Downregulation of long noncoding RNA TUSC7 promoted cell growth, invasion and migration through sponging with miR-616-5p/GSK3β pathway in ovarian cancer

OBJECTIVE

Long non-coding RNAs (lncRNAs) can serve as prognostic markers for cancer patients, including ovarian cancer. The objective of this study was to explore the potential functions and mechanisms of lncRNA-TUSC7 in ovarian cancer.

PATIENTS AND METHODS

RT-PCR or Western blot (WB) was performed to detect expressions of TUSC7, miR-616-5p and GSK3β in ovarian cancer tissues, adjacent normal tissues and ovarian cancer cell lines. Correlation analysis was performed to analyze the correlations between TUSC7 and miR-616-5p, miR-616-5p and GSK3β, TUSC7 and GSK3β. Furthermore, Kaplan-Meier survival analysis was used to analyze overall survival (OS) of patients with TUSC7 low and high expression. Besides, CCK-8 assay was carried out to measure cell proliferation ability and transwell assay was used to measure cell invasion and migration abilities. In addition, WB was performed to measure protein levels in ovarian cancer tissues and ovarian cancer cell lines. Finally, Luciferase reporter assay was performed to verify the binding sites between TUSC7 and miR-616-5p, miR-616-5p and GSK3β.

RESULTS

In this study, we first found that TUSC7 was significantly reduced in ovarian cancer tissues, which was associated with advanced stage and poor diagnosis for ovarian cancer patients. MiR-616-5p was increased in ovarian cancer tissues and cancer cell lines, which was negatively correlated with TUSC7 and GSK3β. GSK3β was found to be reduced in ovarian cancer tissues, which was positively correlated with TUSC7. Of note, we found that TUSC7 overexpression inhibited cell proliferation, invasion and migration in SKOV3 cells. Moreover, protein expressions of Cyclin D1, N-cadherin, Vimentin, MMP-9 and MMP-2 were also repressed. Notably, Luciferase reporter assay proved that TUSC7 could directly sponge with miR-616-5p, which could directly bind with GSK3β, a tumor suppressor, regulating the β-catenin signaling. Finally, we proved that TUSC7 regulated cell proliferation, invasion and migration via miR-616-5p/GSK3β signaling pathway in SKOV3 cells.

CONCLUSIONS

According to the results, our study revealed that TUSC7 was repressed in patients with ovarian cancer, which might be used as a prognostic factor for ovarian cancer patients. Furthermore, we first discovered that the reduced TUSC7 promoted cell proliferation, invasion and migration of ovarian cancer via miR-616-5p/GSK3β/β-catenin pathway, which might provide a novel promising therapeutic target for ovarian cancer.

[China guideline for the screening and early detection of female breast cancer(2021, Beijing)]

Breast cancer is the commonest malignant tumor among Chinese females, ranking first in terms of incidence of female cancers. Commissioned by the Disease Prevention and Control Bureau of National Health Commission of the People's Republic of China, the National Cancer Center formulated the Guideline for Screening and Early Diagnosis and Treatment of Female Breast Cancer in China according to WHO Handbook for Guideline Development. The methods on Cochrane China were referred to for the formulation of the system evaluation procedures. The GRADE methods for assessment, formulation and evaluation were adopted for the classification of evidence quality and recommendation strength, and the items were reported according to Reporting Items for Practice Guidelines in Healthcare. Based on the results of evaluation, the guideline gives evidence-based recommendations for the appropriate population and technical procedures for breast cancer screening and early diagnosis and treatment after comprehensive consideration of China's national conditions, the advantages and disadvantages of the evidence, the quality of the evidence, the economic cost of screening, the feedback of multidisciplinary clinical research respondents, and in-person expert consensus. It is aimed at regulating the practices of female breast cancer screening and early diagnosis and treatment and enhancing the effectiveness of the prevention and control of female breast cancer in China.

Tobacco smoking confers risk for severe COVID-19 unexplainable by pulmonary imaging

BACKGROUND

COVID-19 is a new pneumonia. It has been hypothesized that tobacco smoking history may increase severity of this disease in the patients once infected by the underlying coronavirus SARS-CoV-2 because smoking and COVID-19 both cause lung damage. However, this hypothesis has not been tested.

OBJECTIVE

Current study was designed to focus on smoking history in patients with COVID-19 and test this hypothesis that tobacco smoking history increases risk for severe COVID-19 by damaging the lungs.

METHODS AND RESULTS

This was a single-site, retrospective case series study of clinical associations, between epidemiological findings and clinical manifestations, radiographical or laboratory results. In our well-characterized cohort of 954 patients including 56 with tobacco smoking history, smoking history increased the risk for severe COVID-19 with an odds ratio (OR) of 5.5 (95% CI: 3.1-9.9; P = 7.3 × 10^-8 ). Meta-analysis of ten cohorts for 2891 patients together obtained an OR of 2.5 (95% CI: 1.9-3.3; P < 0.00001). Semi-quantitative analysis of lung images for each of five lobes revealed a significant difference in neither lung damage at first examination nor dynamics of the lung damage at different time-points of examinations between the smoking and nonsmoking groups. No significant differences were found either in laboratory results including D-dimer and C-reactive protein levels except different covariances for density of the immune cells lymphocyte (P = 3.8 × 10^-64 ) and neutrophil (P = 3.9 × 10^-46 ).

CONCLUSION

Tobacco smoking history increases the risk for great severity of COVID-19 but this risk is achieved unlikely by affecting the lungs.

[China guideline for the screening and early detection of lung cancer(2021, Beijing)]

In China, the malignant tumor with the highest incidence and motality is lung cancer (LC). As screening and early detection and treatment are effective in reducing LC mortality, formulating a guideline in line with China's national conditions for the screening and early detection and treatment of LC will greatly promote the homogeneity and accuracy of LC screening, and result in an improvement of the effectiveness of LC screening. Commissioned and directed by the Disease Prevention and Control Bureau of the National Health Commission of the People's Republic of China, the guidline was initiated by the National Cancer Center of China and formulated with joint effort by experts from different disciplines. Following the principles and methods in WHO Handbook for Guideline Development, the guidline integrates the latest development in LC screening and early diagnosis and treatment worldwide while fully considering China's national conditions and practical experience in LC screening. It provides detailed evidence-based recommendations for different aspects of LC screening, such as the targeted population, the technologies and the procedures, to regulate the practices of LC screening and early diagnosis and treatment and enhance the effectiveness of the prevention and control of LC in China.

Association between hsa_circ_0006156 expression and incidence of gastric cancer

OBJECTIVE

To screen the differentially expressed circular ribonucleic acids (circRNAs) related to gastric cancer and to explore their associations with the clinicopathological features of gastric cancer.

PATIENTS AND METHODS

Cancer tissues of 50 gastric cancer patients undergoing surgical resection in our hospital from April 2015 to December 2018 were collected as an experimental group, while the para-carcinoma tissues were used as the control group. First, the differentially expressed circRNAs were screened by analyzing the circRNA profile in the microarray. Then, the expression of hsa_circ_0006156 in tissues was detected via Reverse Transcription-quantitative Polymerase Chain Reaction (RT-qPCR) in both groups. The potential associations of the relative expression level of hsa_circ_0006156 with clinicopathological features and prognosis were analyzed according to the clinical data of gastric cancer patients.

