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

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

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

AIM

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSION

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

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

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

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

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

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

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

AIMS

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSIONS

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

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

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

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

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

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

Background

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

Objectives

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

Methods

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

Results

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

Conclusions

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

Funding Acknowledgement

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

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSION

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

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

OBJECTIVE

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

METHOD

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

RESULTS

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

CONCLUSION

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

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

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

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

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

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

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

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

OBJECTIVE

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

DESIGN

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

RESULTS

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

CONCLUSION

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

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

Background

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

Methodology

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

Results

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

Conclusion

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

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

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

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

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

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

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

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

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

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

P–673 A visualized clinical model predicting cumulative pregnancy rate after IVF-ET: a real-world study

Study question

How is the cumulative pregnancy probability of individual patients after IVF-ET,could we develop a visualized clinical model to predict it based on patient’s characteristics?

Summary answer

The visualized clinical mode incorporates five items of female age, number of oocytes, antral follicle count, endometrium thickness and basal FSH level.

What is known already

Many factors can result in infertility, prognosis prediction is clinically relevant for making the right therapeutic strategy while avoiding overtreatment. It is also helpful in counselling, making the patient aware of possible treatment duration and estimated expense and managing patient’s expectation. Visualized clinical mode and accurate prediction would also be helpful in designing clinical trials to evaluate new treatments.

Study design, size, duration

We conducted a retrospective analysis of a single-center database using prospectively collected data from women who underwent IVF/ICSI treatment from January 2013 to December 2015, All the participants were followed up for at least 2 years, 3538 IVF-ET cycles were included in the study.A total of 3538 IVF/ICSI cycles were included in the study.

Participants/materials, setting, methods

Data from a total of 2312 IVF/ICSI cycles from January 2013 to December 2014 were randomly split into training dataset (1550, 67%) and internal validation dataset (762, 33%). A total of 1226 IVF/ICSI cycles in 2015 was applied to external validation dataset (temporal validation)

Main results and the role of chance

Multivariable logistic regression model combined with restricted cubic splines function was used to test independent prognostic factors and estimate their effects on treatment outcome for patients treated with IVF/ICSI. Female age, number of oocytes retrieved, AFC, endometrium thickness and basal FSH were included the final model. The above model was used to calculate prediction scores for all women in the training and validation datasets. The C-index was 0.693 (95% CI: 0.692∼0.695) in training sets, 0.689 in internal validation sets and 0.710 in external validation sets, which denotes a good performance. Calibration curves suggest excellent model calibration, with an ideal agreement between the prediction and actual observation . The DCA showed that if the threshold probability is between 0 and 0.7, using the nomogram derived in the present study to predict cumulative pregnancy provided a greater benefit than either thetreat-all or the treat-none strategy.

Limitations, reasons for caution

it was a retrospective, single-center study.In the future, prospective, randomized controlled, multicenter clinical studies will be designed.

Wider implications of the findings: The visualized nomogram model provides great predictive value for infertility patients in their first IVF/ICSI cycle, and predicts the pregnancy probability of individuals ,and could help clinicians improving clinical counselling.

Trial registration number

Not applicable

[Sacral nerve magnetic stimulation combined with rehabilitation training in the treatment of primary nocturnal enuresis in children]

Objective: To explore the clinical value of sacral magnetic stimulation (SMS) combined with rehabilitation training in the treatment of primary nocturnal enuresis (PNE) in children. Methods: The clinical data of 57 children with PNE admitted to the Department of Rehabilitation Xuzhou Rehabilitation Hospital, Xuzhou Central Hospital and Xuzhou Children's Hospital from October 2019 to September 2020 were collected and analyzed. The children were divided prospectively into observation group and control group by using random number table method. Bladder function training, awakening training and life and psychological intervention were performed in both groups, while the observation group was treated with SMS based on the above treatment methods. Before and after treatment, the degree and the frequency of enuresis (normal, mild, moderate, severe), therapeutic evaluation and bladder volume were compared. Chi-square test and T test were used for comparison between the two groups. Results: Finally, 28 cases in the observation group and 29 cases in the control group were included. There was no significant difference in age, sex, degree and of frequency enuresis of children between the two groups (all P>0.05).The degree of enuresis in the observation group after 1 month of treatment was better than that in the control group (12 vs. 7 cases, 8 vs. 8 cases, 5 vs. 9 cases, 3 vs. 5 cases, χ²=-2.269, P=0.030). Enuresis times in observation group was lower than that in the control group [(4.2±1.8) vs. (8.1±2.0), t=4.475, P<0.01). The total effective rate and bladder capacity of efficacy evaluation were higher than those of control group [82%(23/28) vs. 48%(14/29), (225±25) vs. (199±21) ml, Z=11.238, t=-2.249, both P<0.05]. Conclusions: SMS is an effective method for the treatment of PNE in children, which can reduce the degree and frequency of enuresis in children, increase the bladder volume and improve the total effective rate of treatment. It is worthy of clinical promotion and application.

