MDA5 attenuate autophagy in chicken embryo fibroblasts infected with IBDV

1. The role of melanoma differentiation-associated protein 5 (MDA5) in infectious bursal disease virus (IBDV)-induced autophagy was studied in chicken embryos.2. Chicken embryo fibroblasts (CEF) were used as the research model and small interfering RNA (siRNA), western blot, indirect enzyme-linked immunosorbent assay (ELISA), real-time fluorescence quantitative polymerase chain reaction (PCR) and transmission electron microscopy were used to detect autophagy, IBDV replication, CEF damage, and activation of both MDA5 and its signalling pathway.3. The results showed that CEF infected with IBDV activated the intracellular MDA5 signalling pathway and caused autophagy via inactivation of the AKT/mTOR pathway. While autophagy promotes IBDV proliferation, MDA5 weakens IBDV-induced CEF autophagy thus inhibiting IBDV replication and protecting CEF cells.4. The results indicated that chMDA5 can be activated by IBDV and attenuate CEF autophagy caused by IBDV infection, thereby inhibiting IBDV replication. This study provided a foundation for further exploring the relationship between viruses, autophagy and the pathogenic mechanism of the MDA5 pathway involved in IBDV.

Relaxation effect of narirutin on rat mesenteric arteries via nitric oxide release and activation of voltage-gated potassium channels

Narirutin is one of the most common flavanones found in citrus fruits. The vascular effects of its analogues naringenin and naringin have been reported but its effects on the cardiovascular system are largely unknown. In this study, relaxation effect of narirutin and its mechanisms of action were investigated by measuring isometric tension in rat mesenteric arteries. Patch-clamping was also used to study the effect of narirutin on potassium channels in vascular smooth muscle cells. Moreover, its effects on phosphorylation of endothelial nitric oxide synthase, cAMP level and phosphodiesterase activity in rat mesenteric arteries were studied by Western blot and biochemical assays. The results showed that pre-incubation of rat mesenteric arteries with narirutin had no influence on acetylcholine-induced endothelial-dependent relaxation. However, narirutin caused a direct concentration-dependent relaxation in rat mesenteric arteries. This relaxation effect was comparable to that of narirutin's structural analogue naringenin. Narirutin-induced relaxation was reduced by the removal of endothelium, NG-nitro-L-arginine methyl ester (a nitric oxide synthase inhibitor), and 4-aminopyridine (a voltage-gated potassium channel blocker). In addition, narirutin increased the phosphorylation of endothelial nitric oxide synthase and increased the voltage-dependent potassium current in mesenteric arterial smooth muscle cells. These effects were abolished by protein kinase A inhibitor. Furthermore, narirutin could increase cAMP level and inhibit phosphodiesterase activity in rat mesenteric arteries. In conclusion, narirutin has vasorelaxing effect and the mechanism involves the inhibition of phosphodiesterase, which increases intracellular cAMP, thereby stimulating the endothelial nitric oxide synthase and activating the voltage-gated potassium channels in vascular smooth muscle cells.

[Research progress of hepatic non-parenchymal cells in nonalcoholic steatohepatitis]

Non-alcoholic steatohepatitis (NASH) is an important link for the progression of metabolic-related fatty liver disease to end-stage liver disease such as cirrhosis and hepatocellular carcinoma, which seriously endangers human health. NASH pathogenesis is complex, and involves the interaction between hepatic parenchymal and non-parenchymal cells (NPCs), sinusoidal endothelial cells, Kupffer cells, hepatic stellate cells, and so on. Herein, the relevant research progress of NPCs in the pathogenesis of NASH is reviewed in order to further understand the role of NPCs in NASH.

P–772 Blastocyst quality and perinatal outcomes in women undergoing single blastocyst transfer in frozen cycles

Study question

Is the morphological grading systems of a blastocyst associated with perinatal outcomes in women undergoing frozen-thawed single blastocyst transfer (SBT)?

Summary answer

Preferential transfer of a blastocyst based on their morphological grading systems appears to be supported by observed differences in perinatal outcomes.

What is known already

The transfer of a morphologically good quality blastocyst is associated with higher implantation and pregnancy rates as compared with a poor quality blastocyst. However to date, the association of the morphologic parameters of the blastocyst (developmental stage, inner cell mass (ICM), and trophectoderm (TE)) with the perinatal outcomes after blastocyst transfer remains unknown.

Study design, size, duration

A retrospective cohort study including 21,648 frozen-thawed SBT cycles from January 2013 to March 2019.

Participants/materials, setting, methods

6037 women with singleton delivery in Peking University Third Hospital were eligible for analysis. Multivariate logistic regression was used to test the risk of factors with the expression of crude odds ratios (OR) and adjusted OR (aOR) with 95% confidence intervals (CI).

Main results and the role of chance

Transfer of a blastocyst with grading lower than 3BB was associated with a higher chance of female baby (49% vs 43%, aOR = 1.27 (1.12, 1.43)) and a higher rate of cesarian section (C-section) (69% vs 65%, aOR = 1.17 (1.03, 1.34)). Compared with stage 4 blastocyst, transfer of a stage 3 blastocyst was associated with a higher chance of preterm delivery (PTD) (aOR = 1.77 (1.08, 2.90)). Both stage 3 and stage 6 blastocyst transfer was associated with a lower chance of female baby (aOR = 0.68 (0.48, 0.97), 0.66 (0.47, 0.93), respectively). Compared with grade A ICM blastocyst transfer, Grade B ICM and grade C ICM blastocyst transfer was associated with a lower chance of a female baby (adjusted OR = 0.84 (0.73, 0.96), 0.63 (0.48, 0.83), respectively) and a higher risk of large for gestational age (LGA) (aOR = 1.20 (1.01, 1.42), 1.46 (1.07, 1.98), respectively). Grade C ICM blastocyst transfer was associated with an increased risk of macrosomia (aOR = 1.66 (1.14, 2.42)).Grade B TE and grade C TE blastocyst transfer had a lower risk of gestational diabetes mellitus (GDM) (aOR = 0.76 (0.60, 0.98), 0.69 (0.50, 0.94), respectively) than grade A TE blastocyst transfer.

Limitations, reasons for caution

The main limitations of this study were its retrospective nature and the relative subjectivity of blastocyst scoring. The follow-up was conducted through a phone call and some patients might not report their obstetrical and neonatal outcomes, leading to a relatively lower rate of several obstetrical outcomes.

Wider implications of the findings: Transfer of a poor quality blastocyst is associated with a higher rate of C-section. The association between ICM grading and LGA and macrosomia would suggest that blastocysts with grade A ICM grading should be transferred preferentially and supports the use of current morphological grading systems for embryo prioritisation.

Trial registration number

N/A

[Effects of different calcium intakes on metabolism in healthy adults under strict dietary intervention]

Objective: To explore the effect of different calcium intakes on metabolism in healthy adults with traditional Chinese dietary pattern. Methods: A total of 64 college students (32 males and 32 females) were recruited from the School of Public Health, Harbin Medical University from September to October 2015. A prospective, randomized, double-blind, placebo-controlled trial design (RCT trial) was used to strictly control the diet of the volunteers through meal preparation, so that the background of the experimental and the control group was exactly the same. In our study, 64 healthy adults were randomly divided into two groups (calcium supplementation and control). The two groups were given the same diet every day. One group was given 400 mg/d of calcium supplementation, which was close to the recommended intake in China (800 mg/d); the other group was given pacebo, the average calcium intake was close to the average intake of Chinese (400 mg/d), calcium intervention lasted for 35 days. Serum and urine samples from pre-intervention, mid-intervention, and post-intervention were collected for metabolomics studies and detection of serum hormone levels and biochemical indicators. PCA and PLS-DA were used to compare the differences in serum and urine metabolites. After adjusting for age and BMI, the differences of hormones [parathyroid hormone, 1, 25(OH)₂D₃] and biochemical indicators were compared by repeated measurement variance analysis. Results: The 64 subjects were aged 23-28 years, including 32 males and 32 females. The baseline characteristics of the calcium supplementation group and the control group were balanced. The results showed that there were no significant differences in blood and urine metabolites, metabolic hormone [parathyroid hormone, 1, 25(OH)₂D₃] levels and biochemical indicators(serum Ca, serum P, glycolipid metabolism and hepatorenal function indicators)between the calcium supplementation group and control group at each time point throughout the trail (P>0.05). Conclusion: No health hazards associated with calcium deficiency was observed in healthy adults in the short term at current calcium intake level (300-400 mg/d).