RESULTS

Six significantly downregulated circRNAs in gastric cancer patients were screened out. The results of RT-qPCR showed that the expression level of hsa_circ_0006156 was significantly lower in gastric cancer tissues than that in para-carcinoma tissues (p<0.05). Accordingly, 50 gastric cancer patients were divided into hsa_circ_0006156 high expression group and hsa_circ_0006156 low expression group based on the fold change of hsa_circ_0006156 in para-carcinoma tissues than that of gastric cancer tissues (fold change>3). The expression level of hsa_circ_0006156 was not correlated with the age and gender of gastric cancer patients (p>0.05) but correlated with the lymph node metastasis (p<0.05), nerve invasion (p<0.05), and degree of tumor differentiation (p<0.05). The expression level of hsa_circ_0006156 was also significantly associated with the progression-free survival (PFS) and overall survival (OS) of patients (p<0.05). According to the multivariate analysis of variance, the PFS of gastric cancer patients was associated with nerve invasion, lymph node metastasis, and hsa_circ_0006156 expression (relative risk coefficient=1.742, 2.329, and 3.003). Meanwhile, the OS was associated with lymph node metastasis, nerve invasion, degree of tumor differentiation, and hsa_circ_0006156 expression (relative risk coefficient =1.604, 2.405, 2.114, and 2.004). Moreover, the survival analysis revealed that PFS was markedly prolonged in the hsa_circ_0006156 high expression group compared with that in the hsa_circ_0006156 low expression group.

CONCLUSIONS

The expression of hsa_circ_0006156 substantially declines in gastric cancer tissues, which is related to the differentiation degree, presence, or absence of lymph node metastasis and prognosis of gastric cancer patients. Therefore, hsa_circ_0006156 may clinically serve as a biomarker for the prognostic prediction of gastric cancer patients.

[Effect of HBV infection pattern on prevalence of fatty liver disease in Jinchang cohort]

Objective: To investigate the influence of HBV infection on the prevalence of fatty liver disease in Jinchang cohort and provide theoretical evidence for the prevention and treatment of fatty liver disease. Methods: Epidemiological investigation, laboratory examination and abdominal ultrasound were conducted in the baseline population of Jinchang cohort to collect the basic data, the differences in the prevalence of fatty liver disease under different HBV infection patterns were described and compared and the influence of different HBV infection patterns on the prevalence of fatty liver disease were evaluated by using logistic regression analysis. Results: The baseline Jinchang cohort population totaled 45 605, including 27 917 males and 17 688 females. The male to female ratio was 1.6∶1. The mean age of the overall population was 46.49 years. Among the 8 common HBV infection modes in the Jinchang cohort, the prevalence of fatty liver was low in HBsAg, HBeAg and HBcAb positive, HBsAg and HBcAb positive, and HBsAg, HBeAb and HBcAb positive groups. For 4 serum markers of HBV infection, the prevalence of fatty liver disease in HBsAg and HBeAg positive groups was lower than that in HBsAg and HBeAg negative groups. Logistic regression analysis showed that being HBsAg and HBcAb positive (OR=0.61, 95%CI: 0.39-0.98) and HBsAg, HBeAg and HBcAb positive (OR=0.52, 95%CI: 0.30-0.89) could reduce the risk for fatty liver disease. Conclusion: Acute HBV infection reduces the prevalence of fatty liver disease, and the reason may be related to the disturbance of the body's fat metabolism by active HBV replication.

[Analysis on influencing factors for nonalcoholic fatty liver disease in Jinchang cohort]

Objective: To explore the influencing factors for non-alcoholic fatty liver disease (NAFLD) in Jinchang cohort, and provide scientific basis for the prevention and control of NAFLD. Methods: A total of 20 051 patients without fatty liver at baseline survey and met the inclusion criteria in Jinchang cohort were selected as study subjects. Prospective cohort study and Cox regression analysis were used to investigate the influencing factors for NAFLD, and the dose-response relationship between related biochemical indicators and NAFLD risk was studied by restricted cubic spline method. Results: The incidence of NAFLD was 42.37/1 000 person years. Multivariate Cox regression analysis showed that being worker and technical personnel (being worker:HR=0.84,95%CI:0.70-0.99;being technical personnel:HR=0.73,95%CI:0.56-0.95), tea drinking (current drinking:HR=0.86,95%CI:0.78-0.94;previous drinking: HR=0.52,95%CI: 0.31-0.86), exercise (occasionally: HR=0.79, 95%CI: 0.68-0.91;frequently:HR=0.60,95%CI:0.52-0.69), low body weight (HR=0.10, 95%CI: 0.05-0.22), daily intake of dairy products >300 ml/day (HR=0.78, 95%CI: 0.71-0.87) and HBV infection (HR=0.77, 95%CI: 0.60-0.99) were the protective factors for NAFLD, while being internal or office workers (HR=1.84, 95%CI: 1.46-2.31), income ≥2 000 yuan (2 000- yuan: HR=1.32, 95%CI: 1.04-1.66; ≥5 000 yuan: HR=1.72, 95%CI:1.11-2.66), bachelor degree or above (HR=1.35,95%CI:1.03-1.76), overweight (HR=2.31, 95%CI:2.08-2.55), obesity (HR=3.95, 95%CI: 3.42-4.56), impaired fasting blood glucose (HR=1.31, 95%CI:1.17-1.47), diabetes (HR=1.53, 95%CI: 1.30-1.80), increased TC (HR=1.37,95%CI:1.24-1.52), increased TG (HR=1.79,95%CI: 1.62-1.98), decreased HDL-C (HR=1.29, 95%CI: 1.14-1.45), increased ALT (HR=1.13, 95%CI: 1.01-1.26) and high-fat diet (HR=1.24, 95%CI: 1.11-1.40) were the risk factors for NAFLD. Moreover, TC, TG, HDL-C, ALT and FPG all showed good dose-response relationship with the incidence of NAFLD. Conclusion: Occupation, education level, income level, tea drinking, exercise, BMI, FPG, blood lipid, ALT, HBV infection and diet were related to the incidence of NAFLD.

[Quality assessment of global colorectal cancer screening guidelines and consensus]

Objective: To systematically evaluate the methodology and reporting quality of colorectal cancer (CRC) screening guidelines/consensus and provide lights for drafting CRC screening guidelines in China. Methods: The literature retrieval for all the Chinese and English guidelines published before September 1^st, 2020 was conducted by using Chinese/English databases, such as China National Knowledge Infrastructure, Wanfang Data, VIP, SinoMed, PubMed, Embase, Web of Science, Cochrane Library, Guideline International Network, and supplement with the official website of multiple regions, such as the U.S. Preventive Services Task Force and American Cancer Society. We utilized The Appraisal of Guidelines for Research & Evaluation Ⅱ (AGREE Ⅱ) and Reporting Items for Practice Guidelines in Healthcare (RIGHT) approaches to assess the quality of CRC screening guidelines/consensus comprehensively. Results: After quality control, a total of 19 guidelines/consensus released by the United States, China, Australia, Canada, Britain, South Korea, and International organizations are successfully included, and strikingly, most of those belong to the United State(7). The results of the AGREE Ⅱ quality evaluation show that the average scores of scope and purpose (87.5%) and clarity of presentation (89.6%) are high. In contrast, there are deficient in stakeholder involvement (47.0%), the rigor of development (42.3%), applicability (47.5%), and editorial independence (50.2%). Among all the guidelines, there are 12 with an overall score of 50 or more, 13 with a recommendation level of "A", 2 with a rating of "B" and 4 with a rating of "C". Additionally, the RIGHT evaluation revealed that the average report rate in each field is necessary information (76.3%), background (77.0%), evidence (55.8%), recommendations (59.4%), review and quality assurance (26.3%), funding and declaration and management of interests (43.4%), other information (49.1%). Among all the guidelines, six have good reporting quality, whereas the additional 13 have general or weak evidence. Furthermore, subgroup analysis indicates that the quality of guidelines in developed countries is superior to that of China. Conclusion: The number of CRC screening guidelines/consensus is increasing gradually, and the overall quality of those is high, but the normative nature is warranted to be strengthened.