[Influence of neuroimaging markers of chronic cerebral small vessel disease on prognosis of patients with cardioembolic stroke]

Data of 189 patients with first-ever cardioembolic stroke (CES) hospitalized in the Second People's Hospital of Changzhou from June 2014 to September 2019 were retrospectively analyzed. The neuoimaging markers of chronic small vessel disease (cSVDm) were evaluated and their total burden (0-3 points) was calculated. At 90 d after onset, 65 patients had poor prognosis. Regression analysis showed that the total cSVDm burden score was an independent riskfactor for the poor prognosis(OR=1.754, 95%CI:1.137-2.707, P=0.011).

Comparing the bone mineral density among male patients with latent autoimmune diabetes and classical type 1 and type 2 diabetes, and exploring risk factors for osteoporosis

AIMS

This study aimed to compare the bone mineral densities (BMDs) among male patients with latent autoimmune diabetes in adults (LADA), classical type 1 diabetes (T1DM), and type 2 diabetes (T2DM), and to examine the risk factors for developing low BMD in these patients.

PATIENTS AND METHODS

Between January 2017 and October 2020, a total of 57, 67, and 223 male patients with LADA, classical T1DM, and T2DM, respectively, were recruited from the endocrinology department of Shanghai Tenth People's Hospital. Hormonal markers of bone metabolism, lipid profiles, uric acid, glycosylated hemoglobin A1c (HbA1c), and beta-cell function were measured using blood samples. BMD was measured at the lumbar spine, femoral neck, and right hip by dual-energy X-ray absorptiometry.

RESULTS

The mean BMD values from all three skeletal sites in male patients with LADA were comparable to those with classical T1DM but were much lower than those with T2DM. After adjusting for confounding factors, multiple linear regression analysis demonstrated that in all male patients with diabetes, body mass index (BMI), uric acid, and fasting C-peptide showed significant positive associations with BMD at all three skeletal sites; however, osteocalcin showed a negative association at all three sites.

CONCLUSIONS

Compared with male patients with T2DM, lower BMDs were observed in patients with LADA and T1DM. Low BMI, uric acid, C-peptide levels, and high osteocalcin levels are risk factors for developing low BMD in male patients with diabetes.

Search for Displaced Leptons in sqrt[s]=13 TeV pp Collisions with the ATLAS Detector

A search for charged leptons with large impact parameters using 139  fb^{-1} of sqrt[s]=13  TeV pp collision data from the ATLAS detector at the LHC is presented, addressing a long-standing gap in coverage of possible new physics signatures. Results are consistent with the background prediction. This search provides unique sensitivity to long-lived scalar supersymmetric lepton partners (sleptons). For lifetimes of 0.1 ns, selectron, smuon, and stau masses up to 720, 680, and 340  GeV, respectively, are excluded at 95% confidence level, drastically improving on the previous best limits from LEP.

