable Mendelian randomization (MR). The findings suggest that habitual vigorous PA increases lumbar spine BMD, and higher overall acceleration average would improve forearm BMD. The results could promote PA intervention targeting individuals with optimized type.

INTRODUCTION

Evidence from epidemiologic studies showed type, frequency, and duration of PA influenced BMD. However, these observational studies may be confounded by many factors, resulting in spurious associations. We aimed to conduct multivariable MR to estimate the causal effect of self-reported and device-measured PA on osteoporosis.

METHODS

Three self-reported and two device-measured PA-related traits were selected as exposures. Outcomes were BMD at different skeletal sites: femoral neck BMD (FN BMD), lumbar spine BMD (LS BMD), and forearm BMD (FA BMD). Exposure datasets were obtained from UK Biobank with total 377,234 subjects. Outcome datasets were obtained from GEFOS consortium with 53,236 subjects. Standard MR analysis and multivariable MR were conducted to assess the total and direct causal effect of PA on BMD.

RESULTS

For self-reported PA, inverse-normalized moderate-to-vigorous had a direct causal effect on FN BMD independently (β = - 1.116 (95% confidence interval, 95%CI: - 2.210, - 0.023), P = 0.045); vigorous PA showed a direct effect (β = 3.592 (95%CI: 0.310, 6.874), P = 0.032) on LS BMD independently. While overall acceleration average and fraction of accelerations both had a direct causal effect on FA BMD independently.

CONCLUSIONS

Habitual vigorous PA could increase LS BMD. Individuals with higher overall acceleration average would have a higher FA BMD.

LncRNA NORAD stimulates proliferation and migration of renal cancer via activating the miR-144-3p/MYCN axis

OBJECTIVE

The purpose of this study was to clarify the potential role of long non-coding RNA (lncRNA) NORAD in the development of renal cancer.

PATIENTS AND METHODS

Expression levels of NORAD, miR-144-3p, and MYCN in renal cancer tissues and cell lines were detected. After overexpression of NORAD, proliferative and migratory changes in ACHN and A498 cells were evaluated by Cell Counting Kit-8 (CCK-8) and transwell assay, respectively. Thereafter, Luciferase assay was conducted to determine the interaction in the NORAD/miR-144-3p/MYCN axis. Besides, its biological function in influencing phenotype changes of renal cancer cells was finally demonstrated by rescue experiments.

RESULTS

The results manifested that NORAD and MYCN were upregulated, while miR-144-3p was downregulated in renal cancer tissues. Overexpression of NORAD stimulated proliferative and migratory potentials in ACHN and A498 cells, which were partially abolished by co-overexpression of miR-144-3p. Moreover, NORAD/miR-144-3p/MYCN axis was found to be responsible for stimulating the malignant development of renal cancer.

CONCLUSIONS

LncRNA NORAD stimulates proliferative and migratory potentials in renal cancer by sponging miR-144-3p to upregulate MYCN.

Autophagy and glycolysis independently attenuate silibinin-induced apoptosis in human hepatocarcinoma HepG2 and Hep3B cells

PURPOSE

The mechanism of cytotoxicity of silibinin on two human hepatocellular carcinoma (HCC) cell lines, HepG2 (p53 wild-type) and Hep3B cells (p53 null), is examined in relation with the induction of autophagy and phosphorylation of AMP-activated protein kinase (p-AMPK).

MATERIALS AND METHODS

Levels of apoptosis in relation to the levels of autophagy and those of glycolysis-related proteins, glucose transporter 1/4 (Glut1/4) and hexokinase-II (HK2), in HepG2 and Hep3B cells were examined.

RESULTS

Silibinin-induced apoptosis was incomplete for HCC cell death in that up-regulated autophagy and/or reduced level of glycolysis, which are induced by silibinin treatment, antagonized silibinin-induced apoptosis. Inhibition of autophagy with 3-methyl adenine (3MA) or blocking of AMP-activated protein kinase (AMPK) activation with Compound C (CC) enhanced silibinin-induced apoptosis. The results confirm that AMPK involved in autophagy as well as in glycolysis remaining with silibinin is responsible for attenuation of silibinin-induced apoptosis. Blocking of AMPK or autophagy contributes to the enhancement of silibinin's cytotoxicity to HepG2 and Hep3B cells.

