Exosome-mediated delivery of SCD-1 siRNA promoted the death of anaplastic thyroid carcinoma cells via regulating ROS level

PURPOSE

Anaplastic thyroid carcinoma (ATC) is one of the most aggressive cancers in the world. Stearoyl-CoA desaturase-1 (SCD-1) is one of major enzymes in the de novo synthesis of fatty acids and is related to cancer aggressiveness and poor patient prognosis. The study aimed to construct exosomes loaded SCD-1 interference, investigate its effects and mechanisms on the cell proliferation and apoptosis of ATC cells.

METHODS

The expressions of SCD-1 in normal thyroid cell line and ATC cell lines were determined by qRT-PCR and western blotting, respectively. Exosomes were prepared and purification then loaded with SCD-1 siRNA by electroporation and observed by transmission electron microscopy. Higher SCD-1 mRNA and protein levels were found in ATC cell lines compared than normal thyroid cell line (P < 0.05), and both Hth-7 and FRO cells could uptake PKH67-labeled exosomes. The effects of exosomes loaded SCD-1 siRNA on ATC cells were measured by CCK8 assay and apoptosis detection kit.

RESULTS

When compared with control group, the cell viability significantly decreased in both two ATC cell lines taken up exosomes loaded SCD-1 siRNA (P < 0.001), and apoptotic and necrotic cells obviously increased (P < 0.05). In order to explore the mechanism of exosomes loaded SCD-1 on ATC, the ROS level was detected by fluorescence reagent. It was found that exosomes loaded SCD-1 siRNA significantly increased intracellular ROS level of ATC cells (P < 0.05).

CONCLUSIONS

Exosomes loaded SCD-1 siRNA inhibited ATC cellular proliferation and promoted cellular apoptosis, and the mechanisms involved maybe the regulation of fatty acids metabolism and ROS level. Our study provides a promising therapeutic strategy for ATC.

Rotary table wobble error analysis and correction of a rotating accelerometer gravity gradiometer

In a rotating accelerometer gravity gradiometer (RAGG), rotary table wobble refers to the shift in the direction of the spin axis during operation. This motion causes errors in the output of the RAGG, but the mechanism is not clear. The purpose of this paper is to analyze the relationship between rotary table wobble and RAGG errors and to propose a method for rejecting these errors. We consider the influence of attitude changes, angular velocity, and angular acceleration caused by the wobble on the specific force, and we describe the error transmission process based on the accelerometer configuration and its measurement principle. Furthermore, we show through a simulated experiment that when the angular velocity noise caused by the wobble is 1 μrad/s, this will produce errors of tens of E. We propose a post-error correction method that is based on the higher-precision RAGG model and motion measurement. The errors in the two channels of the RAGG are reduced to 3.69 E and 1.85 E after error correction. The error analysis of the effects of wobble on a RAGG and the proposed error correction method are of great significance for the development of high-precision gradiometers.

Biochemical and transcriptomic analyses of the symbiotic interaction between Cremastra appendiculata and the mycorrhizal fungus Coprinellus disseminatus

BACKGROUND

Cremastra appendiculata is a rare terrestrial orchid with a high market value as an ornamental and medicinal plant. However, the species depends entirely on fungi for seed germination under natural conditions. In a previous study, we have successfully isolated and identified the mycorrhizal fungus Coprinellus disseminatus which was able to induce the germination of C. appendiculata seeds. We then speculated that C. disseminatus may do so by breaking the testa imposed dormancy of the seeds. In this study, biochemical and transcriptomic analyses were used to characterize the germination of C. appendiculata seeds, collected at different stages of germination, as affected by C. disseminatus.

RESULTS

The lignocellulose in the seeds coat of C. appendiculata was degraded by the mycorrhizal fungus resulting in facilitated absorption of water. The rate of decline in lignin content was 67 and 73% at 6 and 12 days after sowing, respectively. The water content increased from 13 to 90% during symbiosis. A total of 15,382 genes showing significantly different levels of expression (log₂ FPKM≥2.0, Qvalue≤0.05) were successfully identified among all libraries, where the highest number of DEGs was shared between 6 days versus 0 day after symbiotic germination. Gene annotation results suggested that 15 key genes related water-status, such as DHN gene family and Xero 1 were down-regulated. The genes zeaxanthin epoxidase ZEP, 9-cis-epoxycarotenoid dioxygenase NCED3 and β-carotene hydroxylase involved in the biosynthesis of abscisic acid (ABA) were significantly down-regulated in 6 days as compared to 0 day after symbiotic germination.

CONCLUSIONS

This work demonstrates that mycorrhizal fungus C. disseminatus can stimulate C. appendiculata seeds germination through a mechanism of breaking the testa imposed dormancy and inducing water absorption of the embryo.

Mechanism of cadmium tolerance in Salicornia europaea at optimum levels of NaCl

Many saline-alkali soils around the world are polluted by the heavy metal Cd, restricting the development of agriculture and ecology in those regions. The halophyte Salicornia europaea L. is capable of growing healthily in Cd-contaminated saline-alkali soil, suggesting that the species is tolerant to stress caused by both salt and heavy metals. In this study, the mechanism of Cd tolerance in this species was explored under 200 mM NaCl. Flame spectrophotometric assays for ions content and spectrophotometric for organic soluble substances, antioxidant enzyme activity, phytochelatins (PCs) content and phytochelatin synthase (PCS) activity, the photosynthetic parameters by portable photosynthesis measurement system, genes expression by qRT-PCR analysis were carried out. Cd treatment significantly decreased the dry weight, photosynthetic rate, K⁺ , Zn²⁺ , and Fe^2+/3+ content, while significantly increasing Na⁺ and Cd⁺ , soluble organic matter, and reactive oxygen species (ROS) levels. Compared with Cd treatment at 0 mM NaCl, Cd treatment at 200 mM NaCl significantly increased dry weight and photosynthetic rate while significantly decreasing ROS content through increased antioxidant enzyme activity. When exposed to Cd stress, treatment with 200 mM NaCl significantly increased PCs content and PCS activity and up-regulated the expression of the phytochelatin synthase genes CDA1 and PCS1 were, thereby increasing resistance to Cd. NaCl treatment increases the tolerance of S. europaea to the heavy metal Cd by growing rapidly, reducing the quantity of Cd²⁺ from entering the plant shoots, increasing the levels of PCs that chelate Cd²⁺ , thereby reducing its toxicity.

Role of local treatment in primary breast B-cell non-Hodgkin's lymphoma: a propensity score matching-based analysis from SEER database

OBJECTIVE

Primary breast lymphoma (PBL) has been defined as disease localized to breast with or without ipsilateral axillary nodal involvement. Primary breast B-cell non-Hodgkin's lymphoma is rare to be diagnosed clinically. The role of surgery and radiotherapy (RT) as local treatment is unclear. The aim of this study was to evaluate the prognostic factors and investigate the effect of local treatment in patients with primary breast B-cell non-Hodgkin's lymphoma.

