[Preoperative video distraction alleviates separation anxiety and improves induction compliance of preschool children: a randomized controlled clinical trial]

Objective: To explore the effect of video distraction on preoperative separation anxiety and induction compliance of preschool children receiving strabismus surgery under general anesthesia. Methods: In this prospective trial, 80 children aged 3 to 6 years scheduled for strabismus surgery under inhalation anesthesia were randomly allocated to one of two groups, a control group and a video distraction group, with 40 cases in each group. Children in the video distraction group continuously watched videos from waiting in the holding area, separating with parents, entering the operating room and induction of anesthesia, while children in the control group didn't watch videos during the same process. The modified Yale Preoperative Anxiety Scale (mYPAS) of children were recorded upon arriving at the holding area(T₁)and separating with parents(T₂). Induction Compliance Checklist (ICC) score was recorded when the anesthesia induction was performed. The emergence time, the occurrence rate of adverse events in post-anesthesia care unit (PACU) including nausea and vomiting, laryngospasm, severe cough, hypoxemia and sinus bradycardia, incidence of postoperative adverse reactions such as pain, dizziness, nausea and vomiting and lethargy, the parents' satisfaction of anesthesia were also assessed. Results: There were no significant difference in mYPAS score and the proportion of mYPAS score>30 between 2 groups at T₁ (all P>0.05). At T₂, the mYPAS score and the proportion of mYPAS score>30 in video distraction group were (34.41±13.23) and 52.50%, which were lower than those in control group (50.64±20.96, 87.50%) with statistically significant difference (all P<0.05). The ICC score of video distraction group was lower than that of the control group, which was (1.83±2.26) vs (4.03±2.99), and the difference was statistically significant (P<0.05). The proportion of children with ICC score=0 in video distraction group was 37.50%, which was higher than that in the control group (12.50%), while the proportion of children with ICC score=4-10 was lower than that of the control group, which was 17.50% vs 45.00%, and the difference was statistically significant (P<0.05). No significant intergroup differences were observed in emergence time, incidence of adverse events in PACU, and incidence of postoperative adverse reactions (P>0.05). The parents' satisfaction of anesthesia in the video distraction group was (9.23±0.89), which was higher than that in the control group (8.63±1.23), with statistically significant (P<0.05). Conclusion: Preoperative video distraction alleviates separation anxiety, improves induction compliance of preschool children receiving strabismus surgery under general anesthesia, and increases the parents' satisfaction of anesthesia.

POS0754 DEVELOPMENT OF A RISK PREDICTION MODEL FOR VENOUS THROMBOEMBOLISM IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: THE SLE-VTE SCORE

Background:

Patients with systemic lupus erythematosus (SLE) have a substantially increased risk of venous thromboembolism (VTE). An individual VTE risk assessment is important to ensure that all patients are assessed and given adequate thromboprophylaxis.

Objectives:

We conducted this study to develop a risk score for VTE in patients with SLE.

Methods:

Patients with SLE who participated in the Chinese SLE Treatment and Research group were enrolled in this study. Patient baseline information and clinical laboratory indicators were obtained, and VTE events were recorded every 3-6 months during follow-up visits. The risk prediction model was created and internally validated using the bootstrap methods, and a scoring system was established (Figure 1).

Figure 1.

Flow chart of study design.

Results:

Out of 4,502 patients included in this study, 135 had a VTE event. After univariate analysis and Lasso regression, the following 11 variables were identified and included in the risk prediction model: male sex, age, BMI ≥25 kg/m2, hyperlipidemia, hypoalbuminemia, hsCRP>3 mg/L, renal involvement, nervous system involvement, anti-β2-glycoprotein I antibody positivity, lupus anticoagulant positivity, and no use of hydroxychloroquine. The AUC for the SLE-VTE score (Table 1) was 0.947 (95% CI, 0.9249-0.9694). The SLE-VTE score’s sensitivity and specificity with the optimal cutoff value of 13 were 0.919 and 0.881, respectively. The SLE-VTE score was superior to the GAPSS system in predicting the risk of VTE in patients with SLE (AUC= 0.947 vs. 0.680, P< 0.001; integrated discrimination improvement (IDI)= 0.6652, P< 0.001; net reclassification improvement (NRI)= 0.6652, P< 0.001).

Table 1.