CONCLUSION

This study shows that incomplete apoptosis of HCC by silibinin treatment becomes complete by repression of autophagy and/or glycolysis.

[Correlation of damage-associated molecular pattern molecules with age and body mass index]

Objective: To explore the correlation of damage-associated molecular pattern molecules(DAMPs) serum S100, C-reactive protein (CRP), serum amyloid A (SAA) and uric acid (UA) with age and body mass index (BMI) to provide direction for further study of metabolic inflammation and inflammaging. Methods: The observational study method was used,and three hundred and sixty-six healthy people (131 males and 235 females) were selected from the physical examination center of the Second People's Hospital of Hunan Province from May to October 2020. They were divided into three age groups according to the age interval of 20 years, including 156 (53 males and 103 females) aged 20-40 years, 110 (36 males and 74 females) aged 41-60 years, and 100 (42 males and 58 females) aged 61-80 years. Kruskal Wallis H test was used to compare the differences of serum S100, CRP, SAA and UA levels among different age groups. According to the Health Industry Standards of the People's Republic of China-Weight Determination for Adults, the boundary is BMI =24 kg/m². The healthy people were divided into non overweight (BMI<24 kg/m²) and overweight (BMI ≥ 24 kg/m²) two groups. The 1∶1 propensity score was used to match the age and gender. There were 96 non overweight subjects [43 males, 53 females, age 52 (35, 66) years], 96 overweight subjects [44 males, 52 females, age 52 (36, 64) years]. The serum levels of S100, CRP, SAA and UA in different BMI groups were compared by Mann-Whitney U test. Results: The median serum UA concentrations in males and females were 356 and 277 μmol/L, and the levels of serum UA of male was significantly higher than that of female (Z=-10.428, P<0.001); the median serum SAA concentrations in males and females were 3.1 mg/L and 4.4 mg/L, while the serum SAA level of female was significantly higher than that of male (Z=3.652, P<0.001); for 20-40, 41-60, and 61-80 years old group, the median concentration of serum S100 was 0.058, 0.057, 0.070 μg/L, and the median concentration of serum CRP was 0.32, 0.58, 0.93 mg/L; the median serum SAA concentrations were 3.2, 4.0, 5.2 mg/L; serum uric acid concentrations were (301.8±61.5), (298.6±69.8), (329.0±77.8) μmol/L. The levels of serum S100, CRP, SAA, UA in 61-80 years group were significantly higher than those of 20-40 years group (H=-2.749, H=-6.731, H=-5.033, H=-2.521, P=0.018, P<0.001, P<0.001, P=0.035) and 41-60 years old group (H=-2.719, H=-2.539, H=-2.540, H=-2.486, P=0.020, P=0.033, P=0.033, P=0.039).The levels of serum CRP of 41-60 years group was significantly higher than that of 20-40 years group (H=-4.108,P<0.001). There was no significant difference in levels of serum S100, SAA and UA between 20-40 years group and 41-60 years group (H=0.189, H=-2.360, H=-0.165, P=1.000, P=0.055, P=1.000); the levels of serum CRP and SAA were positively correlated with age (r_s =0.342, r_s =0.301, P<0.001, P<0.001); for overweight, non-overweight group, the median concentrations of serum S100 were 0.065 μg/L, 0.059 μg/L, the median concentrations of serum CRP were 0.92 mg/L, 0.47 mg/L, the median concentrations of serum SAA were 5.0 mg/L, 4.1 mg/L, the median concentrations of serum UA were 339.5 μmol/L, 301.5 μmol/L, the levels of CRP, SAA and UA in the overweight group were higher than those in the non-overweight group (Z=4.278, Z=2.025, Z=3.787, P<0.001, P=0.043, P<0.001); the levels of S100 in the overweight group was higher than those in the non-overweight group, but there was no significant difference in S100 between the two groups (Z=0.862, P=0.388); the levels of Serum CRP and UA were positively correlated with BMI (r_s =0.348, r_s =0.264, P<0.001, P=0.009). Conclusions: With the increase of age, the serum S100, CRP, SAA and UA levels of healthy people may be on the rise, especially the serum CRP and SAA levels are positively correlated with age; the serum S100, CRP, SAA and UA levels of overweight people may be higher than those of non-overweight people, especially the serum CRP, UA levels are positively correlated with BMI.