P–218 Analysis of the occurrence of microbial contamination in IVF culture system and the effect of microorganisms on embryo development and clinical outcomes

Study question

what is the source, prevalence, and influence of microbial contamination on in vitro fertilization (IVF) and embryo transfer (ET) cycles?

Summary answer

Microbial contamination mainly occurs on Day 2, most caused by Escherichia coli carried with semen. ICSI could prevent contamination effectively and get good clinical outcomes.

What is known already

Microbial contamination occurs in IVF-ET system occasionally, which is hard to stop happening. The IVF culture system and laboratory environment, the patients’ follicular fluid and semen are not absolutely sterile, while the antibiotics in culture medium isn’t effective for all microbe types, and the artificial operations may bring in microbes. Generally, microbial contamination leads to degradation of embryos, reduction the number of embryos available, and infection of female reproductive tract, which would increase the cost of patients’ time, money, and bring psychological damages. A better understanding of embryo contamination in IVF culture system is of added value.

Study design, size, duration

A total of 29583 IVF-ET cycles were enrolled in this prospective observational study, from January 2010 to December 2020, included 70 microbial contamination cycles discovered in Day1-Day3 (D1-D3) of in vitro culture. Follicular fluid and semen saved on oocyte retrieval day, and culture medium contaminated were examined and identified for microorganisms at each contamination cycle.

Participants/materials, setting, methods

Compared the contamination rate of different insemination methods (IVF/ICSI/IVF+ICSI), different in vitro culture days (D1-D3), and different samples examination (follicular fluid, semen, culture medium) respectively, identified the source of microorganism types, compared the IVF culture outcomes and clinical outcomes between total contamination group (TC group, 42 cases) and partial contamination group (PC group, 28 cases).

Main results and the role of chance

A total of 70 microbial contamination cases occurred in 29583 oocyte retrieving cycles (0.24%), and it was observed only in IVF embryos but never in ICSI (Intracytoplasmic sperm injection) embryos. 38 contamination cases occurred on D2 with a highest ratio (54.3%) compared to D1 (32.9%) and D3(12.9%); Compared with follicular fluid, semen was the main cause inducing contamination from D1 to D3, and Escherichia coli in semen and culture medium, Enterococcus faecalis in follicular fluid proved to be the most common sources. Compared with TC group, the PC group showed a lower rate of No-available embryos (21.4% vs 81.0%) and a higher rate of blastocyst formation (41.2% vs 28.6%), In addition, the clinical pregnancy rate of PC group was higher than that of TC group in both fresh and frozen-thawed embryo transfer cycles (31.3% vs 16.7%, 38.5% vs 0.0%).

Limitations, reasons for caution

Further study is still necessary to better understand the sources that induce microbial contamination embryos, and more efficient methods are required to remove the microbes on these contaminated embryos so as better develop and manage a sterile micro-environment for successful embryo growth.

Wider implications of the findings: The differential embryonic microbe types associated to different IVF culture and clinical outcomes in patients undergoing IVF-ET might have profound implications for understanding the microbial sources and making a better management of IVF culture system.

Trial registration number

Not applicable

Hypoxia-mediated down-regulation of miRNAs' biogenesis promotes tumor immune escape in bladder cancer

BACKGROUND

The study examines the function of hypoxia-mediated down-regulation of microRNAs (miRNAs) (mir-30c, mir-135a, and mir-27a) in the process of bladder cancer immune escape.

METHODS

Quantitative Real-time PCR (qRT-PCR) was carried out to determine gene expression levels of Drosha and Dicer under hypoxia treatment, while western blotting and flow cytometry were used to determine protein expression. Seven reported miRNAs were identified via qRT-PCR assay. Flow cytometry detection of CD3/CD4/CD8-positive expression and statistics. Enzyme-linked immunosorbent assay (ELISA) detected cellular immune factors content. Cell apoptosis was checked via flow cytometry assay. Luciferase report assay and western blot assays were both used to verify the relationship between miRNAs and Casitas B-lineage lymphoma proto-oncogene b (Cbl-b). The animal model was established and Hematoxylin-eosin (HE) staining, TdT-mediated dUTP Nick-End Labeling (TUNEL) staining, and immunohistochemistry (IHC) assays were separately used to verify the conclusions.

RESULTS

The CD3 + /CD4 + expression was increased in the hypoxia group, while CD3 + /CD8 + expression, the cellular immune factors content Interleukin-2 (IL-2) and Tumor Necrosis Factor-α (TNFα) along with the cell apoptosis were suppressed. The protein expression of Cbl-b was found to be up-regulated in the hypoxia group. After constructing the overexpression/ knockdown of Cbl-b in peripheral blood mononuclear cell (PBMC), Cbl-b has been found to promote tumor immune escape in bladder cancer. Furthermore, Cbl-b had been identified as the co-targets of mir-30c, mir-135a, and mir-27a and down-regulation of miRNA biogenesis promotes Cbl-b expression and deactivating T cells in vitro/in vivo.

CONCLUSION

Hypoxia-mediated down-regulation of miRNAs' biogenesis promotes tumor immune escape in bladder cancer, which could bring much more advance to the medical research on tumors.

[Analysis of families with fetal congenital abnormalities but negative prenatal diagnosis by whole exome sequencing]

Objective: To evaluate the value of whole exome sequencing (WES) in prenatal clinical application. Methods: A total of 1 152 cases of congenital abnormal [including structural malformation, nuchal translucency (NT) thickening and intrauterine growth restriction] with traditional prenatal diagnosis [including G-band karyotype analysis and chromosome microarray analysis (CMA)] negative were analyzed. The congenital abnormal fetuses were divided into retrospective group and prospective group according to the time of WES detection, that is whether the pregnancy termination or not. According to the specific location of fetal malformation and their family history, the cohort was divided into subgroups. The clinical prognosis of all fetuses were followed up, and the effect of WES test results on pregnancy decision-making and clinical intervention were analyzed. According to the follow-up results, the data of fetuses with new phenotypes in the third trimester or after birth were re-analyzed. Results: Among 1 152 families who received WES, 5 families were excluded because of nonbiological parents. Among the remaining 1 147 families, 152 fetuses obtained positive diagnosis (13.3%,152/1 147), including 74 fetuses in the retrospective group (16.1%,74/460) and 78 fetuses in the prospective group (11.4%,78/687). In fetuses with negative CMA and G-band karyotype analysis results but new phenotypes in the third trimester or after birth, the positive rate by WES data re-analysis was 4.9% (8/163). A total of 34 (21.3%, 34/160) fetuses were directly affected by the corresponding positive molecular diagnosis. Among 68 cases of live births with diagnostic variation grade 4, 29 cases (42.7%, 29/68) received appropriate medical intervention through rapid review of WES results. Conclusions: WES could increase the detection rate of abnormal fetuses with negative G-banding karyotype analysis and CMA by 13.3%. Prenatal WES could guide pregnancy decision-making and early clinical intervention. It might be an effective strategy to pay attention to the special follow-up of the third trimester and postnatal fetus and to re-analyze the WES data.

