Luteoloside Ameliorates Palmitic Acid-Induced in Vitro Model of Non-alcoholic Fatty Liver Disease via Activating STAT3-Triggered Hepatocyte Regeneration

Luteoloside (Lute), a bioactive natural ingredient, widely exists in nature and possesses hepatoprotective and hepatocyte proliferation-promoting properties. This study aimed to investigate whether Lute could counteract non-alcoholic fatty liver disease (NAFLD)-caused hepatocyte damage via its stimulation of hepatocyte regeneration efficacy and to explore the involved mechanism. LO2 cells and primary hepatocytes were used to examine the hepatocyte proliferation effects of Lute under physiological conditions and in the palmitic acid (PA)- induced in vitro model of NAFLD. STAT3 and cell cycle-related proteins (cyclin D1, c-myc and p21) were evaluated by Western blot. Under physiological conditions, LO2 cells and primary hepatocytes treated with various concentration of Lute for 12 and 24 h showed increased hepatocyte proliferation, especially with 20 μM treatment for 24 h. More notably, under the model conditions, co-incubation with 20 μM of Lute also markedly reversed PA-induced inhibition of cell proliferation and viability in primary hepatocytes. Mechanistically, Lute could activate STAT3 and subsequently increase cyclin D1 and cmyc expression, which positively regulates cell cycle progression, and decrease expression of p21, an inhibitor of cell cycle progression. Furthermore, Luteinduced hepatocyte proliferation-promoting efficacy was abolished by STAT3 inhibitor stattic. Collectively, Lute can alleviate PA-induced hepatocyte damage via activating STAT3-mediated hepatocyte regeneration.

Environmental effects of stratospheric ozone depletion, UV radiation, and interactions with climate change: UNEP Environmental Effects Assessment Panel, Update 2020

This assessment by the Environmental Effects Assessment Panel (EEAP) of the United Nations Environment Programme (UNEP) provides the latest scientific update since our most recent comprehensive assessment (Photochemical and Photobiological Sciences, 2019, 18, 595-828). The interactive effects between the stratospheric ozone layer, solar ultraviolet (UV) radiation, and climate change are presented within the framework of the Montreal Protocol and the United Nations Sustainable Development Goals. We address how these global environmental changes affect the atmosphere and air quality; human health; terrestrial and aquatic ecosystems; biogeochemical cycles; and materials used in outdoor construction, solar energy technologies, and fabrics. In many cases, there is a growing influence from changes in seasonality and extreme events due to climate change. Additionally, we assess the transmission and environmental effects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for the COVID-19 pandemic, in the context of linkages with solar UV radiation and the Montreal Protocol.

Evaluation of Four Methods for the Assessment of Sarcopenia in Older Adults in Nursing Homes

OBJECTIVES

We aimed to evaluate the comparative effectiveness and applicability of using calf circumference (CC), strength, need for assistance with walking, rising from a sitting position, climbing stairs, and the incidence of falls (SARC-F), as well as SARC-F plus CC (SARC-CalF) and the Ishii test, for assessing sarcopenia in older adult nursing home occupants.

METHOD

In this cross-sectional study, the diagnostic criteria of the AWGS2019 were used as the standard, and the accuracy of the four screening methods determined by indicators, including sensitivity, specificity, receiver operating characteristic (ROC) curve, positive predictive values (PPV), and negative predictive values (NPV).

RESULTS

One hundred and ninety-nine older adults, 97 male and 102 female, were included. The prevalence of sarcopenia was 48.7%. Over all the participants, the sensitivity and specificity of CC were 74.22% and 51.96%, respectively, and 40.21% and 83.33%, respectively, for SARC-F. The use of SARC-CalF raised the SARC-F sensitivity (71.14%) while reducing the specificity (60.78%). The Ishii test had a sensitivity of 89.7% and a specificity of 74.51%. The PPV and NPV of CC, SARC-F, SARC-CalF, Ishii test were 0.6/0.68, 0.7/0.59, 0.55/0.63, and 0.77/0.88, respectively. The areas under the curve for CC, SARC-F, SARC-CalF, and the Ishii test were 0.67(95%CI, 0.59-0.74), 0.71(95%CI, 0.64-0.79), 0.71(95%CI, 0.64-0.79), and 0.86 (95% CI,0.81-0.92), respectively. The sensitivity and specificity of CC, SARC-F, SARC-CalF, and the Ishii test for sarcopenia screening in males were 71.69%/56.41%, 29.31%/79.49%, 67.24%/64.10%, and 94.83%/56.41%, respectively, and in females were 79.49%/49.21%, 56.41%/85.71%, 76.92%/58.73%, and 82.05%/85.71%, respectively. The PPV and NPV of CC, SARC-F, SARC-CalF, and the Ishii test in males were 0.71/0.56, 0.68/0.43, 0.74/0.57, and 0.76/0.88, respectively, while in females the values were 0.49/0.79, 0.71/0.76, 0.54/0.8, and 0.78/0.89, respectively.The areas under the curve for CC, SARC-F, SARC-CalF, and the Ishii test in males were 0.7(95%CI, 0.59-0.8), 0.63(95%CI, 0.52-0.75), 0.68(95%CI, 0.57-0.8), and 0.86(95% CI, 0.78-0.94), respectively, and in females 0.69(95%CI, 0.58-0.8), 0.81(95%CI, 0.72-0.89), 0.76(95%CI, 0.67-0.86), and 0.85 (95%CI, 0.77-0.94), respectively.

CONCLUSION

The overall screening ability of the Ishii test for sarcopenia was superior to that of the CC, SARC-F, and SARC-CalF in older adults in nursing homes.

Genetic variants in long non-coding RNAs UCA1 and NEAT1 were associated with the prognosis of oral squamous cell carcinoma

Oral squamous cell carcinoma (OSCC) is known for its high incidence, death rate, and relatively low 5-year survival. Long non-coding RNAs (lncRNAs) have been shown to play a significant role in cancerization and cancer progression. However, research on the association of polymorphisms in these lncRNAs with the prognosis of OSCC is lacking. Fifteen functional single-nucleotide polymorphisms (SNPs) in seven lncRNAs were selected to explore the relationship between these lncRNA SNPs and the prognosis among 209 OSCC patients. Kaplan-Meier analysis and Cox proportional hazards regression models were used to examine the associations. Further functional exploration of significant SNPs was done by eQTL analysis. Using multivariate Cox hazards regression analysis, a predictive role of NEAT1 rs3741384 GG and UCA1 rs7255437 TC+TT in a worse prognosis of OSCC was identified. In addition, a marked increased risk of death was observed with an increasing number of unfavourable genotypes (NUG). The NUG was then incorporated with clinical variables in the receiver operating characteristic curve, and the results indicated a potential role of the NUG in predicting OSCC patient risk of death (area under the curve increase from 0.616 to 0.703). In conclusion, the study findings indicate that genetic variants rs3741384 in NEAT and rs7255437 in UCA1 may influence the survival of OSCC patients.

Vertically stacked RGB LEDs with optimized distributed Bragg reflectors

The design and fabrication of a vertically stacked red-green-blue (RGB) light-emitting diode (LED) with novel, to the best of our knowledge, wavelength-selective distributed Bragg reflectors (DBRs) are demonstrated. The two DBRs are optimized to achieve selective reflectance in the RGB spectral region through theoretical calculations and simulation modeling. The insertion of optimal DBRs into the stack structure can effectively reflect downward emission from the upper chip without filtering the emission from the lower chips, thereby increasing the luminous efficiency for white emission with a color temperature range of 3000-8000 K by 1.6-7.4%. The optical performances of stacked devices with and without DBRs are thoroughly studied, verifying the effectiveness of the proposed wavelength-selective DBR structure.