Fungi carried over in jute bags – a smoking gun for aflatoxin contamination in the food supply chain

India is the largest jute and fifth largest maize producing country in the world. In India maize is commonly stored and transported in jute bags which are used multiple times. Aflatoxin contamination of maize is a major issue in India. This study evaluated the potential impact of re-using jute bags on the risk of aflatoxin contamination of maize in the food supply chain. A total of 121 jute bags were collected in India; 95 had been used for maize and 26 bags were new. Significantly higher numbers of viable aflatoxigenic fungi were counted from re-used bags (27.8 times) (P<0.05), than the number from new bags. There was no significant difference between aflatoxin concentration found in the re-used jute bags and the new jute bags (P>0.05). Further analysis revealed that the aflatoxigenic fungal population (3.0 times) and aflatoxin concentration (1.2 times) were significantly higher in jute bags that had been used for maize with higher aflatoxin contamination (14-188.4 μg/kg total aflatoxins) than in those that had been used for maize with lower contamination (0.8-5.4 μg/kg total aflatoxins) (P<0.05). The significant positive correlation (P<0.05) between the aflatoxigenic fungal population of used jute bags and aflatoxin contamination of their packed maize indicated there is a risk of cross-contamination in the supply chain introduced by re-using jute bags. This is the first study to systematically reveal the potential impact of re-using jute bags on the fungal population and aflatoxin contamination risk. The application of readily applied treatments to re-used jute bags would help to minimise the aflatoxin contamination.

MicroRNA-149 inhibits the progression of lung adenocarcinoma through targeting RAP1B and inactivating Wnt/β-catenin pathway

OBJECTIVE

MicroRNAs (miRNAs) are important regulators in the progression of lung adenocarcinoma (LAD). Moreover, microRNA-149 (miR-149) exhibits different roles in human cancers. Hence, this study mainly focused on the function of miR-149 in LAD.

PATIENTS AND METHODS

Western blot analysis and Real Time-quantitative Polymerase Chain Reaction (RT-qPCR) were used to quantify expression levels. The regulatory mechanism of miR-149/RAP1B was explored by methyl thiazolyl tetrazolium (MTT), transwell, and Dual-Luciferase reporter assays.

RESULTS

Downregulation of miR-149 was detected in LAD and predicted worse prognosis in patients with LAD. Functionally, overexpression of miR-149 inhibited cell viability and metastasis in LAD. In addition, miR-149 directly targets RAP1B and restrained its expression in LAD. Furthermore, upregulation of RAP1B attenuated the inhibitory effect of miR-149 on LAD. Besides that, miR-149 blocked epithelial-mesenchymal transition (EMT) and Wnt/β-catenin pathway in LAD.

CONCLUSIONS

MiR-149 inhibited the progression of LAD by restraining RAP1B/EMT and inactivating Wnt/β-catenin pathway.

PM2.5 exposure induces alveolar epithelial cell apoptosis and causes emphysema through p53/Siva-1

OBJECTIVE

This study aims to investigate whether PM2.5 exposure is involved in the induction of alveolar epithelial cell apoptosis and the progression of emphysema in mice, and to further explore its specific molecular mechanism.

