Pharmacological Mechanisms and Clinical Applications of Curcumin: Update

Curcumin, a well-known hydrophobic polyphenol extracted from the rhizomes of turmeric (Curcuma longa L.), has attracted great interest in the last ten years due to its multiple pharmacological activities. A growing body of evidence has manifested that curcumin has extensive pharmacological activities including anti-inflammatory, anti-oxygenation, lipid regulation, antiviral, and anticancer with hypotoxicity and minor adverse reactions. However, the disadvantages of low bioavailability, short half-life in plasma, low drug concentration in blood, and poor oral absorption severely limited the clinical application of curcumin. Pharmaceutical researchers have carried out plenty of dosage form transformations to improve the druggability of curcumin and have achieved remarkable results. Therefore, the objective of this review summarizes the pharmacological research progress, problems in clinical application and the improvement methods of curcumin's druggability. By reviewing the latest research progress of curcumin, we believe that curcumin has a broad clinical application prospect for its wide range of pharmacological activities with few side effects. The deficiencies of lower bioavailability of curcumin could be improved by dosage form transformation. However, curcumin in the clinical application still requires further study regarding the underlying mechanism and clinical trial verification.

Risk Estimates of Dementia and Alzheimer's Disease among Different Whole Grain Food Consumption Categories: A Pilot Study

OBJECTIVES

Whole grains (WG) have been widely recognized as healthy foods but few prospective studies have examined WG foods consumption and all-cause dementia and Alzheimer's disease (AD) dementia. This pilot study aimed to investigate the relationship between WG and dementia.

METHODS

2958 subjects from the Framingham Offspring cohort were included with the Food Frequency Questionnaire (FFQ) to assess their diet intake. And multivariate Cox proportional regression was conducted to examine the relations.

RESULTS

After an average follow-up of 12.6 years, 322 all-cause dementia were documented, including 247 AD dementia. In the fully adjusted model, participants in the highest vs. the lowest quintiles of WG consumption had lower risks of all-cause dementia (HR, 0.72; 95% CI, 0.53-0.84; P for trend <0.001) and AD dementia (HR, 0.64; 95% CI, 0.47-0.80; P for trend <0.001).

CONCLUSIONS

High consumption of WG foods is associated with decreased risks of all-cause dementia and AD dementia.t disease mortality. Our findings are from a preliminary study and need to be confirmed in comprehensive settings and integrated statistical methods.

A deep clustering-based mass spectral data visualization strategy for anti-renal fibrotic lead compound identification from natural products

We present a deep clustering-based MS data visualization strategy (MCnebula), integrated with the influential open-source automatic MS annotation platform SIRIUS and in vivo and in vitro methods, to screen and validate potential lead compounds from natural products.

LINC00174 triggers the malignant development of breast cancer by negatively regulating miR-1827 level

OBJECTIVE

Long non-coding RNAs (lncRNAs) are extensively involved in tumor development. In-depth researches on cancer-associated lncRNAs provide a theoretical basis for developing prognostic hallmarks and individualized therapeutic targets in breast cancer (BCa). This study aims to detect expression characteristics of LINC00174 in BCa and its biological role in regulating BCa cell phenotypes.

PATIENTS AND METHODS

LINC00174 levels in BCa and adjacent normal tissues were detected by quantitative real-time polymerase chain reaction (qRT-PCR). The influence of LINC00174 on pathological indicators of BCa was analyzed. In MCF-7 and MDA-MB-231 cells with LINC00174 knockdown, proliferative and migratory abilities were examined by cell counting kit-8 (CCK-8), colony formation and transwell assay, respectively. At last, molecular mechanisms of LINC00174 and its downstream gene miR-1827 in regulating BCa development were explored by Luciferase assay and rescue experiments.

RESULTS

LINC00174 was upregulated in BCa tissues than adjacent normal ones. High level of LINC00174 predicted advanced tumor staging, high metastasis rate and poor prognosis in BCa. Knockdown of LINC00174 attenuated proliferative and migratory abilities in BCa cells. MiR-1827 was the target gene binding LINC00174, showing a negative correlation between each other. Silence of miR-1827 abolished the regulatory effects of LINC00174 on proliferative and migratory abilities in BCa cells.

CONCLUSIONS

LINC00174 is upregulated in BCa samples. It is closely linked to tumor staging, metastasis and prognosis in BCa. By negatively regulating miR-1827 level, LINC00174 aggravates the malignant development of BCa.

Multifocal Primary Central Nervous System (CNS) Diffuse Large B-Cell Lymphoma (DLBCL) in a Patient with Aquired Immunodeficiency Syndrome (AIDS)

Introduction/Objective

Primary CNS DLBCL is a rare entity, with an incidence of less than 0.47 per 100,000, however, in immunocompromised patients, especially those with Human Immunodeficiency Virus (HIV-1) infection, the incidence increases dramatically to 2-6 percent. Here we present a case of multifocal DLBCL in a young 28-year-old homeless male with untreated AIDS and polysubstance abuse.