[Value of combined detection of ITGA4 and SFRP2 gene methylation in stool DNA in diagnosis and prognostic evaluation of colorectal tumors]

OBJECTIVE

To investigate the value of quantitative detection of ITGA4 and SFRP2 gene methylation in stool DNA for the early diagnosis and prognostic evaluation of colorectal tumors.

OBJECTIVE

Real-time PCR was used for quantitative assessment of ITGA4 and SFRP2 gene methylation levels in stool samples of 85 patients with colorectal cancer, 65 patients with colorectal adenoma and 40 healthy subjects.

OBJECTIVE

The 3 groups were comparable for age and gender composition. Methylated ITGA4 and SFRP2 promoters were detected in 48.2% and 62.4% of patients with colorectal cancer, respectively, with a combined positivity of 81.2%. ITGA4 and SFRP2 promoter methylation was detected in 23.1% and 43.1% of patients with colorectal adenoma, respectively, with a combined positivity of 69.2%. The positivity rates of ITGA4 and SFRP2 methylation were significantly higher in patients with colorectal cancer than in those with colorectal adenoma (P < 0.001; P= 0.001) and healthy subjects (P < 0.001; P < 0.001). In colorectal cancer group, ITGA4 and SFRP2 promoter methylation levels were correlated with postoperative tumor recurrence in colorectal cancer group, and the relapse-free survival rate was significantly lower in positive patients for ITGA4 and SFRP2 promoter methylation than in the negative patients (P=0.0002; P=0.007). Multivariate analysis with the COX proportional hazard regression model showed that methylation of ITGA4 and SFRP2 gene promoters (P=0.01) and the degree of tumor differentiation (P=0.03) were associated with the recurrence of colorectal cancer, and were independent risk factors for the recurrence of colorectal cancer.

OBJECTIVE

Combined detection of ITGA4 and SFRP2 gene methylation levels in stool DNA can improve the early diagnosis rate of colorectal tumor. ITGA4 and SFRP2 promoter methylation and the degree of tumor differentiation are independent risk factors for colorectal cancer recurrence.

[Survey on tobacco use and associated factors in population in Shandong province, 2016-2017]

Objective: To understand the status of tobacco use and related influencing factors in population in Shandong province. Methods: Stratified multi-stage cluster sampling was used to select respondents from 216 villages (communities) of 36 districts (counties) in Shandong province. Influencing factors on smoking were analyzed by logistic regression model. Results: The adequate sample size was 6 271 participants. After complex weighted, the current smoking prevalence was 23.93%,45.58% in males and 1.18% in females. The Public's smoking rates varied widely among different groups in the population. 45-64 age group had the highest smoking rate (25.07%). Smoking rates were substantially different in education levels, with the highest in junior high school (28.94%). The rate was higher in the rural area (24.98%) than that in the urban areas (23.08%). The average daily smoking rate was 20.23%. The average age of initiating smoking was 21.21 years. The average daily cigarette intake was 16.31 cigarettes. Among all the former and current smokers, the quitting rate was 20.79%. Multiple logistic regression model analysis showed that gender, age, occupation, region, and health knowledge score were correlated with smoking behavior. The current smoking rate of men was much higher than that of women (OR=49.625, 95%CI: 37.832-65.093). The current smoking rate in 45-64 age group was higher than that in the 15-24 age group (OR=1.830, 95%CI: 1.048-3.194). The current smoking rate of medical (OR=0.403, 95%CI: 0.187-0.866) and retired personnel (OR=0.648, 95%CI: 0.481-0.873) were lower than those engaging in agriculture, forestry, animal husbandry and the fishery ,respectively. The prevalence of residents living in the central part showed lower rate on current smoking than that in the eastern region (OR=0.724, 95%CI: 0.606-0.865). The current smoking prevalence of smoke hazard in 1-3 score group was higher than that in the group with 4-6 score (OR=1.432, 95%CI: 1.240-1.654). Conclusions: Smoking rate in adults in Shandong remained stable and at a high level. Comprehensive intervention measures such as tobacco control and health education should be carried out to reduce the smoking rate.

MiR-217 inhibits apoptosis of atherosclerotic endothelial cells via the TLR4/PI3K/Akt/NF-κB pathway

OBJECTIVE

To determine the effect of miR-217 on the apoptosis of atherosclerotic endothelial cells (AECs) through the Toll-like receptor (TLR) 4/PI3K/Akt/NF-κB pathway.

MATERIALS AND METHODS

Oxidized low-density lipoprotein (ox-LDL) was used to construct an atherosclerotic endothelial cell model, and the expression of miR-217/TLR4/PI3K/Akt/NF-κB in the cells was regulated to explore their effects on the viability, apoptosis, inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10)], and endothelial-to-mesenchymal transformation (EndMT) of the endothelial cells.

RESULTS

In AECs, miR-217 expression decreased, and the PI3K/Akt/NF-κB pathway was inhibited. The Dual-Luciferase reporter assay revealed that TLR4 was the target of miR-217, and it was up-regulated in AECs, and the further study revealed that up-regulation of miR-217 protected AECs, increased their activity, reduced their apoptosis, and inhibited inflammatory response and EndMT, while TLR4 acted contrary to miR-217. Besides, it was also found that miR-217 inhibited the PI3K/Akt/NF-κB pathway, thus weakening the influence of si-TLR4 on endothelial cells. Furthermore, miR-217 inhibited EndMT by inhibiting TLR4 from activating the PI3K/Akt/NF-κB signal pathway.

CONCLUSIONS

In AECs, TLR4 expression increased, and miR-217 and the PI3K/Akt/NF-κB signaling pathway are inhibited. Additionally, miR-217 can increase the viability of AECs through the TLR4/PI3K/Akt/ NF-κB signal transduction pathway, and inhibit their apoptosis, inflammatory response, and EndMT.

AB0343 THE CHARACTERISTICS OF T CELLS IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS WITH ANXIETY BASED ON MACHINE LEARNING

Background:

Systemic lupus erythematosus (SLE) is an autoimmune disease, the immune system of patients to be disordered, especially in T cell subsets1. They were prone to mental diseases, anxiety particularly, which lead to suicide2. The recent study had reported that CD4+ T cells in the peripheral blood played the key role in like anxiety behavior of mice3. Although there showed that the level of serum TNF-α in SLE patients with anxiety was higher than without anxiety4, finding the important special mediators especially in T cell subsets was still necessary for the prevention of anxiety in SLE patients.

Objectives:

In total, 108 SLE patients, which met the diagnostic criteria of the American Society of rheumatology (v1997), were enrolled in this study from Affilliated Hospital of Nantong University, China. Exclusion criteria included other autoimmune diseases and active infection (including hepatitis B or C virus, Epstein-Barr virus, human immunodeficiency virus or Mycobacterium tuberculosis infection).

Methods:

We surveyed the abundance of 74 immune cell subpopulations from 108 SLE patients using flow cytometry, and investigated their differences between patients with and without anxiety (24 versus 84). Moreover, machine learning including Lasso regression, Random forest (RF) and Sparsity partial least squares discriminant analysis (sPLS-DA) was employed to build models and futher selected important features for the classification of SLE patients with anxiety.

Results:

SLE patients with anxiety showed higher body mass index (BMI) and lower quality of life. In their peripheral blood, the proportion of internal cell subsets composition of Th cell and Treg cells changed. By machine learning, we finally found that BMI and PD1-CD28- Treg played important rules to developing lupus anxiety.

Conclusion:

In this study, machine learning was applied to build models to select the most important T cell subset in SLE patients with anxiety. These findings suggested that BMI and imbalance of PD1-CD28- Treg containing effector memory Treg cells and effector Treg cells mostly played important roles in the development of SLE anxiety.

