Yak miR-2285o-3p attenuates hypoxia-induced apoptosis by targeting caspase-3

miRNAs are a class of hairpin‐derived RNAs, 21–24 nucleotides in length, which are involved in a range of biological processes. The bta‐miR‐2285 family has over 40 members spanning the entire bovine genome. We previously found that bta‐miR‐2285o‐3p was highly expressed in yak heart and lung when compared with cattle, which prompted us to investigate its potential function in high‐altitude adaptation of yaks. In this study, we detected wide‐spread high expression of bta‐miR‐2285o‐3p in yak tissues. Further experiments revealed that the protein tyrosine phosphatase receptor type M (PTPRM) gene was the host gene of bta‐miR‐2285o‐3p and that two linked SNPs in bta‐mir‐2285o precursor affected the biogenesis of mature miRNA (bta‐miR‐2285o‐3p). Functional analysis in vitro indicated that bta‐miR‐2285o‐3p attenuated hypoxia‐induced apoptosis by targeting very low‐density lipoprotein receptor (VLDLR), phosphatase and tensin homolog (PTEN) and caspase‐3. Expression level analysis in vivo revealed the high negative Pearson’s correlation between bta‐miR‐2285o‐3p and caspase3 in yak, highlighting the potential important roles of bta‐miR‐2285o‐3p in yak high‐altitude adaptation. Our study provides a typical model for deciphering the function of miRNAs in environmental adaptation.

[The treatment strategy and outcome of pregnancy complicated with Stanford type A aortic dissection]

To summarize the clinical characteristics and surgical treatment experience of pregnant women with acute Stanford type A aortic dissection.We collected the clinical data of 12 cases with acute aortic dissection during pregnancy and puerperal period from June 2010 to July 2020 in Beijing Anzhen Hospital and analyzed retrospectively, and summarize the clinical characteristics, treatment and outcomes for both mother and fetus. The age of these patients was(29±5)years old, and the onset time was from 16 weeks of gestation and 1 month after delivery. All the 12 patients underwent surgical treatment. The patients in the puerperium received aortic surgery after delivery. Four of them received the aortic surgery and continued pregnancy. Five of them underwent aortic repair and cesarean section simultaneously. Surgical treatment should be actively considered in pregnancy complicated with acute Stanford type A aortic dissection. Multi-disciplinary team cooperation can effectively improve the safety of the patients and fetus.

Carbapenem-resistant Enterobacterales colonization and subsequent infection in a neonatal intensive care unit in Shanghai, China

Background

Colonization has been reported to play an important role in carbapenem-resistant Enterobacterales (CRE) infection; however, the extent to which carriers develop clinical CRE infection and related risk factors in neonatal intensive care unit (NICU) patients is unclear.

Aim

To investigate the frequency of CRE colonization and its contribution to infections in NICU patients.

Methods

CRE colonization screening and CRE infection surveillance were performed in the NICU in 2017 and 2018.

Findings

Among 1230 unique NICU patients who were screened for CRE colonization, 144 patients tested positive (11.7%, 144/1230), with 9.2% (110/1197) in the intestinal tract, which was higher than that in the upper respiratory tract (6.6%, 62/945) (P=0.026). Gestational age, low birth weight and prolonged hospitalization were risk factors for CRE colonization (all P<0.001). Diversilab homology monitoring found an overall 17.4% (25/144) risk of infection among patients colonized with CRE. For carbapenem-resistant Klebsiella pneumoniae (CR-KP) and carbapenem-resistant Escherichia coli (CR-ECO), the risks were 19.1% (21/110) and 13.8% (4/29), respectively. The independent risk factors for CR-KP clinical infection among CR-KP carriers were receiving mechanical ventilation (odds ratio (OR), 10.177; 95% confidence interval (CI), 2.667–38.830; P=0.013), a high level of neonatal nutritional risk assessment (OR, 0.251; 95% CI, 0.072–0.881; P=0.031) and a high neonatal acute physiology II (SNAP-II) score (OR, 0.256; 95% CI, 0.882–1.034; P=0.025).

Conclusions

The colonization of CRE may increase the incidence of corresponding CRE infection in NICU patients. Receiving mechanical ventilation, malnutrition and critical conditions with high SNAP-II scores were independent risk factors for subsequent CR-KP clinical infection.

Prognostic value of PCSK9 Levels in Non-ST elevation myocardial infarction patients undergoing percutaneous coronary intervention

Background

The role of proprotein convertase subtilisin/kexin type 9 (PCSK9) in predicting major adverse cardiovascular events (MACEs) in Non-ST elevation myocardial infarction (NSTEMI) patients is still an open question and the PCSK9 concentration of clinical usefulness remains unknown in guiding treatment.

Purpose

To explore the role of PCSK9 in predicting major adverse cardiovascular events (MACEs) in Non-ST elevation myocardial infarction patients.

Methods

272 patients with NSTEMI were included in our study, all patients received PCI therapy after admission. Patients were followed up for 1 year and MACEs were recored. Their baseline plasma PCSK9 levels were determined by ELISA. Patients were divided into high, medium and low PCSK9 groups and the associations of PCSK9 with other biomarkers and MACEs were evaluated.

Results

The results showed that PCSK9 levels was related to levels of lipoproteins, high-sensitivity C-reactive protein (r=0.162, P=0.008), platelet volume distribution width (r=0.299, P&lt;0.001) and D-dimer (r=0.285, P&lt;0.001). And the concentrations of PCSK9 was greater higher in people with MACEs (137.2ng/ml vs 243.6ng/ml) (Fig. 1A). The Kaplan-Meier curves showed patients with high PCSK9 level had lower event-free survival rate (Fig. 1B). Survival analysis indicated high level of PCSK9 predicted MACEs independently after adjusted for traditional cardiovascular risk factors and GRACE score (HR=2.646, 95CI%: 1.047–6.686, P=0.027) (Fig. 1C, Fig. 2). Subgroup analysis demonstrated the prognostic value of high PCSK9 level was greater for patients classified by the GRACE score as high risk (Fig. 1D).

Conclusions

In a NSTEMI setting, the concentration of PCSK9 is associated with hypercoagulability and hyper-inflammation. High levels of PCSK9 independently predict future MACEs in NSTEMI patients, particularly those classified by the GRACE score as high risk.

Funding Acknowledgement

Type of funding sources: None.