MATERIALS AND METHODS

We identified patients with primary breast B-cell non-Hodgkin's lymphoma diagnosed between 1998 and 2015 in the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was performed to reduce possible bias between groups. The overall survival (OS) and disease-specific survival (DSS) were calculated using the Kaplan-Meier method. Multivariate Cox regression analysis was used to identify independent prognostic factors.

RESULTS

Altogether 956 patients with primary breast B-cell non-Hodgkin's lymphoma were included. Most patients were white women over the age of 60. The most common histological type was diffuse large B cell lymphoma (DLBCL), and most patients present with stage I disease. Furthermore, old age (>60 years), DLBCL histology and stage IIE disease were the statistically significant factors associated with worse OS and DSS. Surgery did not improve survival of patients, and surgery combined with RT did not achieve a better prognosis than RT alone. RT was associated with better survival in patients with stage IE DLBCL, but patients with stage IE MZL and FL and stage IIE primary breast B-cell non-Hodgkin's lymphoma could not benefit from RT.

CONCLUSIONS

In local treatment, surgery offered no survival benefit for patients with primary breast B-cell non-Hodgkin's lymphoma, while RT is an effective choice because it can improve both OS and DSS in the stage IE DLBCL subgroup.

Gas-Sensing Properties and Preparation of Waste Mask Fibers/ZnS Composites

To realize the resource utilization of waste mask fibers (MF), a layer of ZnS nanoparticles was grown on MF by a one-step hydrothermal method, and a MF/ZnS sensor was successfully prepared. This is the first time that resource utilization of MF has been combined with the development of a high-performance gas sensor. The MF/ZnS sensor showed high sensitivity and recoverability to target vapors at room temperature. Compared with ZnS powder loaded on a ceramic substrate, the MF/ZnS composite responses to four analytes have been improved by 8.4~35.2 times. In addition, the time for the MF/ZnS sensor to complete one response-recovery cycle for all four analytes was less than 30 s. This should be attributed to the high gas permeability of the MF substrate, which made the ZnS particles loaded on the MF more fully exposed to contact with the target vapors. This work not only provides a simple and low-cost method to optimize the sensing performance of gas sensors but also provides a new way for the resource utilization of MF.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11664-022-09644-1.

In Situ Observations of Interstellar Pickup Ions from 1 au to the Outer Heliosphere

Interstellar pickup ions are an ubiquitous and thermodynamically important component of the solar wind plasma in the heliosphere. These PUIs are born from the ionization of the interstellar neutral gas, consisting of hydrogen, helium, and trace amounts of heavier elements, in the solar wind as the heliosphere moves through the local interstellar medium. As cold interstellar neutral atoms become ionized, they form an energetic ring beam distribution comoving with the solar wind. Subsequent scattering in pitch angle by intrinsic and self-generated turbulence and their advection with the radially expanding solar wind leads to the formation of a filled-shell PUI distribution, whose density and pressure relative to the thermal solar wind ions grows with distance from the Sun. This paper reviews the history of in situ measurements of interstellar PUIs in the heliosphere. Starting with the first detection in the 1980s, interstellar PUIs were identified by their highly nonthermal distribution with a cutoff at twice the solar wind speed. Measurements of the PUI distribution shell cutoff and the He focusing cone, a downwind region of increased density formed by the solar gravity, have helped characterize the properties of the interstellar gas from near-Earth vantage points. The preferential heating of interstellar PUIs compared to the core solar wind has become evident in the existence of suprathermal PUI tails, the nonadiabatic cooling index of the PUI distribution, and PUIs' mediation of interplanetary shocks. Unlike the Voyager and Pioneer spacecraft, New Horizon's Solar Wind Around Pluto (SWAP) instrument is taking the only direct measurements of interstellar PUIs in the outer heliosphere, currently out to ∼ 47 au from the Sun or halfway to the heliospheric termination shock.

Search for Lepton-Flavor Violation in Z-Boson Decays with τ Leptons with the ATLAS Detector

A search for lepton-flavor-violating Z→eτ and Z→μτ decays with pp collision data recorded by the ATLAS detector at the LHC is presented. This analysis uses 139  fb^{-1} of Run 2 pp collisions at sqrt[s]=13  TeV and is combined with the results of a similar ATLAS search in the final state in which the τ lepton decays hadronically, using the same data set as well as Run 1 data. The addition of leptonically decaying τ leptons significantly improves the sensitivity reach for Z→ℓτ decays. The Z→ℓτ branching fractions are constrained in this analysis to B(Z→eτ)<7.0×10^{-6} and B(Z→μτ)<7.2×10^{-6} at 95% confidence level. The combination with the previously published analyses sets the strongest constraints to date: B(Z→eτ)<5.0×10^{-6} and B(Z→μτ)<6.5×10^{-6} at 95% confidence level.

[Antiviral therapy and clinical cure for chronic hepatitis B in children: progress and challenges]

Chronic hepatitis B has become a global public health problem. Currently, children with chronic hepatitis B receiving antiviral treatment have become the focus of increasing attention. This article reviews the current status and progress of antiviral treatment, analyzes whether and when to treat, treatment regimen, efficacy and safety evaluation, and further explores the relevant factors for the clinical cure of chronic hepatitis B in children, with hope to provide a scientific basis for the clinical cure of chronic hepatitis B in adults.

A prospective study on vulvovaginal candidiasis: multicentre molecular epidemiology of pathogenic yeasts in China

BACKGROUND

Vulvovaginal candidiasis (VVC) is frequent in women of reproductive age, but very limited data are available on the epidemiology in cases of VVC in China.

OBJECTIVES

The current study has been conducted to reveal the prevalence, species distribution of yeast causing VVC and molecular genetics of Candida albicans in China.

METHODS

Vaginal swabs were collected from 543 VVC outpatients recruited in 12 hospitals in China between September 2017 and March 2018. They were preliminarily incubated on Sabouraud dextrose agar and then positive subjects of which were then transmitted to our institute for further identification. CHROMagar™ was used to isolate Candida species, and all isolates were finally identified by DNA sequencing. Multilocus sequence typing (MLST) was used to analyse phylogenetic relationships of the various C. albicans isolates.

RESULTS

Eleven different yeast species were identified in 543 isolates, among which C. albicans (84.7%) was the most frequent, followed by C. glabrata (8.7%). We obtained 117 unique diploid sequence types from 451 clinical C. albicans isolates and 92 isolates (20.4%) belonged to a New Clade. All the strains appearing in the New Clade were from northern China and they were isolated from non-recurrent VVC.