Disclosure of Interests:

None declared

The Gut Microbiome: a New Frontier in Musculoskeletal Research

PURPOSE OF THE REVIEW

The human gut harbors a complex community of microbes that influence many processes regulating musculoskeletal development and homeostasis. This review gives an update on the current knowledge surrounding the impact of the gut microbiota on musculoskeletal health, with an emphasis on research conducted over the last three years.

RECENT FINDINGS

The gut microbiota and their metabolites are associated with sarcopenia, osteoporosis, osteoarthritis, and rheumatoid arthritis. The field is moving fast from describing simple correlations to pursue establishing causation through clinical trials. The gut microbiota and their microbial-synthesized metabolites hold promise for offering new potential alternatives for the prevention and treatment of musculoskeletal diseases given its malleability and response to environmental stimuli.

Deep learning analysis of the primary tumour and the prediction of lymph node metastases in gastric cancer

BACKGROUND

Lymph node metastasis (LNM) in gastric cancer is a prognostic factor and has implications for the extent of lymph node dissection. The lymphatic drainage of the stomach involves multiple nodal stations with different risks of metastases. The aim of this study was to develop a deep learning system for predicting LNMs in multiple nodal stations based on preoperative CT images in patients with gastric cancer.

METHODS

Preoperative CT images from patients who underwent gastrectomy with lymph node dissection at two medical centres were analysed retrospectively. Using a discovery patient cohort, a system of deep convolutional neural networks was developed to predict pathologically confirmed LNMs at 11 regional nodal stations. To gain understanding about the networks' prediction ability, gradient-weighted class activation mapping for visualization was assessed. The performance was tested in an external cohort of patients by analysis of area under the receiver operating characteristic (ROC) curves (AUC), sensitivity and specificity.

RESULTS

The discovery and external cohorts included 1172 and 527 patients respectively. The deep learning system demonstrated excellent prediction accuracy in the external validation cohort, with a median AUC of 0·876 (range 0·856-0·893), sensitivity of 0·743 (0·551-0·859) and specificity of 0·936 (0·672-0·966) for 11 nodal stations. The imaging models substantially outperformed clinicopathological variables for predicting LNMs (median AUC 0·652, range 0·571-0·763). By visualizing nearly 19 000 subnetworks, imaging features related to intratumoral heterogeneity and the invasive front were found to be most useful for predicting LNMs.

CONCLUSION

A deep learning system for the prediction of LNMs was developed based on preoperative CT images of gastric cancer. The models require further validation but may be used to inform prognosis and guide individualized surgical treatment.

[Mechanism of hepatocyte mitochondrial NDUFA13 deficiency-induced liver fibrogenesis: the role of abnormal hepatic stellate cell activation]

OBJECTIVE

To investigate the role of hepatocyte mitochondrial NDUFA13 loss in the liver fibrogenesis in mice and explore the possible mechanisms.

OBJECTIVE

We used liver-specific NDUFA13 heterozygous knockout mouse models (NDUFA13^fl/-; Alb-Cre) established previously by intercrossing NDUFA13^fl/fl and Alb-Cre mice, with their littermate control NDUFA13^fl/fl mice as the control (n=8). The mice were euthanized at the age of 4 weeks and 2 years, and the liver tissues were collected for HE and Masson staining to observe the pathological changes and fibrosis phenotypes. Western blotting was performed to detect the expression of NDUFA13 protein in the liver tissues, and the infiltration of F4/80⁺ macrophages and the expressions of TGF-β1, TNF-α and IL-1β were analyzed by immunofluorescence assay. The expression levels of α-SMA, matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of matrix metalloproteases 1 (TIMP-1), collagen-Ⅰ and collagen-Ⅲ were assayed by immunohistochemistry.

OBJECTIVE

HE and Masson staining showed obvious inflammatory infiltration but no significant fibrosis in the liver tissues of 4-week-old NDUFA13^fl/- mice, but severe liver damage with massive fibrosis was observed in 2-year-old NDUFA13^fl/- mice. NDUFA13 expression in 2-year-old NDUFA13^fl/- mice markedly decreased compared with that in the control NDUFA13^fl/fl mice as shown by Western blotting (P < 0.05). Immunohistochemistry showed obvious infiltration of F4/80⁺ macrophages in the liver tissue with a large amount of TGF-β1 production (P < 0.05) and TNF-α and IL-1β secretions in NDUFA13^fl/- mice (P < 0.05). NDUFA13 knockout obviously promoted α-SMA expression (P < 0.05) and collagen-Ⅰ and collagen-Ⅲ deposition (P < 0.05) while significantly decreased MMP-9 and increased TIMP-1 expression in the liver (P < 0.05).

OBJECTIVE

Hepatocytes-specific NDUFA13 deficiency can trigger spontaneous and chronic liver fibrosis phenotypes in mice probably in association with abnormal activation of hepatic stellate cells induced by macrophages and inflammatory factors.

Suppression of HAX-1 induced by miR-325 resensitizes bladder cancer cells to cisplatin-induced apoptosis

OBJECTIVE

MicroRNA-325 (miR-325) is a tumor suppressor in some cancers. However, the role of miR-325 in determining the chemosensitivity to cancer cells is still not clear. The aim of this study was to investigate the effect of miR-325 on reversing the cisplatin resistance of bladder cancer.

MATERIALS AND METHODS

Cisplatin-resistant 5637 and T24 bladder cancer cell lines (5637/R and T24/R) were established through long term exposure of them to cisplatin. 3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide (MTT) assays were performed to evaluate the viability of 5637, 5637/R, T24, and T24/R cells. Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR) was used to examine the expression of miR-325 in these cell lines. The regulatory mechanism was confirmed by Western blot analysis and Luciferase reporter assays. After treatment with miR-325 and cisplatin, mitochondrial membrane potential (MMP) and apoptosis were measured using flow cytometry. Expression of hematopoietic cell-specific protein 1-associated protein X-1 (HAX-1) and activation of caspase-9, caspase-7, and caspase-3 were detected by Western blotting.

RESULTS

We found the downregulation of miR-325 in 5637/R and T24/R cells compared to their parental 5637 and T24 cells. Moreover, overexpression of miR-325 in cisplatin-resistant bladder cancer cells was found to increase the cytotoxicity of cisplatin to them. However, transfection with HAX-1 plasmid can abolish the effect of miR-325 on cisplatin. We, then, showed that overexpression of miR-325 suppressed the expression of HAX-1. Thus, miR-325 promoted the mitochondria collapse and cisplatin-induced apoptosis in bladder cancer cells.

CONCLUSIONS

Downregulation of miR-325 is responsible for the development of cisplatin resistance in bladder cancer. Overexpression of miR-325 may represent a novel strategy to reverse the chemoresistance of bladder cancer.

Inhibition of lncRNA-PAX8-AS1-N directly associated with VEGF/TGF-β1/8-OhdG enhances podocyte apoptosis in diabetic nephropathy

OBJECTIVE

Diabetic nephropathy (DN), the microvascular complications of diabetes, is one of the world's public health hazard. But the detailed mechanism of the occurrence and development remains unclear. Oxidative stress caused by multiple factors is recognized as the main cause of disease, and it is also a research focus. Recently, long non-coding RNAs (lncRNAs) have been declared to involve in a large of important bioactivities in many different diseases. In our study, we aimed to verify whether lncRNA PAX8-AS1-N involved in protecting podocyte apoptosis and directly associated with VEGF/TGF-β1/8-OhdG levels in DN, and further investigated the detailed mechanism that PAX8-AS1-N regulated the pathological process.