Methods/Case Report

He presented to the hospital with altered state of consciousness; a Computerized Tomography (CT) scan showed three ring-enhancing masses; one in the left fronto-temporal region, the largest in the left basal ganglia and the third in the cerebellum. The main lesion was biopsied and diagnosed as DLBCL. The patient developed aspiration pneumonia and demised from respiratory failure

Results (if a Case Study enter NA)

NA

Conclusion

Coronal sections of the brain revealed a large grey-tan, soft lesion of poorly defined, irregular borders located in the left basal ganglia that measured 5 x 4 x 4 cm, extended dorsally and laterally. A similar lesion was observed in the deep left cerebral hemisphere, affecting the temporal lobe and extending rostrally into the frontal lobe, but completely separate from the tumor in the basal ganglia. A third, much smaller lesion was found in the right cerebellar hemisphere. Histologically, the tumor was composed of sheets of atypical lymphoid cells with increased nuclear to cytoplasmic ratio, increased mitotic activity, and showed scattered areas of necrosis. In the peripheral areas, tumor cells were located in the Virchow Robin space, and in more central areas they have broken into the brain parenchyma. Tumor cells were positive for CD20 and CD79a, indicating their B-cell origin. Other markers positive by immunohistochemistry were PAX5, MUM1 and BCL6 and the Epstein-Barr Virus (EBV) latent membrane protein (LMP). Fluorescence In situ hybridization (FISH) corroborated the presence of Eptein-Barr encoded RNAs.

Measurement of the Absolute Branching Fraction of D_{s}^{+}→τ^{+}ν_{τ} via τ^{+}→e^{+}ν_{e}ν[over ¯]_{τ}

Using a dataset of 6.32  fb^{-1} of e^{+}e^{-} annihilation data collected with the BESIII detector at center-of-mass energies between 4178 and 4226 MeV, we have measured the absolute branching fraction of the leptonic decay D_{s}^{+}→τ^{+}ν_{τ} via τ^{+}→e^{+}ν_{e}ν[over ¯]_{τ}, and find B_{D_{s}^{+}→τ^{+}ν_{τ}}=(5.27±0.10±0.12)×10^{-2}, where the first uncertainty is statistical and the second is systematic. The precision is improved by a factor of 2 compared to the previous best measurement. Combining with f_{D_{s}^{+}} from lattice quantum chromodynamics calculations or the |V_{cs}| from the CKMfitter group, we extract |V_{cs}|=0.978±0.009±0.012 and f_{D_{s}^{+}}=(251.1±2.4±3.0)  MeV, respectively. Combining our result with the world averages of B_{D_{s}^{+}→τ^{+}ν_{τ}} and B_{D_{s}^{+}→μ^{+}ν_{μ}}, we obtain the ratio of the branching fractions B_{D_{s}^{+}→τ^{+}ν_{τ}}/B_{D_{s}^{+}→μ^{+}ν_{μ}}=9.72±0.37, which is consistent with the standard model prediction of lepton flavor universality.

[Inhibition of the Notch1/Jagged1 pathway promotes homing of bone mesenchymal stem cells to improve asthma in rats]

OBJECTIVE

To explore the association of the Notch1/Jagged1 pathway with the homing of mesenchymal stem cells (BMSCs) to regulate Th1/Th2 drift in asthma.

METHODS

Twenty SD rats were randomly divided into normal control group, model group, BMSC transplantation group, and BMSC+Notch inhibitor group. Ovalbumin sensitization was used to establish rat models of asthma, and BMSCs were transplanted via the tail vein. The pathology of the lung tissue was examined with HE staining, and the contents of interleukin (IL)-5, IL-13, and interferon-γ (IFN-γ) in lung tissue homogenate were determined with enzyme-linked immunosorbent assay. The expressions of Notch1 and Jagged1 mRNA were detected with RT-PCR, and CXCR4 expression in the bronchial epithelial cells was examined using immunofluorescence staining; Western blotting was used to detect the protein expressions of T-bet, GATA-3, Notch1, and Jagged1 in the lung tissue.

RESULTS

Compared with those in the control group, the expressions of IFN-γ and T-bet proteins decreased significantly and the pulmonary expressions of IL-5, IL-13, and GATA-3 proteins as well as Notch1 and Jagged1 mRNA and protein expressions all increased significantly in the model group (P < 0.05 or 0.01). Compared with those in the model group, CXCR4, IFN-γ, and T-bet protein expressions in BMSC group and BMSCs+Notch inhibitor group all increased significantly, and Notch1 and Jagged1 protein expressions in BMSCs group and IL-5, IL-13, Notch1, and Jagged1 mRNA and protein expressions in BMSCs + Notch inhibitor group all decreased significantly (P < 0.05 or 0.01). The expressions of CXCR4 and IFN-γ were significantly higher and the expressions of IL-13 and Notch1 mRNA were significantly lower in BMSCs+Notch inhibitor group than in BMSC group (P < 0.05).

CONCLUSION

In asthmatic rats, the homing of the BMSCs to the lung tissue has a regulatory effect on Th1/Th2 drift, and the Notch1/Jagged1 pathway may participate in the homing of the BMSCs.

