Predicting the hearing outcome in sudden sensorineural hearing loss via machine learning models

OBJECTIVE

Sudden sensorineural hearing loss (SSHL) is a multifactorial disorder with high heterogeneity, thus the outcomes vary widely. This study aimed to develop predictive models based on four machine learning methods for SSHL, identifying the best performer for clinical application.

DESIGN

Single-centre retrospective study.

SETTING

Chinese People's liberation army (PLA) hospital, Beijing, China.

PARTICIPANTS

A total of 1220 in-patient SSHL patients were enrolled between June 2008 and December 2015.

MAIN OUTCOME MEASURES

An advanced deep learning technique, deep belief network (DBN), together with the conventional logistic regression (LR), support vector machine (SVM) and multilayer perceptron (MLP) were developed to predict the dichotomised hearing outcome of SSHL by inputting six feature collections derived from 149 potential predictors. Accuracy, precision, recall, F-score and the area under the receiver operator characteristic curves (ROC-AUC) were exploited to compare the prediction performance of different models.

RESULTS

Overall the best predictive ability was provided by the DBN model when tested in the raw data set with 149 variables, achieving an accuracy of 77.58% and AUC of 0.84. Nevertheless, DBN yielded inferior performance after feature pruning. In contrast, the LR, SVM and MLP models demonstrated opposite trend as the greatest individual prediction powers were obtained when included merely three variables, with the ROC-AUC ranging from 0.79 to 0.81, and then decreased with the increasing size of input features combinations.

CONCLUSIONS

With the input of enough features, DBN can be a robust prediction tool for SSHL. But LR is more practical for early prediction in routine clinical application using three readily available variables, that is time elapse between symptom onset and study entry, initial hearing level and audiogram.

CCDC26 knockdown enhances resistance of gastrointestinal stromal tumor cells to imatinib by interacting with c-KIT

Accumulating evidence indicates that long noncoding RNAs (lncRNAs) are involved in diseases such as cancer. However, little is known about the role of lncRNAs in gastrointestinal stromal tumors (GIST). In the present study, we explored the biological function of the lncRNA coiled-coil domain-containing 26 (CCDC26) in imatinib resistance of GIST. We found that human GIST-882 cells with lower CCDC26 expression were less sensitive to imatinib compared with GIST-T1 cells with higher CCDC26 expression. CCDC26 expression decreased in a time-dependent manner in the presence of imatinib. Moreover, small interfering RNA (siRNA) knockdown of CCDC26 increased GIST cell sensitivity to imatinib. The RNA pull-down experiment showed that CCDC26 can interact with c-KIT and that CCDC26 knockdown can upregulate c-KIT expression. We also found that inhibiting c-KIT induced resistance to imatinib. Lastly, we proved that inhibiting c-KIT can reverse CCDC26 knockdown-mediated imatinib resistance in GIST. We suggest that CCDC26 knockdown can induce imatinib resistance in GIST cells by downregulating c-KIT expression. Our results provide a novel insight into imatinib resistance in GIST.

Fructose and glucose can regulate mammalian target of rapamycin complex 1 and lipogenic gene expression via distinct pathways

Although calorically equivalent to glucose, fructose appears to be more lipogenic, promoting dyslipidemia, fatty liver disease, cardiovascular disease, and diabetes. To better understand how fructose induces lipogenesis, we compared the effects of fructose and glucose on mammalian target of rapamycin complex 1 (mTORC1), which appeared to have both positive and negative effects on lipogenic gene expression. We found that fructose acutely and transiently suppressed mTORC1 signaling in vitro and in vivo The constitutive activation of mTORC1 reduced hepatic lipogenic gene expression and produced hypotriglyceridemia after 1 week of fructose feeding. In contrast, glucose did not suppress mTORC1, and the constitutive activation of mTORC1 failed to suppress plasma triglycerides after 1 week of glucose feeding. Thus, these data reveal fundamental differences in the signaling pathways used by fructose and glucose to regulate lipid metabolism.

Photoexcited Muon Spin Spectroscopy: A New Method for Measuring Excess Carrier Lifetime in Bulk Silicon

We have measured excess carrier lifetime in silicon using photoexcited muon spin spectroscopy. Positive muons implanted deep in a wafer can interact with the optically injected excess carriers and directly probe the bulk carrier lifetime while minimizing the effect from surface recombination. The method is based on the relaxation rate of muon spin asymmetry, which depends on the excess carrier density. The underlying microscopic mechanism has been understood by simulating the four-state muonium model in Si under illumination. We apply the technique to different injection levels and temperatures, and demonstrate its ability for injection- and temperature-dependent lifetime spectroscopy.