The Analysis of Drug-Resistant Gene Mutations of Mycobacterium tuberculosis by GeneChip in Lianyungang, China

BACKGROUND

Tuberculosis (TB) has raised major global health concerns, especially for that caused by drug-resistant Mycobacterium tuberculosis (M. tuberculosis). The control of TB was hampered by time-consuming and insensitive diagnostic methods. GeneChip analysis is a rapid method for screening and identifying the gene mutations of M. tuberculosis. However, there was little relevant information about GeneChip analysis of M. tuberculosis in China.

METHODS

To compare the performance of GeneChip analysis in the diagnosis of drug-resistant M. tuberculosis with traditional drug susceptibility testing (DST), 1,747 sputum specimens from 2014 to 2016 in Lianyungang of China were retrospectively analyzed.

RESULTS

GeneChip analysis showed that the gene mutation site of M. tuberculosis to RFP resistance was 46.37% in rpoB 531 (TCG→TTG), and INH resistance was 69.89% in katG 315 (AGC→ACC). There was not significant different between GeneChip analysis and DST in detecting the resistance of M. tuberculosis to RPF or INH.

CONCLUSIONS

GeneChip analysis could be regarded as a rapid and recommended method for early screening and identifying the drug resistance of M. tuberculosis.

Long noncoding RNA LINP1 promoted proliferation and invasion of ovarian cancer via inhibiting KLF6

OBJECTIVE

Ovarian cancer is one of the most ordinary fatal cancers. The role of long noncoding ribonucleic acids (lncRNAs) in tumor progression has caught the attention of numerous researchers. In this work, lncRNA LINP1 was studied to identify how it functioned in the progression of ovarian cancer.

PATIENTS AND METHODS

Firstly, quantitative real-time polymerase chain reaction (qRT-PCR) was utilized to measure LINP1 expression in ovarian cancer tissues. Furthermore, to identify the function of LINP1 in ovarian cancer, functional experiments were conducted. Also, by performing qRT-PCR and Western blot assay, the underlying mechanism was explored.

RESULTS

In this research, LINP1 expression was remarkably higher in ovarian carcinoma samples compared with adjacent tissues. Moreover, cell proliferation, migration, and invasion were inhibited after LINP1 was silenced in the ovarian cancer cells. Besides, the messenger (mRNA) and the protein of KLF6 were overexpressed after LINP1 was silenced. Furthermore, the KLF6 expression level was negatively related to the LINP1 expression level in ovarian cancer samples.

CONCLUSIONS

We discovered a potential oncogene in ovarian cancer and identified that LINP1 enhanced cell metastasis and proliferation via down-regulating KLF6.

Influence of miR-199a on rats with non-small cell lung cancer via regulating the HIF-1α/VEGF signaling pathway

OBJECTIVE

Micro-ribonucleic acids (miRNAs) are involved in the occurrence of various cancers, and the hypoxia-inducible factor 1-α (HIF-1α) is the main regulator of cell proliferation induced by hypoxia. The relationships of miR-199a and HIF-1α expressions with non-small cell lung cancer (NSCLC) remain unclear, so they were explored in this work.

MATERIALS AND METHODS

On the basis of establishing the rat model of NSCLC, the messenger RNA (mRNA) expressions of miR-199a, HIF-1α and the vascular endothelial growth factor (VEGF) were analyzed in NSCLC rats, and the correlations of miR-199a with the mRNAs of HIF-1α and VEGF and cancer staging were investigated. To further study the role of miR-199a in NSCLC cell proliferation via the HIF-1α/VEGF signaling pathway, NSCLC cells were treated with the signaling pathway inhibitor and transfected with miR-199a mimics, respectively. Also,  the roles of the inhibitor PX-478 and miR-199a mimics in the expressions of miR-199a, HIF-1α, and VEGF proteins, as well as their influences on cell proliferation ability were detected.

RESULTS

In NSCLC rats, the expression of miR-199a was substantially decreased (p<0.01), but the expressions of HIF-1α and VEGF were notably raised (p<0.01). MiR-199a was negatively correlated with the expression of VEGF. As cancer developed, the expression of miR-199a was gradually lowered, but the expressions of HIF-1α and VEGF were gradually increased. Both HIF-1α/VEGF signaling pathway inhibitor PX-478 and miR-199a mimics significantly reduced the expressions of HIF-1α and VEGF proteins (p<0.01) and suppressed the cell proliferation activity.

CONCLUSIONS

MiR-199a prevents the proliferation of NSCLC cells via the targeted down-regulation of the HIF-1α/VEGF signaling pathway.

[Correlation between modified Oxford grading scale and pelvic floor surface electromyography in assessment of pelvic floor muscle function in female patients with stress urinary incontinence]

Objective: To investigate the characteristics of modified Oxford grading scale (MOS) and pelvic floor surface electromyography (sEMG) based on Glazer protocol in patients with stress urinary incontinence (SUI), and analyze the correlation between the two methods. Methods: This study was a cross-sectional survey. A total of 212 subjects in May 2019 were enrolled and divided into SUI group (n=61) and non-SUI group (n=151) based on the commonly used 3 incontinence questions (3IQ). MOS test and sEMG parameters were measured by the same rehabilitator. The sEMG parameters included the mean and variation coefficient in the prerest phase, the maximum and relaxation time of 5 rapid contractions, the mean and variability of EMG in 10 s tonic contraction phase, the mean and variability of EMG in 60 s endurance contraction phase, and the mean and variability of EMG in postrest phase. The differences of the above parameters between SUI group and non-SUI group were compared, the logistic regression and Spearman method were used to analyze the correlation between MOS and sEMG parameters. Results: The prevalence of SUI was 28.8%(61/212) in community, body mass index and delivery mode were the risk factors (all P<0.05). The MOS of the SUI group and the non-SUI group were 3 (2,3) and 3 (3,4), respectively, with significant difference (Z=-2.58, P=0.010). Among the sEMG parameters of SUI group and non-SUI group, the maximum values of phasic contractions were 23.12 (13.65, 37.89), 30.68 (20.28, 47.02) μV, the mean of tonic contractions were 14.32 (9.62, 21.49), 17.65 (12.05, 26.35) μV, and the mean of endurance contractions were 12.78(7.88, 18.76), 16.55(11.13, 22.40) μV, respectively, with statistical significance (Z=-2.34, -2.37, -3.20, all P<0.05). The multivariate logistic regression revealed that both the variation coefficient of tonic contractions (OR=157.86, 95%CI: 1.99-12 595.51, P<0.05) and the amplitude of endurance contractions(OR=1.11, 95%CI: 1.03-1.19, P<0.05) were correlated with SUI. The tonic contractions amplitude had the tendency to be related to SUI (OR=0.95, 95%CI: 0.09-1.00, P<0.05). In all subjects, MOS was correlated with the maximum value of rapid contractions, average value of tonic contractions and average value of endurance contractions (r=0.516, 0.503, 0.464, all P<0.05). In SUI group (r=0.510, 0.442, 0.385, all P<0.05), and non-SUI group (r=0.495, 0.524, 0.488, all P<0.05), MOS was correlated with the above parameters. Conclusions: MOS and sEMG based on Glazer protocol indicate that the contractility of pelvic floor muscle decreases in SUI patients. The results of sEMG and MOS are consistent, which can be used for quantitative evaluation of pelvic floor muscle function in SUI patients.