[Explorative study of the immobilizing effect of full-thickness skin subcutaneous grafting on allogeneic full-thickness skin graft in rats]

Objective: To investigate the immobilizing effect of full-thickness skin subcutaneous grafting on allogeneic full-thickness skin graft in rats. Methods: The experimental research method was used. The inbred male Brown-Norway rats (n=10) and Lewis rats (n=10) were used as donors and recipients respectively. After subcutaneously full-thickness separation of a 2.2 cm×2.2 cm area on the nape of the recipient rat, a full-thickness skin of 2.0 cm×2.0 cm taken from the abdomen of the donor rat was subcutaneously grafted, and the donor site was pulled together and sutured. The autologous skin over the allograft in the recipient rat was excised 5-6 d after grafting, and the stitches were removed 7 d after excision. Within 2 months after grafting, the feeding, activity, and survival of the donor and recipient rats, behavior of tearing and scratching the wounds of the recipient rats, the wound condition after autologous skin excision in recipient rats, and the survival and hair growth of the grafted allogeneic skin were observed. Results: Within 2 months after grafting, the donor and recipient rats all ate normally and could move freely with no abnormal death. No tearing or scratching of the wounds occurred in recipient rats. There was a small amount of exudation and partial epidermal desquamation after autologous skin excision in recipient rats. All transplanted allografts survived, which were free of infection and necrosis, with new hairs growing out smoothly. Conclusions: The immobilizing method of full-thickness skin subcutaneous grafting of allogeneic full-thickness skin graft in rats is simple and time-saving without postoperative dressing change, with reliable pressure fixation and high survival rate of skin grafts, which can be promoted for animal skin grafting models.

Longitudinal impacts of greenness on cardiovascular disease conditions

Introduction

Environmental determinants of health, such as greenness, play an increasing role in our understanding of cardiovascular disease, and can inform how to address geographic cardiovascular disparities. This study assesses the impact of greenness and changes in greenness on cardiovascular disease.

Purpose

The purpose of this study is to investigate the impact of greenness and changes in greenness on cardiovascular disease diagnoses.

Methods

The sample for this prospective, longitudinal study was comprised of 243,558 U.S. Medicare beneficiaries 65 years or older, residing on the same Census Block from 2011 through 2016, and who had a Miami-Dade residential 9-digit zip code. Analyses examined the impact of greenness, measured by mean block-level Normalized Difference Vegetation index (NDVI) from satellite imagery to incidence of new cardiovascular conditions including: acute myocardial infarction, atrial fibrillation, heart failure, ischemic heart disease, hypertension, and stroke/ transient ischemic attack. Zero-inflated poisson regression was used to model the odds of developing any new cardiovascular disease and number of new cardiovascular conditions based on block level greenness while adjusting for individual age, gender, race/ethnicity, number of baseline cardiovascular conditions, and neighborhood characteristics including income and walkability.

Results

Living in a higher greenness Census Block was associated with lower odds of having at least one new cardiovascular condition and having a small number of new conditions, adjusting for individual and neighborhood level characteristics. When compared to individuals living in the lowest tertile of greenness throughout the study, those individuals living in the highest tertile of greenness throughout the study had a 16% lower odds of having any new cardiovascular conditions (OR=0.84, 95% CI: 0.79–0.90, p&lt;0.001) and among individuals developing at least one new cardiovascular disease, 4% fewer new cardiovascular conditions (OR=0.96, 95% CI: 0.92–0.99, p&lt;0.05). When compared to individuals living in the lowest tertile of greenness throughout the study, those individuals living in areas that increased their greenness from the lowest tertile to the highest tertile of greenness had a 15% lower odds of having any new cardiovascular conditions (OR=0.85, 95% CI: 0.75–0.97, p&lt;0.001) and among individuals developing at least one new cardiovascular disease, 9% fewer new cardiovascular conditions (OR=0.91, 95% CI: 0.83–0.99, p&lt;0.05).

Conclusions

High greenness is associated with lower rates of cardiovascular conditions over time, both when greenness increases and when a Census Block maintains high greenness. It is remarkable that these effects appear in five years, a relatively short amount of time for a positive environmental impact; and that even for those who began in the lowest greenness tertile, an increase to the high greenness tertile had a significant effect.

Funding Acknowledgement

Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Robert Wood Johnson Evidence for Action Grant

Heart rate variability and incident type 2 diabetes mellitus

Background

Hyperglycemia and autonomic dysfunction are bidirectionally related. The implications from former cross-sectional studies regarding the association of autonomic dysfunction and diabetes are limited due to the potential reverse causation. We aimed to investigate the association of longitudinal evolution of heart rate variability (HRV) with incident type 2 diabetes mellitus (T2D) among the general population.

Methods

Using data from the prospective population-based cohort study, 7630 participants with available repeated assessments of HRV, who were free of T2D and atrial fibrillation, were included. Measurements of HRV were analyzed from standard 10-s electrocardiograms records, including heart rate and two time-domain HRV markers: the heart-rate corrected standard deviation of the normal-to-normal RR intervals (SDNNc) and heart-rate corrected root mean square of successive RR-interval differences (RMSSDc). Joint models with the Bayes approach were performed to assess the associations between longitudinal evolutions of heart rate and different HRV metrics with incident T2D during follow-up. Models were adjusted for age, sex, body mass index, smoking status, systolic blood pressure, total and high-density lipoprotein cholesterol, use of blood pressure-lowering or lipid-lowering medication, and prevalent cardiovascular disease. Spearmen correlation was used to examine the associations between HRV metrics and glycemic traits (fasting blood glucose, insulin, and homeostatic model assessment of insulin resistance (HOMA-IR) and beta-cell function (HOMA-β)) at baseline.