MATERIALS AND METHODS

We used blood and urine samples of DN patients to detect the expression of lncRNA-PAX8-AS1-N and VEGF/TGF-β1/8-OhdG by ELISA and quantitative reverse transcription polymerase chain reaction (qRT-PCR). Albuminuria level, relative PAX8-AS1-N and VEGF/TGF-β1/8-OhdG levels, and VEGF/TGF-β1/8-OhdG and cleaved-caspase-3 protein levels were detected by ELISA, qRT-PCR, and Western blot, respectively. CCK8 assay was used to measure the proliferation ability of conditionally immortalized mouse podocytes (MPC5). And we used the TUNEL assay to detect MPC5 apoptosis. Luciferase reporter assay was used to confirm the direct target of PAX8-AS-N and miR-17-5p in MPC5.

RESULTS

We found that the lncRNA PAX8-AS1-N was lowly expressed and high expression of VEGF/TGF-β1/8-OhdG and high level of albuminuria in DN patients and high-glucose-treated MPC5. Besides, we proved that LV-PAX8-AS1-N decreased MPC5 apoptosis and suppressed the expression of VEGF/TGF-β1/8-OhdG in vitro experiment. At last, the overexpression of miR-17-5p markedly induced cell apoptosis in MPC5 with high glucose (HG) model. STAT3 reverses the effects of miR-17-5p overexpression in MPC5 with HG model.

CONCLUSIONS

Above that, we found that lncRNA PAX8-AS1-N/miR-17-5p/STAT3 axis was closely related the progression of DN, which could be a potential target for treating DN patients.

[Development of a quality of life questionnaire for adults with anisometropic amblyopia]

Objective: To develop and validate the health-related quality of life (HRQOL) questionnaire for adult patients with anisometropic amblyopia. Methods: Cross-sectional study. A total of 170 adult patients with anisometropic amblyopia, 100 adult patients with other eye diseases and 80 healthy adults with normal vision were recruited at the First Affiliated Hospital of Nanjing Medical University, and 20 healthy adults with normal vision were recruited at Qinhuai Medical District of Easter Theater General Hospital of PLA from December 2019 to February 2020. Individual interviews of 30 adult patients with anisometropic amblyopia generated 80 questionnaire items. For item reduction, 40 adult patients with anisometropic amblyopia were asked to complete the 80-item questionnaire and responses were analyzed. Then factor analyses were performed to identify prominent factors (subscales). The reliability of the questionnaire was evaluated by Cronbach's α coefficient. The overall and sub-scale scores were the average scores of all included items, ranging from 0 (worst HRQOL) to 100 (best HRQOL). The final 20-item questionnaire was administered to additional 100 adult patients with anisometropic amblyopia, 100 adult patients with other eye diseases and 100 visually normal adults. Mean overall and subscale scores were compared across groups using one-way analysis of variance. Results: The final adult anisometropic amblyopia questionnaire (AAAQ) consisted of a function subscale and a psychosocial subscale, each containing 10 items. The Cronbach's α coefficients of the overall, function subscale and psychosocial subscale were 0.88, 0.78 and 0.78. There were 55 males and 45 females in 100 adult anisometropic amblyopia patients, with a median age of 26 years (range, 18 to 43 years). The age and gender distribution were matched with 100 adult patients with other eye diseases and 100 healthy adults with normal vision (all P>0.05). The mean overall score (28.63±9.18), function subscale score (27.69±9.88) and psychosocial subscale score (29.53±9.90) for adult patients with anisometropic amblyopia were significantly lower compared to adult patients with other eye diseases (71.28±8.14, P<0.01; 65.56±7.81, P<0.01; 76.85±10.76, P<0.01) and visually normal adults (84.54±9.13, P<0.01; 81.70±9.27, P<0.01; 87.38±10.06, P<0.01). Conclusion: The AAAQ meets the requirements for validity and reliability of a HRQOL questionnaire, and can be used to assess the HRQOL of adult patients with anisometropic amblyopia. (Chin J Ophthalmol, 2021, 57: 341-347).

Quantum monitoring of cellular metabolic activities in single mitochondria

Free radicals play a vital role in all kinds of biological processes including immune responses. However, free radicals have short lifetimes and are highly reactive, making them difficult to measure using current methods. Here, we demonstrate that relaxometry measurement, or T1, inherited from the field of diamond magnetometry can be used to detect free radicals in living cells with subcellular resolution. This quantum sensing technique is based on defects in diamond, which convert a magnetic signal into an optical signal, allowing nanoscale magnetic resonance measurements. We functionalized fluorescent nanodiamonds (FNDs) to target single mitochondria within macrophage cells to detect the metabolic activity. In addition, we performed measurements on single isolated mitochondria. We were able to detect free radicals generated by individual mitochondria in either living cells or isolated mitochondria after stimulation or inhibition.

Parsing the microRNA genetics basis regulating skeletal muscle fiber types and meat quality traits in pigs

Muscle fibers are closely related to human diseases and livestock meat quality. However, the genetics basis of microRNAs (miRNAs) in regulating muscle fibers is not completely understood. In this study, we constructed the whole genome-wide miRNA expression profiles of porcine fast-twitch muscle [biceps femoris (Bf)] and slow-twitch muscle [soleus (Sol)], and identified hundreds of miRNAs, including four skeletal muscle-highly expressed miRNAs, ssc-miR-378, ssc-let-7f, ssc-miR-26a, and ssc-miR-27b-3p. Moreover, we identified 63 differentially expressed (DE) miRNAs between biceps femoris vs. soleus, which are the key candidate miRNAs regulating the skeletal muscle fiber types. In addition, we found that the expression of DE ssc-miR-499-5p was significantly correlated to the expression of Myoglobin (r = 0.6872, P < 0.0001) and Myosin heavy chain 7 (MYH7; r = 0.5408, P = 0.0020), and pH_45 min (r = 0.3806, P = 0.0380) and glucose content (r = -0.4382, P = 0.0154); while the expression of DE ssc-miR-499-3p was significantly correlated to the expression of Myoglobin (r = 0.5340, P = 0.0024) and pH_45 min (r = 0.4857, P = 0.0065). Taken together, our data established a sound foundation for further studies on the regulatory mechanisms of miRNAs in skeletal muscle fiber conversion and meat quality traits in livestock, and could provide a genetic explanation of the role of miRNAs in human muscular diseases.

[Baseline characteristics of the participants of China National Birth Cohort]

Objective: To explore the effects of environmental, genetic factors as well as the interactions in early life on the short-term and long-term health of offspring and to systematically evaluate the pregnancy outcomes and health of offspring after birth between families with assisted reproductive technology (ART) conception and families with spontaneous conception. Methods: The China National Birth Cohort (CNBC), a multicenter prospective birth cohort study, includes both families with ART conception and families with spontaneous conception. Since 2016, CNBC has recruited families from 24 hospitals located in 12 provinces, municipalities and autonomous regions throughout China. Information and biospecimens were collected before ART treatment, embryo transfer, at early, second, third trimester and delivery, and at 42 days, 6, 12 and 36 months after birth. Results: By June 2020, CNBC had included 27 044 families with ART conception and 29 589 families with spontaneous conception. The majority of the participants are urban residents. Among the families with ART conception, 65.5% of the men and 63.7% of the women had college degrees or higher. The mean age distribution of men and women was (33.83±5.52) and (32.38±4.67) years. 83.2% of women were primiparas, and the prevalence rates of current regular smokers and current alcohol drinkers were 0.8% and 2.1% in women. Among the families with spontaneous conception, 81.5% of the men and 86.5% of the women had college degrees or higher. The mean age distribution of men and women was (32.06±5.09) and (30.40±4.27) years. 67.2% of women were primiparas, and the prevalence rates of current regular smokers and current alcohol drinkers were 0.1% and 2.2% in women. The baseline characteristics were different between the families with ART conception and spontaneous conception in different regions. Conclusion: CNBC provides a powerful and rich resource in studying the impact of genetic, environmental factors and interactions in early life and ART treatment on the health of offspring after birth.