Characterization of different oligomeric forms of CRISP2 in the perinuclear theca versus the fibrous tail structures of boar spermatozoa

Mammalian sperm carry a variety of highly condensed insoluble protein structures such as the perinuclear theca, the fibrous sheath and the outer dense fibers, which are essential to sperm function. We studied the role of cysteine rich secretory protein 2 (CRISP2); a known inducer of non-pathological protein amyloids, in pig sperm with a variety of techniques. CRISP2, which is synthesized during spermatogenesis, was localized by confocal immunofluorescent imaging in the tail and in the post-acrosomal region of the sperm head. High resolution localization by immunogold labeling electron microscopy (EM) of ultrathin cryosections revealed that CRISP2 was present in the perinuclear theca and neck region of the sperm head, as well as in the outer dense fibers and the fibrous sheath of the sperm tail. Interestingly, we found that under native, non-reducing conditions CRISP2 formed oligomers both in the tail and the head but with different molecular weights and different biochemical properties. The tail oligomers were insensitive to reducing conditions but nearly complete dissociated into monomers under 8 M urea treatment, while the head 250 kDa CRISP2 positive oligomer completely dissociated into CRISP2 monomers under reducing conditions. The head specific dissociation of CRISP2 oligomer is likely a result of the reduction of various sulfhydryl groups in the cysteine rich domain of this protein. The sperm head CRISP2 shared typical solubilization characteristics with other perinuclear theca proteins as was shown with sequential detergent and salt treatments. Thus, CRISP2 is likely to participate in the formation of functional protein complexes in both the sperm tail and sperm head, but with differing oligomeric organization and biochemical properties. Future studies will be devoted to the understand the role of CRISP2 in sperm protein complexes formation and how this contributes to the fertilization processes.

Radiomic Phenotypes Distinguish Atypical Teratoid/Rhabdoid Tumors from Medulloblastoma

BACKGROUND AND PURPOSE

Atypical teratoid/rhabdoid tumors and medulloblastomas have similar imaging and histologic features but distinctly different outcomes. We hypothesized that they could be distinguished by MR imaging-based radiomic phenotypes.

MATERIALS AND METHODS

We retrospectively assembled T2-weighted and gadolinium-enhanced T1-weighted images of 48 posterior fossa atypical teratoid/rhabdoid tumors and 96 match-paired medulloblastomas from 7 institutions. Using a holdout test set, we measured the performance of 6 candidate classifier models using 6 imaging features derived by sparse regression of 900 T2WI and 900 T1WI Imaging Biomarker Standardization Initiative-based radiomics features.

RESULTS

From the originally extracted 1800 total Imaging Biomarker Standardization Initiative-based features, sparse regression consistently reduced the feature set to 1 from T1WI and 5 from T2WI. Among classifier models, logistic regression performed with the highest AUC of 0.86, with sensitivity, specificity, accuracy, and F1 scores of 0.80, 0.82, 0.81, and 0.85, respectively. The top 3 important Imaging Biomarker Standardization Initiative features, by decreasing order of relative contribution, included voxel intensity at the 90th percentile, inverse difference moment normalized, and kurtosis-all from T2WI.

CONCLUSIONS

Six quantitative signatures of image intensity, texture, and morphology distinguish atypical teratoid/rhabdoid tumors from medulloblastomas with high prediction performance across different machine learning strategies. Use of this technique for preoperative diagnosis of atypical teratoid/rhabdoid tumors could significantly inform therapeutic strategies and patient care discussions.

[Study on construction and application of technology system of chronic diseases and risk factor surveillance in China]

To study and establish a set technology systems of sampling, investigation, quality control, and data analysis of complex sampling for chronic diseases and risk factor surveillance in China based on the requirements of the WHO and China's national conditions, and provide evidence for the policy making and prevention and control evaluation of chronic diseases and technical support for the research of chronic diseases. Through the study of complex sampling technique, adjustment of surveillance points and evaluation of their representatives, a national and provincial representative surveillance system and a complex weighted data analysis were established. According to the relevant plans, actions, and policies in China and other countries, the surveillance content and index system were studied and constructed, which was in line with China's national conditions, "1 + X" steps surveillance, covering the content of questionnaire , physical measurement, and laboratory testing. Based on modern information technology, a three-level platform of information collection and a multi-center laboratory quality control technology system were established, including sampling, information collection, biological sample management, quality control, and result display. Relying on the above research techniques, a national epidemiological investigation was conducted in China, which covered cerebrovascular disease, mental disorders, digestive system disease, and diabetes complications, to obtain the national representative data. This study reflected the innovation of "combination of medicine and prevention" and multi department cooperation in the fields of clinical medicine and public health and provided some big data for the health policy making and the evaluation of the effects of chronic disease prevention and control.