Final multivariable analysis for venous thromboembolism risk in patients with SLE

β coefficientsOdds ratio* (95% CI)P-valuePoints in scoring systemMale0.6211.86(0.953-3.503)0.0612Age at study entry(≥50)0.8372.308(1.339-3.915)0.0023BMI02(kg/m20.7922.209(1.333-3.627)0.0023Hyperlipemia0.8382.313(1.246-4.166)0.0063Hypoalbuminemia2.1638.697(5.185-14.794)< 0.0017hsCRP>3 mg/L1.4524.272(2.618-6.968)< 0.0015Anti β2GPI1.0132.754(1.543-4.853)0.0013LA1.5594.752(2.799-8.072)< 0.0015Nervous system2.38210.832(6.163-18.998)< 0.0018Lupus nephritis0.8352.305(1.414-3.756)0.0013No use of hydroxychloroquine1.7715.876(3.722-9.401)< 0.0016

BMI: body mass index; hsCRP: Hypersensitive c-reactive protein; ACL: anticardiolipin, antiβ2GPI: anti-β2-glycoprotein I, LA: lupus anticoagulantm;

Values in bold are statistically significant at p <0.05.

Conclusion:

Various factors are related to the occurrence of VTE in patients with SLE. The proposed SLE-VTE risk score can accurately predict the risk of VTE and help identify SLE patients with a high risk of VTE who may benefit from thromboprophylaxis.

References:

[1]Ramirez GA, Efthymiou M, Isenberg DA, Cohen H. Under crossfire: thromboembolic risk in systemic lupus erythematosus. Rheumatology. 2018;58:940-952.

[2]Chung WS, Lin CL, Chang SN, Lu CC, Kao CH. Systemic lupus erythematosus increases the risks of deep vein thrombosis and pulmonary embolism: a nationwide cohort study. J Thromb Haemost. 2014;12:452-458.

[3]Liew NC, Alemany GV, Angchaisuksiri P, et al. Asian venous thromboembolism guidelines: updated recommendations for the prevention of venous thromboembolism. Int Angiol. 2017;36:1.

[4]Savino S, Giovanni S, Veronica M, Dario R, Khamashta MA, Laura BM. GAPSS: the Global Anti-Phospholipid Syndrome Score. Rheumatology. 2013:8.

[5]Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41:543-603.

[6]Moghadamyeghaneh Z, Hanna MH, Carmichael JC, Nguyen NT, Stamos MJ. A Nationwide Analysis of Postoperative Deep Vein Thrombosis and Pulmonary Embolism in Colon and Rectal Surgery. J Gastrointest Surg. 2014;18:2169-2177.

Disclosure of Interests:

None declared

Association between type 1 diabetes mellitus and reduced bone mineral density in children: a meta-analysis

In this meta-analysis, we analyzed 9 cross-sectional studies for an association between type 1 diabetes mellitus (T1DM) and bone mineral density (BMD) in children. We found that BMD Z-scores were significantly reduced in children with T1DM.

INTRODUCTION

Recent cross-sectional studies have examined how T1DM influences bone health in children and adolescents, but the relationship between T1DM and BMD remains unclear due to conflicting reports.

METHODS

In this meta-analysis, we systematically searched PubMed, Cochrane library, and Web of Science databases (for publications through March 12, 2020), and calculated weight mean difference (WMD) along with 95% confidence intervals (CI) using a random-effects model. Heterogeneity was evaluated using the I² method. The Newcastle-Ottawa Scale was used to assess the quality of the included studies.

RESULTS

Data were analyzed from 9 eligible studies, including a total of 1522 children and adolescents. These data were tested for an association between T1DM and BMD. This analysis found a significant decrease in BMD Z-score in the whole body (pooled WMD, - 0.47, 95% CI, - 0.92 to - 0.02, I² = 80.2%) and lumbar spine (pooled WMD, - 0.41, 95% CI, - 0.69 to - 0.12, I² = 80.3%) in children and adolescents with T1DM, which was consistent in published studies from Asia and South America, but inconsistent in the North America and Europe. Importantly, the differences in BMD Z-scores were independent of age, level of glucose control (HbA1c), and prepubertal stage. Sensitivity analyses did not modify these findings. Funnel plot and the Egger test did not reveal significant publication bias.

CONCLUSION

This meta-analysis suggests that T1DM may play a role in decreasing BMD Z-scores in the whole body and lumbar spine in children.

POS0736 IDENTIFICATION OF MOLECULAR PHENOTYPES AND IMMUNE CELL INFILTRATION IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS ACCORDING TO LONGITUDINAL GENE EXPRESSION

Background:

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with highly heterogeneous clinical presentation characterized by disease unpredictable flares and multi-systemic involvement1 2. This clinical heterogeneity calls for design a molecular stratification to improve clinical trial design and formulate personalization treatment therapies.