MATERIALS AND METHODS

A certain number of PM2.5 exposed mice and normal control mice were selected, and a lung resection operation was performed to collect the pulmonary tissue samples, which were then analyzed by hematoxylin and eosin (H&E) staining assay. Subsequently, the total protein in the pulmonary tissues of mice in PM2.5 exposure group and control group was extracted, and the p53 protein level was detected by Western blot. Meanwhile, in A549 cells, after treatment of different doses of PM2.5, the protein levels of p53, caspase3, and clv-caspase3 were examined by Western blot while the mRNA levels of p53, Siva-1, and clv-caspase3 were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR), respectively. In addition, flow cytometry was carried out to measure the incidence of cell apoptosis, while chromatin immunoprecipitation (ChIP) assay was performed to verify whether p53 binds to the Siva-1 promoter region and thus regulates its transcription process.

RESULTS

H&E staining revealed that PM2.5 exposure caused pathological damage in the pulmonary tissues and the expansion of the spatial structure of alveoli, which led to emphysema in mice. Moreover, p53 protein expression in pulmonary tissue of mice in PM2.5 exposure group was remarkably higher than that in the control group. Subsequently, A549 cells were treated with 0, 25, 50, 100 μg/ml PM2.5 for 48 h, and it was found that, with the increase of PM2.5 exposure dose, the p53 protein level, Siva-1 mRNA level and cell apoptosis rate were all found increased in a dose-dependent manner, which could be partially reversed by transfection of si-p53 in A549 cells. In addition, CHIP experiments confirmed that p53 can bind to the Siva-1 promoter region and directly regulate Siva-1 transcription. In A549 cells, PM2.5 exposure increased the expression of the clv-caspase3 protein, which was reversed by the knockdown of p53; however, simultaneous overexpression of Siva-1 could further increase the clv-caspase3 protein level. Additionally, flow cytometry also revealed that PM2.5 exposure induced apoptosis of alveolar epithelial cells, while the knockdown of p53 reduced that, which could be promoted by the overexpression of Siva-1.

CONCLUSIONS

PM2.5 exposure can promote the transcription of Siva-1 to induce apoptosis of alveolar epithelial cells and accelerate the progression of emphysema in mice by enhancing p53 protein expression.

Analysis of physiological and metabolite response of Celosia argentea to copper stress

Copper-tolerant (Cu) plants with high ornamental value play an important role in the ecological restoration of the copper tail mining area. We first discovered Celosia argentea adaptability in a copper mine area in China; however, its resistance to Cu and the underlying mechanism are not clear. In this study, C. argentea was selected for pot culture experiments. Its heavy metal accumulation and translocation, physiological and metabolic products were analysed under different growth concentrations of Cu (0-2400 mg.kg^-1 ) stress. Our results indicated that roots strongly accumulated Cu²⁺ . Oxidative stress defence mechanisms were activated in leaves under Cu treatment. Higher Cu concentrations triggered higher electrolyte leakage (EL), Malondialdehyde (MDA), superoxide dismutase (SOD) and peroxidase (POD) activity, and consequently a higher capacity to scavenge oxygen radicals and maintain cellular membrane integrity. In the citrate cycle, some amino acids and sugars related to biological pathways were altered in C. argentea exposed to Cu stress. Metabolomics data revealed that C. argentea used elevated sugar content as an antioxidant to regulate reactive oxygen species (ROS). Some organic acids and amino acids were up-regulated compared with the control, indicating that these may chelate Cu in cells to remove excess Cu²⁺ . The up-regulation of polyamines and some organic acids may mitigate oxidative stress. These results indicate that C. argentea could be used as a Cu-tolerant plant in Cu mine restoration. Its Cu tolerance mechanism also provides a basis for future plant improvement or breeding for use in mine restoration.