Results

During a median follow-up time of 8.6 years, 871 individuals developed T2D. Based on joint models, one standard deviation (SD) increment of heart rate (hazard ratio [HR], 1.21; 95% CI, 1.09–1.34), log(SDNNc) (HR, 1.10; 95% CI, 0.94–1.27), and log(RMSSDc) (HR, 1.15; 95% CI, 1.02–1.31) was associated with the risk of developing T2D in fully-adjusted models. Subgroup analyses suggested stronger associations among men. The HRs of incident T2D per SD increment were 1.25 (1.09, 1.43) for men and 1.16 (0.99, 1.35) for women for heart rate, 1.23 (1.01, 1.51) for men and 0.97 (0.78, 1.20) for women for log(SDNNc), and 1.24 (1.05, 1.48) for men and 1.09 (0.89, 1.31) for women for log(RMSSDc). Results did not change after excluding participants who were prediabetes at baseline or after exclusion of underweight participants. Spearmen correlation indicated that heart rate was significantly associated with baseline glycemic traits, while RMSSDc was only related to fasting blood glucose.

Conclusion

Our study suggests that both higher heart rate and heart rate variability are associated with an increased risk of T2D development, especially among men.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Erasmus MC and Erasmus University Rotterdam; Netherlands Organization for Scientific Research; Netherlands Organization for Health Research and Development (ZonMw); Research Institute for Diseases in the Elderly; Netherlands Genomics Initiative; Netherlands Ministry of Education, Culture and Science; Netherlands Ministry of Health, Welfare and Sports; European Commission; and Municipality of Rotterdam. We would like to thank the China Scholarship Council for the scholarship to K.W. Forest plot

1637 Ablative Therapies Versus Partial Nephrectomy for Small Renal Masses: A Systematic Review and Meta-Analysis

Introduction

The optimal management of small renal masses is unclear. Ablative therapies (AT) have been advocated as a potential alternative due to lower complication rates and non-inferior oncological outcomes. We performed a systematic review to compare AT and partial nephrectomy (PN) in patients with T1aN0M0 renal masses.

Method

This review is registered on PROSPERO (CRD42020199099). A search was performed on Medline, EMBASE, and Cochrane CENTRAL to identify studies comparing AT and PN. Different modalities and approaches were analysed as subgroups. Outcomes include cancer-specific survival (CSS), overall survival (OS), recurrence-free survival (RFS), metastatic-free survival (MFS), postoperative complications, and change in renal function.

Results

From 1,351 identified records, 30 studies incorporating 85,837 patients were included for meta-analysis. Patients receiving AT were found to have significantly worse CSS, OS, RFS when compared to patients receiving PN (p &lt; 0.05). Patients undergoing AT have a non-inferior MFS and significantly fewer overall complications (HR: 0.79, 95% CI 0.41-1.51, p = 0.48; RR: 0.71, 95% CI 0.53-0.96, p = 0.03). Patients undergoing AT have a smaller decline in renal function post-operatively (SMD: 0.30, 95% CI 0.11-0.50). When limited to studies with propensity score matching, CSS and RFS are no longer significantly different between the two groups (HR: 1.54, 95% CI 0.67-3.52, p = 0.31, HR: 1.72, 95% CI 0.90-3.28, p = 0.10). Subgroup analyses did not show significant differences between different modalities and approaches of AT in all outcomes.

Conclusions

AT is potentially non-inferior to PN when managing small renal masses, and more high-quality propensity score-matched studies with long follow-up time are needed to confirm the non-inferiority.

[Research progress on building of disease control and prevention system of the international experience]

Through literature search in regular database and official websites of relevant countries, this paper combs and summarizes the main characteristics of disease prevention and control systems in five countries, the United States, Germany, South Korea, Australia and Japan, and the European Union at key levels including legal construction, organizational structure, financing, personnel construction and international cooperation, in order to provide decision support for the construction of disease prevention and control system in China in the future.

Sulforaphane overcomes T790M-mediated gefitinib resistance in vitro through epithelial-mesenchymal transition

The purpose of the present study was to investigate the effects of sulforaphane (SFN) on gefitinib-resistant cell lines with a T790 mutation (PC-9/AB11). The PC-9 and PC-9/AB11 cells were stained with H&E and visualized with a light microscope. The CCK-8 assay method was used to evaluate the antiproliferative activity of gefitinib and SFN on the cells. Cell cycle arrest and apoptosis were analyzed via flow cytometry. The cytotoxic interaction between the two drugs was evaluated in vitro using the combination index method, and epithelial-mesenchymal transition (EMT)-related proteins and alterations in the signaling pathways were determined by Western blot analysis. Compared to the PC-9 cells, the gefitinib-resistant PC-9/AB11 cells acquired a T790M mutation and had characteristics in accordance with EMT. The combination of gefitinib and SFN induced dose-dependent antiproliferative effects in the PC-9 and PC-9/AB11 cells, while both induced cell cycle arrest and cell apoptosis only in the PC-9/AB11 cells. The synergistic effect in the PC-9/AB11 cells was associated with this drug combination, as it caused an expression change of the epithelial (E-cadherin, claudin-1) and matrix proteins (vimentin, N-cadherin) in the cells, related to the reversal of EMT, as well as an expression change of the epidermal growth factor receptor (EGFR), p-EGFR, p-AKT, and p-ERK proteins. In this study, SFN overcame T790M-mediated gefitinib resistance in vitro through EMT. Thus, a combination of gefitinib and SFN may be a beneficial treatment strategy for lung cancer patients with acquired resistance due to T790M mutation.