Objectives:

This research was conducted to develop a reliable method to stratify SLE patients combined gene expression information and disease status.

Methods:

The mRNA expression profile of GSE138458 (contained 307 patients and 23 controls) and GSE49454 (contained 111 patients and 16 controls) were downloaded from the publicly GEO databases. After background adjustment, batch correction, and other pre-procession, obtaining a big gene matrix to identify the differentially expressed genes (DEGs) in SLE compared with healthy controls, which were screened by P value < 0.01. SLE subtypes were identified by non-negative matrix factorization (NMF) based on DEGs. Acquired signature genes in different SLE subtypes were conducted to process pathway enrichment analysis in Metascape. SLEDAI score and immune cell infiltration was also performed between subtypes by software package R (version 4.0.3).

Results:

Total 1202 DEGs were imputed to NMF unsupervised machine learning method. Patients with SLE were stratified into two subsets based on 184 signature genes derived from obtained DEGs(Fig.1A, 1B). GO and KEGG enrichment analysis showed that signature genes were mainly involved in negative regulation of innate immune response, toll-like receptor signaling pathway, regulation of immune effector process and so on(Fig.1C). Patients in Sub1 group had severe disease activity measures compared with those in Sub2(Fig.1D). SLEDAI scores from GSE49454 dataset were also higher in Sub1 compare with Sub2(Fig.1E). Further, immune cell infiltration results revealed an insufficient of regulatory T cell, CD8 T cells and naive CD4 T cells in Sub1 and neutrophils cells in Sub2(P<0.05)(Fig.1F).

Conclusion:

Our findings indicate that patients with SLE could be stratified into 2 subtypes which had different lymphocyte status and closely related to disease activity. This phenotyping may help us understand the etiology of the disease, inform patient in the design of clinical trials and guide treatment decision.

References:

[1]Dorner T, Furie R. Novel paradigms in systemic lupus erythematosus. Lancet 2019;393(10188):2344-58. doi: 10.1016/S0140-6736(19)30546-X [published Online First: 2019/06/11].

[2]Fanouriakis A, Tziolos N, Bertsias G, et al. Update οn the diagnosis and management of systemic lupus erythematosus. Annals of the rheumatic diseases 2021;80(1):14-25. doi: 10.1136/annrheumdis-2020-218272 [published Online First: 2020/10/15].

Acknowledgements:

This project was supported by National Science Foundation of China (82001740), Open Fund from the Key Laboratory of Cellular Physiology (Shanxi Medical University) (KLCP2019) and Innovation Plan for Postgraduate Education in Shanxi Province (2020BY078).

Disclosure of Interests:

None declared

[The gender disparity and relevant factors of frailty in the elderly of communities in Beijing based on Fairlie decomposition analysis]

Objective: To analyze the gender disparity and relevant factors of frailty in the elderly of communities in Beijing. Methods: From November 2015 to January 2016, 1 557 participants aged 60 and older in four communities of Dongcheng district in Beijing were recruited by cluster sampling. The information of demographic characteristics, social support, economic status, health status, prevalence situation, cognitive function, emotion and comprehensive assessment of the elderly were collected by a self-made questionnaire. The frailty index (FI) model was used to evaluate the frailty of the elderly. Multivariate nonconditional logistic regression model and Fairlie decomposition method were applied to analyze the relevant factors and their contribution rate to the difference between males and females. Results: The age of subjects was (74.5±8.5) years old, ranging from 60-102 years old, among which 641 were males, accounting for 41.2%. The M (Q₁, Q₃) of FI was 0.09 (0.06, 0.14), among which the value in males was 0.08 (0.05, 0.13), lower than females [0.10 (0.06, 0.15)] (P<0.001).The frail proportion in female was 14.9% (137/916), higher than that of male [8.4% (54/641)] (P<0.001). Multivariate nonconditional logistic regression model analysis demonstrated that common relevant factors associated with frailty in older women and men include: age ≥80 years old, marital status as not married (unmarried, separated, divorced, or widowed), living alone increased the risk of frailty; participating in group activities ≥3 times/week and exercising regularly decreased the risk of frailty (all P<0.05). Fairlie decomposition method showed that the contribution rate of life style, family support, marital status and social support were 32.21%, 15.26%, 8.23% and 4.34%, respectively (all P<0.05). Conclusions: The frailty degree and frailty proportion of elderly women in communities in Beijing were higher than those of men of the same age. The frailty gender difference was related to lifestyle, family support, marital status and social support.