[Formation of study population for causal inference]

Epidemiological analysis describes and compares the characteristics of a certain number of people to make causal inferences. The formation of the study population is always the first step. In this paper, we first define the concepts of cross-sections at both individual level and population level and introduce the three assumptions needed in the measurements in observational studies, i. e. the true values of the attributes are stable with time, the attribute variables are independent and the individuals are independent during the measuring process. We also determine that the causal inference research should be unified based on the time of the occurrence or beginning of a postulated cause, or exposure, should be in. Then, based on the dual roles of the population cross-section with causal thinking, we propose that research designs can be classified into two types with different characteristics: history reconstruction research and future exploration research. Finally, we briefly analyze the research design framework and the relationship between estimated effects and different designs. The discussion of the formation of a study population from the perspective of causal thinking can make a foundation for the classification of causal inference research design with appropriate effect parameters, which needs to be further studied.

Adherence to antihypertensive medications for secondary prevention of cardiovascular disease events: a dose-response meta-analysis

OBJECTIVES

The aim of the study was to explore the association between adherence to antihypertensive medications (AHMs) and the risk of recurrence of cardiovascular disease (CVD) events in patients with a history of CVD events from cohort studies.

STUDY DESIGN

This is a dose-response meta-analysis.

METHODS

PubMed and Embase databases were searched up to March 4, 2021, to identify English-language reports of cohort studies that assessed the association of AHM adherence with risk of recurrence of CVD events. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were estimated by using a fixed- or random-effects model. Restricted cubic splines were used to evaluate the possible linear or non-linear association.

RESULTS

We included nine cohort studies (54,349 patients) in the present meta-analysis. The pooled RR of CVD events was 0.66 (95% CI, 0.54-0.78) for the highest versus lowest AHM adherence category. We did not find any evidence of non-linearity association between AHM adherence and risk of CVD events (P_{non-linearity} = 0.534); for patients with a history of CVD events, the risk of CVD events was reduced by 9% for each 20% increase in AHM adherence (RR, 0.91; 95% CI, 0.85-0.97). The results of sensitivity analysis and subgroup analysis were virtually unchanged.

CONCLUSIONS

The high level of adherence to AHM is an effective strategy for preventing recurrence of CVD events. Patients with a history of CVD events should adhere to AHM.

A comparison of three sampling approaches for detecting PRRSV in suckling piglets

Determining whether porcine reproductive and respiratory syndrome virus (PRRSV) is circulating within a breeding herd is a longstanding surveillance challenge. Most commonly, piglets in farrowing rooms are sampled to infer the PRRSV status of the sow herd, with sample size based on the expectation of hypergeometric distribution and piglet selection based on simple random sampling (SRS), i.e., randomly selecting individuals from a population in a manner that all individuals have equal chance of being selected. Conceptually straightforward, the assumptions upon which it is based (homogeneous population and independence of individuals) rarely hold in modern swine facilities. Alternative approaches for sample selection include two-stage stratified sampling (2SS), i.e., randomly selecting litters (first stratum) and randomly selecting piglets (second stratum) within selected litters, and risk-based sampling (RBS), i.e., selecting litters with a higher risk of having viremic piglets, and randomly selecting pigs within those litters. The objectives of this study were to 1) characterize the pattern of distribution of PRRSV-viremic piglets in farrowing rooms and 2) compare the efficiency of SRS, 2SS, and RBS for the detection of PRRSV-viremic piglets. In 12 sow farms, serum samples were collected from all 4510 piglets in 422 litters housed in 23 farrowing rooms and tested for PRRSV RNA. At the population level, the distribution of PRRSV-viremic pigs was analyzed for population homogeneity and spatial clustering. At the litter level, litter size and sow parity were evaluated as risk factors. A non-homogeneous distribution of PRRSV-viremic piglets was observed in nearly all farrowing rooms (15/16), and spatial clustering detected on 11 occasions (11/16). Simulated sampling based on farrowing room data determined that 2SS required 1-to-25 fewer samples than SRS to detect ≥ 1 viremic piglet in 13 of 16 rooms and the same number of samples in 3 rooms. RBS required 1-to-7 fewer samples than 2SS to detect ≥ 1 viremic piglet in 7 of 16 rooms, the same number of samples in 6 rooms, and 1 more sample in 3 rooms. Notably, SRS was less efficient than either 2SS or RBS in detecting PRRSV-viremic piglets in farrowing rooms, regardless of the confidence level. It may be concluded that the core assumptions upon which most current surveillance methods are based do not hold in modern farrowing room facilities. Simulation-based sample size tables for SRS and 2SS are provided.