[Quality assessment of global lung cancer screening guidelines and consensus]

Objective: To understand the research progress and quality of lung cancer screening guidelines and consensus in China and abroad, and to provide reference for the formulation of high-quality lung cancer screening guidelines in China. Methods: Databases including PubMed, Medline, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, SinoMed, VIP and Wanfang Data were searched, websites and important references were also searched by hand retrieval. The Appraisal of Guidelines for Research & Evaluation Ⅱ(AGREE Ⅱ) and Reporting Items for Practice Guidelines in Healthcare (RIGHT) were used to assess the quality of newly published or updated guidelines and consensus. Results: A total of 9 guidelines and consensus published between 2015 and 2020 were included in this study, with countries including the United States, China, Canada, Saudi Arabia and South Africa. The field of scope and purpose and clarity of presentation scored relatively high but the rigor of development and applicability scored low. Five guidelines were judged to be A-level, all of which were published abroad, and the remaining four were B-level, including three guidelines and consensus issued by China and 1 guideline issued by South Africa. The report rate of RIGHT were higher in basic information and background, lower in review and quality assurance, funding and declaration and management of interests. There were 5 guidelines with a good level and 4 guidelines and consensus with a moderate level. The best overall quality guidelines were those published by the American College of Chest Physicians in 2018 and by the Canadian Task Force on Preventive Health Care in 2016. Conclusions: The number of countries and institutions that issue lung cancer screening guidelines and consensus had been increasing gradually, but the quality in China remained low. It is necessary to develop high-quality lung cancer screening guidelines suitable for China's national conditions in combination with evidence-based methods to guide practice.

[Research progress of quality assessment of cancer screening guidelines and consensus]

Cancer screening is one of approaches to reduce cancer mortality. Standardized cancer screening technology guidelines are the main way to improve scientific standardization and internationalization. With the development of development methodology on guideline making, the number of local and international cancer screening guidelines increases, but the quality is still uneven. This article summarizes the progress of the quality of cancer screening guidelines. It promotes the opportunities and challenges of cancer screening guidelines to reference high-quality cancer screening services in the future in China.

Tracking and Monitoring Mood Stability of Patients With Major Depressive Disorder by Machine Learning Models Using Passive Digital Data: Prospective Naturalistic Multicenter Study

BACKGROUND

Major depressive disorder (MDD) is a common mental illness characterized by persistent sadness and a loss of interest in activities. Using smartphones and wearable devices to monitor the mental condition of patients with MDD has been examined in several studies. However, few studies have used passively collected data to monitor mood changes over time.

OBJECTIVE

The aim of this study is to examine the feasibility of monitoring mood status and stability of patients with MDD using machine learning models trained by passively collected data, including phone use data, sleep data, and step count data.

METHODS

We constructed 950 data samples representing time spans during three consecutive Patient Health Questionnaire-9 assessments. Each data sample was labeled as Steady or Mood Swing, with subgroups Steady-remission, Steady-depressed, Mood Swing-drastic, and Mood Swing-moderate based on patients' Patient Health Questionnaire-9 scores from three visits. A total of 252 features were extracted, and 4 feature selection models were applied; 6 different combinations of types of data were experimented with using 6 different machine learning models.

RESULTS

A total of 334 participants with MDD were enrolled in this study. The highest average accuracy of classification between Steady and Mood Swing was 76.67% (SD 8.47%) and that of recall was 90.44% (SD 6.93%), with features from all types of data being used. Among the 6 combinations of types of data we experimented with, the overall best combination was using call logs, sleep data, step count data, and heart rate data. The accuracies of predicting between Steady-remission and Mood Swing-drastic, Steady-remission and Mood Swing-moderate, and Steady-depressed and Mood Swing-drastic were over 80%, and the accuracy of predicting between Steady-depressed and Mood Swing-moderate and the overall Steady to Mood Swing classification accuracy were over 75%. Comparing all 6 aforementioned combinations, we found that the overall prediction accuracies between Steady-remission and Mood Swing (drastic and moderate) are better than those between Steady-depressed and Mood Swing (drastic and moderate).

CONCLUSIONS

Our proposed method could be used to monitor mood changes in patients with MDD with promising accuracy by using passively collected data, which can be used as a reference by doctors for adjusting treatment plans or for warning patients and their guardians of a relapse.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR1900021461; http://www.chictr.org.cn/showprojen.aspx?proj=36173.

A graphical method for breaking logical loops based on multi-tree structure

Logical loops or circular logics, interpreted as circular supporting relations among systems, remain a longstanding challenge in the probabilistic safety assessment (PSA). Logical loops are commonly found in complex industrial systems. Due to the existence of the logical loops, the minimal cut sets cannot be directly obtained. In order to solve this problem, the logical loops should be broken properly. This paper proposes a graphical method based on multi-tree structure. By constructing the simplified multi-tree, logical loops both in linearly and non-linearly interrelated systems are solved. To illustrate this method, examples of linearly interrelated systems and non-linearly interrelated systems are given in this paper. As a supplement, this method is applied to the well-known complex logical loops in the nuclear power plant. It shows that this method is highly intuitive and efficient by means of graphs.

[Progress on clinical trials of cancer drugs in China, 2020]

Objective: To explore the latest progress of oncology drug clinical trials in China under COVID-19, as well as to provide decision-making evidence for related stakeholders. Research progress of oncology drug trials and approved cancer drugs in China in 2020 were systematically summarized and compared with 2019. Methods: Information Disclosure Platform for Drug Clinical Studies and China Food and Drug Administration Query System for Domestic and Imported Drug were searched for registered clinical trials and approved oncology drugs, respectively. The trial scope, stage, drug type, effect and mechanism of domestic and global pharmaceutical enterprises were compared between 2019 and 2020. Results: A total of 722 cancer drug trials registered in China in 2020, with an annual growth rate of 52.3%, accounting for 28.3% of all registered trials. Among them, 603 (83.5%) trials were initiated by domestic pharmaceutical enterprises, and 105 (14.5%) were international multicenter trials, phase I trials accounted for 44.5%. For all those trials, there were 458 cancer drug varieties, with an annual growth rate of 36.7%, and 361 (85.8%) were developed by domestic enterprises. Most of the investigational products were therapeutic innovative drugs (77.1%), major in tumor treatment (92.8%). In terms of mechanism, targeted drugs were the most popular, accounting for 76.6%, and programmed cell death-1 (PD-1) and epithelial growth factor receptor (EGFR) were the most common targets. In addition, there were 19 anticancer drugs from 17 companies approved in China in 2019, with 10 drugs from domestic companies. Lung cancer and breast cancer are the most common indications for both registered trials and marketed drugs. No statistically significant differences were found between 2020 and 2019 in terms of the distribution of trial sponsor, scope and stage, as well as the distribution of drug type, effect and mechanism (P>0.05). Conclusions: During the Covid-19 epidemic period, clinical trials of oncology drugs in China progress smoothly and maintain a high growth rate. Series of innovative products obtained by domestic enterprises in 2020 is the main driving force of development of oncology drug clinical trials in China.

LncRNA NEAT1 accelerates the occurrence and development of diabetic nephropathy by sponging miR-23c

OBJECTIVE

LncRNA nuclear enriched abundant transcript 1 (NEAT1) has been reported to play an oncogenic role in the occurrence and development of diabetic nephropathy (DN). The aim of our study was to investigate the potential mechanism by which NEAT1 facilitates the progression of DN.

PATIENTS AND METHODS

Quantitative Real-time polymerase chain reaction (qRT-PCR) was carried out to determine the abundance of NEAT1, kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), proliferating cell nuclear antigen (PCNA), Cyclin D1, P38, apoptosis signal-regulating kinase 1 (ASK1), Fibronectin, α smooth muscle actin (α-SMA) and miR-23c in the serum of DN patients, normal patients and mouse mesangial cells (MMCs). Cell proliferation was assessed by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), qRT-PCR and Western blot assays. Flow cytometry and Western blot were applied to measure apoptosis of MMCs. Cell fibrosis and epithelial-to-mesenchymal transition (EMT) were analyzed by qRT-PCR and Western blot. The binding sites between miR-23c and NEAT1 were predicted by starBase bioinformatics software, and the relationship was verified by dual-luciferase reporter assay.

RESULTS

The enrichment of NEAT1 was elevated in the serum of DN patients and MMCs induced by high concentration of glucose. NEAT1 overexpression accelerated proliferation, fibrosis and EMT and restrained apoptosis of MMCs induced by high concentration of glucose. MiR-23c bound to NEAT1, and the inhibition of miR-23c counteracted the suppressive effect of NEAT1 depletion on proliferation, fibrosis and EMT of MMCs induced by high concentration glucose.