YAP suppresses gluconeogenic gene expression through PGC1α

Cell growth and proliferation are tightly coupled to metabolism, and dissecting the signaling molecules which link these processes is an important step toward understanding development, regeneration, and cancer. The transcriptional regulator Yes-associated protein 1 (YAP) is a key regulator of liver size, development, and function. We now show that YAP can also suppress gluconeogenic gene expression. Yap deletion in primary hepatocytes potentiates the gluconeogenic gene response to glucagon and dexamethasone, whereas constitutively active YAP suppresses it. The effects of YAP are mediated by the transcriptional coactivator peroxisome proliferator-activated receptor-gamma coactivator 1. YAP inhibits its ability to bind to and activate transcription from the promoters of its gluconeogenic targets, and the effects of YAP are blunted upon its knockdown. In vivo, constitutively active YAP lowers plasma glucose levels and increases liver size.

CONCLUSION

YAP appears to reprogram cellular metabolism, diverting substrates away from the energy-consuming process of gluconeogenesis and toward the anabolic process of growth. (Hepatology 2017;66:2029-2041).

DUSP4 promotes doxorubicin resistance in gastric cancer through epithelial-mesenchymal transition

Chemoresistance limits treatment efficacy in gastric cancer and doxorubicin resistance is common in gastric cancer cells. Dual specificity phosphatase 4 (DUSP4) has been associated with tumor progression. This study aimed to investigate the mechanism of DUSP4 regulating doxorubicin resistance in gastric cancer cells. Cell Counting Kit-8 (CCK-8) and 5-ethynyl-2'-deoxyuridine (EdU) incorporation assay were used to measure cell viability and proliferation in gastric cancer cells treated with doxorubicin. The expression of DUSP4, E-cadherin and Vimentin protein was detected by Western blotting. Overexpression of DUSP4 was more resistant to doxorubicin in gastric cancer cells. Knockdown of DUSP4 increased the sensitivity of gastric cancer cells to doxorubicin. Moreover, up-regulation of DUSP4 promoted the Epithelial-Mesenchymal Transition (EMT) in gastric cancer cells, but blocking the EMT using a Twist siRNA increased the sensitivity of gastric cancer cells to doxorubicin and confirmed the EMT was involved in DUSP4-mediated doxorubicin resistance. These findings demonstrated that DUSP4 could enhance doxorubicin resistance by promoting EMT in gastric cancer cells.

Risk Factors for Post-Transplant Death in Donation after Circulatory Death Liver Transplantation

PURPOSE

In spite of the increasing success of liver transplantation, there remains inevitable risk of postoperative complications, re-operations, and even death. Risk factors that correlate with post-transplant death have not been fully identified.

MATERIALS AND METHODS

We performed a retrospective analysis of 65 adults that received donation after circulatory death liver transplantation. Binary logistic regression and Cox's proportional hazards regression were employed to identify risk factors that associate with postoperative death and the length of survival period.

RESULTS

Twenty-two recipients (33.8%) deceased during 392.3 ± 45.6 days. The higher preoperative Child-Pugh score (p = .007), prolonged postoperative ICU stay (p = .02), and more postoperative complications (p = .0005) were observed in deceased patients. Advanced pathological staging (p = .02) with more common nerve invasion (p = .03), lymph node invasion (p = .02), and para-tumor satellite lesion (p = .01) were found in deceased group. The higher pre-transplant Child-Pugh score was a risk factor for post-transplant death (OR = 4.38, p = .011), and was correlated with reduced post-transplant survival period (OR = 0.35, p = .009). Nerve invasion was also a risk factor for post-transplant death (OR = 13.85, p = .014), although it failed to affect survival period.

CONCLUSIONS

Our study emphasizes the impact of recipient's pre-transplant liver function as well as pre-transplant nerve invasion by recipient's liver cancer cells on postoperative outcome and survival period in patients receiving liver transplantation.

Two cases about mesh adhesion to intra-abdominal cavity tissue after using mesh to repair an incisional hernia

Abdominal incisional hernia is a common postoperative complication. With the development of a new type of surgical anti-adhesion mesh, mesh repair has become a widely-adopted procedure, particularly in the laparoscopic era. However, there were few reports about use of these new meshes to repair incisional hernia in the abdominal cavity. In this report, we present two cases: one a 72-year-old male and the other a 62-year-old female. Both of those patients suffered incisional hernias during abdominal operations, and therefore underwent open incisional hernia anti-adhesion mesh repair operations. Both of them had recurrent incisional hernias after the first repair operation. During the second hernia repair operation via laparoscopy, tissue from the intestine and omentum were found to have adhered seriously to the old meshes, which could cause many serious problems. We need to pay more attention to the issue of adhesion, try to determine possible reasons and improve in our future work.