A comparison of long-term clinical outcomes between PCI and medical therapy in patients with chronic total occlusion in non-Infarct-related arteries after AMI PCI

Background

Chronic total occlusion (CTO) in a non-infarct-related artery (IRA) is one of the risk factors for mortality after acute myocardial infarction (AMI). However, there are limited data comparing the long-term outcomes of patients underwent successful percutaneous coronary intervention (s-PCI) with patients having medical therapy (MT) in CTO lesion after AMI PCI.

Methods

We retrospectively enrolled 330 patients (n=166 in s-PCI group and n=164 in MT group) with CTO in a non-IRA from a total of 4372 patients who underwent PCI after AMI from July 2011 to July 2019 in our center (Figure 1). Propensity matching (119 matched pairs) was used to adjust for baseline differences. Major adverse cardiovascular and cerebrovascular events (MACCEs) on follow-up were defined as the composite of cardiac death, all cause death, myocardial infarction (MI), stroke and any revascularization. Kaplan-Meier analysis were used to evaluate the long-term outcomes between s-PCI and MT group.

Results

The patients in MT group were older, more likely to be diagnosed as STEMI, had lower eGFR and higher peak troponin T level during AMI compared with s-PCI group. Furthermore, in MT group, the involvement of LAD as IRA (50.6% vs 38.6%, p=0.028) and LCX as CTO vessel (45.1% vs 27.1%, p=0.001) was more frequent than in s-PCI group, and thus the involvement of LAD as CTO vessel was less frequent (28.9% vs 39.8%, p&lt;0.001). During a median follow-up period of 946 days, patients in s-PCI group had significantly lower incidences of cardiac death (3.0% vs 10.4%, p=0.017) and all cause death (5.4% vs 14.0%, p=0.030) when compared with patients in MT group. Moreover, after PSM, patients in s-PCI group still showed lower incidence of cardiac death (2.5% vs 9.2%, p=0.04). The incidence of MI, stroke, revascularization and MACCE showed no significant difference between the two groups both before and after PSM. In multivariate analysis, age (HR 1.06, 95% CI 1.02–1.10, p=0.003) and LVEF&lt;50% (HR 4.71, 95% CI 1.72–12.90, p=0.003) showed significant correlation with long term cardiac death, however, successful CTO PCI showed borderline significance (HR 0.42, 95% CI 0.15–1.16, p=0.095). In subgroup analysis, Kaplan–Meier curve showed s-PCI group had a lower incidence of cardiac death compared with MT in patients with LVEF&lt;50% both before (p=0.011) and after PSM (p=0.045). However, no difference was observed between two groups in patients with LVEF≥50%.

Conclusions

In our center, s-PCI of CTO in non-IRA after AMI PCI showed better long-term cardiac survival as compared with MT. Moreover, patients with low LVEF may be benefit from CTO PCI in non-IRA.

Funding Acknowledgement

Type of funding sources: None. Flow chart of the studyKaplan-Meier analysis between two groups

Latent class cluster analysis of knowledge on acute myocardial infarction symptoms and risk factors in community residents

Background

Knowledge of Acute Myocardial Infarction (AMI) symptoms and risk factors (RF) have been studied worldwide in various populations. However, the studied specific symptom and RF of different surveys varies, the number of surveyed symptom and RF varies, and the criteria for judging good/high knowledge and bad/low knowledge are different (group classification criteria include the number, the percentages or the scores), which makes the results difficult to compare.

Purpose

The aim was to identify clusters of knowledge on symptoms and modifiable RFs using Latent Cluster Analysis, and to further compare characteristics and the awareness of the need for prompt treatment among different clusters.

Methods

A structured questionnaire was used to interview 4122 community residents over 35 years old on their knowledge about AMI symptoms and RFs. Latent GOLD Statistical Package was used to identify and classify the respondent subtypes (latent classes) of the knowledge on AMI symptoms or modifiable RFs. An individual's class membership probabilities are computed from the estimated model parameters and the observed scores. The multivariable logistic regression was performed in order to identify factors that predicted High knowledge membership.

Results

Two and three distinct clusters were identified in terms of knowledge of symptoms and RFs. 62.7% (Symptom High Knowledge Cluster) and 39.5% (RF High Knowledge Cluster) of the respondents were able to identify most symptoms and modifiable RFs. A number of common differences were observed with respect to higher probability of having high knowledge on symptom and RF, which was mostly better among those with higher education and average monthly income, insured, having annual physical examination, have disease history of AMI RFs, AMI history in immediate family member or acquaintance and have been exposed to AMI related public education. There was also significant difference in awareness of the prompt treatment in case of AMI occurs among different symptom or RF clusters.

Conclusions

A moderate or relatively low knowledge regarding AMI symptoms and modifiable RFs was observed in our study. Identification of Symptom or RF knowledge clusters can be a way to detect specific targeted groups that are most likely to possess lower knowledge of AMI with readily identifiable characteristics, which may facilitate health education and further reduce the pre-hospital delay and improve patient outcomes.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): Key Project of Scientific and Technological Support Plan of Tianjin in 2020 Cluster category chartProfile plot

Public awareness of acute myocardial infarction symptoms and emergency response in community residents

Background

Patient delay in seeking help has been reported to be a major factor that related to delay in care of acute myocardial infarction (AMI). Lack the knowledge of symptoms may translate to behavioral deficiencies which lead up to failing to seek medical assistant at early stage of AMI.

Purpose

The aim of present study is to investigate the awareness of AMI symptoms and the emergency responses among community residents over 35 years old.

Methods

The sample was proportionally distributed by age according to the national census data. The sex ratio was 1:1. The sample size is calculated according to the significance level of 0.05, the allowable error of 0.1, and the estimated Excellent awareness level of 10%. The final sample size is adjusted to 4200, considering non-response rate of 20%. Multi-stage stratified random sampling was used. On the first stage, two districts each in urban and rural regions were randomly selected. On the second stage, 3–10 community health service centers were randomly selected in each district. On the third stage, residents over 35 managed by the community health service center were proportionally sampled to be interviewed. A structured questionnaire was used and the survey was conducted in a face-to-face interview by clinical physicians. Logistic regression was applied to analyze factors related to Good knowledge.