CONCLUSIONS

LncRNA NEAT1 promoted proliferation, fibrosis and EMT while impeded apoptosis of MMCs through sponging miR-23c. LncRNA NEAT1 and miR-23c might be underlying therapeutic targets for the treatment of DN.

A graphical method for breaking logical loops based on multi-tree structure

Logical loops or circular logics, interpreted as circular supporting relations among systems, remain a longstanding challenge in the probabilistic safety assessment (PSA). Logical loops are commonly found in complex industrial systems. Due to the existence of the logical loops, the minimal cut sets cannot be directly obtained. In order to solve this problem, the logical loops should be broken properly. This paper proposes a graphical method based on multi-tree structure. By constructing the simplified multi-tree, logical loops both in linearly and non-linearly interrelated systems are solved. To illustrate this method, examples of linearly interrelated systems and non-linearly interrelated systems are given in this paper. As a supplement, this method is applied to the well-known complex logical loops in the nuclear power plant. It shows that this method is highly intuitive and efficient by means of graphs.

[Diagnostic performance of quantitative fecal immunochemical test in detection of advanced colorectal neoplasia]

Objective: To evaluate the diagnostic performance of quantitative fecal immunochemical testing (FIT) and to provide reference for designing effective colorectal cancer (CRC) screening strategy in China. Methods: Based on an ongoing randomized controlled trial comparing the colorectal cancer screening strategies, this current study involved 3 407 participants aged 50-74 years who had undergone colonoscopies. All the feces samples were collected from the participants prior to receiving the colonoscopy. Fecal hemoglobin (Hb) was tested by FIT following a standardized operation process. Diagnosis-related indicators of FIT were calculated using the colonoscopy results as the gold standard. Results: Among the 3 407 participants, the mean age (SD) as 60.5 (6.3) years and 1 753 (51.5%) were males. The participants involved 28 (0.8%) CRCs, 255 (7.5%) advanced adenomas, 677 (19.9%) nonadvanced adenomas, and 2 447 (71.8%) benign or negative findings. With an overall positivity rate of 2.8% (96/3 407) at the recommended cutoff value of 20 μg Hb/g, the sensitivities of FIT for both CRC and advanced adenoma were 57.1% (95%CI: 37.2%-75.5%) and 11.0% (95%CI: 7.4%-15.5%), respectively, with the corresponding specificity as 98.4% (95%CI: 97.8%-98.8%). At a decreased cut-off value of 5 μg Hb/g, the sensitivities for detecting CRC and advanced adenoma increased to 64.3% (95%CI: 44.1%-81.4%) and 16.5% (95%CI: 12.1%-21.6%), respectively, but the specificity reduced to 95.2% (95%CI: 94.4%-95.9%). The areas under the ROC curve for CRC and advanced adenoma were 0.908 (95%CI: 0.842-0.973) and 0.657 (95%CI: 0.621-0.692), respectively. Of the diagnostic performance, there were no significant differences noticed by different sex and age groups. Conclusions: In our study, the quantitative FIT showed modest sensitivity in detecting CRC but limited sensitivity in detecting advanced adenoma. In population-based CRC screening programs, the quantitative FIT had the advantage of adjusting the positive threshold based on the targeted detection rate and available resource load of colonoscopy.

[Rates on the acceptance of colonoscopy, fecal immunochemical test and a novel risk-adapted screening approach in the screening programs of colorectal cancer as well as related associated factors]

Objective: To compare the rates of acceptance of colonoscopy, fecal immunochemical test (FIT), or a novel risk-adapted screening approach in the colorectal cancer (CRC) screening program. Related risk factors were also studied. Methods: The study has been based on an ongoing randomized controlled trial on colorectal cancer screening programs in six centers of research since May 2018. The involved participants were those who presented at the baseline screening phase. All the participants were randomly allocated into one of the following three intervention arms in a 1∶2∶2 ratio: colonoscopy group, FIT group, and a novel risk-adapted screening group. All the participants underwent risk assessment on CRC by an established risk score system. The subjects with high-risk were recommended to undertake the colonoscopy while the low-risk ones were receiving the FIT. Detailed epidemiological data was collected through questionnaires and clinical examinations. Rates of participation and compliance in all three groups were calculated. Multivariate logistic regression models were used to explore the potential associated factors related to the acceptance of screening. Results: There were 19 546 eligible participants involved in the study, including 3 916 in the colonoscopy group, 7 854 in the FIT group, and 7 776 in the novel risk-adapted screening group, respectively. Among the 19 546 participants, the mean age was 60.5 years (SD=6.5), and 8 154 (41.7%) were males. The rates of participation in the colonoscopy, FIT and the novel risk-adapted screening groups were 42.5%, 94.0% and 85.2%, respectively. In the novel risk-adapted screening group, the participation rate was 49.2% for the high-risk participants who need to undertake colonoscopy and was 94.0% for the low-risk ones who need to undertake FIT. Results from the multivariate logistic regression models demonstrated that there were several factors associated with the rates of participation in CRC screening, including age, background of education, history of smoking cigarettes, previous history of bowel examination, chronic inflammatory bowel disease and family history of CRC among the 1(st)-degree relatives. Conclusions: FIT and the novel risk-adapted screening approach showed superior participation rates to the colonoscopy. Further efforts including health promotion campaign for specific target population are needed to improve the engagement which ensures the effectiveness of CRC screening programs.

[Role of institutional cultural building in the schistosomiasis control program of Jiangsu Province]

Jiangsu Province was once one of the provinces that are hyperendemic for schistosomiasis in China. Following the concerted efforts for nearly 70 years, the transmission of schistosomiasis was interrupted in the province in 2019, which is the first province to achieve the national criteria of interruption of schistosomiasis transmission among the 5 provinces locating in the marshland and lake regions. In addition to political, economic and scientific and technical factors that greatly contribute to the huge achievements from schistosomiasis control in Jiangsu Province, the spiritual implication of Jiangsu schistosomiasis control culture that is mainly characterized by dedication, rigorousness, truth-seeking and innovation play a vital role in the schistosomiasis control program of Jiangsu Province, which encourages generations of schistosomiasis control professionals working in Jiangsu Province to fight against the "God of plague".

Antiretroviral Adherence, Drug Resistance, and the Impact of Social Determinants of Health in HIV-1 Patients in the US

Adherence to antiretroviral therapy (ART) is critical to achieving viral suppression. However, social determinants of health (SDoH) can undermine patient adherence to ART, resulting in drug resistance that compromises future treatment options. We assessed ART adherence and HIV-1 drug resistance at the national and state levels in the US and investigated their associations with SDoH and other HIV-related outcomes. Data were obtained from Symphony Health's Integrated Dataverse (IDV), Monogram/LabCorp Database, as well as national and publicly available databases, including Centers for Disease Control and Prevention (CDC), American Community Survey (ACS), and J. Kaiser Family Foundation (KFF). Inferential analyses were performed to investigate associations using patient-level data, and the results were reported by state and overall within the nation. Correlations between continuous variables were estimated by the Spearman's test, and that between continuous variable and categorical variable were estimated using one-way analysis of variance (ANOVA). State-level rates of poor adherence and resistance ranged from 26 to 55% and 20 to 54%, respectively. Female gender, non-white race, low education, poverty, and unemployment were associated with poor adherence; female gender was associated with drug resistance. Both adherence and resistance were correlated to HIV prevalence rates. Our findings suggest that US patients living with HIV face great challenges associated with poor ART adherence and HIV-1 drug resistance.

Circulating microRNA-146a and microRNA-146b exhibit potential to serve as markers for acute pancreatitis management and prognosis

OBJECTIVE

This study aimed to explore the association of microRNA(miR)-146a and miR-146b expressions with risk, severity, in-hospital death of acute pancreatitis (AP).