CONCLUSIONS

Our findings suggest that C. albicans are still the main cause of VVC in China and the majority of C. albicans isolates belongs to Clade 1 with DST 79 and DST 45 being two most common. Moreover, the New Clade revealed in our study seems to be specific to northern China.

[Effects of LINC00839 targeting miR-3666 on proliferation, migration and invasion of hepatocellular carcinoma cells]

Objective: To investigate the effects of lncRNA LINC00839 on the proliferation, migration and invasion of hepatocellular carcinoma cells and its mechanism. Methods: Real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect the expression of LINC00839 and miR-3666 in hepatocellular carcinoma tissues and adjacent tissues. Pearson correlation was used to analyze the correlation between LINC00839 and miR-3666 expression in liver cancer tissues. Hepatocellular carcinoma cells MHCC97H were cultured in vitro and divided into si-NC group, si-LINC00839 group, miR-NC group, miR-3666 group, si-LINC00839+ anti-miR-NC group, and si-LINC00839+ anti-miR-3666 group. Methylthiazoletrazolium (MTT) method and clone formation experiment were used to detect cell proliferation. Transwell array was used to detect the cell migration and invasion. Western blot was used to detect the protein expressions of p21, E-cadherin and MMP-2. The double luciferase reporter gene experiment was used to verify the regulatory relationship between LINC00839 and miR-3666. Results: Compared with adjacent tissues, the expression level of LINC00839 in hepatocellular carcinoma tissues increased (2.82±0.27 vs. 0.96±0.10, P<0.001), but the expression level of miR-3666 decreased (0.23±0.02 vs. 1.01±0.10, P<0.001). The expression levels of LINC00839 and miR-3666 in liver cancer tissue were negatively correlated (r=-0.658, P<0.001). The survival rate of MHCC97H cells in the si-LINC00839 group [(53.91±5.41)% vs. (100.53±10.22)%], the number of clones formed (92.0±8.0 vs. 164.0±14.3), the number of migration (131.0±12.7 vs. 247.0±22.4), the number of invasion (66.0±6.4 vs. 120.0±11.6) and the protein level of MMP-2 (0.20±0.02 vs. 0.67±0.06) were lower than those in the si-NC group (P<0.001). However, the protein levels of p21 (0.76±0.07 vs. 0.25±0.02) and E-cadherin (0.78±0.08 vs. 0.14±0.01) were higher than those in the si-NC group (P<0.001). LINC00839 targeted and negatively regulated the expression of miR-3666. The survival rate of MHCC97-H cells in the miR-3666 group [(47.93±4.86)% vs. (100.11±10.21)%], the number of clone formation (78.0±7.7 vs. 166.0±15.9), the number of migration (117.0±12.1 vs. 250.0±25.0), the number of invasion (57.0±5.7 vs. 121.0±12.3) and the protein level of MMP-2 (0.16±0.01 vs. 0.69±0.07) were lower than those in the miR-NC group (all P<0.001). However, the protein levels of p21 (0.83±0.08 vs. 0.24±0.02) and E-cadherin (0.87±0.09 vs. 0.13±0.01)were higher than those in the miR-NC group (all P<0.001). The survival rate of MHCC97-H cells in the si-LINC00839+ anti-miR-3666 group [(89.94±9.05)% vs. (54.12±5.39)%], the number of clones (143.0±13.8 vs. 94.0±9.4), the number of migration (208.0±19.8 vs. 129.0±12.6), the number of invasion (108.0±10.1 vs. 65.0±6.4) and the protein level of MMP-2 (0.31±0.03 vs 0.66±0.06) were higher than those in the si-LINC00839+ anti-miR-NC group (P<0.001). However, the protein levels of p21 (0.31±0.03 vs. 0.74±0.07) and E-cadherin (0.28±0.03 vs. 0.80±0.08) were lower than those int the si-LINC00839+ anti-miR-NC group (P<0.001). Conclusion: Inhibition of LINC00839 expression may inhibit the proliferation, migration and invasion of hepatocellular carcinoma cells by targeting up-regulation of miR-3666 expression.

Application of a shear-wave elastography prediction model to distinguish between benign and malignant breast lesions and the adjustment of ultrasound Breast Imaging Reporting and Data System classifications

AIM

To explore a real-time shear-wave elastography (SWE) prediction model distinguishing benign from malignant breast lesions and to determine its application in adjusting ultrasound Breast Imaging Reporting and Data System (BI-RADS) classifications.

MATERIALS AND METHODS

Four hundred and sixty-eight patients with 488 breast lesions were enrolled. Patients underwent hollow-needle puncture or surgical resection for histopathological examinations. Ultrasound examinations, both conventional ultrasound and real-time SWE, were performed <2 weeks prior to sampling. Statistical analyses were implemented to distinguish benign from malignant breast lesions and adjust ultrasound BI-RADS 3 and 4a classifications.

RESULTS

The real-time SWE indicators Emax and Ecol showed the highest diagnostic efficiency in distinguishing between benign and malignant lesions through quantitative and qualitative indicators, respectively. The area under the curve (AUC) for Emax was 0.837 while that for Ecol was 0.828. The AUC of the real-time SWE prediction model, constructed by multivariate logistic regression, for diagnosing benign and malignant breast lesions was 0.850.

CONCLUSION

The real-time SWE prediction model aids in the differential diagnosis of benign and malignant breast lesions but cannot replace conventional ultrasound. The model improves the diagnostic performance of ultrasound BI-RADS 3 and 4a classifications.

ESR1 mediated circ_0004018 suppresses angiogenesis in hepatocellular carcinoma via recruiting FUS and stabilizing TIMP2 expression

Angiogenesis has been certified to account for tumor pathobiology. Circular RNAs (circRNAs) have been demonstrated to be involved in angiogenesis-related diseases, including hepatocellular carcinoma (HCC). Nevertheless, the regulatory roles of most circRNAs remain obscure. This study aims to uncover the function of hsa_circ_0004018 on angiogenesis in HCC. Firstly, quantitative real-time RT-PCR (RT-qPCR) analyzed that circ_0004018 was definitely down-regulated in HCC. Western blot analysis was conducted to detect the protein level of fused protein in sarcoma (FUS) and TIMP metallopeptidase inhibitor 2 (TIMP2). Functional assays were carried out to assess the impacts of circ_0004018 on HCC. From the experimental results, we found that overexpression of circ_0004018 significantly inhibited angiogenesis in HCC. The regulatory mechanism of circ_0004018 in HCC was determined by chromatin immunoprecipitation (ChIP), luciferase reporter assays and RNA immunoprecipitation (RIP) assay. Therefore, we proved that estrogen receptor 1 (ESR1) mediated circ_0004018 regulated TIMP2 by recruiting FUS. A series of rescue assays verified that circ_0004018 participated in angiogenesis in HCC via modulating TIMP2. In summary, this paper disclosed that ESR1 activated circ_0004018 inhibited angiogenesis in HCC via binding to FUS and stabilizing TIMP2 expression.