[Preliminary observation on the treatment of primary pterygium with modified conjunctival transplantation and amniotic membrane transplantation combined with use of interferon eye drops]

Objective: To observe the clinical effect of modified conjunctival transplantation and amniotic membrane transplantation combined with use of interferon (IFN) alpha-2b eye drops in the treatment of primary pterygium. Methods: This was a prospective case-control study. Patients with primary pterygium were treated from June 1, 2018 to December 31, 2018 in the Department of Ophthalmology, Beijing Tongren Hospital, and they were divided into two groups (the experimental group and the control group) by the method of randomized block design. Patients in the experimental group received modified conjunctival transplantation and amniotic membrane transplantation combined with use of IFN alpha-2b eye drops, while patients in the control group received pterygium resection combined with conjunctival autograft transplantation. The pterygium type and size were observed before operation, while visual acuity, intraocular pressure and anterior segment details were recorded either. The follow-up was done at 1 week, 2 weeks, 1 month, 3 months, 6 months and 12 months after operation. The visual acuity, corneal epithelial defect, and pterygium recurrence were observed. All data in this manuscript are enumeration data, the expected frequency of pterygium type distribution in the two groups was more than 5, and the chi square test was used, fisher's exact test was used to compare the other data between the two groups. Results: Seventy patients (77 eyes) with pterygium were in this study, including 30 males and 40 females, aged from 50-70 years old. There were 35 cases (38 eyes) in the experimental group and 35 cases (39 eyes) in the control group. 12 months after operation there were 54 cases (60 eyes) including 28 cases (30 eyes) in the experimental group and 26 cases (30 eyes) in the control group with complete data. The corneal epithelium defects of 1 eye in each group was repaired within 7-14 days after operation, and the rest eyes were completely repaired within 7 days after operation. There was no significant difference in the distribution of corneal epithelial healing between the two groups (P= 1.00). There was no significant difference between the two groups in the number of eyes distribute with decreased visual acuity (2 eyes in each group), stable visual acuity (15 eyes in the experimental group and 23 eyes in the control group), and improved visual acuity (13 eyes in the experimental group and 5 eyes in the control group) (P=0.053). There was no recurrence in the two groups at 12 months after surgery, and there was no significant difference between the two groups in the number of patients with conjunctival hyperplasia of grades 1, 2 and 3 (P=0.405). Conclusions: Modified conjunctival transplantation and amniotic membrane transplantation combined with use of IFN alpha-2b eye drops got low recurrence rate for primary pterygium and less damage to the healthy conjunctival tissue. This combined treatment strategy provides a new choice for the treatment of pterygium. (Chin J Ophthalmol, 2020, 56: 768-773).

Nicotinamide protects chronic hypoxic myocardial cells through regulating mTOR pathway and inducing autophagy

OBJECTIVE

To determine the protective effect of nicotinamide on chronic hypoxic myocardial cells and its underlying mechanism.

MATERIALS AND METHODS

The H9C2 cell lines were taken as objects of study, and were divided into blank group, hypoxia group and nicotinamide treatment group. The cell viability, apoptosis level, autophagy level and mammalian target of rapamycin (mTOR) pathway activity in each group were detected via Cell Counting Kit-8 (CCK8) assay, Hoechst staining, immunofluorescence staining, Polymerase Chain Reaction (PCR) and Western blotting, respectively.

RESULTS

Nicotinamide could protect the viability of normoxic and chronic hypoxic myocardial cells. Besides, it could also inhibit the expression of caspase3 messenger ribonucleic acid (mRNA) in chronic hypoxic myocardial cells, and reduce the expression of apoptosis-related proteins. Furthermore, it could induce the mRNA expression of autophagy-associated gene 5 (ATG5) and increase the expression of autophagy-related proteins. Further study on the mechanism of nicotinamide showed that nicotinamide could inhibit the activity of the mTOR pathway, thus regulating the autophagy.

CONCLUSIONS

Nicotinamide induces the autophagy of chronic hypoxic myocardial cells by regulating the mTOR pathway, thereby protecting cells from apoptosis.

Decreased expression of miR-551b predicts poor prognosis and promotes tumorigenesis by targeting PTP4A3 in human colorectal cancer

OBJECTIVE

MiR-551b has been reported to display tumor-suppressive and oncogenic potential in several cancers, but there has been no study on the roles of miR-551b in colorectal cancer (CRC). In this work, we aimed to explore the potential functions and mechanisms of miR-551b in the modulation of the CRC progression.

PATIENTS AND METHODS

The expressions of miR-551b were examined in 122 pairs of CRC cancer tissues and adjacent non-tumor samples by Real Time-Polymerase Chain Reaction (RT-PCR). The clinical significance of miR-551b in CRC patients was explored using a Chi-square test, Kaplan-Meier assays, and multivariate analysis. MiR-551b mimics and inhibitors were used to establish miR-551b upregulation and downregulation models in CRC cells to examine the functions of miR-551b on cells proliferation, migration, invasion, and apoptosis. Dual-luciferase reporter assays were conducted for the validation of the possible modulation of a putative target of miR-551b.

RESULTS

We showed that miR-551b was significantly down-regulated in CRC tissues and cell lines. It was observed that miR-551b expressions were correlated with lymph nodes metastasis, TNM stage, and poor prognosis. Multivariate analysis identifies low level of miR-551b expressions as an independent predictor for a shorter overall survival. The functional assessment suggested that forced miR-551b expression distinctly suppressed CRC cells growth, invasion, and migration, while the suppression of miR-551b displayed the opposite trend. Mechanistic studies confirmed that PTP4A3 was identified as a direct target of miR-551b in CRC. Interesting observations revealed that the cells capacities were higher in miR-551b +PTP4A3 group, when compared with those in miR-551b group, indicating that up-regulation of PTP4A3 rescued the repressive functions of miR-551b overexpression on CRC cells growth and migration.

CONCLUSIONS

The findings of our study first showed that miR-551b, a potential tumor suppressor, may be used as a promising prognostic predictor and therapeutic target for CRC.

Metformin with propofol enhances the scavenging ability of free radicals and inhibits lipid peroxidation in mice

OBJECTIVE

The aim of this study was to investigate the effects of metformin on anesthetic effect and anti-oxidative capacity in mice anesthetized with propofol.

MATERIALS AND METHODS

A total of 150 C57BL/6 mice were randomly assigned into the compatibility of an equivalent threshold dose of metformin with propofol group, and compatibility of different doses of metformin with 80 mg/kg propofol group, with 10 subgroups and 15 mice in each. Metformin and propofol were intraperitoneally injected in mice. The induction time of anesthesia in each mouse was recorded. 1 min after the disappearance of righting reflex, serum samples, and brain tissues were harvested, respectively. Subsequently, the contents of superoxide dismutase (SOD), malondialdehyde (MDA), and lactate dehydrogenase (LDH) in serum and brain homogenate of each group were measured. Furthermore, the protein expressions of nuclear factor-kappaB (NF-κB) and Nuclear erythroid 2-related factor 2 (Nrf2) were analyzed by Western blot.

RESULTS

Metformin supplementation did not influence the induction time of propofol anesthesia in mice, while the dose of propofol was significantly decreased. Besides, no significant correlation was found between an-esthesia induction time and the dose of metformin. Meanwhile, a certain dose of metformin could markedly increase the SOD activity in mouse brain tissues, whereas it could decrease the serum levels of MDA and LDH. In addition, metformin could remarkably inhibit the NF-κB activity and promote the Nrf2 expression.

CONCLUSIONS

Metformin improves the anesthetic effect of a single dose or continuous intraperitoneal injection of propofol in mice. The compatibility of a certain dose of metformin with propofol can enhance the scavenging ability of free radicals and their metabolites. Furthermore, this inhibits lipid peroxidation in mice via NF-κB inhibition and Nrf2 activation.