PATIENTS AND METHODS

50 severe AP (SAP) patients, 50 moderate-severe AP (MSAP) patients, 50 mild AP (MAP) patients and 50 healthy controls (HCs) were enrolled. Plasma samples were collected after the enrollment, then miR-146a and miR-146b expressions were detected by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Ranson's score, Acute Physiology and Chronic Health Evaluation (APACHE) II score, sequential organ failure assessment (SOFA) score, C-reactive protein (CRP) as well as in-hospital mortality were assessed in AP patients.

RESULTS

Both miR-146a and miR-146b expressions were the highest in SAP patients, followed by MSAP patients, MAP patients and HCs. Meanwhile, they distinguished SAP, MSAP, MAP patients from HCs, and also distinguished SAP, MSAP and MAP patients from each other. In SAP, MSAP and MAP patients, MiR-146a positively correlated with Ranson's score, APACHE II score, SOFA score and CRP. Besides, miR-146b positively correlated with Ranson's score, APACHE II score, SOFA score and CRP in SAP patients; correlated with Ranson's score, APACHE II score and CRP in MSAP patients; and correlated with Ranson's score and SOFA score in MAP patients. Notably, miR-146a predicted increased in-hospital death risk of both SAP and MSAP patients, while miR-146b predicted raised in-hospital death risk of SAP patients but not MSAP patients.

CONCLUSIONS

Circulating miR-146a and miR-146b exhibit potential as markers for AP management and prognosis.

[Analysis of pregnancy outcome of single and double blastocysts in the freeze-thaw cycle]

Objective: To compare the clinical outcomes of one and two blastocysts in the freeze-thaw transplantation cycle. Methods: Totally 3 675 cycles of frozen thawed blastocyst transplantation in Reproductive Medical Center of the Second Nanning People's Hospital from January 2012 to December 2016 were analyzed retrospectively. According to the quantity and quality of transferred blastocysts, all the patient were divided into two groups: (1) one embryo group, including the single excellent group (one high quality blastocyst) and the single non excellent group (one non high quality blastocyst); (2) two embryo groups, including the double excellent group (two high quality blastocysts), the one excellent and one non excellent group (one high quality blastocyst+one non high quality blastocyst), and the two non excellent group (two non high quality blastocysts were transplanted). Then the patients were divided into subgroups according to their ages: less than 35 years old, 35-40 years old and over 40 years old. On this basis, the implantation rate, clinical pregnancy rate, multiple birth rate and live birth rate were compared. Results: (1) The implantation rate, clinical pregnancy rate, multiple birth rate, preterm birth rate and live birth rate were all significantly increased, while the abortion rate was significantly reduced in the double blastocyst group (all P<0.05). (2) In the group of<35 years old, the rates of multiple birth and preterm birth in the double blastocyst group were significantly higher than those in the single optimal group (P<0.01). (3) In the 35-40 years old group, the clinical pregnancy rate, multiple birth rate and live birth rate of the double excellent group were significantly higher than those of the single excellent group (P<0.01); while the clinical pregnancy rate and live birth rate of the one excellent and one non excellent group and the double non excellent group were not significantly different from those of the single excellent group (P>0.05), but the multiple birth rate and preterm birth rate were significantly increased (P<0.01). The clinical pregnancy rate, live birth rate and multiple birth rate of double non optimal group were significantly higher than those of single non optimal group (P<0.01). (4) In the group>40 years old, there were no significant differences in clinical pregnancy rate and live birth rate between the two groups (P>0.05). There were no significant differences in implantation rate, clinical pregnancy rate and live birth rate between double non optimal group and single non optimal group (P>0.05). Conclusion: No matter the age of the patients, if the couple have high quality blastocysts, we should give priority to single high quality blastocyst transplantation; even if they have no high quality blastocysts, we should also consider single blastocyst transplantation, in order to reduce the risk of multiple pregnancy and improve the cumulative live birth rate, so as to improve the pregnancy outcome.

Early and late pregnancy loss in women with polycystic ovary syndrome undergoing IVF/ICSI treatment: a retrospective cohort analysis of 21 820 pregnancies

OBJECTIVE

To examine early and late pregnancy loss in women with and without polycystic ovary syndrome (PCOS) undergoing IVF/ICSI transfers.

DESIGN

Retrospective cohort study.

SETTING

Reproductive medicine centre at a tertiary hospital.

POPULATION

We studied women with a positive β-human chorionic gonadotropin (β-hCG) after in vitro fertilisation/intra-cytoplasmic sperm injection (IVF/ICSI) treatment from May 2014 to April 2019.

METHODS

Odds ratios (OR) for early (≤13 weeks) and late (>13 weeks) pregnancy loss were calculated among women with and without PCOS for plurality of the pregnancy with adjustment for confounding factors.

MAIN OUTCOME MEASURES

Early pregnancy loss (EPL) and late pregnancy loss (LPL).

RESULTS

From 21 820 women identified with a positive β-hCG, 2357 (10.8%) women had PCOS, and 19 463 (89.2%) women did not. EPL occurred in 16.6% (391) of women with PCOS versus 18.3% (3565) in women with non-PCOS (OR 0.89, 95% CI 0.79-0.99, P = 0.04). After adjustment for age and other confounders, the rate of EPL was not statistically significantly associated with PCOS status (adjusted OR [aOR] 0.91, 95% CI 0.80-1.05). Women with PCOS demonstrated a higher rate of LPL (6.4% in PCOS versus 3.6% in non-PCOS, OR 1.81, 95% CI 1.48-2.21, P < 0.001). In multivariable analysis, the potential impact of PCOS was less strong (aOR 1.38, 95% CI 0.96-1.98), with BMI and maternal comorbidities also associated with LPL (aOR 1.08, 95% CI 1.04-1.1 and aOR 2.07, 95% CI 1.43-3.00, respectively).

CONCLUSIONS

Polycystic ovary syndrome was not independently associated with EPL. There was an increased risk of LPL but this difference was not statistically significant.

TWEETABLE ABSTRACT

Polycystic ovary syndrome women are at increased risk of late pregnancy loss, partly driven by elevated BMI and maternal comorbidities.

MiR-16 inhibits hepatocellular carcinoma progression by targeting FEAT through NF-κB signaling pathway

OBJECTIVE

MicroRNA-16 (miR-16) expression has been proved to take part in the initiation and development of several cancers, including hepatocellular carcinoma (HCC). However, its role and its molecular mechanism in HCC cells remain unclear. Our study aimed to elucidate miR-16 probable role and potential mechanism in HCC cells.

PATIENTS AND METHODS

MiR-16 expression in HCC was measured by Real Time-Polymerase Chain Reaction (RT-PCR). MiR-16 mimic or inhibitor was applied to increase or decrease miR-16 expression in Huh7 cells separately. The cell viability was measured by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide). The invaded cells and migrated cells were detected by the transwell assay. The epithelial-mesenchymal transition (EMT) and the nuclear factor-κB (NF-κB) were performed using Western blot. The tumor growth was measured via xenograft tumor formation assay. Moreover, bioinformatical methods and luciferase reporter assay were carried out to confirm the miR-16 target gene.

RESULTS

MiR-16 expression was downregulated in HCC tissues and cells. Furthermore, the increasing miR-16 expression was suppressed, whereas the decreasing miR-16 expression promoted cell proliferation, invasion, and migration in Huh7 cells. Moreover, miR-16 targeted FEAT in regulating HCC progression. FEAT was associated with a poor prognosis of HCC patients. Especially, miR-16 suppressed EMT and NF-κB pathway in HCC and inhibited the tumor growth in vivo.

CONCLUSIONS

We stated that miR-16 suppressed HCC cell progression by targeting FEAT and inhibiting EMT and NF-κB pathway. MiR-16 may be clinically utilized as a factor for the clinical diagnosis and prognosis of HCC.