[Study on community health management and control of hypertension in patients aged 35 years and above in China, 2015]

Objective: To understand the current status of community health management, treatment and control of hypertension in patients aged 35 years and above in China in 2015, and identify the influencing factors. Methods: Using the questionnaire survey results and physical measurement information collected by China Chronic Diseases and Nutrition Monitoring System in 2015, hypertension patients aged 35 years and above diagnosed at township health center level (community health service centers) or above were selected as the research subjects. The patients were complexly weighted to analyze their general characteristics, community health management, treatment and control status. Results: This study included 23 974 hypertension patients aged 35 years and above diagnosed by medical and health institutions at township level and above in 2015. After complex weighting, the community health management rate of hypertension patients aged 35 years and above was 54.10% (95%CI: 51.02%-57.17%), the standardized community management rate was 45.72% (95%CI: 42.93%-48.51%), the treatment rate was 88.16% (95%CI: 87.00%-89.31%), and the control rate was 22.67% (95%CI: 21.25%-24.09%), the treatment control rate was 27.76% (95%CI: 26.09%-29.42%). Multivariate analysis showed that patients in urban areas as well as in rural areas who were aged over 65 years old (OR=1.40, 95%CI: 1.05-1.87; OR=3.11, 95%CI: 2.22-4.36), taking medicine as prescribed (OR=2.15, 95%CI: 1.46-3.15; OR=1.35, 95%CI: 1.13-1.62), monitoring blood pressure (OR=2.34, 95%CI: 1.88-2.90; OR=3.10, 95%CI: 2.72-3.53) were more willing to accept community health management of hypertension. Urban hypertension patients with high education level (OR=0.51, 95%CI: 0.39-0.66), moderate alcohol consumption (OR=0.69, 95%CI: 0.57-0.84) or excessive alcohol consumption (OR=0.73, 95%CI: 0.58-0.92) had a poor acceptance of community hypertension management. Overweight (OR=0.74, 95%CI: 0.61-0.91; OR=0.83, 95%CI: 0.71-0.98), obesity (OR=0.54, 95%CI: 0.45-0.65; OR=0.67, 95%CI: 0.54-0.83) patients in urban areas as well as in rural areas with hypertension had poor blood pressure control, and patient taking medication as prescribed (OR=4.58, 95%CI: 3.16-6.63; OR=2.84, 95%CI: 2.18-3.69) had better blood pressure control. Urban hypertension patients in central China (OR=0.74, 95%CI: 0.61-0.89) or with excessive alcohol consumption (OR=0.72, 95%CI: 0.54-0.97) had poor blood pressure control while urban hypertension patients with other chronic diseases (OR=1.22, 95%CI: 1.04-1.44) and participating in standardized hypertension community management (OR=1.29, 95%CI: 1.06-1.58) had better blood pressure control.Rural hypertension patients who located in central and western China (OR=0.71, 95%CI: 0.58-0.87; OR=0.62, 95%CI: 0.47-0.80), with moderate alcohol consumption (OR=0.81, 95%CI: 0.67-0.98), taking salt more than 6 g per day (OR=0.80, 95%CI: 0.69-0.93) had poor blood pressure control, and the rural hypertension patients who underwent blood pressure monitoring (OR=1.38, 95%CI: 1.18-1.61) had better blood pressure control. Conclusions: The community health management of hypertension in patients aged 35 years and above has been improved in China, but there is still a certain gap between the control of hypertension and related indicators. It is necessary to take multi standardized intervention measures for the better prevention and control of hypertension.

[Clinicopathological features and molecular characteristics of tall cell and hobnail variants of papillary thyroid carcinoma]

Objective: To investigate the clinicopathological and molecular genetic characteristics of tall cell variant and hobnail variant of papillary thyroid carcinoma (PTC). Methods: Twenty-one cases of tall cell variant (TCV-PTC) of PTC (TCV-PTC) and ten cases of hobnail variant of PTC (HV-PTC), as the highly aggressive group, were collected from Xuanwu Hospital from August 2009 to August 2015. Twenty-two cases of follicular variant and 21 classical PTC cases were included as control. Relevant clinical and pathologic data were obtained, and in some cases, paraffin samples were selected for gene mutation spectrum analysis using second generation sequencing. Results: There were 18 males and 56 females; 57 patients were younger than 55 years of age, and 17 patients were 55 years or older. The mean tumor size was 1.6 cm for the high-aggressive group (TCV-PTC and HV-PTC), 1.1 cm for the follicular subtype, and 1.6 cm for the classical type. There were 54 cases with thyroid capsule invasion, 24 cases with extra-thyroidal invasion, and 45 patients with lymph node metastases. Regional recurrence occurred in 7 cases, no recurrence in 54 cases, and 13 patients were lost to follow-up. The highly aggressive group was more likely to show extra-thyroidal invasion, lymph node metastases and recurrence than those with classical PTC (P<0.05). Within this cohort, BRAF V600E mutation was detected in 53 cases and TERT promoter mutation in 6 cases. Compared with the single mutation group and no mutation group, BRAF and TERT promoter co-mutation group was more commonly detected in older age, male, larger tumor size and more prone to extra-thyroid invasion (P<0.05). In addition, among BRAF and TERT co-mutation cases, the highly-aggressive group accounted for the highest proportion (5/6). Conclusions: TCV-PTC and HV-PTC, as highly-aggressive variants of PTC, show more aggressive biologic behavior (more lymph node metastasis, external thyroid invasion and recurrences) than the classical and follicular variants of PTC. Coexisting BRAF and TERT promoter mutations may be associated with invasive biologic behavior.

Diagnostic accuracy of interleukin-27 in tuberculous pleurisy: a systematic review and meta-analysis

OBJECTIVE

This study aimed to conduct a systematic review of the diagnostic value of interleukin-27 (IL-27) for tuberculous pleurisy (TP).

METHODS

Literature on IL-27 diagnosis of TP was retrieved and screened from six databases (four English databases and two Chinese databases). The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and summary receiver operating characteristic curve (SROC) were measured to assess accurately the comprehensive evaluation of IL-27 for TP.

RESULTS

Eleven studies with a total of 1454 patients were identified in the analysis. The combined diagnostic value of IL-27 for TP was as follows: sensitivity of 0.95 (95% confidence interval [CI]: 0.93-0.97), specificity of 0.91 (95% CI: 0.89-0.92), positive likelihood ratio of 13.99 (95% CI: 7.01-27.93), negative likelihood ratio of 0.07 (95% CI: 0.05-0.10), diagnostic odds ratio of 275.20 (95% CI: 112.83-671.23) and area under the SROC of 0.9830.

CONCLUSION

IL-27 has an excellent diagnostic value for TP and could be used as a diagnostic biomarker for TP.