Novel Two-Dimensional Layered MoSi2Z4 (Z = P, As): New Promising Optoelectronic Materials

Very recently, two new two-dimensional (2D) layered semi-conducting materials MoSi2N4 and WSi2N4 were successfully synthesized in experiments, and a large family of these two 2D materials, namely MA2Z4, was also predicted theoretically (Science, 369, 670 (2020)). Motivated by this exciting family, in this work, we systematically investigate the mechanical, electronic and optical properties of monolayer and bilayer MoSi2P4 and MoSi2As4 by using the first-principles calculation method. Numerical results indicate that both monolayer and bilayer MoSi2Z4 (Z = P, As) present good structural stability, isotropic mechanical parameters, moderate bandgap, favorable carrier mobilities, remarkable optical absorption, superior photon responsivity and external quantum efficiency. Especially, due to the wave-functions of band edges dominated by d orbital of the middle-layer Mo atoms are screened effectively, the bandgap and optical absorption hardly depend on the number of layers, providing an added convenience in the experimental fabrication of few-layer MoSi2Z4-based electronic and optoelectronic devices. We also build a monolayer MoSi2Z4-based 2D optoelectronic device, and quantitatively evaluate the photocurrent as a function of energy and polarization angle of the incident light. Our investigation verifies the excellent performance of a few-layer MoSi2Z4 and expands their potential application in nanoscale electronic and optoelectronic devices.

[Feasibility on the diagnosis of non-calcified plaque based on radiomics of pericoronary adipose tissue on plain CT scan image]

Objective: To investigate the diagnostic value of radiomics model based on plain CT scan of peripheral coronary artery adipose tissue for non-calcified plaque. Methods: The image data of 461 patients undergoing coronary CT angiography (CCTA) in the Department of Radiology of the First Affiliated Hospital of Suzhou University from August 1,2019 to July 31,2020 were retrospectively analyzed. Two hundred and six cases (355 branches) with non-calcified plaques, and 255 cases (510 branches) with no coronary artery disease were detected by CCTA. The regions of interest (ROI) of the pericoronary adipose tissue were segmented on the plain CT scan images (coronary calcification score (CCS) sequence). The coronary ROI was determined by selecting the coronary artery with a length of 40 mm and starting at 10 mm from the opening of the coronary artery, and the pericoronary adipose ROI was generated automatically. The pericoronary fat attenuation index (FAI) was then performed, and the radiomics features were extracted. The 865 coronary arteries were divided into the training group (n=606) and the testing group (n=259) at a ratio of 7∶3, and the radiomics model was carried out. The receiver operating characteristic (ROC) analysis was used to assess the FAI value and the diagnostic efficacy of the radiomics model for non-calcified plaque. Results: A total of 1 692 features were extracted from images of pericoronary adipose based on plain scan. All features were screened by using max-relevance and min-redundancy (mRMR) and least absolute shrinkage and selection operator (LASSO), and 14 features were selected for the establishment of the radiomics model. The accuracy, sensitivity, specificity and area under the curve (AUC) of the model in distinguishing patients with non-calcified plaque and those without coronary stenosis in the testing group were 70.3%, 63.2%, 75.2% and 0.75, respectively. Conclusion: The radiomics model based on plain CT scan of the pericoronary adipose tissue had good diagnostic efficacy for non-calcified plaque.

[A prospective multi-center clinical investigation of HIV-negative pulmonary cryptococcosis in China]