Expression of Autophagy-Associated Protein in Rat Muscle Tissues after Antemortem and Postmortem Injury

Abstract

Objective To study the expression of the three autophagy-associated proteins, BECN1, LC3 and p62, after the injury of the skeletal muscle of rats and to explore its application in differentiation between antemortem and postmortem injury. Methods The 72 healthy Sprague-Dawley rats were randomly divided into the undamaged control group, the antemortem injury group （0.5 h, 1 h, 2 h, 4 h, 8 h, 16 h and 24 h） and postmortem injury group （0.5 h, 1 h, 2 h and 4 h）. A model of the injured right hind limb of rats was constructed. The expressions of the autophagy-associated proteins, BECN1, LC3-2/LC3-1 and p62, in the control group, the antemortem injury group and postmortem injury group were detected by Western blotting method. The data were respectively centralized and standardized and the orthogonal partial least square-discrimination analysis （OPLS-DA） identification model of antemortem and postmortem injury groups was constructed. Results The expression of BECN1, p62 protein and LC3-2/LC3-1 after the injury of the skeletal muscle of the rats showed different degrees of changes, but the differences among the 3 groups had no statistical significance. Antemortem and postmortem injury groups can be distinguished by centralizing and standardizing the expression levels of autophagy protein BECN1 and the ratio of LC3-2/LC3-1. The principal components extracted from OPLS-DA model of antemortem injury and postmortem injury had a relatively good interpretation of the model （R_x²=0.563, R_y²=0.439）, but it were less predictive （Q²=0.366）. Conclusion The expression of BECN1 and the ratio of LC3-2/LC3-1 in injured local tissue of the rat skeletal muscle can be used for the differentiation of antemortem injury group and postmortem injury group.

GALNT10 promotes the proliferation and metastatic ability of gastric cancer and reduces 5-fluorouracil sensitivity by activating HOXD13

OBJECTIVE

To investigate the expression and potential mechanism of GALNT10 in gastric cancer (GC).

PATIENTS AND METHODS

A total of 60 cases of GC tissues, as well as normal tissues were collected. The total RNA of GC specimens and cells were extracted by TRIzol method and the level of GALNT10 was examined by quantitative real-time polymerase chain reaction (qRT-PCR). In addition, the relationship between GALNT10 and clinical parameters and prognosis of GC patients was analyzed. Subsequently, Lentivirus was used to construct GALNT10 knockdown GC cell lines, and cell counting kit-8 (CCK-8) and transwell assays were applied to analyze the influence of GALNT10 on GC cell function. Bioinformatics and Luciferase assay was used to evaluate the relationship between GALNT10 and HOXD13. Furthermore, 5-fluorouracil (5-Fu)-resistant cells were used to detect the relationship between GALNT10 and 5-Fu sensitivity of GC cells.

RESULTS

qRT-PCR results revealed that GALNT10 level was markedly increased in tissues, as well as cell lines of GC. Statistical analysis suggested that GALNT10 expression was in close relation with the incidence of lymph node and distant metastasis along with poor prognosis in GC patients, but not with other indicators. CCK-8 and transwell migration experiment results indicated that GALNT10 silencing can inhibit the proliferative and migration ability of GC cells. Western blot results displayed that the HOXD13 level was remarkably decreased after GALNT10 knocking down. In addition, Luciferase gene assay indicated that GALNT10 could bind to HOXD13. Further rescue experiments showed that HOXD13overexpression can synergistically reverse the inhibitory effect of GALNT10 knockdown on GC cell proliferative and migration ability, which further demonstrated that GALNT10 could promote GC cell metastasis ability and reduce the sensitivity to 5-Fu by regulating HOXD13.

CONCLUSIONS

GALNT10 could regulate the proliferative and migration ability of GC cells and reduce the sensitivity to 5-Fu by enhancing the expression of HOXD13. Therefore, GALNT10 was expected to be a new therapeutic target for diagnosis of 5-fluorouracil resistance in GC.

[The effect of welding ultraviolet on the antioxidant function and DNA of workers]

Objective: To explore the skin damage, oxidative damage and DNA damage of welding workers caused by ultra violet. Methods: From 1 May to 30 June 2017, 125 welding workers were selected as the contact group, which was divided into 2, 4, 6, 8 and 10-year-working age groups with 25 workers in each group and 25 healthy volunteers as the control group. The workers in the contact group were investigated with questionnaires on the distribution and wearing of protective equipment; the subjects in the two groups were examined in dermatology, and the peripheral blood was collected to detect the total antioxidant capacity (T-AOC) and DNA damage of mononuclear cells, and the influence of ultraviolet on the above indexes was analyzed. Results: The distribution rates of welding mask, dust mask and goggles were 100.0% (125/125) , 96.0% (120/125) , 98.4% (123/125) , respectively, and the distribution rates of welding gloves were 64.8% (81/125) ; the wearing rates of welding mask and goggles were 100.0% (125/125) , 90.4% (113/125) , and the wearing rates of dust mask and welding gloves were 89.6% (112/125) and 64.0% (80/125) , respectively. The acute skin injuries such as hand and face peeling and skin pruritus were serious in the 2-year-working age group, and the chronic skin injuries such as insensitive and numbness and verrucous vegetations were the main manifestations in the 10-year-working age group. Compared with the control group, T-AOC in peripheral blood of workers exposed to 6, 8 and 10 years decreased significantly, and DNA content in comet tail of workers exposed to various working years increased significantly (P<0.05) , while DNA content in comet tail increased with working years (F=1501.130, P<0.05) . Conclusion: UV welding can cause skin damage, reduce the antioxidant capacity of the body, and increase DNA damage with the increase of working age.

Assessment of surgical outcomes and oncological safety for submental artery perforator flap reconstruction after ablation of oral cancer

The submental artery perforator flap (SAPF) has been a new option for the intraoral reconstruction of oral squamous cell carcinoma (OSCC) patients in recent years, but its surgical outcomes have not been well assessed. We compared the surgical outcomes and oncological safety of SAPF reconstruction for medium-sized soft-tissue defects after the ablation of primary oral cancer with traditional submental island flaps (SIF) and anterolateral thigh perforator flaps (ALTPF). Fifty-one SAPFs, 30 SIF, and 74 ALTPF were reviewed for the intraoral medium-sized reconstructions after the ablation of oral cancer from our institutional clinical oncological databases. We performed comparative assessments on the variables of surgical outcome and oncological safety among the 3 cohorts. A Kaplan-Meier estimate of survival for each flap was calculated. Operating time was significantly reduced in the SIF and SAPF groups than ALTPF (p = 0.021 and 0.014, respectively). Flap thickness of SAPF was the significantly thinnest (mean 0.5 cm) among three groups. The common complications of donor site for both SAPF and SIF group were incision dehiscence and orocutaneous fistula. There was no significant difference in disease-free survival (DFS) among the 3 groups. However, several OSCC patients with the SIF reconstruction were found to have recurrences with a metastatic lymph node under the flap after the first operation. SAPF could be a versatile choice of the intraoral reconstruction for the medium-sized soft-tissue defects after the ablation of oral cancer.

[Disease burden of colorectal cancer in China: any changes in recent years?]