Early-Onset Subgroup of Type 2 Diabetes and Risk of Dementia, Alzheimer's Disease and Stroke: A Cohort Study

BACKGROUND

This study aimed to assess the relation of early-onset type 2 diabetes (age<55years) versus later in life to the risk of dementia, Alzheimer Disease (AD) dementia and stroke.

METHODS

This study was based on the Framingham Heart Study Offspring cohort (FHS-OS) which is a community-based prospective cohort. Glycemic status was ascertained at serial examinations over six decades among participants who initially did not have diabetes. Surveillance for incident events including dementia and stroke has been continued for approximately 30 years.

RESULTS

At baseline, there were 142 (5%) subjects with onset of diabetes prior to age 55 years, 172 (6%) subjects with 55-64 years, 349 (11%) subjects over 65 years and 2389 (78%) subjects without diabetes. The risk of dementia, AD and stroke increased with decreasing age of diabetes onset (P<0.05, for trend). Compared with never developing diabetes, early-onset diabetes conferred a higher risk of all dementia, AD dementia and stroke [HR 2.86(1.16-5.51) for dementia; HR 2.42(1.63-4.33) for AD; HR 2.85(1.37-3.98) for stroke]. Whereas later-onset diabetes was only associated with greater risk for stroke, neither dementia nor AD.

CONCLUSION

Early-onset diabetes was stronger associated with an increased risk of all dementia, AD dementia and stroke than later-onset.

Observation of D^{0}→K_{1}(1270)^{-}e^{+}ν_{e}

Using 2.93  fb^{-1} of e^{+}e^{-} collision data taken with the BESIII detector at a center-of-mass energy of 3.773 GeV, the observation of the D^{0}→K_{1}(1270)^{-}e^{+}ν_{e} semileptonic decay is presented. The statistical significance of the decay D^{0}→K_{1}(1270)^{-}e^{+}ν_{e} is greater than 10σ. The branching fraction of D^{0}→K_{1}(1270)^{-}e^{+}ν_{e} is measured to be (1.09±0.13_{-0.16}^{+0.09}±0.12)×10^{-3}. Here, the first uncertainty is statistical, the second is systematic, and the third originates from the assumed branching fraction of K_{1}(1270)^{-}→K^{-}π^{+}π^{-}. The fraction of longitudinal polarization in D^{0}→K_{1}(1270)^{-}e^{+}ν_{e} is determined for the first time to be 0.50±0.19_{stat}±0.08_{syst}.

The efficacy and safety of flow-diverting device and coil embolization for intracranial aneurysms: a meta-analysis

OBJECTIVE

To compare the clinical efficacy and safety of flow-diverting device (FDD) and coil embolization therapy (CET) in the treatment of intracranial aneurysms through a meta-analysis.

MATERIALS AND METHODS

We comprehensively searched in PubMed, Embase, Cochrane Library, CNKI, Wan Fang, VIP databases, and China Biology Medicine disc (CBM) for eligible literature. Odds ratio (SMD) and 95% confidence intervals (CIs) were considered as effect measures. Statistical heterogeneity was tested by Cochran's Q statistic and I2 tests, and sensitivity analysis was used to evaluate the stability of research results. Publication bias was detected by funnel diagrams.

RESULTS

A total of 888 patients from 9 studies were finally enrolled in our analysis. Through meta-analysis, the results showed that the aneurysm occlusion rate in the FDD group was significantly higher than that in the CET group (OR, 95% CI=1.68, 1.20 to 2.36, p=0.002), and the retreatment rate after aneurysm operation in the FDD group was significantly lower than that in the FDD group (OR, 95% CI=0.40, 0.22 to 0.74, p=0.003). There was no significant difference in the proportion of mRS score (0-2) between the two groups during postoperative follow-up (OR, 95% CI=0.63, 0.20 to 1.94, p=0.43). In terms of safety, there was no significant difference in the incidence of postoperative complications (OR, 95% CI=1.11, 0.68 to 1.81, p=0.67) and mortality (OR, 95% CI=1.35, 0.53 to 3.42) between the two groups.

CONCLUSIONS

Compared with CET, FDD has achieved satisfactory results in increasing the rate of aneurysm occlusion and reducing the rate of retreatment of intracranial aneurysms. There is no significant difference in security between FDD and CET, though. These findings are reported in this paper, but because of the limitations of the included study, they need to be further verified by well-designed multicenter randomized controlled trials (RCT).

First Measurement of the Absolute Branching Fraction of Λ→pμ^{-}ν[over ¯]_{μ}

The absolute branching fraction of Λ→pμ^{-}ν[over ¯]_{μ} is reported for the first time based on an e^{+}e^{-} annihilation sample of 10×10^{9}  J/ψ events collected with the BESIII detector at sqrt[s]=3.097  GeV. The branching fraction is determined to be B(Λ→pμ^{-}ν[over ¯]_{μ})=[1.48±0.21(stat)±0.08(syst)]×10^{-4}, which is improved by about 30% in precision over the previous indirect measurements. Combining this result with the world average of B(Λ→pe^{-}ν[over ¯]_{e}), we obtain the ratio {[Γ(Λ→pμ^{-}ν[over ¯]_{μ})]/[Γ(Λ→pe^{-}ν[over ¯]_{e})]} to be 0.178±0.028, which agrees with the standard model prediction assuming lepton flavor universality. The asymmetry of the branching fractions of Λ→pμ^{-}ν[over ¯]_{μ} and Λ[over ¯]→p[over ¯]μ^{+}ν_{μ} is also determined, and no evidence for CP violation is found.