Sevoflurane-Induced miR-211-5p Promotes Neuronal Apoptosis by Inhibiting Efemp2

Sevoflurane exposure can result in serious neurological side effects including neuronal apoptosis and cognitive impairment. Although the microRNA miR-211-5p is profoundly upregulated following sevoflurane exposure in neonatal rodent models, the impact of miR-211-5p on neuronal apoptosis and cognitive impairment postsevoflurane exposure has not yet been elucidated. Here, we found that sevoflurane upregulated miR-211-5p and downregulated EGF-Containing Fibulin Extracellular Matrix Protein 2 (Efemp2, Fibulin-4) levels in vitro and in vivo. Sevoflurane's effect on miR-211-5p expression was based on enhancing primary miR-211 transcription. miR-211-5p targets Efemp2's mRNA 3′-untranslated region, reducing Efemp2 expression. RNA immunoprecipitation revealed significant enrichment of the miR-211-5p:Efemp2 mRNA dyad in the RNA-induced silencing complex. miR-211-5p mimics downregulated Efemp2, leading to phosphorylation of Smad2 and Smad3, upregulation of pro-apoptotic Bim, and mitochondrial release of allograft inflammatory factor 1 and cytochrome C. In contrast, miR-211-5p hairpin inhibitor (AntimiR-211-5p) negatively regulated this apoptotic pathway and reduced neuronal apoptosis in an Efemp2-dependent manner. Sevoflurane-exposed mice administered AntimiR-211-5p displayed reduced cortical apoptosis levels and near-term cognitive impairment. In conclusion, sevoflurane-induced miR-211-5p promotes neuronal apoptosis via Efemp2 inhibition. Summary statement: This study revealed the significance of sevoflurane-induced increases in miR-211-5p on the promotion of neuronal apoptosis via inhibition of Efemp2 and its downstream targets.

First-line Cemiplimab versus Standard Chemotherapy in Advanced Non-small Cell Lung Cancer Patients with at Least 50% Programmed Cell Death Receptor Ligand-1 Positivity: Analysis of Cost-effectiveness

AIMS

The EMPOWER-Lung 1 trial showed that cemiplimab significantly prolongs the duration of progression-free survival and overall survival in advanced non-small cell lung cancer (NSCLC) patients with at least 50% programmed cell death receptor ligand-1 (PD-L1) positivity, yet the financial burden may limit its use. The aim of the present study was to evaluate the cost-effectiveness of cemiplimab versus chemotherapy in a US setting.

MATERIALS AND METHODS

A Markov model, with three mutually exclusive health states, was used to compare the expected health outcomes and cost of cemiplimab with chemotherapy. Survival data and transition probabilities were collected from the EMPOWER-Lung 1 trial. Utility values and costs are publicly available from open sources. One-way and probabilistic sensitivity analyses were conducted in both the whole population and subgroups to test the robustness of the parameters and structure.

RESULTS

Treatment of NSCLC with cemiplimab yielded an extra 1.07 quality-adjusted life years (QALYs) at an additional cost of $98 211 compared with chemotherapy, associated with an incremental cost-effectiveness ratio of $91 891/QALY and an incremental net health benefit of 0.087 QALYs at a willingness to pay threshold of $100 000/QALY. The probabilistic sensitivity analysis indicated that cemiplimab provided an 83.2% probability of being cost-effective. One-way sensitivity analysis suggested that the price of cemiplimab was the chief driver in this model. A subgroup analysis showed that cemiplimab was the preferred incremental net health benefit in more than half of the subgroups, including patients with squamous type disease and metastases.

CONCLUSIONS

Cemiplimab is a cost-effective option in the first-line treatment of NSCLC in patients who are at least 50% PD-L1 positive from an American perspective.

[Advances in clinical application of obstruction catheter in prevention and treatment of intestinal obstruction]

Intestinal obstruction is one of the most common diseases in abdominal surgery, and its prevention and treatment is a clinical difficulty. Although surgical operation can solve the symptoms of obstruction, there are many postoperative complications, and it is easy to develop re-obstruction due to postoperative abdominal adhesion. The internal fixation of small intestine with obstruction catheter provides a new idea for the prevention of postoperative adhesive bowel obstruction. The use of transanal ileus catheter provides the possibility of direct intestinal anastomosis after resection of malignant obstruction in the left hemicolon and can reduce the incidence of postoperative complications. However, sufficient attention should be paid to the related complications, and prevention and treatment should be planned. It is important to note that the use of obstruction catheter is only one of the conservative treatments for bowel obstruction, and it is not a complete replacement of surgery. Surgical treatment should still be considered, if the catheter fails to significantly move, if the obstructive symptoms do not significantly improve 5 days after catheterization.

Modification of Enteromorpha prolifera with dielectric barrier discharge plasma to enhance malachite green adsorption

Dyes, a kind of visible chemical, have severe deleterious effects on human health and ecological environment. In this work, batch biosorption experiments were carried out under various experimental conditions such as pH value and agitation time to optimize the potentiality of Enteromorpha prolifera for the removal of malachite green (MG) dye from aqueous solution (70·7%). Then, the algal biomass was treated with a dielectric barrier discharge (DBD) in helium for 4 and 10 min to enhance MG removal efficiency (84·7 and 96·6%). In addition, Fourier-transform infrared spectroscopy in combination with scanning electron microscopy was employed to monitor the chemical and physical changes of algal cells treated by DBD. This study illustrates that DBD may serve as an effective tool to activate the functional groups on the cell wall surface for dye binding, and it even offers an alternative new technique to improve the adsorption properties of native biosorbents for the removal of toxic dyes from wastewater.

The association between methylation in specific cpg sites of slc6a4 gene promoter region and prognosis of acs patients with different level of burnout

Background

Given that psychosocial disorders like depression and burnout are top causes of disease burden, meanwhile have negative effect on the prognosis of acute coronary syndrome (ACS), many studies mounted on their pathogenesis. Recently, epigenetic modifications of stress-related genes like serotonin transporter gene (SLC6A4) have been found to be involved in these disease courses, but the study to investigate the influence of methylation of SLC6A4 gene on the association of these disorders and prognosis of ACS is not found.

Objectives

To investigate the association of methylation of SLC6A4 gene and prognosis of patients with ACS who were in different level of burnout.

Methods

Patients with first onset of ACS were enrolled, and their blood sample, demographic and clinical data were collected. Then they were evaluated baseline level of burnout, anxiety, depression, quality of life and heart rate variability (HRV) before discharge, by Copenhagen Burnout Inventory (CBI), Hospital Anxiety and Depression Scale (HADS), 8-item Short Form Generic Health-Related Quality-of-life Questionnaire (SF-8), Seattle Angina Questionnaire (SAQ) and ambulatory electrocardiogram (24h-AECG) respectively. At one-month and six-month's follow-up, their physical performance was evaluated by Short Physical Performance Battery (SPPB) and same indices above were assessed repeatedly. Genomic DNA was extracted from whole blood, and methylation level in 11 CpG sites of SLC6A4 gene promotor region were tested by bisulfite sequencing PCR (BSP) technique. Last, the associations among burnout, anxiety, depression, and their interactions with methylation were analyzed by IBM SPSS Statistics 24.0, so as the association of methylation and the prognosis of ACS.