Ultra-large non-volatile modulation of magnetic moments in PbZr0.2Ti0.8O3/MgO/La0.7Sr0.3MnO3 heterostructure at room temperature via interfacial polarization mediation

Multiferroic hybrid structures PbZr0.2Ti0.8O3 (PZT)/La0.7Sr0.3MnO3 (LSMO) and PZT/MgO/LSMO were epitaxially deposited on (001) Nb:SrTiO3 crystals. Crystallinity and ferroelectric domain structures were investigated for the PZT/LSMO heterostructure. Interestingly, relatively high non-volatile magnetoelectric coupling effects were observed in both heterostructures at room temperature. The change of chemical valence for Mn and Ti at the PZT/MgO/LSMO interface may play a dominant role rather than external strain or orbital reconstruction, which lead to a large modulation of the magnetization. Correspondingly, the transport behavior of the PZT/MgO/LSMO heterostructure is investigated to confirm the role of oxygen vacancies motion. Our result indicates that the PZT/MgO/LSMO heterostructure have a promising application for future high-density non-volatile memories.

Continuous blood purification in children with severe sepsis

This study aims to analyse the clinical effects of continuous blood purification (CBP) in children with severe sepsis to form a basis for CBP application in this context. One hundred and twenty children with severe sepsis treated in Binzhou People’s Hospital, Shandong, China, from June 2013 to June 2014 were divided into two groups, a treatment and a control group, depending on parental preference. The control group was treated conventionally, and the treatment group underwent CBP in addition to conventional therapy. Cardiovascular and respiratory parameters were measured on admission and after 72 h. This study also assayed interleukin (IL)-8 and tumour necrosis factor (TNF)-α levels, and monitored clinical outcomes and prognosis. The cardiovascular and respiratory parameters of the treatment group improved to a significantly greater extent than did those of the control group (all P less than 0.05). After treatment, the levels of IL-8, IL-6, IL-10, and TNF-α declined in both groups, but more so in the treatment group (all P<0.05). The white blood cell count and C-reactive protein level fell more in the treatment than control group, with statistical significance (both P less than 0.05). CBP remarkably improved the cardiovascular and respiratory functions of children with severe sepsis, probably by eliminating factors mediating inflammation.

Thrombolysis of deep vein thrombosis and inhibiting chemotaxis of macrophage by MCP-1 blockage

OBJECTIVE

Deep vein thrombosis (DVT) is one common vascular complication after trauma or surgery. Macrophage plays an important role in recanalization of thrombosis and monocyte chemotactic protein 1 (MCP-1) has a potent chemotactic role for macrophage. This study investigated the role of MCP-1 and macrophage in DVT thrombolysis.

MATERIALS AND METHODS

DVT mice model was established for evaluating thrombosis grades, and divided into DVT, DVT + MCP-1 recombinant protein, and DVT + MCP-1 neutralizing antibody groups. MCP-1 mRNA and protein expression, weight/length ratio of thrombosis were tested at 1, 5, 9 and 15 day after DVT. F4/80 protein expression in thrombosis on day 9 was measured to reflect infiltration of macrophage.

RESULTS

DVT model mice had thrombosis grade at 2.47 ± 0.22 whilst no thrombosis occurred in sham group. DVT group had gradually increased MCP-1 mRNA and protein expression, which reached the peak at day 9, followed by decreased expression. Thrombosis weight/length ratio showed decreasing trends. MCP-1 protein injection significantly elevated MCP-1 expression, decreased thrombosis weight/length ratio, and elevated macrophage infiltration. Injection of MCP-1 antibody remarkably decreased MCP-1 expression, elevated thrombosis weight/length ratio and macrophage infiltration.

CONCLUSIONS

MCP-1 up-regulation participates in macrophage chemotaxis and thrombolysis after DVT formation. The blockade of MCP-1 weakens its thrombolysis effects.