Results

The top three symptom recognized by public is “pain or discomfort in the chest” (71.3%), followed by “difficulty breathing” (65.1%) and “pain or discomfort in the jaw, neck, or back” (60.9%). 85.0% chose to call an ambulance as first response when witness others having an AMI. Those who lives alone (OR=1.408; 95% CI, 1.005–1.972) and whose immediate family had been diagnosed with AMI (OR=1.510; 95% CI, 1.040–2.192) has better knowledge. A significant positive correlation was observed for those with hypertension (OR=1.199; 95% CI, 1.007–1.429), while a negative correlation was observed for those with diabetes (OR=0.788; 95% CI, 0.626–0.992). Public education could improve Good knowledge (OR=1.662; 95% CI, 1.388–1.990), while doctoral advise has been shown negative impact (OR=0.824; 95% CI, 0.691–0.984).

Conclusions

Our data provide first population-based estimates of public awareness in our country. Further promotional strategies to increase overall awareness in general public are seriously needed.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): Major Science and Technology Projects of Tianjin Science and Technology Commission Multivariable logistic regression

402 Assessed and Discharged - An Audit of Discharge Summaries Completion During On-Calls

Aim

Effective health care provision is heavily dependent on timely, reliable transfer of patient information. Failure of this communication between professionals could result in redundancy of tests, delay in treatment, which may in turn endanger patient safety. The NHS Standard Contract requirements state discharge summaries should be completed within 24 hours of hospital assessment and discharge. Discharge summaries for patients who were reviewed but not admitted have been observed to be poorly completed and this audit aims to clarify this.

Method

On-Call Patient Lists between 1 December to 14 December 2020 were studied retrospectively. Patients who were assessed by the on-call surgical team but not admitted were included in the audit. Patients referred to other specialties were excluded. Hospital electronic system was reviewed for electronic records frim the encounter including clinical note or discharge summary.

Results

In total, 47 patients were identified during the 2 week- period. 40/47 patients were referred from AE and 9 of these patients were discharged from AE directly. 3 of the patients had a clinical note or discharge summary completed on the hospital electronic system. Overall, 18 of the 47 (38.3%) patients had a clinical note or discharge summary on the electronic system, with 6 (12.8%) of them being recorded as discharge summaries.

Conclusions

The overall completion of discharge summaries for this group of patients was poor. Awareness of this failing and the importance of professional communication should be highlighted with the juniors during surgical meeting to improve compliance before re-audit.

1135 Improving Surgical Discharge Summaries

Introduction

Discharge summaries are a means of communication to the patient, the GP and for medical records. An initial audit showed surgical discharge summaries contained misleading information and sometimes omitted relevant information. Changes were implemented to improve the accuracy of surgical discharge summaries.

Method

The initial audit assessed the accuracy of discharge summaries over a two-week period and the re-audit was conducted after implementation of change over a similar time period. Data was extracted from electronic patient records (EPR). Change implementation included educating the surgical team on the need for accurate discharge summaries. The EPR team was notified of the intrinsic error in the PowerChart system which is widely used in various NHS Trust.

Results

Incidence of misdiagnosis or misleading diagnosis in discharge summaries reduced from 42% to zero, lack of relevant investigations decreased from 7% to 1%, No follow up status reduced from 23% to 10% (usually post appendicectomy patients which are not routinely followed up but this needs to be stated in the discharge summary for clarity), at both initial audit and re-audit all patients had relevant surgery or procedures done included in their discharge summaries while the rate at which relevant medications were not stated in the discharge summary decreased from 4% to zero.

Conclusions

Discharge summaries are vital for record keeping and are usually the only written information a patient receives regarding their hospital stay. It is important that errors in EPR systems be flagged up for review.

1222 Improving Consenting for Emergency General Surgery During The COVID-19 Pandemic

Aim

Patients undergoing surgery during the Covid pandemic are exposed to increased risks of pulmonary complications and mortality. These novel risks need to be documented on the consent form. We carried out various interventions to ensure appropriate consenting and documentation following an initial audit that revealed poor compliance with published guidelines.

Method

The initial audit reviewed consent forms of patients undergoing emergency surgery over two-weeks in May 2020 while the re-audit was over a two-week period in June 2020 following implementation of interventions. Inclusion Criteria: Age &gt;18-years, urgent or emergency laparoscopic surgery Exclusion criteria: Age &lt;18-years, Open surgery, ‘Covid-light’ areas, NELA.

Results

57 consent forms were assessed during the audit loop: 22 laparoscopic appendicectomies and diagnostic laparoscopies, 14 incision and drainage, 8 laparoscopic cholecystectomies, 4 hernia repairs, and 9 other procedures. Consenting for covid pneumonia increased from 70% to 89%, potential ITU admission 56% from 25% and the risk of death 63% from 21%

Conclusions

The covid pandemic changed our surgical practice. There are many unknowns regarding the risks to surgical patients, however, evidence shows increased risks of covid pneumonia, ITU admission and death in the perioperative period. Our consenting and the documentation of such conversations with patients must reflect our new reality.

261 The Use of MRCP to Investigate Bile Duct Stones

Aim

Association of Upper Gastrointestinal Surgeons (AUGIS) latest guideline advocates stratification of patients with gallstone disease to determine their risks of common bile duct (CBD) stone and to perform Magnetic resonance cholangiopancreatography (MRCP) for those at intermediate risk. The study assessed the appropriateness of our local hospital’s MRCP requests in accordance to the AUGIS standard.

Method

Inpatient MRCP requests for suspected ductal gallstones between June and December 2019 were identified retrospectively. Admission history, ultrasound, MRCP findings and liver function tests were collected from hospital electronic records. Patients with previous cholecystectomy were excluded. Patients were categorized into ‘low risk’, ‘intermediate risk’ and ‘high risk’.

Results

67 patients were included in the study and 24 patients were discovered to have CBD stones on MRCP. The majority of patients (54%) were considered ‘intermediate risk’, whilst the ‘low risk’ group consisted of 13% of the MRCP requests and ‘high risk’ group comprised of 33 %. Amongst those in the ‘low risk’ group, only 1 of 9 patients (11%) had cbd stone identified on MRCP. 19% patients in the intermediate group were found to have CBD stone, whilst 73% patients in the high-risk group were identified to have CBD stone. On average, patients underwent MRCP within a day of request.