LncRNA LINC00467 contributes to osteosarcoma growth and metastasis through regulating HMGA1 by directly targeting miR-217

OBJECTIVE

Osteosarcoma (OS) is a common primary bone tumor. Despite multiple treatment strategies have made great progress, the overall clinical outcome of OS patients is frustrating. Long non-coding RNA (lncRNA) LINC00467 has been reported in several cancers, while the research of the role of LINC00467 in OS is limited. The aim of this study was to figure out the potential mechanism of LINC00467 in OS.

PATIENTS AND METHODS

The expression levels of LINC00467, microRNA-217 (miR-217) and high mobility group A1 (HMGA1) were quantified by reverse transcription quantitative polymerase chain reaction (qRT-PCR). Cell counting kit-8 (CCK-8), flow cytometry and transwell assay were performed to detect cell proliferation, apoptosis, migration and invasion, respectively. The protein levels of HMGA1, B-cell lymphoma-2 (Bcl-2), Bax, Cleaved Caspase-3 (C-Caspase 3), E-cadherin, N-cadherin and vimentin were measured by Western blot assay. Online software starbase was used to predict the binding sites of miR-217. Luciferase report assay and RNA Binding Protein Immunoprecipitation (RIP) assay were carried out for detecting the interaction between miR-217 and LINC00467 or HMGA1.

RESULTS

The expression of LINC00467 and HMGA1 was increased in OS tissues and cells, while miR-217 expression was reduced. High expression of HMGA1 led to the poor overall survival. Down-regulation of LINC00467 or up-regulation of miR-217 could accelerate cell apoptosis, and slump cell proliferation, migration, invasion and EMT. However, miR-217 under-expression or HMGA1 over-expression could rescue these effects. Moreover, it was indicated that LINC00467 directly targeted miR-217 and HMGA1 was a target of miR-217.

CONCLUSIONS

LINC00467 promoted cell proliferation, migration, invasion and EMT, and suppressed cell apoptosis by up-regulating HMGA1 via targeting miR-217.

[Analysis for the breast cancer screening among urban population in Hebei province, 2018-2019]

From 2018 to 2019, 3 453 cases of high-risk population were screened by the Cancer Screening Program in Urban China (CanSPUC) in Hebei Province, with the age of (53.94±8.00). 147 and 686 cases of breast cancer positive and suspicious positive patients were found, with the positive rate and suspicious positive rate of 4.26% and 19.87% respectively. The suspicious positive rate of 45-49 years old age group was the highest (28.32%), and the positive rate of over 70 years old age group was the highest (7.32%). The positive detection rate of mammography combined with ultrasound was 5.16%, which was higher than that of ultrasound alone (2.46%) (χ²=30.28,P<0.001) or mammography alone (3.06%) (χ²=14.56,P<0.001).

Retraction notice to "30MO ORIENT-3: A randomized, open-label, phase III study of sintilimab versus docetaxel in previously treated advanced/metastatic squamous non-small cell lung cancer (sqNSCLC)": [Annals of Oncology Volume 31, Supplement 7, December 2020, Page S1428]

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article was retracted at the request of the authors. The authors of this abstract have advised that full agreement between authors and sponsors on publication of the abstract has not been reached and they are therefore unable to publish this data at present.

MicroRNA-29c-3p inhibits osteosarcoma cell proliferation through targeting PIK3R3

OBJECTIVE

MicroRNAs (miRNAs) are endogenous, non-coding small RNAs involving in pathological regulation. Previous studies have shown that microRNA-29c-3p is a tumor-suppressor gene. However, the role of microRNA-29c-3p in osteosarcoma (OS) has not been reported. This study aims to investigate the potential influence of microRNA-29c-3p on the progression of OS.

PATIENTS AND METHODS

Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR) was applied to examine microRNA-29c-3p levels in 40 matched pairs of OS tumor tissues and adjacent ones. The correlation between microRNA-29c-3p expression and clinical indicators in OS patient was analyzed. At the same time, qRT-PCR was used to detect microRNA-29c-3p level in OS cell lines. In addition, microRNA-29c-3p knockdown and the overexpression models were constructed in OS cell lines. The effects of microRNA-29c-3p on the biological functions of OS cells were analyzed via cell counting kit-8 (CCK-8) and transwell assays. Finally, the potential mechanism underlying microRNA-29c-3p in OS was explored by Western Blot and cell recovery experiment.