TRPS1 knockdown inhibits angiogenic vascular mimicry in human triple negative breast cancer cells

PURPOSE

Vascular mimicry (VM) tubules are lumen structures comprised of malignant tumor cells without the participation of endothelial cells. VM simulates blood vessel function in tumors to deliver a sufficient blood supply for proliferation, invasion, and metastasis of malignant tumors, thereby reducing the clinical effects of anti-angiogenic treatments. The elimination or prevention of malignant tumor VM development therefore represents an urgent research goal as a therapeutic strategy to and cut off nutrients required for tumor growth. The GATA transcription factor TRPS1 is abnormally up-regulated in breast cancer, osteosarcoma, prostate cancer, and other tumor tissues, and is instrumental in regulating cell proliferation, differentiation, and tissue growth and development.

METHODS

Here, we explored the effects of TRPS1 knockdown on VM and the proteins underlying its development in triple-negative breast cancer cell line MDA-MB-231.

RESULTS

We found that TRPS1 knockdown resulted in obvious inhibition of VM development. Fluorescence microscopy of F-actin and tubulin revealed that loss of TRPS1 function resulted in disruption of cytoskeleton and microtubule formation, respectively. In addition, TRPS1-suppressed cells exhibited reduced accumulation of VM-associated proteins EphA2, MMP-2, MMP-9, VEGF, and VE-cadherin. Moreover, it is interesting to know that the capacity for migration and invasion were limited in MDA-MB-231cells after TRPS1 knockdown and that the average number of VM tubules, their length, and number of intersections were also significantly decreased.

CONCLUSIONS

Based on our results, and in light of previous studies, we thus proposed that TRPS1 suppression negatively affects vascular mimicry possibly through reduced TRPS1-mediated transcriptional regulation of VM-related protein VEGF-A.

Climate and air pollution exposure are associated with thyroid function parameters: a retrospective cross-sectional study

OBJECTIVES

There are still controversies about the impact of climatic and environmental factors on thyroid function parameters in healthy populations. We investigated the relationships between climate, air pollution exposure, and thyroid function fluctuations.

METHODS

We retrospectively reviewed 327,913 individuals attending routine health checks from December 2013 to December 2018. We analyzed the associations between thyroid function and climatic factors using Spearman's correlation analysis. We explored the relationships between thyroid function and air pollution exposure using multiple linear regression analysis, after adjusting for age, sex, season, and outdoor temperature. We also performed subgroup analyses by age and sex and sensitivity analyses of different anti-thyroid peroxidase antibody status.

RESULTS

Thyroid-stimulating hormone (TSH) and free triiodothyronine (FT3) were negatively associated with outdoor temperature (r = - 0.66, P < 0.001; r = - 0.55, P < 0.001), while free thyroxine (FT4) and FT4/FT3 were positively associated with temperature (r = 0.35, P < 0.001; r = 0.79, P < 0.001). An increase of 10 μg/m³ in fine particulate matter ≤ 2.5 μm (PM2.5) was associated with a decrease of 0.12 pmol/L in FT4 and an increase of 0.07 pmol/L in FT3 (both P < 0.01). FT4/FT3 was significantly negatively associated with PM2.5 (coefficient: - 0.06, P < 0.01). These results remained robust in hierarchical analyses and sensitivity analyses.

CONCLUSIONS

Thyroid function parameters are associated with climate and air pollution exposure. These factors may influence variations in thyroid function. Our results also highlight the importance of public health interventions to reduce air pollution.