Objective: To update the disease burden of colorectal cancer (CRC) in Chinese population by integrating the latest multi-source evidences. Methods: Groups of data from GLOBOCAN, series of Chinese Cancer Registry Annual Report (annual report), Cancer Incidence in Five Continents (CI5), Global Burden of Disease Project 2017 (GBD), China Death Cause Surveillance Datasets and China Health Statistical Yearbooks (yearbook) were used to extract the information. Data on incidence, mortality, disability-adjusted life year (DALY) and percentage distribution of sub-location of CRC were used to analyze the latest disease burden in China, and age-standardized rates by world standard population were mainly used. Joinpoint Trend Analysis Software 4.7.0.0 was applied for time trend analysis. Data related to the economic burden of CRC in China were gathered by literature review. Results: (1) Current status: according to the latest annual report, the incidence and mortality rates of CRC were 17.1 per 100 000 and 7.9 per 100 000, respectively among the covered registration sites in 2015. The incidence ratios of male to female and that of urban to rural were 1.5 and 1.4, with the mortality ratios were 1.6 and 1.4, respectively. Similar to data from the annual report, the mortality rate was reported as 6.9 per 100 000 in 2017 by the surveillance data sets. Data from the GBD project showed that, the DALYs caused by CRC in China in 2017 was 4.254 million person years (doubled compared with that of 1990), accounting for 22.4% of the global burden of CRC. (2) Time trends: according to the annual reports, from 2009 to 2015, the incidence rate and mortality rate of CRC in China decreased by 10.2% and 9.5%, respectively. The same trend was also observed in urban sites, but was opposite in rural areas (increased 20.0% in incidence and 15.2% in mortality). Results from the Joinpoint analysis showed that the averaged annual percentage change (AAPC) was estimated as -1.6% (P<0.05) in the national mortality rate. Similarly, in the incidence and mortality rates of urban sites appeared as AAPC=-1.5% and -1.4% (all P<0.05), but inversely in the incidence rate from the rural sites as AAPC=3.3% (P<0.05). The yearbook data showed a 9.8% increase in urban and 20.6% increase in rural on the mortality in 2017 when compared with 2004, but the Joinpoint analysis showed no statistical significance (P<0.05). (3) Distribution of sub-location of CRC: the annual report showed that among all the new CRC cases in China in 2015, colon, rectal and anal cancer accounted for 49.6%, 49.2% and 1.2%, respectively, while the proportions were 51.3%, 47.6% and 1.1%, respectively in 2009. The proportion of colon cancer was continuously higher in the urban (>52%) than that in the rural areas (<44%). The CI5 Ⅺ data showed that ascending and sigmoid colons were more commonly seen among all the colon cancers. (4) Economic burden: the average annual growth rate of the medical expenditure per CRC patient in China ranged from 6.9% to 9.2%, and the 1-year out-of-pocket expenditure of a newly diagnosed patient accounted for about 60% of their previous-year household income. Conclusions: In China, the overall disease burden of CRC might have been decreased slightly but generally remained stable in the last several years, however, the rising burden appeared in the rural areas should not be ignored. In consistent with findings from a previous review, men and people from the urban areas are considered the target populations for CRC. The finding of higher proportion of colon cancer in urban areas suggests the impact of development of socioeconomic and medical technologies on CRC development and detection. The economic burden of CRC continued to grow.

CHANGES OF WNT/B-CATENIN SIGNALING AND DIFFERENTIATION POTENTIAL OF BONE MARROW MESENCHYMAL STEM CELLS IN PROCESS OF BONE LOSS IN OVARIECTOMIZED RATS

Background

In vitro studies of the changes about osteoblastogenesis and adipogenesis potential of BMSCs were not clear. As it is the critical pathway for osteogenic differentiation and bone formation, whether or not Wnt/β-catenin signalling is involved in the changes of osteogenic and adipogenic potential of BMSCs and participates in bone content decrease of ovariectomized (OVX)osteoporosis rats has been rarely reported.

Material/Methods

BMSCs from femurs of ovariectomzed rats were isolated and cultured in vitro. The proliferation potential of BMSCs was analysed by CCK-8 assays . Osteoblastic and adipogenic differentiation potential of the BMSCs was assessed by ALP activity assay, Alizarin red S staining, Oil red O staining and RT-PCR analysis.

Results

The results demonstrated that BMSCs from bilateral ovariectomization rats were endowed with lower proliferation and osteoblastic differentiation potential but higher adipogenic potential than the control group in vitro. In addition, β-catenin was found to have been decreased in OVX BMSCs, indicating that Wnt/β-catenin signalling pathways were suppressed in OVX BMSCs .

Conclusions

Results suggested that changes in the Wnt canonical signalling pathway may be related to imbalances of osteogenic and adipogenic potential of BMSCs, and this may be an important factor related to bone content decrease in ovariectomized osteoporosis rats.

Regulatory effect of lncRNA NKILA on autophagy induced by sepsis kidney injury

OBJECTIVE

The aim of this study was to investigate the regulatory effect of long non-coding RNA (lncRNA) NKILA on autophagy in sepsis-induced kidney injury.

MATERIALS AND METHODS

Sepsis model was successfully established in rats by cecal ligation and puncture (CLP). Hematoxylin and eosin (HE) staining was performed to evaluate the pathological lesions in rat kidney tissues. Subsequently, serum samples of sepsis rats were collected. The levels of blood urea nitrogen (BUN) and serum creatinine (SCr) were determined. Western blot and quantitative real time-polymerase chain reaction (qRT-PCR) were conducted to detect the protein and mRNA expression levels of LC3, Beclin-1, activated caspase-3, p-Akt (308), p-Akt (472), Akt and NKILA in kidney tissues of sepsis rats at different time points, respectively. Subsequently, HK-2 cells were induced with different doses of lipopolysaccharide (LPS) for different time points. The expression levels of the above genes in cells were detected as well. Finally, changes in autophagy and apoptosis in LPS-induced HK-2 cells with the treatment of PI3K pathway inhibitor or Akt inhibitor were observed.

RESULTS

Typical pathological lesions were observed in kidney tissues of sepsis rats, with increased serum levels of BUN and SCr. This indicated the successful construction of the sepsis model in rats. The expression levels of LC3, Beclin-1, and NKILA/Akt significantly increased in kidney tissues of sepsis rats. In vitro experiments revealed that NKILA expression in HK-2 cells gradually up-regulated with the increase of LPS dose and prolongation of LPS induction. The expressions of LC3 and NKILA/Akt were higher at 10 mg/L LPS treatment, and 8 h of LPS induction. Furthermore, the treatment of PI3K pathway inhibitor or Akt inhibitor remarkably down-regulated LPS-induced LC3 expression, while it accelerated cell apoptosis and up-regulated NKILA expression.

CONCLUSIONS

Autophagy occurs at sepsis-induced kidney injury, which can be regulated by NKILA/Akt pathway.

Influence of mesenchymal stem cells on respiratory distress syndrome in newborn swines via the JAK-STAT signaling pathway

OBJECTIVE

Acute respiratory distress syndrome (ARDS) threatens humans' health worldwide, causing huge labor and economic cost investment. This study aims to explore whether mesenchymal stem cells (MSCs) affect RDS in newborn swines via the Janus kinase-signal transducers and activators of transcription (JAK-STAT) signaling pathway by the establishment of the model of the disease.

MATERIALS AND METHODS

The phosphorylation of the JAK-STAT signal transduction proteins was first detected via Western blotting to verify the regulatory effect of MSCs on RDS in newborn swines through the JAK-STAT signaling pathway. Then, the Reverse Transcription-Polymerase Chain Reaction (RT-PCR) was utilized to analyze the influences of the injection of MSCs into the blood of newborn model RDS swines on inflammatory factors in vivo. To further demonstrate the signal transduction function put forwarded, the RT-PCR and enzyme-linked immunosorbent assay (ELISA) were adopted to analyze the influences of the JAK-STAT signaling pathway inhibitor on the expression of the signature proteins of RDS in newborn swines and the changes in the inflammatory factors.

RESULTS

MSCs induced the phosphorylation of JAK and STAT, and they activated the JAK-STAT signal transduction of RDS in newborn swines. Compared with those in normal saline group, the interleukin (IL)-2, IL-6, IL-8, and tumor necrosis factor-α (TNF-α) expression levels in MSC group were increased, namely, MSCs substantially promoted their expression levels (p<0.05), but those of IL-10 and IL-13 were significantly decreased (p<0.05).

CONCLUSIONS

The inhibitor of the JAK-STAT signaling pathway can suppress the therapeutic effect of MSCs on RDS in newborn swines.

Novel SLC26A6 gene polymorphism rs184187143 is associated with diabetic ketoacidosis of gestational diabetes

OBJECTIVE

Diabetic ketoacidosis is one of the most serious acute complications of the gestational diabetes and is marked by the triad of the uncontrolled hyperglycemia, acidosis, and ketosis. Diabetic ketoacidosis can be a life-threatening emergency for mother and fetus, whose genetic factors resulting in diabetic ketoacidosis remain unclear. This study aimed to explore the correlation between SLC26A6 gene polymorphism rs184187143 and the risk of diabetic ketoacidosis of gestational diabetic mellitus (GDM).