RESULTS

QRT-PCR results revealed that microRNA-29c-3p level in OS tumor tissues was conspicuously lower than that in adjacent tissues. Compared with OS patients with the high expression of microRNA-29c-3p, those with low expression of microRNA-29c-3p had a higher incidence of distant metastasis and worse overall survival. Cell proliferative capacity and invasiveness in OS were enhanced after knockdown of microRNA-29c-3p; while the opposite results were observed after the overexpression of microRNA-29c-3p. QRT-PCR results revealed that microRNA-29c-3p negatively regulated PIK3R3 expression in OS cells. Moreover, microRNA-29c-3p and PIK3R3 levels were confirmed to be negatively correlated in OS tissues. In addition, cell reverse experiment demonstrated that PIK3R3 was responsible for the malignant progression of OS regulated by microRNA-29c-3p.

CONCLUSIONS

MicroRNA-29c-3p expression was reduced in OS, and conspicuously associated with distant metastasis and poor prognosis. MicroRNA-29c-3p might inhibit the malignant progression of OS by modulating PIK3R3 expression.

[A real-world study of 176 cases with aplastic anemia treated in outpatient]

目的

探索真实世界门诊治疗再生障碍性贫血（AA）患者的诊断流程、治疗及疗效。

方法

评估2018年1月至2019年12月门诊治疗176例AA患者的诊断流程、治疗方案及疗效。

结果

患者出现症状至首次就诊中位时间7（5～120）个月，就诊原因包括出血（52.3%）、贫血（51.7%）、感染（6.8%）。诊断流程中168例（95.5%）患者完成髂骨骨髓穿刺（骨穿），仅22例（17.1%）完善了多部位骨穿（胸骨分类）；骨髓活检完成率85.1%（143/168）；只有59.5%（100/168）和58.9%（99/168）完成了骨髓流式免疫分型及染色体核型分析；86例（48.5%）完成阵发性睡眠性血红蛋白尿（PNH）克隆筛查；造血祖细胞培养检查完成率最低，仅45例（26.8%）。环孢素A（CsA）联合雄激素及左旋咪唑为最常见治疗方案，总计77例（43.8%），其次为CsA联合雄激素45例（25.6%），单用CsA者24例（13.6%），单用雄激素者16例（9.1%），14例（7.9%）患者确诊后选择中药或未治疗。根据门诊复诊频率将176例患者分为复诊规律组（每年≥4次）130例（73.9%）和复诊欠规律组（每年<4次）46例（26.1%）。复诊规律组6个月有效率较高（52.5%对28.0%，P＝0.005），12个月高质量缓解率更好（40.7%对16.7%，P＝0.027），24个月复发率更低（4.4%对36.4%，P＝0.001）。

结论

真实世界治疗的AA患者诊断流程需重视多部位骨穿检查并完成PNH克隆筛查、流式免疫分型、染色体核型分析及造血祖细胞培养检查；门诊规律复诊患者可获得高质量缓解，复发率低，推荐每年至少复诊4次。

[Fuxinfang improves hypoxia-induced injury of human aortic endothelial cells by regulating c-Fos-NR4A1-p38 pathway]

OBJECTIVE

To explore the molecular mechanism of Fuxinfang for improving injury of human aortic endothelial progenitor cells (HAECs).

OBJECTIVE

Serum samples were collected from male SD rats treated with Fuxinfang (n=8) or saline (n= 5). HAECs cultured in normoxia or hypoxic condition (2% O₂) were treated with serum from normal rats or with diluted serum (1% and 10%) from rats treated with Fuxinfang. The differentially expressed genes (DEGs) between Fuxinfang-treated and control cells were detected using high-throughput sequencing to screen the target DEGs that participated in arterial endothelial cell injury and underwent changes in response to both hypoxia and Fuxinfang treatment. AmiGo and String databases were used to infer the interactions among the target genes, and the expressions of the genes were analyzed in HAECs with different treatments using enzyme-linked immunosorbent assay (ELISA) and Western blotting.