[Quantitative measurement of cross-sectional area of small pulmonary vessels in pulmonary embolism]

Objective: The relationship between the percentage of total cross-sectional area (% CSA) of small pulmonary vessels for the lung area in CTPA and the right ventricular function parameters in patients with pulmonary embolism. Methods: 120 patients with PE and 72 healthy subjects underwent CTPA and all date were analyzed Retrospectively. The main pulmonary artery diameter (mPA), the ratio of the main pulmonary artery to the ascending aorta diameter (rPA), right ventricle/left ventricular diameter ratio (RVd/LVd), and the pulmonary artery obstruction index (PAOI) in the PE group were measured for all subjects. The %CSA<5 mm(2) and 5-10 mm(2) for the lung area (%CSA(<5) and %CSA(5-10)) of small pulmonary vessels were measured with Image J image-processing program. According to the risk stratification of the 2018 Guidelines for the Diagnosis and Treatment of Pulmonary Thromboembolism, PE patients were divided into medium-high risk group (RVd/LVd>1) and low-risk group (RVd/LVd<1). The indexes of PE in medium-high risk group, low risk group and control group were compared by ANOVA, and the indexes among PE subgroups were compared by independent sample t-test. Spearman correlation method was used to analyze the correlation between %CSA and right ventricular function parameters of PE patients. Results: %CSA(<5) of medium-high risk group, low-risk group and control group were (0.69±0.19)%, (0.95±0.27)% and (0.99±0.30)% (P<0.01), respectively. %CSA(5-10) of three groups were (0.63±0.15)%, (0.84±0.18)%, and (0.85±0.25)% (P<0.01), respectively; %CSA(<5) and %CSA(5-10) of medium-high risk group were lower than low-risk group and control group. %CSA(<5) and %CSA(5-10) in PE patients correlated negatively with RVd/LVd, rPA and mPA (r=-0.545/-0.549, -0.235/-0.352, -0.239/-0.298, respectively). Conclusion: The measurement of % CSA<(5) and %CSA (5-10) in CTPA were negatively correlated with RVd/LVd in patients with pulmonary embolism, which indirectly reflected the severity of the pulmonary embolism patients.

Patterning Chronic Active Demyelination in Slowly Expanding/Evolving White Matter MS Lesions

BACKGROUND AND PURPOSE

Slowly expanding/evolving lesions measured by conventional T1-weighted/T2-weighted brain MR imaging may contribute to progressive disability accumulation in MS. We evaluated the longitudinal change in myelin and axonal tissue integrity in white matter slowly expanding/evolving lesions by means of the magnetization transfer ratio and DTI radial diffusivity.

MATERIALS AND METHODS

Slowly expanding/evolving lesions were detected within the Study to Assess the Efficacy, Safety, Tolerability, and Pharmacokinetics of BIIB033 in Participants With Relapsing Forms of Multiple Sclerosis When Used Concurrently With Avonex (SYNERGY) Phase 2 clinical trial dataset (NCT01864148), comprising patients with relapsing-remitting and secondary-progressive MS (n = 299) with T1-weighted/T2-weighted MR imaging at all trial time points (baseline to week 72).

RESULTS

Compared with non-slowly expanding/evolving lesions (areas not classified as slowly expanding/evolving lesion) of baseline nonenhancing T2 lesions, slowly expanding/evolving lesions had a lower normalized magnetization transfer ratio and greater DTI radial diffusivity, both in patients with relapsing-remitting MS (n = 242) and secondary-progressive MS (n = 57, P < .001 for all). Although the changes with time in both the normalized magnetization transfer ratio and DTI radial diffusivity between slowly expanding/evolving lesions and non-slowly expanding/evolving lesions were positively correlated (P < .001), a decrease in the normalized magnetization transfer ratio and a greater increase in DTI radial diffusivity were observed in slowly expanding/evolving lesions versus non-slowly expanding/evolving lesions from baseline to week 72 in relapsing-remitting MS and secondary-progressive MS (P < .001 for all).

CONCLUSIONS

Patterns of longitudinal change in the normalized magnetization transfer ratio and DTI radial diffusivity in slowly expanding/evolving lesions were consistent with progressive demyelination and tissue loss, as seen in smoldering white matter MS plaques.

CircRNA ZNF609 promotes growth and metastasis of nasopharyngeal carcinoma by competing with microRNA-150-5p

OBJECTIVE

This study aims to explore the biological function of circular RNA ZNF609 (circ-ZNF609) in regulating the occurrence and progression of nasopharyngeal carcinoma (NPC), and to investigate the possible underlying mechanism.

PATIENTS AND METHODS

The expression levels of circ-ZNF609, microRNA-150-5p and Sp1 in NPC tissues and normal nasopharyngeal epithelial tissues were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Circ-ZNF609 expression was silenced in NPC cell lines (5-8F and HONE-1). Cellular behaviors of NPC cells were determined using Cell Counting Kit-8 (CCK-8), wound healing and transwell assay. The binding relationship among microRNA-150-5p, circ-ZNF609 and Sp1 was detected by Dual-Luciferase reporter gene assay. In addition, the protein expression of Sp1 after altering expression of circ-ZNF609 or microRNA-150-5p was detected by Western blot.

RESULTS

The expression levels of circ-ZNF609 and Sp1 in NPC tissues were markedly higher than those of normal nasopharyngeal epithelial tissues. However, the expression of microRNA-150-5p was significantly lower in NPC tissues. The knockdown of circ-ZNF609 in NPC cells 5-8F and HONE-1 significantly inhibited the proliferative, migratory and invasive behaviors of NPC cells. Meanwhile, microRNA-150-5p knockdown in NPC cells showed the opposite effect on cellular behaviors of NPC cells. Dual-Luciferase reporter gene assay revealed that circ-ZNF609 could bind to microRNA-150-5p, and Sp1 was a target gene of microRNA-150-5p. Western blot results showed that circ-ZNF609 could stabilize the expression of Sp1, while microRNA-150-5p degraded Sp1 expression. Furthermore, the knockdown of Sp1 in NPC cells reversed the carcinogenic effect of circ-ZNF609.

CONCLUSIONS

Highly expressed circ-ZNF609 adsorbs microRNA-150-5p to upregulate Sp1 expression, thereby promoting the proliferation and metastatic ability of NPC cells.

Long noncoding RNA LINP1 promoted proliferation and invasion of ovarian cancer via inhibiting KLF6

Since this article has been suspected of research misconduct and the corresponding authors did not respond to our request to prove originality of data and figures, "Long noncoding RNA LINP1 promoted proliferation and invasion of ovarian cancer via inhibiting KLF6, by Y. Li, C.-Z. Hou, Y.-L. Dong, L. Zhu, H. Xu, published in Eur Rev Med Pharmacol Sci 2020; 24 (1): 36-42-DOI: 10.26355/eurrev_202001_19893-PMID: 31957816" has been withdrawn. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/19893.

[Imaging features and clinical analysis of diffuse uterine leiomyomatosis cases]

Objective: To discuss the imaging, clinical features and management of diffuse uterine leiomyomatosis (DUL). Methods: Six cases of DUL confirmed in Peking Union Medical College Hospital from August 2009 to September 2019 were reviewed on their image and clinical data. Retrospective analysis was conducted on their perioperative and postoperative follow-up data. Results: The average age of the first diagnosis of DUL was (27±3) years old. All of the patients complained menorrhagia and three patients suffered moderate to severe anemia. Three patients were diagnosed infertility. Pelvic ultrasound and MRI showed symmetrical enlarged uterus with complete replacement of the myometrium by innumerable, confluent leiomyomas.Four patients were treated with GnRH-a before operation to reduce the volume of myoma and correct anemia. Among the six patients, five had undergone myomectomy because of DUL before visiting Peking Union Medical College Hospital. Three patients underwent open myomectomy. The number of resected myoma was 188-300 and the bleeding volume was 1 200-2 500 ml. Two of them suffered recurrence at 51 and 40 months after operation. One received sirolimus for 20 months without recurrence until now. Other three patients underwent hysterectomy. One patient underwent partial small bowel resection and partial omentum resection because of severe pelvic adhesion during hysterectomy, and the blood loss was 2 000 ml. Conclusions: Pelvic imaging especially MRI is helpful for early recognition and preoperative evaluation for DUL. Fertility preservation is a great challenge for DUL patients. The risk of recurrence after myomectomy is high. Hysterectomy is the last choice to completely cure DUL at present.

The invasion status of lymphovascular space and lymph nodes in cervical cancer assessed by mono-exponential and bi-exponential DWI-related parameters

AIM

To investigate whether mono-exponential and bi-exponential diffusion-weighted imaging (DWI)-related parameters of the primary tumour can evaluate the status of lymphovascular space invasion (LVSI) and lymph node metastasis (LNM) in patients with cervical carcinoma preoperatively.