Results

74 patients were enrolled. Chi-square test implied that methylation of CpG7 was more obvious in non-anxiety group compared to anxiety group. And log linear model was used to explore the association among burnout, anxiety, depression, and their interactions with methylation, only the interaction of non-methylation of CpG7 and anxiety was positively correlated to the distribution of frequency. Next, five CpG sites (CpG6–10) were included in generalized estimating equations (GEEs) to analyze the association of methylation and prognosis indices of ACS patients. Results showed that methylation of CpG7 was positively correlated to standard diviation of NN intervals (SDNN), square root of the mean squared differences of successive NN intervals (RMSSD), high frequency (HF), low frequency (LF), very low frequency (VLF), total power (TP), and no significant relations were found among the score of SPPB, SF-8, SAQ and methylation.

Conclusions

Methylation in CpG7 of SLC6A4 gene promotor region may foretell a good prognosis of ACS patients by being correlated to less anxiety. Epigenetic modifications could be promising biomarkers to help identifying people that need special rehabilitation strategy.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): Nature Science Foundation of Yunnan Province; Yunnan Health Training Project of High Level Talents

Host inflammatory response is the major marker of severe respiratory syncytial virus infection in older adults

OBJECTIVES

We aim to study the viral kinetics and host inflammatory response of RSV infection in older adults, and their correlation with disease severity.

METHODS

We performed a prospective observational study in adults with RSV infection. We serially collected nasal-throat swabs for quantification of RSV-A and RSV-B viral load, and peripheral blood samples for measurement of cytokine/chemokine concentrations. The study endpoints were (i) requiring supplemental oxygen therapy, and (ii) non-invasive ventilation, intensive care, or died within 30 days of admission. We performed multivariable logistic regression models to identify independent variables for severe disease.

RESULTS

We enrolled 71 hospitalized patients and 10 outpatients treated for RSV infection (median age 75 years, 51% male, and 74% with comorbidities). Among hospitalized patients, 61% required supplemental oxygen therapy, and 18% had severe disease requiring non-invasive ventilation or intensive care, or died within 30 days. Inflammatory cytokine/chemokines IL-6, CXCL8/IL-8, CXCL9/MIG and CXCL10/IP-10 increased significantly during the acute phase of illness. IL-6 concentration was independently associated with severe disease after adjusting for confounding factors. RSV viral load was not associated with disease severity throughout the course of illness.

CONCLUSION

Host inflammatory response is a major marker of severe disease in older adults with RSV infection.

Cell depleted areas do not repopulate after diphtheria toxin-induced killing of mandibular cartilage chondrocytes

OBJECTIVE

Growth of mandibular condylar cartilage (MCC) is associated with cell proliferation within the polymorphic cell layer and subsequent differentiation into chondrocytes that reside along the condylar surface and along the cartilage/subchondral bone interface. We examined whether cells in the polymorphic layer would proliferate and repopulate toxin-induced cell-depleted areas in MCCs of adult mice.

METHOD

We induced diphtheria toxin (DTA) expression (ROSA26l-s-lDTA) to cell-autonomously kill large fractions of MCC chondrocytes throughout the cartilage or along the articular cartilage surface with Aggrecan-CreERt2 (AcanCreERt2) or Lubricin-CreERt2 (Prg4CreERt2) Cre-recombinase-inducible mice, respectively. We examined MCCs from these mice shortly after cell killing or several months later with histology and confocal microscopy for evidence of chondrocyte proliferation and repopulation.

RESULTS

AcanCreERt2-induced DTA expression killed an average of 53% MCC chondrocytes in adult mice after 1 week (39-66%, 95% confidence interval (CI)). Twelve weeks later, surviving chondrocytes had proliferated but not migrated to cell depleted areas. Prg4CreERt2-induced DTA expression killed an average of 24% surface chondrocytes in mice after 5 weeks (14-34% CI). After thirteen weeks there was 34% fewer surface chondrocytes (4-63% CI) in Prg4CreERt2 DTA-induced mice compared to controls.

CONCLUSION

In adult mice, after diphtheria toxin-mediated chondrocyte killing, cell depleted areas within MCC cartilage are not repopulated by new cells.

Search for New Phenomena in Final States with Two Leptons and One or No b-Tagged Jets at sqrt[s]=13 TeV Using the ATLAS Detector

A search for new phenomena is presented in final states with two leptons and one or no b-tagged jets. The event selection requires the two leptons to have opposite charge, the same flavor (electrons or muons), and a large invariant mass. The analysis is based on the full run-2 proton-proton collision dataset recorded at a center-of-mass energy of sqrt[s]=13  TeV by the ATLAS experiment at the LHC, corresponding to an integrated luminosity of 139  fb^{-1}. No significant deviation from the expected background is observed in the data. Inspired by the B-meson decay anomalies, a four-fermion contact interaction between two quarks (b, s) and two leptons (ee or μμ) is used as a benchmark signal model, which is characterized by the energy scale and coupling, Λ and g_{*}, respectively. Contact interactions with Λ/g_{*} lower than 2.0 (2.4) TeV are excluded for electrons (muons) at the 95% confidence level, still far below the value that is favored by the B-meson decay anomalies. Model-independent limits are set as a function of the minimum dilepton invariant mass, which allow the results to be reinterpreted in various signal scenarios.

[Summary of research methods of stroke disease burden in big data era]

Stroke has high disability rate and high mortality rate, resulting in huge disease burden to society and individuals. In the context of highly informationization of global health system, countries have built and improved various public health information platform to provide support for health decision-making through public health information collection, classification, extraction, analysis and sharing in the research of disease burden of stroke. Based on the retrieval of domestic and foreign literatures, this paper summarizes the research methods of stroke-caused disease burden and its public health information sources in China, evaluates the significance of public health as well as the limitations of each research method of disease burden and describes the application and development of stroke-caused disease burden big data platform in the world, and provide suggestions for establishing a more modern and information-based stroke-caused disease burden evaluation system in China by analyzing the limitations of the existing stroke-caused disease burden evaluation system.