Conclusions

A high proportion of patients at high risk for CBD stone were referred for MRCP, contrary to AUGIS guideline. Inpatient MRCP referrals should be considered carefully in this category as it potentially increases length of stay without change in clinical management.

[Current situation and suggestions of public health personnel training in disease control and prevention institutions]

Under the background that the national health has become the national priority development strategy, it is essential to speed up public health ability among talents. Based on the consulting project of the Chinese Academy of Engineering, "Research on the training strategy of medical and health personnel in China", this paper analyzes the current situation and existing problems of public health personnel training in disease control and prevention institutions. Based on three stages of public health education, this paper puts forward that the public health personnel training should first solve the problem of public health personnel team construction and create programs on college education-post graduate education-continuing education. Through the personnel training system, different training modes are designed for other groups of people to improve the ability of public health personnel in an all-around way.

[Identification and genetic analysis of new mutations in EYA1 gene of BOS syndrome]

Objective: To analyze the clinical manifestations of a patient with branchiootic syndrome(BOS) and her families and to carry out genetic testing in order to specify the biological pathogenesis. Methods: Clinical data of the patient and her families were collected. Genomic DNA in the peripheral blood of the proband and her family members was extracted. All exons of 406 deafness-related susceptible genes as well as their flanking regions were sequenced by high-throughput sequencing, and the mutation sites of the proband and her parents were validated by Sanger sequencing. Results: There were nine members in three generations, of whom four presented with hearing loss, preauricular fistula and branchial fistula which met the diagnostic criteria of BOS. Proband and her mother presented with auricle malformation and inner ear malformation. And no one had abnormalities in the kidneys of all the patients. Pedigree analysis revealed that the mode of inheritance in the family was consistent with the autosomal dominant pattern. Mutational analysis showed that all the affected patients detected a heterozygous frameshift variation c.1255delT in the EYA1 gene, which had not been reported. Genotype and phenotype were co-isolated in this family. Such a frameshift variation produced a premature termination codon, thereby causing premature termination of translation (p.C419VFS*12). ACMG identified that the mutation was pathogenic. This mutation was novel and not detected in controls. A heterozygous missense variation mutation c.403G>A(p.G135S) in EYA1 gene was also detected in three members of this family. ACMG identified that the mutation clinical significance was uncertain. However, two of whom were normal, which seemed the disease was not caused by this mutation in this family. Conclusions: A novel frameshift mutation in EYA1(c.1255delT) is the main molecular etiology of BOS in the Chinese family. This study expands the mutational spectrum of EYA1 gene. The clinical manifestations are heterogeneous among patients in this family. The diagnosis of BOS should combine gene tests with clinical phenotypes analysis.

Effects of isometric resistance exercise of the lower limbs on intraocular pressure and ocular perfusion pressure among healthy adults: A meta-analysis

BACKGROUND

The main risks for glaucoma are increased intraocular pressure (IOP) and decreased ocular perfusion pressure (OPP). This review aims to examine the potential impact of lower limb isometric resistance exercise on intraocular pressure and ocular perfusion pressure.

METHOD

A meta-analysis was conducted to determine the potential impact of isometric exercise on IOP and OPP. The literature on the relationship between isometric resistance exercise and IOP was systematically searched according to the "Cochrane Handbook" in the databases of Pubmed, Web of Science, EBSCO, and Scopus through December 31, 2020. The search terms used were "exercise," "train," "isometric," "intraocular pressure," and "ocular perfusion pressure," and the mean differences of the data were analyzed using the Stata 16.0 software, with a 95% confidence interval.

RESULTS

A total of 13 studies, which included 268 adult participants consisting of 162 men and 106 women, were selected. All the exercise programs that were included were isometric resistance exercises of the lower limbs with intervention times of 1min, 2min, or 6min. The increase in IOP after intervention was as follows: I²=87.1%, P=0.001 using random-effects model combined statistics, SMD=1.03 (0.48, 1.59), and the increase in OPP was as follows: I²=94.5%, P=0.001 using random-effects model combined statistics, SMD=2.94 (1.65, 4.22), with both results showing high heterogeneity.

CONCLUSION

As isometric exercise may cause an increase in IOP and OPP, therefore, people with glaucoma and related high risk should perform isometric exercise with caution.

Erratum: Azimuthal Anisotropy of K_{S}^{0} and Λ+Λ[over ¯] Production at Midrapidity from Au+Au Collisions at sqrt[s]_{NN}=130 GeV [Phys. Rev. Lett. 89, 132301 (2002)]

This corrects the article DOI: 10.1103/PhysRevLett.89.132301.

[Effects of neoadjuvant chemoradiotherapy on infiltrating immune cells in the tumor microenvironment of rectal cancer]

OBJECTIVE

To detect the changes in the number and phenotype of tumor infiltrating immune cells in rectal cancer tissues before and after neoadjuvant concurrent chemoradiotherapy (CRT) and analyze their correlation with the clinicopathological parameters of the patients.

METHODS

The protein expressions of CD3, CD4, CD8, CD56 and Foxp3 in biopsy specimens and postoperative pathological specimens collected from 20 rectal cancer patients before and after neoadjuvant CRT were detected using Elivision^TM Plus immunohistochemistry, and the results were statistically analyzed.

RESULTS

Compared with the measurements before the therapy, neoadjuvant CRT resulted in significant increments in CD3 (21.8% vs 48.8%, P < 0.001), CD4(16.5% vs 42.2%, P < 0.001), CD8(8.3% vs 33.4%, P < 0.001)and CD56(0 vs 7.6%, P=0.012), obvious reduction in Foxp3 expression(26.0% vs 15.3%, P=0.005), but no significant changes in CD4/CD8 ratio of(2.7 vs 5.1).Multivariate analysis showed that the increase of CD3-positive cells(HR=0.16, P=0.028)and CD8-positive cells(HR=0.03, P=0.001)was positively correlated with the disease-free survival of the patients after the operation.

CONCLUSION

Neoadjuvant CRT can significantly increase the proportions of infiltrating immune cells positive for CD3, CD4, CD8 and CD56 and decrease the proportion of Treg lymphocytes in the tumor tissues in patients with rectal cancer.The patients with increased CD3-and CD8-positive T lymphocytes may have longer disease-free survival after the surgery.

Erratum: Azimuthal Anisotropy at the Relativistic Heavy Ion Collider: The First and Fourth Harmonics [Phys. Rev. Lett. 92, 062301 (2004)]

This corrects the article DOI: 10.1103/PhysRevLett.92.062301.