MATERIALS AND METHODS

Eighty patients with cervical carcinoma were enrolled, who underwent preoperative multi b-value DWI and radical hysterectomy. They were classified into LVSI(+) versus LVSI(-) and LNM(+) versus LNM(-) according to postoperative pathology. The apparent diffusion coefficient (ADC), pure molecular diffusion (D), pseudo-diffusion coefficient (D∗), and perfusion fraction (f) were calculated from the whole tumour (__whole) and tumour margin (__margin). All parameters were compared between LVSI(+) and LVSI(-) and between LNM(+) and LNM(-). Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed to evaluate the diagnostic performance of these parameters.

RESULTS

f__margin and D∗__whole showed significant differences in differentiating LVSI(+) from LVSI(-) tumours (p=0.002, 0.008, respectively), while LNM(+) tumours presented with significantly higher ADC__margin than that of LNM(-) tumours (p=0.009). The other parameters were not independent related factors with the status of LVSI or LNM according to logistic regression analysis (p>0.05). The area under the ROC curve of f__margin combined with D∗__whole in discriminating LVSI(+) from LVSI(-) was 0.826 (95% confidence interval [CI]: 0.691-0.961), while ADC__margin in differentiating LNM(+) from LNM(-) was 0.788 (95% CI: 0.648-0.928).

CONCLUSIONS

The parameters generated from mono-exponential and bi-exponential DWI of the primary cervical carcinoma could help discriminate its status regarding LVSI (f__margin and D∗__whole) and LNM (ADC__margin).

[Clinical effect of free thoracodorsal artery perforator flap in reconstructing large scar on the facial subunit]

Objective: To explore the clinical effect of free transplantation of thoracodorsal artery perforator flap in reconstructing large scar on the facial subunit. Methods: From April 2014 to March 2018, 7 patients with large facial scar were admitted to Ningbo NO.6 Hospital, including 3 males and 4 females, aged from 31 to 49 years, 4 with frontal involvement and 3 with chin and neck. Color Doppler ultrasound was used for the positioning of the thoracodorsal artery perforating vessel, and scar resection was performed according to the principle of facial subunit repair. The wound area was 8 cm×6 cm-21 cm×8 cm, and the wound was repaired with the free thoracodorsal artery perforator flap in the area of 9 cm×7 cm-22 cm×9 cm. The donor site was closed directly by suturing. The consistency of the location of the perforating vessel explored during the operation with its preoperative positioning and the flap survival were recorded. The color, texture, and appearance of the flap and the healing condition, scar formation, and function of the donor area were observed during follow-up. Results: The locations of the perforating vessels of 7 patients explored during the operation were consistent with those positioned by color Doppler ultrasound before the operation. All the flaps of the 7 cases survived successfully after operation. Postoperative follow-up of 12-18 months showed that the flap color was similar to the surrounding skin of the recipient area, with soft texture and no obvious contracture. Slight bloated appearance was observed in the flaps of 4 cases. All the 7 patients had postoperative healing of the flap donor site without obvious scar hyperplasia or influence on shoulder joint function. Conclusions: The anatomy of the perforating vessel of the thoracodorsal artery perforator flap is relatively constant and the flap can be cut in large area with soft texture, good appearance, and concealed donor area, which is a good choice for reconstructing large scar on the facial subunit.

Enhancement of charge-mediated magnetoelectric coupling in Fe3O4/SrTiO3/Ba0.6Sr0.4TiO3 heterostructure

The in-plane magnetic hysteresis loops of Fe₃O₄/SrTiO₃(STO) and Fe₃O₄/STO/Ba_0.6Sr_0.4TiO₃(BSTO) heterostructures have been investigated at 200 K under various electric fields. The bottom BSTO layer of the STO/BSTO bilayer is used to improve the dielectric properties of the top STO layer. The polarization of the STO/BSTO bilayer is ∼78% larger than that of the STO layer at room temperature due to the improvement of surface topography and the contribution of electrostatic interlayer coupling. A significant enlargement (∼70%) in the magnetoelectric response of Fe₃O₄/STO/BSTO heterostructure has been achieved at 200 K and 300 kV cm^-1 after introducing the BSTO layer, since the STO/BSTO bilayer with larger dielectric constant supplies more polarization charges at its interface to the Fe₃O₄ layer than the STO layer. It indicates that the dielectric bilayer improves the polarization and thus benefits the magnetoelectric coupling in the multiferroic heterostructure.

Value of preoperative computed tomography in predicting the local staging of cancer of the tongue at primary surgery

Preoperative staging is essential for the planning of treatment of cancer. This study was designed to evaluate the accuracy of computed tomography (CT) in predicting the local stage of tongue cancer by comparing it with the gold standard of histopathology. A total of 233 patients with newly-diagnosed tongue cancer was retrospectively reviewed, and the size of the tumour and the status of the cervical lymph node were compared between CT images and histopathological results. Patients with stage II cancer were followed up to assess the influence of inaccurate preoperative staging on prognosis. The accuracy of local staging by CT was 47.6% (111/233), with 59.7% (139/233) for tumour stage, and 70.4% (164/233) for nodal stage. The greatest dimension of the tumour on the CT image was about 2mm less than that measured by histopathology. The estimated volume of tumour was a quarter smaller. The accuracy of predicting malignant lymph nodes by CT was 68.9% (n=161). Among patients with stage II disease, simultaneous neck dissection was less likely in the understaged group than in the accurately staged one. The reoperation rate was a little higher but not significantly so. We conclude that the accuracy of CT in predicting local staging for tongue cancer was only moderate, because it underestimated the size of the tumour and needed to improve the criteria for detecting malignant lymph nodes. Understaging on CT images may influence the prognosis of patients with early stage tongue cancer.

The importance of proper and prompt treatment of ocular syphilis: a lesson from permanent vision loss in 52 eyes

BACKGROUND

Ocular involvement can occur at any stage of syphilis. Prompt diagnosis and proper treatment of ocular syphilis are vital to avoid long-term consequences.

OBJECTIVES

To describe the risk factors for ocular syphilis and clinical features of blindness caused by syphilis.

METHODS

We report risk factors for ocular syphilis amongst patients seen at the Shanghai Skin Disease Hospital between October 2009 and October 2017. We identify patients with ocular syphilis resulting in blindness and report the clinical characteristics, laboratory findings and treatment outcomes of these patients.

RESULTS

A total of 8310 new cases of syphilis were seen, of which 213 patients had ocular disease and 50 patients had blindness due to syphilis. Increasing age and higher RPR titres were associated with ocular involvement but there was no association with HIV status. Blindness in syphilis was restricted predominantly to patients with optic nerve involvement and not patients with isolated uveitis. Fifty patients (and a total of 67 eyes) met the WHO definition of blindness prior to treatment for syphilis. At the end of follow-up, vision had improved in 24 of 67 eyes (35.8%) after treatment. Successful treatment of uveitis was associated with the best improvement in visual acuity, whilst patient with underlying optic atrophy prior to treatment had the worst visual outcome.

CONCLUSIONS

Ocular involvement is an important manifestation of syphilis which may result in blindness. Our data demonstrate outcomes for ocular syphilis are poor if detected late; early recognition and diagnosis is therefore vital to avoid permanent visual loss.