[Association between alcohol consumption and insomnia in employed floating population in China]

Objective: To explore the relationship between alcohol consumption and insomnia among 18-59 years old employed floating population in mainland China, and provide scientific basis for the relevant policies to improve the sleep status of employed floating population from the perspective of alcohol consumption. Methods: Data were from Chinese Floating Population Chronic Disease Surveillance (2012). Floating population were selected from industries in 170 counties and districts of 31 provinces/autonomous regions, and Xinjiang Construction Corps in mainland China by using the stratified multistage cluster sampling. Demographic information, behavioral risk factors, insomnia, social pressure and chronic diseases were collected through using the face-to-face questionnaire. After complex weighting of the data, a multivariable logistic regression was used to explore the sleep status and its influencing factors among the employed floating population. Results: A total of 48 499 subjects were included in the analysis. The proportions of the employed floating population who never drank alcohol, drank small amount, and drank excessively were 48.3%, 41.8% and 9.9%, respectively. The prevalence of insomnia among the general, male and female employed floating population was 28.6%, 25.8% and 32.3%, respectively. The prevalence of insomnia among the employed floating population aged between 45 and 59 years old (32.2%) was higher than that in the population aged between 18 and 44 years old (28.2%). The multivariable logistic regression analysis showed that after adjusting confounding factors, compared with the employed floating population who never consumed alcohol as the reference group, the OR values of insomnia for the employed floating population with moderate drinking and excessive drinking were 1.40 and 1.53, respectively. The OR values of insomnia for the male and female employed floating population with moderate drinking were 1.28 and 1.53. The OR values of insomnia for the male and female employed floating population with excessive drinking were both 1.46. The OR values of insomnia for the population aged 18-44 years and 45-59 years with excessive drinking were 1.41 and 1.27. The OR values of insomnia for the population aged 18-44 years and 45-59 years with excessive drinking were 1.55 and 1.37. Conclusion: Small amount of drinking and excessive drinking are associated with insomnia among the employed floating population in mainland China. The association between excessive drinking and insomnia is stronger than that between small amount of drinking and insomnia.

Mineral deposition intervention through reduction of phosphorus intake suppresses osteoarthritic lesions in temporomandibular joint

OBJECTIVE

To explore the suppressing impact of low phosphorus intake on osteoarthritic temporomandibular joint and the possible mechanisms of nuclear acid injury in the insulted chondrocytes.

DESIGN

Chondrocytes were loaded with fluid flow shear stress (FFSS) with or without low phosphorus medium. Seventy-two mice (sampled at 3-, 7- and 11-wk, n = 6) and forty-eight rats (sampled at 12-wks for different testing purpose, n = 6) were applied with unilateral anterior crossbite (UAC) with or without low phosphorus diet. In the FFSS model, the Ca and P content, molecules related to nucleic acid degradation and the mineral-producing responses in chondrocytes were detected. The effect of culture dish stiffness on chondrocytes osteogenic differentiation was measured. In the UAC model, the content of Ca and P in serum were tested. The condylar cartilage ossification and stiffness were detected using micro-CT, scanning electron microscope and atomic force microscope.

RESULTS

FFSS induced nucleic acid degradation, Pi accumulation and mineral-producing responses in the cultured chondrocytes, all were alleviated by low P medium. Stiffer dish bottoms promoted the osteogenic differentiation of the cultured chondrocytes. UAC stimulated cartilage degeneration and chondrocytes nucleic acid damage, increased PARP 1 and serum P content, and enhanced ossification and stiffening of the cartilage, all were suppressed by low phosphorus diet (all, P < 0.05).

CONCLUSION

Nucleic acid damage takes a role in phosphorus production in osteoarthritic cartilage, contributing to the enhanced mineralization and stiffness of the cartilage that in turn promotes cartilage degradation, which can be alleviated by low phosphorus intake.

Perceived stress and possible stressors in the general public in China during the COVID-19 pandemic

Background

The COVID-19 pandemic is spreading worldwide and a study found that front-line medical staff reported high levels of perceived stress during this pandemic. However, some findings indicated that the general public had more psychological problems than front-line medical staff. Therefore, the current study aimed to investigate perceived stress levels and to identify possible stressors affecting the general public in China during the severe stage of COVID-19 pandemic.

Methodology

An anonymous questionnaire survey was conducted online from February 18 to25, 2020, with 1921 Chinese people aged 18-68 years (M = 29.28, SD = 10.66).

Results

Most participants reported low to mild perceived stress levels. Moreover, social stressors (e.g., disruption of normal life), rather than physical (e.g., burdened work) or psychological stressors (e.g., worried about self-infection) were the most frequently reported stressors of the general public.

Conclusion

In summary, our findings addressed an ongoing relevant situation affecting nations, communities, and individuals worldwide, and provided suggestions to regulate the perceived stress in the general public.

Transcript profiles analysis of citrus aquaporins in response to fruit water loss during storage

Water loss is an essential factor that affects the maintenance of quality of citrus fruit during postharvest handling and storage. Aquaporins (AQPs) play an important role in the transport of water across membranes. However, the expression profiling of AQPs is incomplete for citrus fruits during storage. In this study, a post-harvest storage experiment was performed using sweet orange fruits to determine changes in water loss and fruit quality. Also, genome-wide expression analysis of CsAQP genes was carried out in fruit of different citrus varieties during storage. Low humidity storage conditions accelerated the postharvest water loss and texture decline and increased the TSS content in the fruit. A total of 39 non-redundant CsAQP genes were identified. A comprehensive analysis of these genes demonstrated that all AQPs had conserved filter motifs in the different citrus varieties examined. Moreover, multiple expression analysis revealed AQPs had complex expression profiles upon water loss in citrus fruit, being time-specific in tight-skin varieties (orange and pomelo varieties), tissue-specific between peel and pulp, and variety-specific between loose-skin (mandarin varieties) and tight-skin varieties (such as sweet orange and pummelo). These results indicated that the relative humidity in storage environment affected the postharvest water loss and quality of citrus fruit. Besides, the alternation in AQPs expression may partially account for the different water loss ratio in citrus varieties and the transfer of water between the peel and the pulp of citrus fruit during storage.

[Objective sleep characteristics and risk factors for sleep apnea in heart failure patients with different left ventricular ejection fraction]

OBJECTIVE

To investigate the objective sleep characteristics and the independent risk factors for sleep apnea in heart failure (HF) patients with different left ventricular ejection fractions (LVEF).

METHODS

A total of 107 patients with chronic HF hospitalized in the Department of Cardiology of our hospital from April, 2019 to October, 2020 were included in this study. According to the LVEF measured by echocardiography, the patients were divided into reduced ejection fraction (HFrEF) group (n=35), mid-range ejection fraction (HFmrEF) group (n=21), and preserved ejection fraction (HFpEF) group (n=51). The baseline demographic and clinical characteristics of the patients were recorded. To assess the objective sleep characteristics, whole night polysomnography was scheduled for all the patients. Spearman correlation and multinomial logistic regression analyses were used to explore the factors affecting objective sleep characteristics.