P–583 Differential lipidomic characteristics of children born to women with polycystic ovary syndrome

Study question

To describe lipidomic characteristics of offspring born to polycystic ovary syndrome (PCOS-off) women and assess the associations of clinical phenotypes changes with differential lipids.

Summary answer

PCOS-off showed specific changes in lipidomics and some differential lipids (e.g., phosphatidylcholines, lysophosphatidylcholine and sphingomyelin) may be the potential markers of aberrant cardiometabolic health.

What is known already

Polycystic ovary syndrome (PCOS), the most prevalent endocrine disorder characterized by ovulatory dysfunction, hyperandrogenism and polycystic ovarian morphology, affects about 8–13% of women of fertile age. Aberrant metabolic pathophysiological changes and increased pregnancy complications associated with PCOS predispose PCOS patients to have suboptimal intrauterine environments and that may produce a detrimental impact on the cardiometabolic health of their children.

Study design, size, duration

A total of 141 blood plasma samples from 70 children born to PCOS women (43 girls, 27 boys) and 71 healthy control children (44 girls, 27 boys) were obtained for lipidomics.

Participants/materials, setting, methods

Blood samples were centrifuged at 2000 rpm, 4 °C for 20 min, and the upper plasma was collected and used for lipid extraction. Then the waters ACQUITY UPLC I-Class system and The Xevo G2-S Q-TOF with an electrospray ionization (ESI) source (Waters, Manchester, UK) was used for chromatographic analysis and mass spectrometry analysis separately.

Main results and the role of chance

In total, 44 metabolites were found to be significantly altered in PCOS-off, including 8 up-regulated and 36 down-regulated metabolites. After stratified by sex, 44 metabolites were found to express differently in girls born to PCOS women (PCOS-g). 13 metabolites were up-regulated, and 31 metabolites were down-regulated, most of which belong to glycerolipids species. While 46 metabolites were found to express differently in boys born to PCOS women (PCOS-b) with 9 increased metabolites and 35 decreased ones, most of which were glycerophospholipids metabolites. Additionally, significant associations between metabolites changes and weight Z-score as well as high density lipoprotein level were found in PCOS-off. In PCOS-g, triglyceride, low density lipoprotein and high density lipoprotein level were found to be correlated with some metabolites, whereas in PCOS-b, thyroid stimulating hormone and high density lipoprotein were correlated with some lipids.

Limitations, reasons for caution

Other species of metabolites except lipids are not included in this study. Besides, some potential confounding maternal factors, such as smoking, drinking, breastfeeding etc. were not included due to the lack of data.

Wider implications of the findings: The results had broadened our understanding of PCOS-off’s cardiometabolic status and emphasized monitor and special management in this susceptible group of population.

Trial registration number

Not applicable

Accuracy of Bolton's Analysis among Different Malocclusion Patients Plaster Models and Digital Models Obtained by Ex Vivo Scanning with iTero Scanner in Chinese Han Population

Aim

This investigation aimed to compare the accuracy of Bolton's analysis on plaster models of various malocclusion groups by utilizing digital calipers and iTero scanner.

Materials and Methods

The data consisted maxillary and mandibular plaster study casts of 61 patients (Class I-20, Class II-20, Class III-21) there were 31 males and 30 females. iTero®element scanner was utilized to scan the models and Bolton's analysis was performed on digital models. Also, the Digital caliper was utilized to perform the Manual measurements. Mesiodistal tooth widths, Anterior and Overall Bolton ratio was measured utilizing OrthoCAD™ software on digital models and plaster models with digital calipers. Statistical analysis was performed utilizing One-way ANOVA and independent T-test.

Results

Results revealed anterior and overall Bolton ratios showed significant differences (P < 0.05) for the measurements performed utilizing digital models. Anterior ratio for (Group 1) iTero measurements depicted the statistical significant value (P < 0.03) and overall ratio for (Group 2) digital caliper measurements depicted the statistical significant value (P < 0.02).

Conclusion

With the introduction of intra-oral laser scanners it has become more convenient for the practitioner to perform the intra-oral digital scanning and carry out the model analysis digitally and iTero scanner can also be utilized extra-orally to perform the scanning and model analysis. Our study concludes that intra-oral laser scanner like iTero is more convenient for an orthodontist, and can be utilized for extra-oral scanning of orthodontic dental models as the measurements obtained on digital models was as accurate as the conventional method.

Tri-domain proteins 27 reduce inflammation and apoptosis in HK-2 cells and protect against acute kidney injury in mice

OBJECTIVE

The kidney is one of the most commonly damaged organs in sepsis. Acute kidney injury (AKI) induced by sepsis is a clinically dangerous disease with a high mortality rate. Therefore, it is particularly important to find a way to prevent and treat sepsis-induced AKI.

MATERIALS AND METHODS

Human renal tubular epithelial cell line (HK-2) and 8-week-old C57BL/6 mice were used. Lipopolysaccharide (LPS) was used to induce HK-2 cell injury and mouse AKI. Lentiviruses overexpressing TRIM27 were constructed to increase TRIM27 expression in HK-2 cells. Then, the effects of TRIM27 on the inflammation and apoptosis of HK-2 cells were analyzed, and those of TRIM27 recombinant protein on AKI in mice was detected by immunohistochemical staining and Western blot.

RESULTS

It was found that TRIM27 overexpression reduced the expressions of inflammatory factors and signaling molecules in apoptosis-related pathways in HK-2 cells, but increased the ratio of Bcl-2 to Bax in HK-2 cells, indicating the anti-apoptotic effect of TRIM27. Toll-like receptor 4 (TLR4)/NF-κB signaling pathway is an important mechanism of LPS mediated renal injury, and TRIM27 overexpression in HK-2 cells significantly inhibited the activity of TLR4/NF-κB signaling pathway. In addition, AKI was significantly relieved in mice treated with TRIM27 recombinant.

CONCLUSIONS

TRIM27 exerts anti-inflammatory and anti-apoptotic effects by inhibiting the TLR4/NF-κB signaling pathway, which effectively alleviates LPS-induced HK-2 cell damage and mouse AKI.