[Profile of China National Birth Cohort]

With the rapid changes in lifestyle, natural and social environment, the reproductive health status of couples in childbearing age continues to decline, and long-term outcomes of the rapidly increasing offspring conceived by assisted reproductive technology (ART) needs to be evaluated urgently. Therefore, the focus of research now needs to be extended from death and severe diseases to full life cycle and full disease spectrum. In order to meet the demand for such research, we launched the China National Birth Cohort (CNBC) study, an ongoing prospective and longitudinal study aiming to recruit 30 000 families underwent ART and 30 000 families with spontaneous pregnancies. Long-term follow-up programs will be conducted for both spouses and their offspring. Data of couples and their offspring, such as environmental exposure, reproductive history, psychological and behavioral status, will be collected during follow-up. Peripheral blood, urine, umbilical blood, follicular fluid, semen were also collected at different follow-up nodes. Based on high-quality data and biological samples, CNBC will play an extremely important supporting role and have a far-reaching impact on maternal and children's health care and reproductive health in China. This paper is exactly a brief introduction to the construction and basic design of CNBC.

[Efficacy and safety of segmental radiofrequency ablation for isolation of the superior vena cava in patients with atrial fibrillation]

Objective: To analyze the three-dimensional distribution of functional sinus node, right phrenic nerve and superior vena cava(SVC)-right atrial muscle sleeves by three-dimensional electrophysiological technique in patients with atrial fibrillation (AF), and to investigate the efficacy and safety of segmental radiofrequency catheter ablation (RFCA) for isolation of superior vena cava in these patients. Methods: In this retrospective study, we enrolled 136 AF patients who underwent first RFCA in the First Affiliated Hospital of Zhengzhou University from July 2018 to June 2019 and all patients underwent SVC isolation under sinus rhythm. Baseline clinical data of patients were collected. The functional sinus node was defined by activation mapping, pacing was guided by three-dimensional mapping (Carto) system, localization of the right phrenic nerve was defined by pacing map, the superior vena cava-right atrial muscle sleeves was determined according to the change of potential during SVC isolation, segmental RFCA was performed for SVC isolation, the three-dimensional distribution of functional sinus node, right phrenic nerve and superior vena cava(SVC)-right atrial muscle sleeves was determined by three-dimensional electrophysiological technique. Immediate SVC isolation was achieved in all patients. Patients were evaluated immediately after RFCA and patients were followed at 3, 6, 9, and 12 months after RFCA. Holter monitoring was performed every 3 months, the chest radiograph and the SVC ultrasonic examination were performed every 6 months after RFCA. Postoperative complications were assessed. Results: The mean age of the 136 patients with AF was (51.6±14.2) years, 86 (63.2%) were male, 98 cases (72.1%) were paroxysmal AF and 38 cases (27.9%) were persistent AF. Right atrium activation mapping revealed that 17 (12.5%) functional sinus node were located in the SVC, 78 (57.4%) were located at the SVC-right atrium junctions, 41 (30.1%) were located below the junction level. From the head to foot view, 83 (61.0%) functional sinus node were located at the anterior lateral segment of the SVC-right atrium three-dimensional reconstruction model, 34 (25.0%) located at the posterior lateral segment, 15 (11.0%) located at the anterior wall, 4 (2.9%) located at posterior wall or anterior septum. A total of 294 SVC muscle sleeves were detected among all patients, 94 (32.0%) SVC muscle sleeves were located at the anterior septum of the SVC-right atrium three-dimensional reconstruction model, 76 (25.9%) were located at the posterior septum, 21(7.1%) were located at the posterior free wall, 11 (3.7%) were located at the posterior lateral, 27 (9.2%) were located at anterior lateral wall and 65 (22.1%) were located at the anterior free wall. Right phrenic nerve positioned relatively fix, 133 (97.8%) were located at the lateral segment of the SVC-right atrium three-dimensional reconstruction model, 3 (2.2%) were located at the anterior free wall. Sinus rhythm and SVC isolation were successfully restored immediately after RFCA, no significant SVC stenosis, right phrenic nerve palsy and functional sinus node injury occurred immediately post procedure. All patients were followed up for (11.2±3.6) months and none had postoperative complication. Conclusions: Three-dimensional electrophysiological can determine the spatial location of functional sinus node, right phrenic nerve and SVC-right atrial sleeves. On this basis, segmental RFCA is a safe and effective method to achieve complete isolation of SVC.

[Effect of laparoscopic novel W-H fundoplication in patients with proton pump inhibitor dependent gastroesophageal reflux disease]

Objective: To investigate the effect of a novel laparoscopic W-H fundoplication in the treatment of proton pump inhibitor (PPI) dependent gastroesophageal reflux disease (GERD). Methods: The clinical data of PPI dependent GERD patients who underwent laparoscopic W-H fundoplication in PLA Rocket Force Characteristic Medical Center from October 1st, 2018 to April 30th, 2019 were analyzed retrospectively. The GERD symptom score, subjective symptom relief, PPI withdrawal, efficacy satisfaction and postoperative complications were followed up and analyzed by a questionnaire. Results: A total of 80 GERD patients were included in this study, and 49 were male and 31 were female, with a median age of 58 years. Among all patients, 85% (68/80) are with esophagitis and 77.5% (62/80) with hiatal hernia. The operation time was 67 (52, 73) minutes, without intraoperative complications and conversion to laparotomy. The postoperative follow-up period was 16 (14, 18) months. The postoperative GERD symptom scores were significantly lower than those before surgery, with an statistical difference (all P<0.05). The subjective remission degree of the overall digestive and respiratory symptoms were 100 (90, 100)% and 100 (80, 100)%, respectively. During the follow-up period, the PPI discontinuation rate was 83% (69/80), and the satisfactory rate was 93% (75/80). Postoperative complications included dysphagia, flatulence, increased exhaust and diarrhea, and the incidence was 61% (49/80), 8% (6/80), 5% (4/80) and 4% (3/80), respectively, and 16% (13/80) of the patients had prolonged occasional mild dysphagia. There was no death, symptomatic recurrence or reoperation. Conclusions: The novel W-H fundoplication has a good medium-term efficacy, with significant GERD symptom control rate and PPI discontinuation rate. The postoperative dysphagia is common, but it is self-limiting and does not affect the satisfaction of the surgical effect.

Efficient generation of a high-field terahertz pulse train in bulk lithium niobate crystals by optical rectification

We demonstrate a highly efficient method for the generation of a high-field terahertz (THz) pulse train via optical rectification (OR) in congruent lithium niobate (LN) crystals driven by temporally shaped laser pulses. A narrowband THz pulse has been successfully achieved with sub-percent level conversion efficiency and multi MV/cm peak field at 0.26 THz. For the single-cycle THz generation, we achieved a THz pulse with 373-μJ energy in a LN crystal excited by a 100-mJ laser pulse at room temperature. The conversion efficiency is further improved to 0.77 % pumped by a 20-mJ laser pulse with a smaller pump beam size (6 mm in horizontal and 15 mm in vertical). This method holds great potential for generating mJ-level narrow-band THz pulse trains, which may have a major impact in mJ-scale applications like terahertz-based accelerators and light sources.

Declarations: management of a pulmonary arteriovenous fistulae by uniportal video-assisted thoracoscopic surgery: a case report

BACKGROUND

A pulmonary arteriovenous fistula (PAVF) is a rare condition that is associated with pulmonary arteriovenous malformation (PAVM). Few reports have described managing PAVMs using uniportal video-assisted thoracoscopic surgery (VATS).

CASE PRESENTATION

A 13-year-old child with PAVF in the left inferior pulmonary artery was treated by uniportal VATS with left lower lobectomy. After surgery, hemoptysis did not recur and there were no postoperative complications. Six months after the operation, postoperative review of computerized tomography showed no recrudescence of PAVF.