[Analysis on the efficacy and safety of fibrinolytic therapy in patients with acute ST-segment elevation myocardial infarction during the COVID-19 epidemic]

Objective: To evaluate the efficacy and safety of fibrinolysis strategy in patients with acute ST-segment elevation myocardial infarction (STEMI) during the COVID-19 epidemic, and to provide reference value for optimization of fibrinolytic process on the premise of prevention and control of COVID-19 transmission, including self-protection of medical staff. Methods: The efficacy and safety of fibrinolysis were retrospectively analyzed in 7 patients with acute STEM, who hospitalized from February 29, 2020 to April 3, 2020 in the Department of Cardiology, Wuhan Union Hospital of Tongji Medical College, Huazhong University of Science and Technology. To optimize the fibrinolytic process on the premise of prevention and control of COVID-19 transmission, including self-protection of medical staff, a full-time medical team in charge of fibrinolysis under third-grade protection was established. The acute STEMI patients were treated immediately in a fixed and isolated area in emergency department before receiving green channel fibrinolysis. Blood samples for complete blood count, COVID-19 antibody test and nasopharyngeal swab samples for COVID-19 nucleic acid test were made before fibrinolysis, while the chest CT examination was accomplished after fibrinolysis. By comparing differences of time from the first electrocardiogram (ECG) to fibrinolysis before and after the improvement of fibrinolytic process, the effect of optimization of the fibrinolytic process was evaluated. Results: In the present study, seven patients with acute STEMI received fibrinolysis therapy, 6 of them achieved reperfusion and no bleeding was observed in all of the patients. Five out of the 7 patients were hospitalized after fibrinolysis, and the hospitalization days were 19.6 days on average. By following up to April 14, 2020, none of the 7 patients died. The first 2 patients were treated according to the routine medical procedure and the time from the first ECG to fibrinolysis were 201 and 106 minutes, respectively. After the optimization of the fibrinolytic process, the time from the first ECG to fibrinolysis of the last 5 patients were 42, 46, 51, 43 and 54 minutes, respectively，which was significantly shorter than that before optimization. Conclusions: During the COVID-19 epidemic, fibrinolysis in patients with acute STEMI is safe, effective and easy to implement. Therefore, it is recommended as the top priority for the patients with acute STEMI with indications for fibrinolysis. On the premise of prevention and control of COVID-19 transmission, including self-protection of medical staff, the duration of myocardial ischemia can be shortened by optimization of the fibrinolytic process.

Sacrocolpopexy compared with transvaginal mesh surgery: a systematic review and meta-analysis

BACKGROUND

The use of mesh is controversial in the treatment of female pelvic organ prolapse.

OBJECTIVES

To systematically review the outcomes of sacrocolpopexy compared with transvaginal mesh surgery and to provide evidence-based suggestions.

SEARCH STRATEGY

The MEDLINE, EMBASE, Cochrane Library and clinicaltrials.gov databases were searched on 21 November 2018.

SELECTION CRITERIA

Randomised controlled trials and prospective and retrospective cohort studies were included.

DATA COLLECTION AND ANALYSIS

Data were extracted by one reviewer and examined by a second reviewer for accuracy. Odds ratios and 95% CI were calculated using random-effects models.

MAIN RESULTS

Twenty comparative studies were included. The meta-analysis was performed with subgroups. The summary odds ratios of the randomised controlled group were 1.84 (95% CI 0.79-4.29, I²  = 75%) for anatomical success, 1.41 (95% CI 0.47-4.24, I²  = 38%) for subjective success, 0.42 (95% CI 0.18-0.98, I²  = 0%) for mesh complications, 0.61 (95% CI 0.20-1.91, I²  = 0%) for prolapse reoperation and 0.44 (95% CI 0.23-0.88, I²  = 0%) for de novo dyspareunia. The mean differences were 0.77 (95% CI 0.31-1.23, I²  = 66%) for total vaginal length and -1.28 (95% CI -2.00 to -0.55, I²  = 66%) for point C after surgery.

CONCLUSIONS

Very-low-quality evidence indicated that the anatomical and subjective success rates of sacrocolpopexy were similar to those of transvaginal mesh surgery; sacrocolpopexy might be more beneficial than transvaginal mesh surgery in terms of mesh-related complication rates, prolapse recurrence and de novo dyspareunia. However, additional high-quality randomised trials with long-term follow-up durations are needed.

TWEETABLE ABSTRACT

Sacrocolpopexy is beneficial after surgical anatomical changes and has decreased rates of mesh-related complications and dyspareunia.

[Experts consensus for the diagnosis, treatment, and prevention of Coronavirus disease 2019 in the elderly]

Coronavirus disease 2019 (COVID-19) can cause great damage to the elderly patients and lead to high mortality. The clinical presentations and auxiliary examinations of the elderly patients with COVID-19 are atypical, due to the physiological ageing deterioration and basal pathological state. The treatment strategy for the elderly patients has its own characteristics and treatment protocol should be considered accordingly. To improve the diagnosis, treatment, and prevention of COVID-19 in the elderly, the Expert Committee of Geriatric Respiratory and Critical Care Medicine, China Society of Geriatrics established the "Expert consensus for the diagnosis, treatment, and prevention of Coronavirus disease 2019 in the elderly" . We focused on the clinical characteristics and key points for better treatment and prevention of COVID-19 in the elderly. (1) For diagnosis, atypical clinical presentation of COVID-19 in the elderly should be emphasized, which may be complicated by underlying disease. (2) For treatment, strategy of multiple disciplinary team (mainly the respiratory and critical care medicine) should be adopted and multiple systemic functions should be considered. (3) For prevention, health care model about integrated management of acute and chronic diseases, in and out of hospital should be applied.

[A study on the end criteria of forced vital capacity curve in adults]

Objective: To explore the end criteria of forced vital capacity(FVC) curve in adults. Methods: A multicenter cross-sectional study was performed in Zhongshan Hospital Affiliated to Fudan University, the First Affiliated Hospital of Fujian Medical University, and the Third Affiliated Hospital of Inner Mongolia Medical University from January 2017 to August 2017. A consecutive sample of subjects who completed the spirometry test and FVC curves met end criteria of no volume change (<0.025 L) for ≥ 1 s were qualified in this study. Subjects were divided into a normal group (n=610), an obstructive group (n=536), and a restrictive group(n=306) according to pulmonary function test results. The FET values in different groups were compared. The side effects in the 3 groups and the diagnostic accuracy, specificity and security of different FET in the obstructive group were assessed. Results: The FET values of the normal group, the obstructive group, and the restricted group were (4.00±1.07) s, (8.08±1.56) s and (2.97±0.76) s respectively, and the 95% CI of FET in the 3 groups were between 3.88-4.12 s, 7.02-10.14 and 2.21- 3.73 s (F=2 263.80, P<0.01). When the exhalation platform was used as the standard of FVC curve, the adverse reaction rate in the normal group and the restricted group were 1.1% and 1.3% respectively, lower than the rate of 17.2% in the obstructive group (χ(2)=92.73, χ(2)=48.49 respectively; all P<0.05). In the obstructive group, 7 s as the ending criterion had similar incidence of adverse reactions to 6 s (χ(2)=0.01, P=0.93). With further extension of expiration time, the incidence of adverse reactions increased significantly. In the obstructive group, the sensitivity of FEV(1)/FEV(7) was 99.25%, higher than that at FEV(1)/FEV(6) (χ(2)=4.06, P=0.04), and the specificity of diagnosis was very similar and 100%. Conclusions: FET was variable in subjects with different lung function status. It is not appropriate to use a fixed FET≥ 6 s as the end criterion of spirometry for adults. For patients with normal lung function or restrictive lung function defect, exhalation platform should be used as the end of exhalation standard. For patients with obstructive lung function defect, an FET of up to 7 s is appropriate.

THU0544 MULTIMODAL PHOTOACOUSTIC/ULTRASONIC IMAGING SYSTEM: A NEW IMAGING METHOD FOR EVALUATING RA

Background:

Photoacoustic imaging (PAI), a new imaging technique which can be integrating with ultrasound (US) imaging, has shown potential in visualizing small joints. We have developed a multimodal photoacoustic/ultrasound (PA/US) imaging system, equipped with a handheld probe, which can provide dual-wavelength PA/US imaging to identify the micro-vessels of the inflamed articular regions and measure the oxygenation level of human inflamed synovium.

Objectives:

To validate the potential value for RA of the imaging system.