[Gender difference in secular trends of body height in Chinese Han adolescents aged 18 years, 1985-2014]

Objective: To analyze the gender difference in secular trends of body height in Chinese Han adolescents aged 18 years from 1985 to 2014. Methods: Data were extracted from 1985, 1995, 2000, 2005, 2010 and 2014 Chinese National Surveys in Students' Constitution and Health. A total of 124 099 Chinese Han adolescents aged 18 years were included in the analysis. ANOVA test was used to compare the body height between different subgroups stratified by gender and the mean difference and ratio in body height were calculated. Quantile regression model was used to assess the association between body height and gender over time in the adolescents stratified by region or area. Results: The mean body height of adolescents aged 18 years increased significantly from 1985 to 2014 with the rate of 1.3 cm/decade in male adolescents and 0.8 cm/decade in female adolescents, and the highest increment occurred from 1995 to 2005 in both groups. Male adolescents were taller than female adolescents at each subgroup (P<0.05). Gender difference in body height increased from 11.1 cm in 1985 to 12.6 cm in 2014 and ratio remained to be 1.07-1.08. The body height was taller in adolescents in urban area than in rural area (P<0.05) and in northeastern China than in other regions (P<0.05) in both male and female adolescents. The body height of obese male adolescents had been taller since 2000 and the body height of obese female adolescents had been taller since 2010 than other groups. When adjusted for urban-rural areas, region, socioeconomic status and nutritional status, the body height increased over time at P₅, P₂₅, P₅₀, P₇₅ and P₉₅ in both male and female adolescents, and the increments of gender difference in body height at different percentile ranged from 0.45 cm/decade to 0.57 cm/decade. When stratified by region, the gender difference in body height showed similar trend with total sample except P₅ and P₉₅ in northeastern China, the difference of increments were not significant. Conclusions: From 1985 to 2014, the gender difference in body height of Chinese Han adolescents aged 18 years increased, and male adolescents showed greater increase than female adolescents. Moreover, the adolescents in northeastern and eastern China had larger increment in body height. It is necessary to paid more attention to the adolescents in central and western China to promote their physical development.

[Survey on provincial disease prevention and control professionals' attitudes and cognition to public health physician standardized training in China]

Objective: To understand the attitudes and cognition of disease control and prevention professionals at provincial level on public health physician standardized training and provide evidence for the improvement of the standardized training and exploration of more effective training mode in China. Methods: By cluster sampling, 2 193 professionals at provincial centers for disease control and prevention (CDC) in 6 provinces, including Jiangsu and Guangdong, Shanxi and Hubei,Sichuan and Xinjiang were selected as the study subjects, the sample size was estimated to be 1 933 persons. Results: A total of 1 716 provincial-level CDC professionals were surveyed, the support rate to the standardized training was 70.7%(1 213/1 716). The level of support was negatively associated with the educational level of professionals and their specialty of public health and preventive medicine. Of 875 public health and preventive medicine professionals, 61.6%(318/516) of those with master's degree or above supported the standard training for public health physicians, which was lower than 73.1%(225/308) of those with bachelor's degree and 86.3%(44/51) of those with college degree or below. There were 14.9%(232/1 555) of the respondents suggested a two year training, and 60.4%(933/1 544) suggesting a field training mode. In terms of training content, 86.6%(1 355/1 564) suggesting "epidemiological survey and public health practice", and 76.7%(1 199/1 564) suggesting "basic theories and methodology". Conclusions: In general, the professionals of provincial CDC showed a relatively low interest in the standardized training for public health physicians and failed to reach a consensus. Besides, they were ill-informed about current training duration, method and content. Thas, the professionals at provincial CDC are suggested to be the key target-population whom should be mobilized during the training pilot period, especially the highly educated ones with relevant specialties of public health. It is suggested that public health physician standardized training should to be implemented in whole CDC system to reach full consensus based on its practical achievements and effects. It is also suggested to establish public health graduate medical education system in China.

OTX1 is a novel regulator of proliferation, migration, invasion and apoptosis in lung adenocarcinoma

OBJECTIVE

Orthodenticle Homeobox 1 (OTX1) has been found to be closely related to the development of several human tumours. However, the function and underlying molecular mechanisms of OTX1 in non-small cell lung cancer (NSCLC) are unclear. This research was performed to investigate the effects of downregulating OTX1 gene expression on the proliferation, migration, invasion, cell cycle and apoptosis of human NSCLC cell lines.

PATIENTS AND METHODS

Cultured NCI-H292 and XWLC cells were transfected with control small interfering RNA (siNC) or experimental siRNA (siOTX1). The mRNA levels were detected using a quantitative real-time PCR (RT-qPCR) assay. A Cell Counting Kit-8 (CCK-8) and a Real Time Cell Analyzer (RTCA) were used to determine cell activity. The RTCA and transwell chambers were used to assess cell migration and invasion. In addition, cell cycle progression and apoptosis were measured using flow cytometry, and the expression levels of key signalling pathway proteins were examined by Western blotting.

RESULTS

The results revealed that compared with the control group, the experimental group exhibited significantly decreased cell activity (***p<0.001), significantly decreased migration and invasion abilities (***p<0.001), and cell cycle arrest in G2/M phase (*p<0.05). However, the number of apoptotic cells was higher in the experimental group than in the control group (*p<0.05). The Western blotting results were consistent with the functional experiment results.

CONCLUSIONS

Silencing the OTX1 gene suppressed the proliferation, migration and invasion of NCI-H292 and XWLC cells, impeded the cell cycle transition from G2 to M phase, and accelerated apoptosis, revealing OTX1, a regulator of NSCLC, as a potential new therapeutic target.

[Pay attention to implementing measures, promote prevention and control of myopia]

The prevention and control of myopia among children and adoles cents is a systematic project. It is necessary to make full use of the establishment of relevant policies and strategies for myopia prevention and control, the improvement of surveillance measures, the application of prevention and control standards, the promotion of appropriate technologies and the construction of demonstration areas. These measures will help ensure the promotion of students' physical activities, popularize knowledge of prevention and control of health, promote the effective implementation of myopia prevention and control measures proposed in the Comprehensive Prevention and Control of Myopia in Children and Adolescents Implementation Plan, so as to protect the visual health of children and adolescents.

[Speckle-type POZ protein up-regulates c-Jun protein expression and promotes proliferation and invasion of renal carcinoma cells]

OBJECTIVE

To investigate the effect of speckle-type POZ protein (SPOP) on proliferation, apoptosis, migration and invasion of renal cell carcinoma (RCC) and explore the potential mechanisms.