OBJECTIVE

HAECs cultured in hypoxia did not show obvious changes in cell morphology or expressions of hypoxia-related factors in response to treatment with 1% or 10% serum from Fuxinfang-treated rats. The results of high-throughput sequencing showed a total of 7134 DEGs (4205 up-regulated and 2929 down-regulated genes) in HAECs in hypoxia model group and 762 DEGs (305 upregulated and 457 down-regulated genes) in Fuxinfang-treated HAECs. Analysis of AmiGo and String databases and the constructed protein-protein interaction network identified c-Fos, NR4A1, and p38MAPK as the target genes. The results of ELISA and Western blotting showed that the expressions of c-Fos, NR4A1, p38MAPK and pp38MAPK increased significantly in cells with hypoxic exposure (P < 0.05); treatment with the serum containing Fuxinfang significantly reduced the expression levels of c-Fos, NR4A1 and p-p38MAPK in hypoxic HAECs in a concentration-dependent manner (P < 0.05).

OBJECTIVE

The serum from Fuxinfang-treated rats can concentration-dependently inhibit the expressions of the DEGs occurring in hypoxia. Fuxinfang improves hypoxic injuries of HAECs possibly by down-regulating the expression of c-Fos to inhibit NR4A1 expression and suppressing hypoxia-induced p38 phosphorylation.

Influence of miR-155 on behaviors of depression mice through regulating Wnt/β-catenin signaling pathway

OBJECTIVE

To study the influence of micro ribonucleic acid (miR)-155 on depression-like behaviors of depression mice, and to explore the role of Wnt/b-catenin signaling pathway in behavioral regulation of depression mice.

MATERIALS AND METHODS

The mouse model of depression was established via chronic unpredictable mild stress (CUMS). All mice were randomly divided into control group (n=12), model group (n=12), and fluoxetine group (n=12). The expression level of miR-155 in the hippocampus of mice in each group was detected via quantitative Polymerase Chain Reaction (qPCR). The changes in the behaviors of mice in each group were evaluated via behavioral experiments. The apoptosis level in the hippocampus of mice in each group was detected via terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining. Moreover, the content of inflammatory factors in the hippocampus of mice in each group was detected using the enzyme-linked immunosorbent assay (ELISA) kits. The expression levels of Wnt/b-catenin signaling pathway-related proteins in each group were detected via Western blotting.

RESULTS

The expression level of miR-155 in the hippocampus was significantly higher in model group than that in control group (p<0.01). Meanwhile, the expression level of miR-155 was significantly lower in fluoxetine group than that in model group (p<0.01). There were no statistically significant differences in the crossing score and rearing score in the open field test among groups (p>0.05). Compared with those in control group, the immobility time in tail suspension test and forced swimming test were significantly increased (p<0.01), while the sucrose preference degree significantly declined (p<0.01) in model group. Fluoxetine could significantly reduce the immobility time in tail suspension test and forced swimming test (p<0.01) and increase the sucrose preference degree (p<0.01) in model group. The number of TUNEL-positive cells in the hippocampus of mice in model group was significantly larger than that in control group (p<0.01). Fluoxetine could effectively reduce the number of TUNEL-positive cells in the hippocampus (p<0.01). Compared with those in control group, the content of tumor necrosis factor-α (TNF-a), interleukin-1b (IL-1b), and IL-6 in the hippocampus was significantly increased (p<0.01), while the content of IL-10 was significantly decreased (p<0.01) in model group. Fluoxetine could effectively reduce the content of TNF-a, IL-1b, and IL-6 (p<0.01) and increase the content of IL-10 (p<0.01). Besides, in model group, the expression levels of dishevelled-1 (DVL-1) and b-catenin in hippocampus remarkably declined (p<0.01), while the expression levels of glycogen synthase kinase-3b (GSK-3b) and adenomatous polyposis coli (APC) were remarkably increased (p<0.01) compared with those in control group. Fluoxetine could effectively lower the expressions of GSK-3b and APC in the hippocampus (p<0.01) and increase the expressions of DVL-1 and b-catenin (p<0.01) in model group.

CONCLUSIONS

MiR-155 is involved in regulating the depression-like behaviors of depression mice through promoting the release of inflammatory factors and the apoptosis of hippocampal neurons. Its mechanism may be related to the inhibition of the Wnt/b-catenin signaling pathway.