Methods:

A total of 32 RA patients received PA/US examination on seven small joints (MCP2, MCP3, PIP2, PIP3, MTP2, MTP5, and wrist of the clinically dominant side). The 0-3 score was used to semi-quantify the PA and PD signals of the inflammatory articular lesions, and the sums of PA and PD scores (PA-sum and PD-sum) were utilized. The relative oxygen saturation (SO2) values of the inflamed regions were measured by calculating the ratio of PA signals at the wavelength of 750nm and 830nm. All the patients were classified to 3 PA+SO2 patterns (Pattern 1: no or minimal PA signals; Pattern 2: evident PA signals and hyperoxia; Pattern 3: evident PA signals and hypoxia). The correlations between imaging scores and laboratory data, as well as clinical scoring systems were assessed.

Results:

A total of 32 patients of RA were recruited aged from 25-71 years-old were examined. PD-sum had moderate correlation with the clinical scores (r=0.529, 0.546, 0.490, 0.493 for DAS28ESR, DAS28CRP, SDAI, CDAI), moderate correlations with TJC (r=0.575) and SJC (r=0.491), fair correlation with VAS (r=0.239), poor correlation with PGA (r=0.153), and moderate correlation with EGA (r=0.457). The PA-sum had substantial correlations with the clinical scores (r= 0.699, 0.746, 0.723, 0.736 for DAS28ESR, DAS28CRP, SDAI, CDAI), substantial correlations with TJC (r=0.787) and SJC (r=0.694), moderate correlations with VAS (r=0.544) and PGA (r=0.529), and substantial correlation with EGA (r=0.708).

Ten patients were classified as Pattern 1, 12 as Pattern 2, 9 as Pattern 3. The PA+ SO2 patterns presented substantial correlations with the clinical scores (DAS28ESR r=0.690, DAS28CRP r=0.782, SDAI r=0.805, CDAI r=0.799, SJC r=647, TJC r=0.676, respectively), substantial correlation with VAS (r=0.714), and moderate correlation with PGA (r=0.476) and EGA (r=0.502). Significant differences between those who were classified as hypoxia and hyperoxia with evident PA signals, were detected in VAS (p=0.020) and PGA (p=0.026).

Conclusion:

The PA-sum scores and the PA+SO2 patterns can be utilized as objective imaging parameters reflecting the disease activity of RA. PAI may serve as a supplement to conventional US examinations for RA patients.

References:

[1]Backhaus, M., et al., Evaluation of a novel 7-joint ultrasound score in daily rheumatologic practice: a pilot project. Arthritis Rheum, 2009. 61(9): p. 1194-201.

[2]Colebatch, A.N., et al., EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis, 2013. 72(6): p. 804-14.

Figure 1.

the photo of the multimodal PA/US imaging system

Figure 2.

an example of the PA/US imaging

Disclosure of Interests:

Chenyang Zhao: None declared, Qian Wang: None declared, Xixi Tao: None declared, Chen Yu: None declared, Sirui Liu: None declared, Mengtao Li: None declared, Xinping Tian: None declared, Zhenhong Qi: None declared, Jianchu Li: None declared, Fang Yang: None declared, Lei Zhu: None declared, Xiaofeng Zeng Consultant of: MSD Pharmaceuticals, Meng Yang: None declared, Yuxin Jiang: None declared

Evidence for supercoughers in an analysis of six tuberculosis cohorts from China, Peru, The Gambia and Uganda

BACKGROUND: It is very difficult to observe tuberculosis (TB) transmission chains and thus, identify superspreaders. We investigate cough duration as a proxy measure of transmission to assess the presence of potential TB superspreaders.DESIGN: We analyzed six studies from China, Peru, The Gambia and Uganda, and determined the distribution of cough duration and compared it with several theoretical distributions. To determine factors associated with cough duration, we used linear regression and boosted regression trees to examine the predictive power of patient, clinical and environmental characteristics.RESULTS: We found within-study heterogeneity in cough duration and strong similarities across studies. Approximately 20% of patients contributed 50% of total cough days, and around 50% of patients contributed 80% of total cough days. The cough duration distribution suggested an initially increasing, and subsequently, decreasing hazard of diagnosis. While some of the exposure variables showed statistically significant associations with cough duration, none of them had a strong effect. Multivariate analyses of different model types did not produce a model that had good predictive power.CONCLUSION: We found consistent evidence for the presence of supercoughers, but no characteristics predictive of such individuals.

0113 Evaluating Closed-Loop Auditory Stimulation During Sleep as an Intervention to Improve Memory Consolidation Deficits in Schizophrenia

Introduction

Converging evidence supports the hypothesis that reduced sleep spindles and spindle-slow oscillation (SO) coordination contribute to cognitive deficits in schizophrenia. Closed-loop auditory stimulation in healthy adults increases sleep spindles and improves declarative memory consolidation. Here we investigated whether closed-loop auditory stimulation also improves sleep-dependent procedural memory consolidation as a first step towards an intervention in schizophrenia.

Methods

Thirteen healthy adults participated in two nap sessions (stimulation or detection only) with polysomnography in a counterbalanced order. Participants were trained on the finger tapping Motor Sequence Task (MST), which measures sleep-dependent motor procedural memory consolidation, prior to napping and were tested after awakening. We detected the negative peak of SOs during non-REM sleep and, in the stimulation condition, delivered 50ms of pink noise during the SO up-state.

Results

Auditory stimulation increased SOs and spindles during the SO up-state in a frontocentral cluster of electrodes 800-1200ms after stimulation compared to detection only (p&lt;0.05). Stimulation also showed promise for improving memory consolidation (33% increase in MST overnap improvement from detection-only) but this did not reach significance in this small sample and data collection is ongoing.

Conclusion

Auditory stimulation evoked coordinated spindle-SO events that mediate memory consolidation, but more subjects are needed to evaluate whether it also improves memory. If it does, we will test the effects of stimulation on sleep-dependent memory deficits in patients with schizophrenia. Closed-loop auditory stimulation shows promise as a safe, scalable intervention for cognitive deficits that can be implemented at home with commercially available devices.

Support

R01 MH67720 (DSM & RS), NIH-NHLBI 5T32HL007901-17 (BB), K24MH099421 (DSM), and Simons Foundation (DSM).

Photosynthetic performance and growth responses of Liriope muscari (Decne.) L.H. Bailey (Asparagaceae) planted within poplar forests having different canopy densities

Background

Liriope muscari (Decne.) L.H. Bailey is a valuable horticultural and medicinal plant that grows under a range of light intensities, from high to low, in the understories of shrubs. To understand how this species adapts to these various environments, we selected two groups of lilyturf growing under poplar trees at two different spacings. Each group was divided into three types, open field, forest edge and shaded forest with high, medium and low irradiance levels, respectively, and then we examined their photosynthetic characteristics, physiology and biomasses.

Results

Light saturation point, light compensation point and in situ net photosynthetic rate (P_N) were highest in lilyturf growing under high light. In contrast, lilyturf growing under low light had a higher apparent quantum yield and Chl a and b contents, indicating that they adapted to low light. Although the leaves of lilyturf growing under low light were small, their root tubers were heavier.

Conclusions

The research demonstrates the eco-physiological basis of lilyturf’s shade adaptation mechanism as indicated by photosynthetic activity, chlorophyll fluorescence, Chl a, Chl b and Car contents when grown under different irradiances. We believe that lilyturf is a shade-tolerant plant suitable for planting in undergrowth, but attention should be paid to the canopy density of the forest when interplanting. The findings presented here advance our understanding of the photosynthetic characteristics of understory plants and may assist in the optimization of irradiances in the future.