Objective: To investigate the current status of the diagnosis and treatment of pulmonary cryptococcosis in respiratory medicine and improve the understanding of the clinical characteristics of HIV-negative pulmonary cryptococcosis in China. Methods: A prospective multi-center open cohort study was designed to screen for pulmonary cryptococcosis in the general wards and intensive care units of the Department of Respiratory Diseases in 22 hospitals. The HIV-negative patients with positive cryptococcal etiological diagnosis based on smear culture, antigen detection and histopathology were enrolled in the study. The clinical data of enrolled patients were collected and analyzed. Results: A total of 457 cases of pulmonary cryptococcosis were enrolled, among which 3.28% (15/457) were disseminated infections. The case fatality rate was 0.88% (4/457). The majority of the cases were diagnosed by histopathological examinations (74.40%, 340/457) and cryptococcus antigen detection (37.64%, 172/457). Patients with pulmonary cryptococcosis accounted for 2.04‰ (457/223 748) of the total hospitalized patients in the Department of Respiratory Diseases during the same period, and the ratio was the highest in south and east China. Meanwhile, 70.24% (321/457) of the patients had no underlying diseases, while 87.75% (401/457) were found to have immunocompetent status. Cough and expectoration were the most common clinical symptoms in patients with pulmonary cryptococcosis. However, 25.16% (115/457) of the patients had no clinical symptom or physical signs. In terms of imaging features on pulmonary CT, multiple pulmonary lesions were more common than isolated lesions, and there were more subpleural lesions than perihilar or medial lesions. Morphologically, most of the lesions were middle-sized nodules (1-5 cm) or small-sized nodules (3 mm to 1 cm). The sensitivity of serum cryptococcus antigen test was 71.99% (203/282). Moreover, antigen-positive patients differed from antigen-negative patients in terms of basic immune status, clinical symptoms, imaging features and infection types. Meanwhile, immunocompromised patients differed from immunocompetent patients in terms of clinical symptoms, physical signs, infection-related inflammation indicator levels, imaging features, serum cryptococcus antigen positive rate and prognosis. Conclusions: The majority of cases of HIV-negative pulmonary cryptococcosis in China had no underlying disease or immunocompromised status, and the overrall prognosis was favorable. However, early diagnosis of HIV-negative pulmonary cryptococcosis remains challenging due to the complicated manifestations of the disease.

Impacts of Stress Response and Negative Emotion on Mental Health of College Students During the COVID-19 Outbreak

OBJECT

In this study, we aimed to explore the influences of stress responses and negative emotion on mental health of college students during the initial COVID-19 outbreak in China.

METHODS

A nationally representative sample of 1,351 college students, aged 18-23 years, took part in an online survey during the COVID-19 outbreak. The ANOVA, correlation coefficients, structural equation modeling (path analysis), and other statistical analysis methods were used for data analysis.

RESULTS

(1) The Chinese college students' epidemic panic and cognitive evaluation were found to be moderate (3.73 ± 0.74, 3.76 ± 0.62), while their defensive response was higher (4.61 ± 0.55). Their mental health during the COVID-19 outbreak was found to be good (3.75 ± 0.76). (2) The quality of their mental health was significantly and negatively associated with epidemic panic, and the quality of their mental health was significantly and positively associated with defensive response. (3) The quality of their mental health was significantly and negatively associated with negative emotion. (4) College students' epidemic panic and defensive response to the COVID-19 had a directly predictive effect on their mental health.

CONCLUSION

College students' negative emotion played a partial mediating role in the relationship between epidemic panic and mental health. College students' negative emotion played a complete mediating role in the relationship between cognitive appraisal and mental health.

[Thyroid disruptor p, p'-DDE inhibited the expression of LHX4 and DIS3L protein in Nthy-ori-3-1 cells]

Objective: To observe the changes of LHX4 and DIS3L mRNA and protein expression in Nthy-ori-3-1 cells after the treatment of thyroid disruptor p, p'-DDE. Methods: Nthy-ori-3-1 cells in logarithmic growth phase were treated with 0, 0.5, 1.0, 2.0 and 5.0 μg/ml p, p'-DDE solution. The growth state and morphology of the cells were observed by microscope. The mRNA levels of LHX4 and DIS3L were detected by real-time fluorescent quantitative PCR, and the protein expression levels of LHX4 and DIS3L were detected by Western blot. Results: when the concentrations of p, p'-DDE were 0, 0.5, 1.0 and 2.0 μg/ml, Nthy-ori-3-1 cells grew normally. There were 33 differential genes in 2.0 μg/ml group, among which 13 genes were down regulated and 20 genes were up-regulated. Compared with the control group, the protein expression levels of LHX4 and DIS3L in 1.0 and 2.0 μg/ml groups were significantly decreased (P<0.05) , and the relative expression levels of LHX4 and DIS3L protein mRNA in 1.0 μg/ml group were significantly decreased (P<0.05) . Conclusion: p, p'-DDE can affect the protein expression of LHX4 and dis3l in nthy-ori-3-1 cells.