PATIENTS AND METHODS

A total of 98 patients with GDM and 98 patients with diabetic ketoacidosis of GDM were enrolled. The direct sequencing of the products by Polymerase Chain Reactions of the extracted genomic DNA from the involved patients was performed to analyze the SLC26A6 gene polymorphism rs184187143, and the further genotype frequencies were compared to the statistical analysis of the clinical and biochemical data.

RESULTS

A significantly increased prevalence of the G allele (p = 0.032, OR = 2.326, 95% CI = 1.539-3.516), C/G genotype (p = 0.021, OR = 3.582, 95% CI = 1.216-10.558), and a previously uncharacterized rs184187143, was discovered in the diabetic ketoacidosis of the GDM group. The genotype of SLC26A6 rs184187143 was shown to be markedly associated with increased prevalence of the diabetic ketoacidosis of GDM.

CONCLUSIONS

Our study firstly established that the G allele and C/G genotype of rs184187143 single nucleotide polymorphism (SNP) in SLC26A6 gene was closely linked with the increased risk for the development of the diabetic ketoacidosis of GDM.

[Establishment of Mathematical Models for Skeletal Age Determination of Extremitas Sternalis of Clavicle in Shanxi Adolescents]

Objective To develop mathematical models for skeletal age determination with multiple statistic method based on the correlation between age and the growth of the epiphysis of extremitas sternalis of clavicle in Shanxi adolescents. Methods The 562 Shanxi sternoclavicular joint samples （454 cases of modelling, 108 cases of external verification） were scanned by the thin-section computed tomography. After volume rendering was obtained, indicators such as area of epiphysis, area of metaphysis, longest diameter of epiphysis and longest diameter of metaphysis of both extremitas sternalis of clavicle were collected. Indicators such as the ratio of area of epiphysis to area of metaphysis, and the ratio of longest diameter of epiphysis to longest diameter of metaphysis of both sides were calculated. Then multiple linear regression and random forest discriminant models were used to build mathematical models for age determination of adolescents. Results The obtained indicators exhibited a strong correlation with age （r>0.85）. The multiple linear regression model for males and females （all 4 indicators entering the model） based on the ratio of longest diameter of epiphysis to longest diameter of metaphysis and the ratio of area of epiphysis to area of metaphysis had an internal validation accuracy rate （±1.0 year） of over 92% and 108 cases had an external validation accuracy rate of over 70% （±1.0 year）. The out of bag error rates of random forest discriminant models were less than 2% for people over 18.0 years old （≥18.0 years old） and under 18.0 years old. The external validation accuracy rates of the 108 cases were over 80%. Conclusion The regression and discriminant models established in this study have certain reliability and accuracy and can be used in age determination of Shanxi adolescents.

Combined mTOR/MEK inhibition prevents proliferation and induces apoptosis in NF2-mutant tumors

OBJECTIVE

Merlin is encoded by Neurofibromatosis type 2 gene (NF-2), a tumor suppressor gene, which causes some multiple tumors forming disease of the nervous system in case of function loss. Bioinformatics analysis suggested that patients with NF-2 mutation had a worse prognosis, while it was associated with PI3K/mTOR activation, implying abnormal apoptosis in NF-2 mutation related tumors. Hence, we supposed that the inhibitors of PI3K/mTOR pathway might play a role in suppressing the tumor proliferation.

MATERIALS AND METHODS

Two representative NF-2 mutation tumor model of NCI-H2452 and HEI193 cell lines were adopted, while two PI3K/mTOR pathway inhibitors Trametinib and Vistusertib were chosen to study the proliferation and apoptosis of the tumor cells.

RESULTS

CCK8 cell counting experiment showed that both Trametinib and Vistusertib could inhibit the proliferation of NCI-H2452 cell in vitro, while the combination of Trametinib and Vistusertib was more significant. Flow cytometry results showed that both Trametinib and Vistusertib could enhance apoptosis of NCI-H2452 cell in vitro, while the combination of Trametinib and Vistusertib was more significant. Similar results were also achieved for HEI193 cell lines. In vivo tumorigenicity experiments demonstrated that the tumor volume and weight were significantly decreased by both Trametinib and Vistusertib, while their combination had the most significant effect. Western blot results demonstrated that both Trametinib and Vistusertib could inhibit PI3K/mTOR /MEK pathway and enhance the expression of merlin.

CONCLUSIONS

We found that PI3K/mTOR inhibitor could decrease the proliferation of NF-2 mutation tumor cell lines by enhancing apoptosis, while the combination of two drugs might have a better effect.

Long noncoding RNA LINC00662 functions as miRNA sponge to promote the prostate cancer tumorigenesis through targeting miR-34a

OBJECTIVE

Mounting evidence indicates that long noncoding RNAs (lncRNAs) play a critical role in the tumorigenesis. Up-regulation of lncRNA LINC00662 (LINC00662) has previously confirmed in several tumors. However, the study of LINC00662 in prostate cancer (PCa) is limited. Hence, to determine the expression pattern and function of LINC00662 in PCa.

PATIENTS AND METHODS

LINC00662 expression was first detected in PCa cell lines and tissue samples by qRT-PCR. Based on follow-up data, correlations of LINC00662 expression and clinicopathological features, including overall survival, in PCa patients were evaluated. Cell proliferation, migration, invasion, and apoptosis were detected by CCK-8 assay, colony-forming assay, Wound-healing assay, transwell assay, and flow cytometry, respectively. Additionally, LINC00662-specific miRNA was further confirmed using the dual-luciferase reporter assay and RT-PCR.

RESULTS

LINC00662 was significantly upregulated in PCa tissues and cell lines compared with adjacent normal tissue and a normal prostate epithelial cell line. Higher expression of LINC00662 was positively associated with distant metastasis and shorter overall survival. In addition, multivariate analysis revealed that tissue LINC00662 expression was confirmed to be an independent prognostic factor for PCa. Furthermore, LINC00662 silencing inhibited the proliferation, migration, and invasion of PC-3 and LNCaP cells, and promoted apoptosis in vitro. Bioinformatics methods and luciferase reporter assay revealed the close link within miR-34a and 3'-untranslated region (UTR) of LINC00662 and further confirmed that LINC00662 could function as a sponge of miR-34a in PCa cells. Also, the results of RT-PCR showed that knockdown of LINC00662 suppressed the expression levels of miR-34a.

CONCLUSIONS

The current results further enhanced our understanding of the effects of LINC00662 in PCa and may help to provide a new potential target for PCa treatment.

[A nomogram to predict non-sentinel lymph node metastasis for breast cancer patients with positive axillary sentinel lymph node]

Objective: To identify the risk factors of non-sentinel lymph node (nSLN) metastasis in breast cancer patients with 1~2 positive axillary sentinel lymph node (SLN) and construct an accurate prediction model. Methods: Retrospective chart review was performed in 917 breast cancer patients who underwent surgery treatment between 2002 and 2017 and pathologically confirmed 1-2 positive SLNs. According to the date of surgery, patients were divided into training group (497 cases) and validation group (420 cases). A nomogram was built to predict nSLN metastasis and the accuracy of the model was validated. Results: Among the 917 patients, 251 (27.4%) had nSLN metastasis. Univariate analysis showed tumor grade, lymphovascular invasion (LVI), extra-capsular extension (ECE), the number of positive and negative SLN and macro-metastasis of SLN were associated with nSLN metastasis (all P<0.05). Multivariate Logistic regression analysis showed the numbers of positive SLN, negative SLN and macro-metastasis of SLN were independent predictors of nSLN metastasis (all P<0.05). A nomogram was constructed based on the 6 factors. The area under the receiver operating characteristic curve was 0.718 for the training group and 0.742 for the validation group. Conclusion: We have developed a nomogram that uses 6 risk factors commonly available to accurately estimate the likelihood of nSLN metastasis for individual patient, which might be helpful for radiation oncologists to make a decision on regional nodal irradiation.