CONCLUSIONS

PAVF is a rare case that should be diagnosed and treated early. 3D- computerized tomography (CT) reconstruction is useful for diagnosis and preoperative assessment. The case shows that PAVF can be managed with uniportal VATS.

NLRP6-caspase 4 inflammasome activation in response to cariogenic bacterial lipoteichoic acid in human dental pulp inflammation

AIM

To explore the presence and function of NLRP6-caspase 4 inflammasome in human pulp tissue and human dental pulp cells (HDPCs).

METHODOLOGY

Pulp tissue was collected from freshly extracted human caries-free third molars and third molars with irreversible pulpitis. Quantitative real-time polymerase chain reaction (qRT-PCR) and western blot were performed to assess the expression of NLRP6-caspase 4 inflammasome. HDPCs were prepared from normal human pulp tissues and challenged with Porphyromonas gingivalis LPS. Enzyme-linked immunosorbent assay (ELISA) and qRT-PCR were performed to assess if LPS can upregulate NLRP6 and caspase-4. HDPCs were further challenged with LPS followed with cytosolic Streptococcus mutans lipoteichoic acid (LTA). SiRNA targeting NLRP6 and Casp4 and pharmacology inhibitor Ac-FLTD-CMK and MCC950 were used to assess if Streptococcus mutans LTA can activate the NLRP6 but not the NLRP3 inflammasome. Western blot and ELISA were performed to evaluate inflammasome activation. The Student's t-test and one-way anova were used for statistical analysis.

RESULTS

NLRP6-caspase 4 inflammasome was upregulated and activated in inflamed human dental pulp tissue. In HDPCs, Porphyromonas gingivalis LPS upregulated the expression of NLRP6, CASP1 and CASP4 in a type I interferon dependent manner. After LPS priming, cytosolic Streptococcus mutans LTA triggered NLRP6-caspase 4 inflammasome activation. Knockdown of NLRP6 or CASP4 using siRNA or using pharmacology inhibitor Ac-FLTD-CMK but not MCC950 efficiently suppressed inflammasome activation by cytosolic LTA.

CONCLUSIONS

NLRP6-caspase 4 inflammasome may play an important role in pulp inflammation and immune defence. Inflammatory caspases represent a pharmacological target to restrain pulpal inflammation.

Ion tracks in silicon formed by much lower energy deposition than the track formation threshold

Damaged regions of cylindrical shapes called ion tracks, typically in nano-meters wide and tens micro-meters long, are formed along the ion trajectories in many insulators, when high energy ions in the electronic stopping regime are injected. In most cases, the ion tracks were assumed as consequences of dense electronic energy deposition from the high energy ions, except some cases where the synergy effect with the nuclear energy deposition plays an important role. In crystalline Si (c-Si), no tracks have been observed with any monomer ions up to GeV. Tracks are formed in c-Si under 40 MeV fullerene (C₆₀) cluster ion irradiation, which provides much higher energy deposition than monomer ions. The track diameter decreases with decreasing the ion energy until they disappear at an extrapolated value of ~ 17 MeV. However, here we report the track formation of 10 nm in diameter under C₆₀ ion irradiation of 6 MeV, i.e., much lower than the extrapolated threshold. The diameters of 10 nm were comparable to those under 40 MeV C₆₀ irradiation. Furthermore, the tracks formed by 6 MeV C₆₀ irradiation consisted of damaged crystalline, while those formed by 40 MeV C₆₀ irradiation were amorphous. The track formation was observed down to 1 MeV and probably lower with decreasing the track diameters. The track lengths were much shorter than those expected from the drop of S_e below the threshold. These track formations at such low energies cannot be explained by the conventional purely electronic energy deposition mechanism, indicating another origin, e.g., the synergy effect between the electronic and nuclear energy depositions, or dual transitions of transient melting and boiling.

[Operative efficacy of 13 malignant uterine tumors after Cf-252 intracavitary irradiation]

Objective: To investigate the surgical therapeutic efficacy of uterine tumors patients underwent Cf-252 neutron intra-cavity and external radiotherapy, and evaluate the application value of Cf-252 neutron radiotherapy. Methods: Thirteen cases of uterine tumor with local suspicious lesions or poor prognostic factors after CF-252 neutron intracavity and external radiotherapy were treated with surgery. Among them, 12 cases underwent extrafascial hysterectomy, 1 case underwent extensive hysterectomy and lymphadenectomy. The postoperative pathology and follow-up results were used to evaluate the efficacy. Results: Nine cases showed severe response to radiotherapy in postoperative cervical pathological tissues without residual tumor, and survived for more than 3-14 years, the median survival time was 8 years. All of 4 cases with residual tumor died within 1 year. Delayed healing of vaginal wounds occurred in 3 of the 12 cases. Conclusions: Cf-252 is a good brachytherapy source. The cervical tissue shows severe response to radiotherapy and prolonged healing time of vaginal wound is observed in some cases after CF-252 radiotherapy. To those uterine tumor patients with local suspicious lesions or poor prognostic factors after CF-252 neutron intracavity and external radiotherapy, extrafascial hysterectomy is a safe and feasible treatment method.

[Incidence and management of cesarean scar pregnancies after in vitro fertilization-embryo transfer]

Objective: To explore the incidence, clinical characteristics, management strategies and reproductive outcomes of cesarean scar pregnancies (CSP) after in vitro fertilization-embryo transfer (IVF-ET). Methods: The patients who were diagnosed with CSP followed IVF/ET in the Center for Reproductive Medicine of Peking University Third Hospital between April 1, 2010 and March 31, 2020 were included. The clinical data of each patient were analyzed retrospectively. Results: There were a total of 1 441 patients with secondary infertility complicated with a history of cesarean section and achieved clinical pregnancy after IVF-ET treatments, of which CSP accounted for 1.94% (28/1 441). The average age of CSP patients was (34±3) years old, and 50.0% (14/28) of the patients had a history of artificial abortion. The incidence of CSP in embryo transfers at the cleavage stage had no significantly difference from transfers at the blastocyst stage (1.74% vs 2.20%, χ(2)=0.408, P=0.523), and the incidence of CSP in fresh embryo transfers had no significantly difference from frozen-thawed embryo transfers (1.77% vs 2.23%, χ(2)=0.372, P=0.542). The average gestational age at diagnosis was (47±6) days. According to the classification based on imaging examination during early pregnancy, a case of type Ⅰ CSP received expectant treatment and achieved live birth at third trimester of pregnancy. Two cases of heterotopic cesarean scar pregnancy underwent transvaginal selective reduction of CSP, and intrauterine pregnancies were followed by live births at third trimester of pregnancy. One case of type Ⅲ CSP underwent laparoscopic CSP excision and uterine repair, and 24 patients with type Ⅰ or type Ⅱ CSP underwent hysteroscopic CSP excision with/without uterine artery embolization. After CSP treatment, 5 patients achieved clinical pregnancy through embryo transfer, all of which were normal intrauterine pregnancy followed by term live birth. Conclusions: Color ultrasonography should be performed during early pregnancy to confirm the occurrence of CSP in patients receiving IVF-ET after previous cesarean section. Treatment of CSP should be individualized, and patients with Type Ⅰ CSP who are strictly selected have the opportunity for expectant treatment.