[Analysis of selective endoscopy results during the epidemic of coronavirus disease 2019 (COVID-19)]

Objective: To explore the necessity and safety of selective endoscopy to detect gastrointestinal (GI) malignancy during the outbreak of coronavirus disease 2019 (COVID-19). Methods: A retrospective cohort study was carried out to analyze the clinical data of selective endoscopy performed at the Endoscopic Center, Zhongshan Hospital of Fudan University from February 20 to March 6, 2020. Clinical data included epidemiological questionnaire, chief complaints, endoscopic findings and biopsy pathology results, etc. All medical staff had blood test for IgM/IgG antibodies of COVID-19. Patients and their families were followed up by phone to determine whether they were infected with COVID-19. Meanwhile, the clinical data of selective endoscopy during the same period from February 20 to March 6, 2019 were collected as the control group to compare the overall results of endoscopy examinations during the epidemic and the detection rate of GI malignancy. Results: A total of 911 patients underwent endoscopy in the epidemic period group, and a total of 5746 cases in the control group, which was 6.3 times over the epidemic period group. In the epidemic period group, 544 cases received gastroscopy and 367 cases received colonoscopy, while 3433 cases received gastroscopy and 2313 cases received colonoscopy in the control group, which were both 6.3 times of epidemic period group. Gastroscopy revealed that 39 patients (7.2%) were diagnosed with upper GI malignancies in the epidemic period group and 77 patients (2.2%) in the control group with significant difference (χ(2)=40.243, P<0.001). The detection rate of gastric cancer in these two groups was 3.3% (n=18) and 1.7% (n=59) respectively with significant difference (χ(2)=6.254,P=0.012). The detection rate of esophageal cancer was 3.7% (n=20) and 0.5% (n=18) respectively with significant difference (χ(2)=49.303,P<0.001). Colonoscopy revealed that colorectal cancer was found in 32 cases (8.7%) of the epidemic period group and 88 cases (3.8%) of the control group with significant difference (χ(2)=17.888, P<0.001). During the epidemic period, no infection of medical staff was found through the blood test of IgM/IgG antibodies on COVID-19. No patient and family members were infected with COVID-19 by phone follow-up. Conclusion: Compared with the same period in 2019, the number of selective endoscopy decreases sharply during the epidemic period, while the detection rate of various GI malignant tumors increases significantly, which indicates that patients with high-risk symptoms of GI malignancies should still receive endoscopy as soon as possible. Provided strict adherence to the epidemic prevention standards formulated by the state and professional societies, it is necessary to carry out clinical diagnosis and treatment as soon as possible.

[A multicenter survey of the accessibility of essential medicines for children in China]

Objective: To investigate the availability, prices and affordability of essential medicines in pediatric population across China, in the hope of improving rational use of medicines. Methods: A multicenter cross-sectional survey of medicine prices, availability and affordability was conducted in 17 provinces, municipalities and autonomous region across east, south-central part, west and north of China. Data on 42 medicines used in pediatric population, both original and generic, were collected in 55 public hospitals from May 26 to June 2, 2017. Availability was expressed as the percentage of hospitals with stock of the target medicine on the day of data collection,and median price ratio (MPR) was the ratio of price upon investigation to international reference. Based on national minimum daily wage, affordability represents the number of working days needed to earn the expense which covers a standard course using the target medicine. Statistical software SPSS 13.0 was applied for descriptive analysis of availability, MPR and affordability. Results: Mean Availability of original and generic medicine was 33% and 32%, with median MPR being 5.43 and 1.55. Among the 19 medicines with price information for both original and generic product, the median MPR was 7.73 and 2.04 respectively. Regarding the five medicines used to treat four common pediatric diseases (pneumonia,peptic ulcer, congenital hypothyroidism, refractory nephrotic syndrome), the affordability was 0.63 (0.16-6.17) d for generic medicine, and 1.03 (0.16-11.53) d for its original counterpart. Conclusions: The availability to both original and generic products of the 42 medicines used in pediatric population was low in China. The prices of generic medicines seem to be lower and affordability higher than those of original medicines. There is an urgent need to improve the availability and affordability of pediatric medicines.

Initial-switched boosting bifurcations in 2D hyperchaotic map

Recently, the coexistence of initial-boosting attractors in continuous-time systems has been attracting more attention. How do you implement the coexistence of initial-boosting attractors in a discrete-time map? To address this issue, this paper proposes a novel two-dimensional (2D) hyperchaotic map with a simple algebraic structure. The 2D hyperchaotic map has two special cases of line and no fixed points. The parameter-dependent and initial-boosting bifurcations for these two cases of line and no fixed points are investigated by employing several numerical methods. The simulated results indicate that complex dynamical behaviors including hyperchaos, chaos, and period are closely related to the control parameter and initial conditions. Particularly, the boosting bifurcations of the 2D hyperchaotic map are switched by one of its initial conditions. The distinct property allows the dynamic amplitudes of hyperchaotic/chaotic sequences to be controlled by switching the initial condition, which is especially suitable for chaos-based engineering applications. Besides, a microcontroller-based hardware platform is developed to confirm the generation of initial-switched boosting hyperchaos/chaos.

Growth hormone-releasing hormone promotes therapeutic effects of peripheral blood endothelial progenitor cells in ischemic repair

PURPOSE

In peripheral artery disease, blockage of the blood supply to the limbs leads to blood flow attenuation and tissue ischemia. We investigated whether growth hormone-releasing hormone (GHRH) could enhance the biological functions and therapeutic effects of endothelial progenitor cells (EPCs) derived from adult human peripheral blood (PB).

METHODS

EPCs were isolated from human PB (PB-EPCs) and cord blood and expanded in vitro. PB-EPCs incubated with or without GHRH were evaluated for proliferation, migration, and angiogenesis capacity and apoptosis rates under oxidative stress conditions. Activation of STAT3 and Akt pathways was evaluated using Western blot. A hind-limb ischemia (HLI) mouse model was used to study the efficacy of GHRH in improving EPC therapy in vivo.

RESULTS

GHRH enhanced the proliferation, migration, and angiogenesis capacity of PB-EPCs and reduced apoptosis under H₂O₂ stimulation. These beneficial effects were GHRH receptor-dependent and were paralleled by increased phosphorylation of STAT3 and Akt. Transplantation of GHRH-preconditioned EPCs into HLI model mice enhanced blood flow recovery by increasing vascular formation density and enhanced tissue regeneration at the lesion site.

CONCLUSION

Our studies demonstrate a novel role for GHRH in dramatically improving therapeutic angiogenesis in HLI by enhancing the biological functions of EPCs. These findings support additional studies to explore the full potential of GHRH in augmenting cell therapy for the management of ischemia.

[Analysis on the consciousness of the cancer early detection and its influencing factors among urban residents in China from 2015 to 2017]

Objective: To understand the consciousness of the cancer early detection among urban residents and identify the influencing factors from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. Self-designed questionnaires were used to collect population, socioeconomic indicators, self-cancer risk assessment, regular participation in physical examination and other information. The multivariate logistic regression model was used to identify the factors of people who had not regularly participated in the regular physical examination in the past five years. Results: The self-assessment results of 32 357 residents showed that there were 27.54% (8 882) of total study population with self-reported cancer risk, 45.48% (14 671) without cancer risk and 26.98% (8 704) with unclear judgement on their own cancer risk. Among population with cancer risk, 79.84% (7 091) considered physical examination accounted. In the past five years, there were 21 105 (65.43%) residents participated in regular physical examination and 11 148 (34.56%) participated in non-scheduled one, respectively. The multivariate logistic regression analysis showed that compared with unmarried and western region residents, divorced, middle and eastern region residents had a stronger consciousness to participate in the regular physical examination (P<0.05). Compare with residents with annual household income less than 20 000 CNY in 2014, cancer risk assessment/screening intervention population, and self-assessment with cancer risk, residents with annual household income between 20 000 CNY and 59 000 CNY in 2014, occupational population, community residents, cancer patients, self-reported cancer-free risk, and self-assessment with unclear judgement of cancer risk were less likely to participate in the regular physical examination (all P values <0.05). Conclusion: From 2015 to 2017, the Chinese urban residents had a acceptable consciousness of the cancer early detection. The marital status, annual household income, population group and self-assessment of cancer risk were related to the consciousness of the cancer early detection of people who had not participated in the regular physical examination in the past five years.