OBJECTIVE

Renal carcinoma cell lines (786-O, A704, and Caki-2) cultured in vitro were transfected with a SPOP-overexpressing plasmid, and the changes in proliferation of the cells were detected using colony formation and MTT assay; TUNEL assay was used to assess apoptosis of the cells. The changes in migration and invasion abilities of the cells were examined using wound healing assay and Transwell assay. The mRNA and protein levels of SPOP and c-Jun in the transfected cells were measured using real-time PCR and Western blotting.

OBJECTIVE

SPOP over-expression obviously promoted the proliferation, migration and invasion of 786-O, A704 and Caki-2 cells (P < 0.05). Compared with the control cells, 786-o and Caki-2 cells over-expressing SPOP exhibited significantly lowered apoptosis rates (P < 0.05). The results of real-time PCR demonstrated that the transfected cells did not show obvious changes in the mRNA level of c-Jun, but the protein expressions of SPOP and c-jun increased significantly as shown by Western blotting (P < 0.05).

OBJECTIVE

SPOP can promote proliferation, migration, and invasion and suppress apoptosis of renal carcinoma cells possibly by promoting the expression of c-Jun.

Collision between soliton and polarization domain walls in fiber lasers

We report on the experimental observation of coexistence of solitons and polarization domains, as well as features of soliton collision with polarization domain walls (or kink solitons) in a single mode fiber laser. Depending on the sign of cavity dispersion, either bright or dark solitons have been formed in our fiber laser. Under suitable laser operation conditions, they could even coexist with polarization domains and collide with the domain walls. We show experimental evidence of both the elastic and inelastic soliton collisions with the domain wall solitons. Some interesting features of soliton interaction with polarization domains in a fiber laser are also firstly revealed.

Effects of oral sialic acid on gut development, liver function and gut microbiota in mice

Sialic acid (N-acetylneuraminic acid), a 9-carbon monosaccharide, has been widely studied in immunology, oncology and neurology. However, the effects of sialic acid on organ and intestinal development, liver function and gut microbiota were rarely studied. In this study, we found that oral sialic acid tended to increase the relative weight of liver and decreased the serum aspartate aminotransferase (GPT) activity. In addition, sialic acid treatment markedly reduced gut villus length, depth, the ratio of villus length/depth (L/D), areas, width and the number of goblet cells. Furthermore, gut microbes were changed in response to oral sialic acid, such as Staphylococcus lentus, Corynebacterium stationis, Corynebacterium urealyticum, Jeotgalibaca sp_PTS2502, Ignatzschineria indica, Sporosarcina pasteurii, Sporosarcina sp_HW10C2, Facklamia tabacinasalis, Oblitimonas alkaliphila, Erysipelatoclostridium ramosum, Blautia sp_YL58, Bacteroids thetaiotaomicron, Morganella morganii, Clostridioides difficile, Helicobacter tryphlonius, Clostridium sp_Clone47, Alistipes finegoldii, [pseudomonas]_geniculata and Pseudomonas parafulva at the species level. In conclusion, oral sialic acid altered the intestinal pathological state and microbial compositions, and the effect of sialic acid on host health should be further studied.

LncRNA NEAT1 regulates proliferation, apoptosis and invasion of liver cancer

OBJECTIVE

The occurrence and progression of hepatocellular carcinoma (HCC) is a multi-step complex process and the exact molecular mechanisms remain to be elucidated. LncRNA NEAT1 is involved in tumorigenesis and progression. However, the role of LncRNA NEAT1 in HCC remains unclear.

PATIENTS AND METHODS

The tumor tissues and adjacent tissues of HCC patients were collected and LncRNA NEAT1 expression was detected by Real time PCR. The hepatoma cell line HepG2 was cultured and transfected with lnc RNA NEAT1 siRNA or lnc RNA NEAT1 plasmid followed by analysis of LncRNA NEAT1 expression, cell proliferation by MTT assay, as well as Caspase 3 activity. In addition, cell apoptosis and cell cycle were assessed by flow cytometry and cell invasion was measured by transwell chambers. The expression of EGFR, Bax and Bcl-2 was detected by Western blot.

RESULTS

LncRNA NEAT1 expression was significantly increased in HCC tissues compared with adjacent tissues (p < 0.05). Compared with the siRNA group, transfection of lncRNA NEAT1 siRNA into HepG2 cells significantly inhibited cell proliferation, increased Caspase 3 activity and apoptosis, reduced cell invasion, as well as arrested cell cycle (p < 0.05). Meanwhile, lncRNA NEAT1 siRNA also significantly decreased Bcl-2 and EGFR expression and increased Bax expression (p < 0.05). Transfection of lncRNA NEAT1 plasmid in hepatoma cells HepG2 reversed the above changes, compared with vector group, the differences were statistically significant (p < 0.05).

CONCLUSIONS

LncRNA NEAT1 expression is increased in liver cancer tissues. Down-regulation of LncRNA NEAT1 can inhibit EGFR expression and promote hepatoma cell apoptosis, inhibit cell cycle, thus inhibiting tumor proliferation and invasion.

CircRNA EPB41L2 inhibits tumorigenicity of lung adenocarcinoma through regulating CDH4 by miR-211-5p

OBJECTIVE

Circular RNAs (circRNAs) can make contributions to cell proliferation, migration and invasion in lung adenocarcinoma (LUAD). Circ_Band 4.1-like protein 2 (circ_EPB41L2) was found to have anti-tumor roles in lung cancer. Herein, we investigated the roles of circ_EPB41L2 in LUAD tumorigenicity.

PATIENTS AND METHODS

The expression of circ_EPB41L2, microRNA (miR)-211-5p, and Cadherin-4 (CDH4) was measured using quantitative real-time polymerase chain reaction. Western blot was used to detect the levels of CDH4, Ki67, and E-cadherin. Cell proliferation, migration and invasion were examined using 3-(4,5)-dimethylthiazol(-z-y1)-3,5-di-phenyltetrazoliumbromide (MTT) assay and transwell assay, respectively. The interaction between miR-211-5p and circ_EPB41L2 or CDH4 was confirmed by Dual-Luciferase reporter assay. In vivo experiments were conducted using the murine xenograft model.