Gut microbiota disorder caused by diterpenoids extracted from Euphorbia pekinensis aggravates intestinal mucosal damage

Gut microbiota disorder will lead to intestinal damage. This study evaluated the influence of total diterpenoids extracted from Euphorbia pekinensis (TDEP) on gut microbiota and intestinal mucosal barrier after long‐term administration, and the correlations between gut microbiota and intestinal mucosal barrier were analysed by Spearman correlation analysis. Mice were randomly divided to control group, TDEP groups (4, 8, 16 mg/kg), TDEP (16 mg/kg) + antibiotic group. Two weeks after intragastric administration, inflammatory factors (TNF‐α, IL‐6, IL‐1β) and LPS in serum, short chain fatty acids (SCFAs) in feces were tested by Enzyme‐linked immunosorbent assay (ELISA) and high‐performance liquid chromatography (HPLC), respectively. The expression of tight junction (TJ) protein in colon was measured by western blotting. Furthermore, the effects of TDEP on gut microbiota community in mice have been investigated by 16SrDNA high‐throughput sequencing. The results showed TDEP significantly increased the levels of inflammatory factors in dose‐dependent manners, and decreased the expression of TJ protein and SCFAs, and the composition of gut microbiota of mice in TDEP group was significantly different from that of control group. When antibiotics were added, the diversity of gut microbiota was significantly reduced, and the colon injury was more serious. Finally, through correlation analysis, we have found nine key bacteria (Barnesiella, Muribaculaceae_unclassified, Alloprevotella, Candidatus_Arthromitus, Enterorhabdus, Alistipes, Bilophila, Mucispirillum, Ruminiclostridium) that may be related to colon injury caused by TDEP. Taken together, the disturbance of gut microbiota caused by TDEP may aggravate the colon injury, and its possible mechanism may be related to the decrease of SCFAs in feces, disrupted the expression of TJ protein in colon and increasing the contents of inflammatory factors.

Direct Measurement of the Branching Fractions B(ψ(3686)→J/ψX) and B(ψ(3770)→J/ψX), and Observation of the State R(3760) in e^{+}e^{-}→J/ψX

We report a measurement of the observed cross sections of e^{+}e^{-}→J/ψX based on 3.21  fb^{-1} of data accumulated at energies from 3.645 to 3.891 GeV with the BESIII detector operated at the BEPCII collider. In analysis of the cross sections, we measured the decay branching fractions of B(ψ(3686)→J/ψX)=(64.4±0.6±1.6)% and B(ψ(3770)→J/ψX)=(0.5±0.2±0.1)% for the first time. The energy-dependent line shape of these cross sections cannot be well described by two Breit-Wigner (BW) amplitudes of the expected decays ψ(3686)→J/ψX and ψ(3770)→J/ψX. Instead, it can be better described with one more BW amplitude of the decay R(3760)→J/ψX. Under this assumption, we extracted the R(3760) mass M_{R(3760)}=3766.2±3.8±0.4  MeV/c^{2} , total width Γ_{R(3760)}^{tot}=22.2±5.9±1.4  MeV, and product of leptonic width and decay branching fraction Γ_{R(3760)}^{ee}B[R(3760)→J/ψX]=(79.4±85.5±11.7)  eV. The significance of the R(3760) is 5.3σ. The first uncertainties of these measured quantities are from fits to the cross sections and second systematic.

Identification and validation of 12 immune-related genes as a prognostic signature for colon adenocarcinoma

Colon adenocarcinoma (COAD) is a common malignant tumor of the digestive tract that threatens human health seriously. Thus, it is urgent to explore biomarkers that can be used to evaluate a patient's survival prognosis overall as a supplementary treatment. RNA-seq expression profiles were downloaded from The Cancer Genome Atlas and Gene Expression Omnibus, and Lasso and multivariate Cox regression analyses were used for developing the prognostic model. Finally, a nomogram comprising the prognostic model was established to evaluate survival overall. A risk model comprised of a total of 12 immune-related gene pairs was constructed. Further analysis revealed the model's independent prognostic ability in relation to other clinical characteristics. This model's nomogram could help clinicians choose personalized treatment for COAD patients. This model has significant potential to complement COAD's clinical identifying characteristics, and also provide new insights into the identification of colon cancer patients with a high risk of death.