Bypassing the Structural Bottleneck in the Ultrafast Melting of Electronic Order

Impulsive optical excitation generally results in a complex nonequilibrium electron and lattice dynamics that involves multiple processes on distinct timescales, and a common conception is that for times shorter than about 100 fs the gap in the electronic spectrum is not seriously affected by lattice vibrations. Here, however, by directly monitoring the photoinduced collapse of the spectral gap in a canonical charge-density-wave material, the blue bronze Rb_{0.3}MoO_{3}, we find that ultrafast (∼60  fs) vibrational disordering due to efficient hot-electron energy dissipation quenches the gap significantly faster than the typical structural bottleneck time corresponding to one half-cycle oscillation (∼315  fs) of the coherent charge-density-wave amplitude mode. This result not only demonstrates the importance of incoherent lattice motion in the photoinduced quenching of electronic order, but also resolves the perennial debate about the nature of the spectral gap in a coupled electron-lattice system.

Recurrent Extra-gastrointestinal Stromal Tumor of the Vagina: A Case Report and Review of the Literature

Gastrointestinal tumors are uncommonly found outside the gastrointestinal tract, and extremely rare in the vaginal wall. In this case report, a 39-year-old female, she was finally diagnosed with an extra gastrointestinal stromal tumor (EGIST) when she presented with a recurrent vaginal tumor, while misdiagnosed after the first surgery. She had definitive surgical clearance and was taking targeted drug therapy with no sign of recurrence after follow-up for 13 months. Immunohistochemistry and cytogenetic's remain the most definitive method to diagnose EGISTs. Surgical resection and postoperative adjuvant targeted therapy are the optimum treatment options.

Glycation sites and bioactivity of lactose-glycated caseinate hydrolysate in lipopolysaccharide-injured IEC-6 cells

During the thermal processing of milk, Maillard reactions occur between proteins and lactose to generate glycated proteins. In this study, a lactose-glycated caseinate was hydrolyzed by trypsin. The obtained glycated caseinate (GCN) hydrolysate had a lactose content of 10.8 g/kg of protein. We identified its glycation sites and then assessed it for its protective effect against lipopolysaccharide-induced barrier injury using a rat intestinal epithelial cell line (IEC-6 cells) as a cell model and unglycated caseinate (CN) hydrolysate as a reference. Results from our liquid chromatography-mass spectrometry analysis of the GCN hydrolysate verified that lactose glycation occurred at the Lys residues in 3 casein components (α_S1-casein, β-casein, and κ-casein), and this resulted in the formation of 5 peptides with the following amino acid sequences: EMPFPKYPKYPVEPF, HIQKEDVPSE, GSENSEKTTMPL, NQDKTEIPT, and EGIHAQQKEPM. The results from cell experiments showed that the 2 hydrolysates could promote cell growth and decrease lactate dehydrogenase release in the lipopolysaccharide-injured cells; more importantly, they could partially protect the damaged barrier function of the cells by increasing trans-epithelial electrical resistance, decreasing epithelial permeability, and upregulating the expression of the 3 tight junction proteins zonula occludens-1, occludin, and claudin-1. However, compared with CN hydrolysate, GCN hydrolysate showed lower efficacy in protecting against cellular barrier dysfunction. We propose that the different chemical characteristics of the CN hydrolysate and the GCN hydrolysate (i.e., amino acid loss and lactose conjugation) contributed to the lower barrier-protective efficacy of the GCN hydrolysate. During dairy processing, protein glycation of the Maillard type might have a non-negligible, unfavorable effect on dairy proteins, in view of the resulting protein glycation we found and the critical function of proteins for maintaining the integrity of the intestinal barrier.

RETRACTED: ORIENT-3: A randomized, open-label, phase III study of sintilimab versus docetaxel in previously treated advanced/metastatic squamous non-small cell lung cancer (sqNSCLC)

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article was retracted at the request of the authors. The authors of this abstract have advised that full agreement between authors and sponsors on publication of the abstract has not been reached and they are therefore unable to publish this data at present.

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.

[Relationship between frailty status and risk of death in the elderly based on frailty index analysis]