RESULTS

Circ_EPB41L2 and CDH4 were down-regulated in LUAD tissues and cell lines. Overexpressed circ_EPB41L2 or CDH4 acted as a suppressor in the LUAD cell proliferation, invasion and migration in vitro. MiR-211-5p directly bound to circRNA_EPB41L2 and CDH4 3'-UTR, and circ_EPB41L2 indirectly regulated CDH4 expression by binding to miR-211-5p in LUAD cells. Furthermore, rescue assay showed circ_EPB41L2 played a protective role by repressing proliferation, migration and invasion through regulating CDH4 and miR-211-5p in LUAD cells. Besides, in vivo experiments indicated circ_EPB41L2 overexpression also inhibited tumor growth through regulating miR-211-5p and CDH4.

CONCLUSIONS

Circ_EPB41L2 functioned as a tumor suppressor to inhibit the proliferation, migration and invasion through regulating CDH4 by miR-211-5p in LUAD cells, suggesting a new understanding on the tumorigenesis of LUAD and novel molecular therapeutic targets.

Circular RNA circCRIM1 suppresses lung adenocarcinoma cell migration, invasion, EMT, and glycolysis through regulating miR-125b-5p/BTG2 axis

OBJECTIVE

The present studies indicate that circRNAs play pivotal roles in human cancers. Lung adenocarcinoma (LUAC), one of lung cancer types, has high metastasis rate. Herein, we focused our study on the function and mechanism of circular RNA circCRIM1 in LUAC development.

PATIENTS AND METHODS

Quantitative Real-time polymerase chain reaction (qRT-PCR) was performed to detect the levels of circCRIM1, miR-125b-5p, and BTG anti-proliferation factor 2 (BTG2). Transwell assay was carried out to assess cell migration and invasion. The protein levels of BTG2, EMT markers, and HK2 were measured by Western blot. Glycolysis was analyzed through determining glucose consumption and lactate production. Furthermore, the targets of circCRIM1 and miR-125b-5p were predicted and verified by starBase and the dual-luciferase reporter assay, respectively. Also, whether circCRIM1 affecting tumor growth in vivo was explored using mouse xenograft assay.

RESULTS

CircCRIM1 and BTG2 were downregulated, and miR-125b-5p was upregulated in LUAC tissues/cells. CircCRIM1 upregulation inhibited LUAC cell migration, invasion, epithelial-mesenchymal transition (EMT), glycolysis, and tumor growth. Moreover, circCRIM1 regulated LUAC cell development through targeting miR-125b-5p. MiR-125b-5p affected LUAC cell growth via binding to BTG2. Also, circCRIM1 promoted BTG2 expression by inhibiting miR-125b-5p expression in LUAC cells.

CONCLUSIONS

CircCRIM1 was lowly expressed in LUAC. Moreover, circCRIM1 functioned as a sponge of miR-125b-5p to improve BTG2 expression, thereby suppressing LUAC development. Our finding indicated that circCRIM1 could be considered as a biomarker and target for the diagnosis and therapy of LUAC patients.

Phosphatase and tensin homolog (PTEN) suppresses triacylglycerol accumulation and monounsaturated fatty acid synthesis in goat mammary epithelial cells

Phosphatase and tensin homolog (PTEN) is a well-known tumor suppressor in nonruminants and regulates various cellular processes including growth through dephosphorylation of phosphoinositide substrates. Although studies with bovine mammary tissue suggested a role for PTEN during lactation, its potential role in lipid metabolism remains unknown. Objectives of the present study were to determine PTEN abundance in goat mammary tissue at 2 stages of lactation (n = 6 Xinong Saanen dairy goats per stage), and to use gene-silencing and adenoviral transfections in vitro with isolated goat mammary epithelial cells (GMEC) to evaluate the role of PTEN abundance of lipid metabolism-related genes. Abundance of PTEN decreased by 51.5% at peak lactation compared with the dry period. The PTEN was overexpressed in isolated GMEC through adenoviral transfection using an adenovirus system with Ad-GFP (recombinant adenovirus of green fluorescent protein) as control, and silenced via targeted small interfering RNA (siRNA) transfection with a scrambled small interfering RNA as a negative control. Cell culture was performed for 48 h before RNA extraction, triacylglycerol (TAG) analysis, and fatty acid analysis. Overexpression of PTEN downregulated abundance of acetyl-coenzyme A carboxylase α (ACACA), fatty acid synthase (FASN), sterol regulatory element binding transcription factor1 (SREBF1), stearoyl-coenzyme A desaturase 1 (SCD1), diacylglycerol acytransferase 1 (DGAT1), 1-acylglycerol-3-phosphate O-acyltransferase 6 (AGPAT6) coupled with an increase in patatin-like-phospholipase domain containing 2 (PNPLA2), hormone-sensitive lipase (LIPE), and carnitine palmitoyltransferase 1 β (CPT1B). Furthermore, overexpressing PTEN in vitro resulted in a significant decrease in TAG concentration and concentration of C16:1. In contrast, interference of PTEN led to an opposite effect on lipid metabolism in GMEC. These changes suggested a shift from lipogenesis and esterification to lipolysis and fatty acid oxidation. Collectively, PTEN seems to play a role in monounsaturated fatty acids synthesis and lipid accumulation in GMEC.

[Ocular toxicity induced by tamoxifen: an overview]

By reviewing the recent articles regarding the ocular side effect of tamoxifen when treating breast cancer and glioma, this article summarized the incidence and the potential mechanism of the side effects of tamoxifen, and the specific ocular toxicity including keratopathy, cataract, retinopathy, optic neuropathy. This review would provide guidance for clinical ophthalmologists to early identify and appropriately manage tamoxifen induced ocular diseases. (Chin J Ophthalmol, 2021, 57: 232-236).

[The study of the association between lung cancer screening and smoking behavior change]

The smoking cessation rate of 1 314 people at high risk of lung cancer in the area of lung cancer screening and early diagnosis and early treatment in Sichuan Province increased from 22.37% at baseline to 41.78% after screening (χ²=227.97, P<0.001), and the smoking amount of persistent smokers decreased from 20 cigarettes per day to 15 cigarettes per day (t=11.76, P<0.001). Those with positive results in lung cancer screening were more likely to quit smoking or continue to quit smoking. Male, younger age or lower education level would increase the risk of continuous smoking or relapse (P<0.05).