[Application value of machine learning algorithms for predicting recurrence after resection of early-stage hepatocellular carcinoma]

Objective: To compare the performance of multiple machine learning algorithms in predicting recurrence after resection of early-stage hepatocellular carcinoma(HCC). Methods: Clinical data of 882 early-stage HCC patients who were admitted to the First Affiliated Hospital of Nanjing Medical University from May 2009 to December 2019 and treated with curative surgical resection were retrospectively collected. There were 701 males and 181 females,with an age of (57.3±10.5)years(range:21 to 86 years). All patients were randomly assigned in a 2∶1 ratio, the training dataset consisted of 588 patients and the test dataset consisted of 294 patients. The construction of machine learning-based prediction models included random survival forest(RSF),gradient boosting machine,elastic net regression and Cox regression model. The prediction accuracy of the model was measured by the concordance index(C-index). The prediction error of the model was measured by the integrated Brier score. Model fit was assessed by the calibration plot. The performance of machine learning models with that of rival model and HCC staging systems was compared. All models were validated in the independent test dataset. Results: Median recurrence-free survival was 61.7 months in the training dataset while median recurrence-free survival was 61.9 months in the validation dataset, there was no significant difference between two datasets in terms of recurrence-free survival(χ²=0.029,P=0.865). The RSF model consisted of 5 commonly used clinicopathological characteristics, including albumin-bilirubin grade,serum alpha fetoprotein,tumor number,type of hepatectomy and microvascular invasion. In both training and test datasets,the RSF model provided the best prediction accuracy,with respective C-index of 0.758(95%CI:0.725 to 0.791) and 0.749(95%CI:0.700 to 0.797),and the lowest prediction error,with respective integrated Brier score of 0.171 and 0.151. The prediction accuracy of RSF model for recurrence after resection of early-stage HCC was superior to that of other machine learning models,rival model(ERASL model) as well as HCC staging systems(BCLC,CNLC and TNM staging),with statistically significant difference(P<0.01). Calibration curves demonstrated good agreement between RSF model-predicted probabilities and observed outcomes.All patients could be stratified into low-risk,intermediate-risk or high-risk group based on RSF model;statistically significant differences among three risk groups were observed in both training and test datasets(P<0.01). The risk stratification of RSF model was superior to that of TNM staging. Conclusion: The proposed RSF model assembled with 5 commonly used clinicopathological characteristics in this study can predict the recurrence risk with favorable accuracy that may facilitate clinical decision-support for patients with early-stage HCC.

Post-process optimization of 3D printed poly(lactic-co-glycolic acid) dental implant scaffold for enhanced structure and mechanical properties: effects of sonication duration and power

We described a technique of a post-process stage to partially remove the poly(vinyl alcohol) (PVA) binder in Poly(lactic-co-glycolic acid) (PLGA) dental scaffolds. The scaffolds were exposed to ultrasonic waves while immersed in an ethanol/acetone solvent mixture that possessed both polar and nonpolar properties. A factorial experiment was conducted in which the scaffolds were treated to three levels of sonication power (p_W): 0, 20% (22 W) and 40% (44 W), and soaking duration (t): 5, 15, and 30 min. The treated scaffolds were characterized by FT-IR, optical microscopy, and mechanical (compressive) testing. FT-IR revealed that the amount of PVA decreased with increasing p_W and t. Two-way ANOVA revealed that increasing p_W and t, respectively, resulted in increasing scaffold surface area to volume (SVR). Sonication and solvent caused structural damage (i.e., unevenness) on the scaffold surface, but the damage was minimal at 20% p_W and 30 min. The optimal values of p_W and t resulting in enhanced fracture strength, strain and toughness were 20% and 30 min, respectively, which corroborated the findings of minimal structural damage. However, sonication had no significant effects on the scaffold stiffness. Mechanistic analysis of the effects of sonication predicted that the ultrasonic energy absorbed by the scaffold was sufficient to disrupt the van Der Waals bonds between the PVA and PLGA but not high enough to disrupt the covalent bonds within the PLGA. This technique is promising as it can partially remove the PVA from the scaffold, and mitigate problematic issues down the line, such as thermal degradation during sterilization, and undue delay/variability in biodegradation.

[Radical surgery for colon cancer guided by membrane anatomy theory]

Like other solid tumors, colon cancer surgery has undergone a century-old journey from lumpectomy to organ resection and then to lymphadenectomy. From the Toldt fascia to complete mesenteric resection, and from local resection to D3 radical treatment, local recurrence rates have been reduced, but remain a nuisance to surgeons and patients. Based on the theory of membrane anatomy, radical surgery for colon cancer will focus more on removing the mesocolon from the mesentery bed while maintaining the integrity of the posterior fascia to avoid the occurrence of "fifth metastasis" as much as possible. Thanks to the membrane anatomy theory, its strong reproducibility and replicability, a new phase of colorectal surgery is on the horizon.

Proteomics analysis of hip articular cartilage identifies differentially expressed proteins associated with osteonecrosis of the femoral head

OBJECTIVE

The cartilage degeneration that accompanies subchondral bone necrosis plays an important role in the development of osteonecrosis of femoral head (ONFH). To better understand the molecular basis of cartilage degradation in ONFH, we compared the proteomic profiles of ONFH cartilage with that of fracture control.

DESIGN

Hip cartilage samples were collected from 16 ONFH patients and 16 matched controls with femoral neck fracture. Proteomics analysis was conducted using tandem mass tag-based quantitation technique. Gene ontology (GO) analysis, KEGG pathway and protein-protein interaction analysis were used to investigate the functions of the altered proteins and biological pathways. Differentially expressed proteins including alpha-2-HS-glycoprotein (AHSG) and Cytokine-like protein 1 (Cytl1) were validated by Western blot (WB) and immunohistochemistry (IHC).