Polyphenols in Eucalyptus leaves improved the egg and meat qualities and protected against ethanol-induced oxidative damage in laying hens

Polyphenols in Eucalyptus leaves (PE) were value resources due to various pharmacological activities, but data on the effect on laying hens are very scare. This study was conducted to determine the effect of PE on the laying performance, egg traits, meat quality, antioxidant status and liver tissues of laying hens. One hundred and twenty 256-day-old Yueqinhuang laying hens were randomly assigned to four treatment groups (different levels of PE at 0, 0.5, 0.8 and 1.2 g/kg diet) for 63 days with 15 replicates per group. Addition of 0.8 g/kg PE not only improved the egg trait by increasing the eggshell thickness and decreasing MDA production and cholesterol content in the egg yolk, but also significantly enhanced meat quality of hens, as suggested by the increase pH_45 min (p < .01) and a* value, and decrease drip loss rate (p < .01). Meanwhile, under acute ethanol-induced oxidative damage condition, supplementation of 0.8 g/kg PE enhanced the serum antioxidant status by increasing enzymatic activities (GSH-PX, T-SOD, T-AOC), inhibited oxidative damage and provided protective effect to liver tissue. In conclusion, addition of 0.8 g/kg PE not only improved the egg traits and meat quality without obvious adverse effects, but also increased the serum antioxidant status of the hens and protected their liver tissue from ethanol-induced oxidative damage. This study indicated that PE could be utilized as an effective feed additive for laying hens to improve health performance and egg traits.

[Development of Magnetic Anastomosis Device for Colostomy]

Introduction of a new magnetic anastomosis device for colostomy including its design and operaging principal. The anastomosis device is composed of magnetic base and anastomosis ring. It is convenient for colon and abdominal subcutaneous tissue going together through the magnetic attraction. The colostomy completes with magnetic compression anastomosis. The device has the advantage of making operation easer, reducing the operation steps and can better solve the colostomy ischemic necrosis, colostomy retraction, colostomy joint complications of skin mucous membrane and the skin diease around the colostomy. Patients can real y benefit from this device.

Frizzled proteins are colonic epithelial receptors for C. difficile toxin B

Clostridium difficile toxin B (TcdB) is a critical virulence factor that causes diseases associated with C. difficile infection. Here we carried out CRISPR-Cas9-mediated genome-wide screens and identified the members of the Wnt receptor frizzled family (FZDs) as TcdB receptors. TcdB binds to the conserved Wnt-binding site known as the cysteine-rich domain (CRD), with the highest affinity towards FZD1, 2 and 7. TcdB competes with Wnt for binding to FZDs, and its binding blocks Wnt signalling. FZD1/2/7 triple-knockout cells are highly resistant to TcdB, and recombinant FZD2-CRD prevented TcdB binding to the colonic epithelium. Colonic organoids cultured from FZD7-knockout mice, combined with knockdown of FZD1 and 2, showed increased resistance to TcdB. The colonic epithelium in FZD7-knockout mice was less susceptible to TcdB-induced tissue damage in vivo. These findings establish FZDs as physiologically relevant receptors for TcdB in the colonic epithelium.

Analysis of uridine diphosphate glucuronosyl transferase 1A1 gene mutations in neonates with unconjugated hyperbilirubinemia

This study was carried out to analyze uridine diphosphate (UDP)-glucuronosyltransferase 1A1 (UGT1A1) gene mutations in neonates with unconjugated hyperbilirubinemia, from two different ethnic groups. Polymerase chain reaction and gene sequencing were used to analyze the differences in genotypes and allele frequencies of different gene mutations among the ethnic groups; this was followed by checking their correlation with the serum bilirubin level and the occurrence of unconjugated hyperbilirubinemia in neonates. Our results reveal that the UGT1A1 mutant genotype, 211G>A, is distributed differently in the case vs control groups, as well as in the Zhuang vs Han ethnic groups. Moreover, this difference is statistically significant (P < 0.05); the total serum bilirubin (TSB) and unconjugated bilirubin (UCB) levels in patients carrying the single homozygous mutation, 211G>A, were markedly higher than that in patients without the mutation (P < 0.05). Furthermore, the TSB and UCB levels were significantly different between patients carrying single or compound 211G>A heterozygous mutation, (TA)6/7, and 1941C>G/2042C>G heterozygous mutation, and patients without mutation (P > 0.05). Our findings suggest that the 211G>A mutation in the first exon may be a risk factor for unconjugated hyperbilirubinemia in Zhuang and Han neonates. The serum bilirubin levels seem to be affected by the homozygosity or heterozygosity of the UGT1A1 gene mutation; 211G>A homozygous mutation is an important factor that causes a rise in bilirubin in neonates with unconjugated hyperbilirubinemia.