Baicalin attenuates endometritis in a rabbit model induced by infection with Escherichia coli and Staphylococcus aureus via NF-κB and JNK signaling pathways

In this study, a rabbit endometritis model was developed to study cow endometritis. In addition, the protective effects of baicalin (a flavonoid) against endometritis were investigated. Clinical symptoms, differential leukocyte counting, uterine secretion smear microscopy and chemical examination, urine testing, and signs of necropsy showed abnormal changes and inflammatory responses in the uterus of rabbits. Histopathological results revealed visible inflammatory exudates and blood spots between intercellular spaces which confirmed that the rabbit endometritis model was successfully developed. Most importantly, these inflammatory signs were partially attenuated with baicalin treatment. The data revealed that the increased body temperature and leukocyte cells, pus, and the detachment of epithelial cells were alleviated with baicalin administration in a dose-dependent manner. Histopathological tissue changes such as inflammatory cells infiltrates, hyperemia, hemorrhages, and shedding of epithelial cells were partially attenuated with baicalin treatment. In addition, the mRNA expression of inflammation-related genes (iNOS, IL-1β, TNF-α, IL-10, IL-4, and IL-6) was significantly altered in RAW264.7 cells after LPS treatment. Further, the phosphorylated protein expression of JNK, p65, and IκBα were significantly reduced with LPS treatment. Intriguingly, baicalin pretreatment reversed the alteration in mRNA expression of inflammation-related genes and significantly reduced the phosphorylation of JNK, p65, and IκBα. In summary, our results suggest that baicalin has protective effects on bacterial-induced endometritis in rabbits that involve the suppression of NF-κB and JNK signaling pathways and pro-inflammatory cytokines.

Expression of lncRNA-ANRIL in patients with coronary heart disease before and after treatment and its short-term prognosis predictive value

OBJECTIVE

This study was designed to explore the expression of LncRNA-ANRIL in patients with coronary heart disease before and after treatment and its short-term survival prediction value.

PATIENTS AND METHODS

Eighty-three patients with coronary heart disease who came to our hospital undergoing interventional therapy were selected as a research group, 81 healthy volunteers who came to our hospital for normal physical examination during the same period were selected as a control group, and LncRNA-ANRIL of subjects in the two groups before and after treatment were detected by RT-PCR. Levels of Gensini score, lactate dehydrogenase (LDH), creatine kinase isoenzyme (CK-MB), creatine kinase (CK), and BNP of patients in research group before treatment were evaluated and detected, and the correlation between those and LncRNA-ANRIL was analyzed. Then, the effective treatment of LncRNA-ANRIL for patients with coronary heart disease and the predictive value of poor prognosis were analyzed.

RESULTS

The expression of LncRNA-ANRIL in patients with coronary heart disease was lower than that of normal subjects (p<0.05), and the expression levels of Gensini score, LDH, CK-MB, CK, and BNP gradually increased with the increased number of their diseased vessels (p<0.05). The expression of LncRNA-ANRIL was negatively correlated with expressions of Gensini score, LDH, CK-MB, CK, and BNP (p<0.05); ROC of LncRNA-ANRIL in predicting effective treatment, and poor prognosis of patients with coronary heart disease was over 0.9, as well as smoking; LncRNA-ANRIL, Gensini score, LDH, CK-MB, CK, and BNP were independent risk factors for the occurrence of MACE.

CONCLUSIONS

LncRNA-ANRIL expresses low in the serum of patients with coronary heart disease, and it has high predictive value both for effective treatment and poor prognosis of them. Also, lncRNA-ANRIL is also an independent risk factor for their poor prognosis.

Synergistic breast cancer suppression efficacy of doxorubicin by combination with glycyrrhetinic acid as an angiogenesis inhibitor

BACKGROUND

Therapeutic regimens of breast cancer treatment are increasingly inclined to adopt combination strategy based on the broad spectrum antitumor effect of doxorubicin (Dox). Currently, combination therapy comprises of conventional anti-cancer drugs and angiogenesis inhibitors have been corroborated as an effective approach in cancer treatment.

PURPOSE

We explored the ability of a natural anti-angiogenic compound glycyrrhetinic acid (GA), derived from an edible-medicinal herb licorice, to enhance the breast cancer suppression effect of Dox.

STUDY DESIGN

The drug ratio of GA and Dox with synergistic anticancer effect against MCF-7 cells was optimized by combination index (CI) value in vitro, followed by evaluation of the improved anticancer effects and reduced side-effects of this combination in vitro and in vivo.

METHODS

Cell viability was measured by MTT assay. Analyses of mitochondrial membrane potential and cell apoptosis on MCF-7 cells were performed by JC-1 dye and Annexin V-FITC/PI assays. The cellular accumulation of Dox when combined with GA was evaluated. Levels of apoptosis-related proteins in MCF-7 cells were measured by Western blot analysis. Synergistic anti-angiogenic effects on HUVECs were evaluated. A breast cancer mouse model was established to investigate the anti-tumor effects in vivo.

RESULTS

Based on the optimization by CI value, Dox and GA at 1:20 molar ratio was chosen as the optimal combination drug ratio that exhibited synergistic effect against MCF-7 breast cancer cells. In addition, the combination of GA and Dox exhibited significantly enhanced cytotoxicity, apoptosis, and loss of mitochondrial membrane potential via the upregulation of a mitochondrial-dependent apoptosis pathway against MCF-7 cells. Interestingly, the addition of GA increased the intracellular accumulation of Dox in MCF-7 cells. Moreover, VEGF-induced HUVECs proliferation, migration, and tube formation were strongly inhibited by Dox when used with GA via the significant down-regulation of VEGFR2-mediated pathway, indicating that the combination of Dox and GA could exhibit ideal synergistic anti-angiogenesis effect. Expectedly, the enhanced anti-tumor efficacy of Dox and reduced Dox-induced cardiotoxicity when used in combination with GA were evident in a mouse breast tumor model.

CONCLUSIONS

These findings support that the combination of Dox with GA is a novel and promising therapeutic strategy for the treatment of breast cancer.

Intratumoral interleukin-9 delineates a distinct immunogenic class of gastric cancer patients with better prognosis and adjuvant chemotherapeutic response

Interleukin-9 (IL-9) is a T cell cytokine that is associated with inflammation and allergy, but the expression level of IL-9 in gastric cancer and its clinical significance are less well established. Our study aims to uncover the critical role of IL-9 in the progression of gastric cancer. Here, a total of 453 patients with gastric cancer undergoing curative resection were enrolled for immunohistochemical analyses, and Kaplan-Meier analysis was conducted to compare overall survival of patients in different subgroups. We further investigated the correlation between IL-9 expression and functional status of intratumoral CD8⁺ T cells by means of Flow cytometry. Moreover, in vitro study was preformed to further explore the influence of IL-9 on anti-tumor immunity. Results indicated that gastric cancer patients with high IL-9 expression showed improved overall survival and gained more benefit from 5-fluorouracil-based adjuvant chemotherapy (ACT). High IL-9 expression was associated with increased numbers and elevated function of intratumoral CD8⁺ T cells. In vitro study revealed that recombinant human IL-9 (rhIL-9) exhibit anti-tumor activity via enhancing the function of intratumoral CD8⁺ T cells. Moreover, we found rhIL-9 could augment the efficacy of Pembrolizumab in gastric cancer. In summary, these results suggest that IL-9 expression could act as an independent predictor for overall survival and ACT response and enhancing IL-9 signaling might represent an important therapeutic strategy in gastric cancer.

First-Principles Study of Anharmonic Lattice Dynamics in Low Thermal Conductivity AgCrSe_{2}: Evidence for a Large Resonant Four-Phonon Scattering

We report a study of the anharmonic lattice dynamics in low lattice thermal conductivity (κ_{l}) material AgCrSe_{2} by many-body perturbation theory. We demonstrate surprisingly giant four-phonon scattering exclusive for the heat-carrying transverse acoustic phonons due to large quartic anharmonicity and nondispersive phonon band structure, which lead to four-phonon Fermi resonance and breaks the classical τ^{-1}∼ω^{m}T^{n} relation for phonon-phonon interactions. This strong resonant scattering extends over the Brillouin zone and substantially suppresses the thermal transport, even down to a low temperature of 100 K. The present results provide fundamental insights into the four-phonon resonant dynamics in the low-κ_{l} system with flat phonon dispersions, i.e., cuprous halides and skutterudites.