RESULTS

303 differentially expressed proteins were identified in ONFH cartilage with 72 up-regulated and 231 down-regulated. Collagen turnover, glycosaminoglycan biosynthesis, metabolic pathways, and complement and coagulation cascades were significantly modified in ONFH cartilage. WB and IHC confirmed the increased expression of AHSG and decreased expression of Cytl1 in ONFH cartilage.

CONCLUSIONS

Our results reveal the implication of altered protein expression in the development of ONFH, and provide novel clues for pathogenesis studies of cartilage degradation in ONFH.

Efficacy and safety of glucokinase activators for type 2 diabetes mellitus therapy: a meta-analysis of double-blind randomized controlled trials

OBJECTIVE

We aimed to assess the efficacy and safety of oral glucokinase activator (GKA) in the treatment of type 2 diabetes mellitus (T2DM).

MATERIALS AND METHODS

We searched and collected randomized controlled trials (RCTs) of glucokinase activators in the treatment of T2DM from PubMed, ClinicalTrails, Cochrane Library, Web of Science, and CNKI databases. Revman5.3 software was used to do the meta-analysis, and the Cochrane tool was used to evaluate the risk of bias in the included RCTs.

RESULTS

Seven double-blind RTCs were included in the final analysis, with a total of 762 patients. For the efficacy, the meta-analysis found that GKAs lowed the levels of fasting blood glucose (FPG) (mean difference -0.71, 95% CI: -1.11 to -0.31, based on 459 patients from 5 works of literature) and glycated hemoglobin (HbA1c) (mean difference: -0.65%, 95% CI: -0.82 to -0.48, based on 570 patients from 4 works of literature). Subgroup analysis showed GKAs combined with metformin, but not used alone, reduced the levels of FPG. In terms of safety, GKAs did not affect the total rate of adverse events (AEs). GKAs did not affected the risks of diarrhea (RR 1.59, 95% CI: 0.7 to 3.65,  p =0.26), headache (RR 0.96, 95% CI: 0.41-2.21, p =0.60), and nausea (RR 2.23, 95% CI: 0.55-9.12,  p =0.24), but they increased the risk of hypoglycemia (RR 1.81, 95% CI: 1.35 to 2.42, p <0.0001, based on 570 patients from 4 literatures).

CONCLUSIONS

Oral GKAs combined with metformin has an evident hypoglycemic effect on T2DM, and they seem to be relatively good tolerant. Further clinical studies are still necessary to explore its long-term efficacy and safety.

[Risk factors of blood loss during liver transplantation in children with biliary atresia and its influence on prognosis]

Objectives: To study the risk factors for massive intraoperative blood loss in children with biliary atresia who underwent liver transplantation for the first time,and to analyze their impacts on graft survival,hospital stay and postoperative complications. Methods: The data of 613 children with biliary atresia who underwent liver transplantation at Department of Pediatric Organ Transplantation,Tianjin First Central Hospital from January 2015 to December 2018 were collected and analyzed. There were 270 males and 343 females, aged 7.4 (3.9) months (range: 3.2 to 148.4 months), the body weight of the recipients were (7.8±3.5) kg (range: 4.0 to 43.3 kg).According to the 85^th quad of estimated blood loss(EBL),they were divided into two groups:massive EBL group(96 cases) and non massive EBL group(517 cases). The age,height,weight and other factors between the two groups were analyzed and compared. Univariate Logistic regression and multiple stepwise regression were used to determine the risk factors of massive EBL. Then,the postoperative complications of the two groups,including portal vein thrombosis and portal vein anastomotic stenosis etc.,were analyzed and compared by chi square test. Kaplan Meier curve and log rank test were used to analyze the recipient and graft survival rate of the two groups. Results: During the study period,713 transplants were performed and 613 patients were enrolled in the study. Ninety-six patients(15.7%) had massive EBL,and the postoperative hospital stay was 21(16) days(range:2 to 116 days),the hospital stay of non-massive EBL group was 22(12)days(range:3 to 138 days)(U=24 224.0,P=0.32). Univariate Logistic regression analysis showed that the recipient's weight,Kasai portoenterostomy,platelet count,operation time and cold ischemia time were the risk factors of massive EBL during biliary atresia transplantation. Multiple regression analysis showed that cold ischemia time ≥10 hours,prolonged operation time(≥8 hours) and body weight<5.5 kg were important independent risk factors for massive EBL.The incidence of portal vein thrombosis,hepatic vein stenosis,intestinal leakage and pulmonary infection in patients with massive EBL were significantly higher than those without massive EBL(3.1% vs. 0.8%,9.4% vs. 2.1%,6.3% vs. 0.8%,30.2% vs. 20.1%,all P<0.05). The 3-year overall graft and recipient survival rate were significantly lower in patients with massive EBL than those without massive EBL(87.5% vs. 95.7%,P=0.001;84.4% vs. 95.4%,P<0.01,respectively). Conclusions: In children with biliary atresia who underwent liver transplantation for the first time,the effective control of intraoperative bleeding should shorten the operation time and reduce the cold ischemia time as far as possible,on the premise of ensuring the safety of operation. For children without growth disorder,the weight of children should be increased to more than 5.5 kg as far as possible to receive the operation. Reducing intraoperative bleeding is of great significance to the prognosis of children.