Objective: To analyze the relationship between frailty status and the risk of death in the elderly based on the frailty index (FI). Methods: Data from a prospective cohort study conducted between 2005 and 2015 in elderly people of an urban community in Beijing were analyzed. The variables related to health and frailty status based on the 2005 baseline survey and death as outcome variables collected in 2015 were used. A FI model was used to evaluate the correlation between FI and mortality in the elderly people in different age groups was analyzed. Cox regression was applied to evaluate the influence of FI on the risk of death, and Kaplan-Meier curves was used to show the survival rate of different frailty levels in the elderly adults. Results: Of the 1 301 elderly people included in the analysis, 403 died during 2005-2015, with the 10-year mortality rate of 31.0%(403/1 301). The mortality rate of the elderly increased with the increase of FI, but, with the increase of FI value, the rate of mortality increased slowly. The limit value of FI causing death was around 0.70, indicating any new health problem might cause death at this value. Cox regression analysis showed that higher FI was associated with higher risk for death (HR=1.143, 95%CI: 1.034-1.248, P=0.000), and FI was more significantly associated with death than age (HR=1.143 vs. HR=1.048, t=5.827, P=0.000). With the increase of age, the effect of frailty on the risk of death decreased (HR=1.179 to HR=1.120). Kaplan-Meier curves showed that the survival rate of the elderly in all age groups decreased with the increase of frailty (Log-rank=317.812, 354.203, 247.258, all P=0.000). The survival time between different frailty levels in the elderly were significantly different, except for the elderly adults aged ≥80 years with severe frailty level (0.4≤FI<0.5, FI≥0.5, P=0.368). Conclusions: Compared with other evaluation tools of frailty, FI model can better reflect the frailty status of the elderly in communities in Beijing and has a high sensitivity in predicting adverse outcomes such as mortality. In the intervention of frailty in the elderly, focusing on relatively young elderly might be more effective in reducing the adverse outcomes caused by frailty.

[The mediating role of psychological capital between occupational stress and suicidal ideation]

Objective: To analyze the mediating effect of psychological capital (PsyCap) between occupational stress and suicidal ideation. Methods: In September 2017, stratified-cluster sampling method was adopted to select employees of an electronic manufacturing service industry as respondents for a questionnaire survey in Jiangsu province. The demographic characteristics of employees were collected. A total of 2 465 employees were investigated, and 2 216 valid questionnaires were collected. The level of occupational stress and PsyCap was assessed by the Effort-Reward Imbalance Scale(ERI)and PsyCap Questionnaire. Results: The age of 2 216 employees was (28.70±5.26) years old, including 1 230 males (55.5%). The scores of occupational stress on effort, reward and over-commitment were (3.08±0.63), (3.73±0.60) and (2.51±0.68), respectively. The average ERI index (ratio of effort to return) was (0.88±0.39). The total score of PsyCap was (86.62±15.23). The detection rate of suicidal ideation within two weeks was 13.9% (309/2 216). The average score of effort and over-commitment and the ERI index were positively correlated with the number of suicidal ideation detected within two weeks, with correlation coefficients about 0.081, 0.141 and 0.164, respectively. The average score of reward and total score of PsyCap were negatively correlated with the number of suicidal ideation detected within two weeks, with correlation coefficients about -0.206 and -0.228, respectively. The mediating effect results showed that PsyCap had mediating effect on the effort, reward, over-commitment and suicidal ideation of occupational stress respectively, with mediating effect values of -0.087 (95%CI: -0.018,-0.019), -0.299 (95%CI: -0.428,-0.200) and 0.096 (95%CI: 0.0394, -0.170). The mediating effect percentages were 9.43%, 17.92%, and 9.54%, respectively. Conclusion: PsyCap has a mediating effect between effort, reward, over-commitment of occupational stress and suicidal ideation.

Truncated stathmin-2 is a marker of TDP-43 pathology in frontotemporal dementia

No treatment for frontotemporal dementia (FTD), the second most common type of early-onset dementia, is available, but therapeutics are being investigated to target the 2 main proteins associated with FTD pathological subtypes: TDP-43 (FTLD-TDP) and tau (FTLD-tau). Testing potential therapies in clinical trials is hampered by our inability to distinguish between patients with FTLD-TDP and FTLD-tau. Therefore, we evaluated truncated stathmin-2 (STMN2) as a proxy of TDP-43 pathology, given the reports that TDP-43 dysfunction causes truncated STMN2 accumulation. Truncated STMN2 accumulated in human induced pluripotent stem cell-derived neurons depleted of TDP-43, but not in those with pathogenic TARDBP mutations in the absence of TDP-43 aggregation or loss of nuclear protein. In RNA-Seq analyses of human brain samples from the NYGC ALS cohort, truncated STMN2 RNA was confined to tissues and disease subtypes marked by TDP-43 inclusions. Last, we validated that truncated STMN2 RNA was elevated in the frontal cortex of a cohort of patients with FTLD-TDP but not in controls or patients with progressive supranuclear palsy, a type of FTLD-tau. Further, in patients with FTLD-TDP, we observed significant associations of truncated STMN2 RNA with phosphorylated TDP-43 levels and an earlier age of disease onset. Overall, our data uncovered truncated STMN2 as a marker for TDP-43 dysfunction in FTD.