[Cost-effectiveness of primary prophylaxis with PEG-rhG-CSF in early-stage breast cancer patients receiving chemotherapy in China]

Objective: To evaluate the cost effectiveness of primary prophylaxis (PP) with pegylated recombinant human granulocyte colony stimulating factor (PEG-rhG-CSF), PP with recombinant human granulocyte colony stimulating factor (rhG-CSF) and no prophylaxis in women with early-stage breast cancer in China. Methods: Two phase Markov models were constructed for a hypothetical cohort of patients aged 45 with stage Ⅱ breast cancer. The first phase modelled costs and outcomes of 4 cycles docetaxel combined with cyclophosphamide [TC×4, febrile neutropenia (FN) risk>20%] chemotherapy, which assumptions based on literature reviews, including FN rates [base-case (deterministic sensitivity analysis range), 0.29 (0.24-0.35)] and related events [FN case-fatality, 3.4 (2.7-4.1)]. Second phase modelled the long term survival which was link with the relative dose intensity (RDI) [mortality hazard ratio (HR) of RDI < 85% vs ≥85%, 1.45 (1.00-2.32)]. Clinical effectiveness, therapeutic costs, and economic utilities were estimated from peer-reviewed publications and expert opinions in case of unavailability of published evidences. Results: Compared to rhG-CSF PP and no prophylaxis, the cost of PEG-rhG-CSF PP increased to 5 208.19 RMB and 5 222.73 RMB, respectively. The quality-adjusted life-years (QALYs) enhanced to 0.066 and 0.297, respectively. Accordingly, the incremental cost effectiveness ratios (ICERs) are 79 146.3 RMB and 17 558.77 RMB per QALY, which were both below the willingness to pay (WTP) threshold of three times GDP per capita (18, 000 RMB) recommended by the WHO. Sensitivity analysis suggested that the more clinically effective the primary prophylaxis with PEG-rhG-CSF is, the more cost-effective primary prophylaxis with PEG-rhG-CSF will be. And the lower the mortality HR of RDI<85% vs ≥85% is, the more cost-effective primary prophylaxis with PEG-rhG-CSF will be. Conclusion: Although the cost of PP PEG-rhG-CSF is higher, considering the additional benefits, the administrating of PP PEG-rhG-CSF is likely to be a cost-effective alternative to PP rhG-CSF and no prophylaxis in patients with early stage breast cancer whose FN risks are more than 20% in China.

[Current management and future prospect of HER-2 mutant non-small cell lung cancer]

Since Erb-B2 receptor tyrosine kinase 2 (HER-2) was regarded as oncogenic driver gene for malignancies, HER-2 targeted therapy has benefited many patients with breast cancer and gastric cancer. However, as a member of the epidermal growth factor receptor (EGFR) family, HER-2 has failed to respond well to both traditional anti-HER-2 and anti-EGFR targeted agents when compared to EGFR in non-small cell lung cancer (NSCLC). It is reported that unlike gene copy number variation in breast cancer, HER-2 intragenic kinase domain mutations (the exon 20 in-frame insertions are dominant, and missense mutations in kinase domain are also observed) in NSCLC might account for the poor response to traditional HER-2 or EGFR tyrosine kinase inhibitors (TKIs). In this review, we summarize the pathogenesis, molecular variations, clinical features and current therapeutic strategies for HER-2 mutated NSCLC to discuss the challenges and perspectives for this population.

MicroRNA-199 inhibits proliferation and promotes apoptosis in children with acute myeloid leukemia by mediating caspase-3

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, "MicroRNA-199 inhibits proliferation and promotes apoptosis in children with acute myeloid leukemia by mediating caspase-3, by F. Xue, Y. Zhu, F. Xu, L.-J. Zhou, F. Han, S.-C. Wang, published in Eur Rev Med Pharmacol Sci 2019; 23 (9): 3584-3593-DOI: 10.26355/eurrev_201905_17780-PMID: 31114982" has been withdrawn. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/17780.