RESULTS

The patients in HFpEF group had significantly lower proportion of non-rapid eye movement sleep stage 1, apnea hypopnea index (AHI), and central sleep apnea (CSA) than those in HFrEF group (all P < 0.05). The baseline demographic data or sleep structures in HFmrEF group did not differ significantly from those in the other two groups. Spearman correlation analysis revealed significant correlations of the male sex, diuretics use, NT-proBNP, LVEF, and total cholesterol levels with the severity of AHI (all P < 0.05). After adjusting for potential confounders, multiple logistics regression analysis showed that age, drinking, and LVEF levels were independently associated with the severity of AHI (all P < 0.05).

CONCLUSION

Abnormal objective sleep architectures occur in all HF patients, manifested mainly by sleep apnea. The incidences of sleep apnea and CSA are lower in patients with HFpEF than in those with HFrEF. Age, drinking, and LVEF levels are independent risk factors for the occurrence and severity of sleep apnea.

[Cost-effectiveness of anti-tumor associated antigen autoantibody screening for hepatocellular carcinoma in the population with chronic hepatitis B-related cirrhosis]

Objective: To evaluate the cost-effectiveness of anti-tumor associated antigen autoantibody (TAAb) for hepatocellular carcinoma (HCC) screening in cirrhosis population with chronic hepatitis B (CHB). Methods: A simulated cohort of 40-year-old patients with CHB cirrhosis was established with a sample size of 10 000. Using TAAb screening alone or TAAb and AFP screening in parallel (TAAb + AFP) as the research strategy, and liver ultrasound and AFP screening in parallel (liver ultrasound + AFP) as the control strategy, the decision analysis Markov model was constructed and the model validity was evaluated. The 6-month cycle was simulated using TreeAge Pro 2020 software. Cost and quality-adjusted life years (QALY) were calculated. Incremental cost-effectiveness ratio (ICER) was used to compare the two strategies, and sensitivity analysis was used to evaluate the uncertainty of results. Results: The Markov model had a total of 11 outcomes, of which 7 were natural outcomes and 4 wereclinical intervention outcomes, and the goodness of fit was 0.969. The lifetime screening cost of TAAb+AFP strategy for HCC screening was 249 612 yuan/case, and the QALY per capita was 7.704 years. Compared with liver ultrasound +AFP strategy (247 805 yuan/case), the total health cost increased by 1 807 yuan/case, and the QALY obtained was 0.014. The ICER was 127 635 yuan /QALY. When the TAAb screening fee was higher than 889.552 yuan, or the discount rate was higher than 0.068, or the antiviral treatment compliance was lower than 45.1%, ICER > 212 676 yuan /QALY. When the single TAAb screening fee was 400-600 yuan, the TAAB+AFP strategy had cost effective value. When the willingness to pay was 70 892, 141 784 and 212 676 yuan /QALY, the probability of cost-effectiveness of TAAb+AFP strategy was 70.6%, 75.3% and 77.8%, respectively. Conclusion: It is cost-effective to use TAAb+AFP for early screening of liver cancer in Chinese population with CHB cirrhosis.

Flupentixol/melitracen for chronic refractory cough after treatment failure with other neuromodulators

BACKGROUND: Gabapentin and baclofen are recommended for the treatment of chronic refractory cough (CRC). We investigated the efficacy of flupentixol/melitracen in patients unresponsive to these neuromodulators.METHODS: A total of 101 patients with CRC who failed to respond to gabapentin and baclofen were recruited, and treated with flupentixol/melitracen. The prevalence of cough resolution and changes in the Cough Symptom Score (CSS), cough thresholds to capsaicin, Hull Airway Reflux Questionnaire (HARQ), Leicester Cough Questionnaire (LCQ), Generalized Anxiety Disorder-7, Hamilton Anxiety Rating Scale, Patient Health Questionnaire-9, and Hamilton Depression Rating Scale-24 were evaluated after treatment.RESULTS: Ninety-eight patients (97.0%) completed the study. The overall successful cough resolution rate was 62.4% (63/101). Cough resolution was accompanied by an obvious decrease in the CSS and HARQ score and a remarkable increase in cough thresholds to capsaicin challenge and LCQ score, whereas anxiety and depression scores did not change significantly. The prevalence of adverse effects (e.g., insomnia and dizziness) was 21.8%. The prevalence of cough recurrence within 2 weeks after treatment cessation was 17.8%.CONCLUSION: Flupentixol/melitracen may be an efficacious option for CRC unresponsive to other neuromodulators.

[The value of serum cystatin C for the evaluation of renal function damage in patients with proliferative diabetic retinopathy]

Objective: To investigate the value of serum cystatin C for the evaluation of renal function damage in patients with proliferative diabetic retinopathy (PDR). Methods: The clinical data of PDR patients treated in ophthalmic wards of Beijing Tongren Hospital from July 2019 to January 2021 were retrospectively analyzed. The estimated glomerular filtration rate (eGFR) was calculated by the abbreviated Modification of Diet in Renal Disease (MDRD) study equation. Based on the eGFR level, the patients were divided into no obvious renal function damage group [≥ 60 ml·min⁻¹·(1.73 m²)⁻¹] and renal inadequacy group [<60 ml·min⁻¹·(1.73 m²)⁻¹]. The clinical characteristics between the two groups were compared. Multivariate logistic regression analysis was performed to identify the relevant factors of renal inadequacy. The value of cystatin C to predict the renal inadequacy was calculated by the receiver operating characteristic (ROC) curves. Results: A total of 1 009 patients [593 males and 416 females; mean age: (52±12) years] were finally included in the study, with 192 cases (19.0%) and 817 cases (81.0%) in renal inadequacy group and no obvious renal function damage group, respectively. There were no significant statistically differences in gender, age, diastolic blood pressure, body mass index, fasting blood glucose and low-density lipoprotein between the two groups (all P>0.05). The systolic blood pressure, blood urea nitrogen, creatinine, uric acid, triglyceride, cholesterol and cystatin C were higher in the renal inadequacy group than those of no obvious renal function damage group (all P<0.05). However, the glycosylated hemoglobin, albumin and high-density lipoprotein were lower in the renal inadequacy group (all P<0.05). Multivariate logistic regression analysis showed that serum creatinine (OR=1.189, 95%CI: 1.101-1.284, P<0.001) and cystatin C (OR=3.175, 95%CI: 1.272-7.923, P=0.013) were independent risk factors for renal inadequacy in PDR patients. The ROC curve showed that cystatin C had a predictive value for renal inadequacy, with an area under the curve (AUC) of 0.966 (95%CI: 0.952-0.979). Meanwhile, the cutoff value was 1.315 mg/L, and the Youden index was 0.826, with the sensitivity of 94.3% and specificity of 88.4%. Conclusion: Serum cystatin C can be used as an important laboratory indicator to evaluate the renal impairment in PDR patients.