Genome-wide Analysis Reflects Novel 5-Hydroxymethylcytosines Implicated in Diabetic Nephropathy and the Biomarker Potential

AIM

Diabetic nephropathy (DN) has become the most common cause of end-stage renal disease (ESRD) in most countries. Elucidating novel epigenetic contributors to DN can not only enhance our understanding of this complex disorder, but also lay the foundation for developing more effective monitoring tools and preventive interventions in the future, thus contributing to our ultimate goal of improving patient care.

METHODS

The 5hmC-Seal, a highly selective, chemical labeling technique, was used to profile genome-wide 5-hydroxymethylcytosines (5hmC), a stable cytosine modification type marking gene activation, in circulating cell-free DNA (cfDNA) samples from a cohort of patients recruited at Zhongnan Hospital, including T2D patients with nephropathy (DN, n = 12), T2D patients with non-DN vascular complications (non-DN, n = 29), and T2D patients without any complication (controls, n = 14). Differentially analysis was performed to find DN-associated 5hmC features, followed by the exploration of biomarker potential of 5hmC in cfDNA for DN using a machine learning approach.

RESULTS

Genome-wide analyses of 5hmC in cfDNA detected 427 and 336 differential 5hmC modifications associated with DN, compared with non-DN individuals and controls, and suggested relevant pathways such as NOD-like receptor signaling pathway and tyrosine metabolism. Our exploration using a machine learning approach revealed an exploratory model comprised of ten 5hmC genes showing the possibility to distinguish DN from non-DN individuals or controls.

CONCLUSION

Genome-wide analysis suggests the possibility of exploiting novel 5hmC in patient-derived cfDNA as a non-invasive tool for monitoring DN in high risk T2D patients in the future.

Toehold-mediated strand displacement coupled with single nanoparticle dark-field microscopy imaging for ultrasensitive biosensing

Highly sensitive detection of biomarkers is essential for disease prevention and early diagnosis. Herein, a highly sensitive strategy was proposed for microRNA-21 (miRNA-21) detection by the incorporation of programmable toehold-mediated strand displacement (TMSD) and dark-field microscopy imaging. Firstly, efficient and specific TSMD was carried out via hybridization between the substrate strand (Sub) and two short probe strands (P1, P2). Then, miRNA-21 could specifically hybridize with Sub due to the toehold that existed on its tail, which triggered the amplification with the help of the assist strands, and forming a large number of Sub-assist double-stranded DNA (dsDNA). This process realized the targeted highly specific recognition of miRNA-21 and the amplification of the trace target to high-output dsDNA. Additionally, as glucose oxidase (Gox) was modified on the end of the assist strands in advance, hydrogen peroxide was generated after adding glucose to the system, which further etched gold-silver core-shell nanocubes (Au@Ag NCs). As a result, the size of Au@Ag NCs decreased and the scattering intensity reduced simultaneously. The scattering intensity reduction value of Au@Ag NCs has a linear relationship with miRNA-21 concentration in the range of 1.0 to 100.0 fM with a limit of detection of 1.0 fM. Finally, the proposed method has been successfully demonstrated for the determination of miRNA-21 in lung cancer cell A549 lysate.

Knee symptom but not radiographic knee osteoarthritis increases the risk of falls and fractures: results from the Osteoarthritis Initiative

OBJECTIVE

To describe the effect of knee symptoms and radiographic osteoarthritis (ROA) on the risk of falls, recurrent falls, and fractures.

DESIGN

Participants from the Osteoarthritis Initiative were classified as having 'no', 'unilateral' or 'bilateral' knee symptoms (≥19 on a 0-96 Western Ontario and McMaster Universities Osteoarthritis Index) and ROA (Kellgren-Lawrence grade ≥2) for each visit. Self-reported falls and fractures in the past 12 months were extracted at baseline and follow-up visits until month 96. Recurrent falls were defined as having ≥2 falls in the past 12 months. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated using mixed-effects complementary log-log regression.

RESULTS

Of 4465 participants, 3145 (70%), 1681 (38%), and 806 (18%) experienced at least one fall, recurrent fall, and fracture, respectively, over 96 months. Compared to participants without symptomatic knee, unilateral and bilateral knee symptoms were associated with a 17% increased risk of falls and a 36-46% increased risk of recurrent falls, and bilateral knee symptoms increased the risk of fractures (HR 1.45, 95%CI 1.17 to 1.81). Compared to participants with no ROA in either knee, bilateral ROA was associated with a reduced risk of falls (HR 0.87, 95%CI 0.77 to 0.99) and fractures (HR 0.78, 95%CI 0.64 to 0.96). No statistically significant interactions between knee symptoms and ROA were observed.

CONCLUSIONS

This large population-based study showed that knee symptoms but not ROA increased the risk of falls, recurrent falls, and fractures, and that adults with bilateral ROA may have a lower risk of falls and fractures.

222 Robotic Surgery: Public Perceptions and Current Misconceptions

Aim

While surgeons and robotic companies are key stakeholders involved in the adoption of Robotic Surgery (RS), the public's role is often overlooked. However, given that patients hold ultimate power over their healthcare decisions, public acceptance of RS is crucial. This study aims to identify public understanding, opinions and misconceptions on RS and present solutions to facilitate its wider integration.

Method

An online questionnaire distributed via social media platforms between February and May 2021 identified the views of UK adults on RS. The data was evaluated using thematic analysis, descriptive statistics, and statistical analysis. Statistical differences in age, gender, education level, and presence in the medical field were also sought.

Results

263 responses were obtained, with 216 (82.1%) analysed. Demographic differences provided significantly different results. Participants were relatively uninformed about RS, with a median knowledge score of 4.00(2.00–6.00) on a 10-point likert scale. Fears surrounding increased risk, reduced precision and technological failure were identified, alongside misconceptions on what RS entails, including it being autonomous. However, providing factual information in the survey about RS statistically increased participant comfort (p=<0.0001). Most (61.8%) participants believed robot manufacturers were responsible for malfunctions, but doctors were held accountable more by older, less educated, and non-medical participants.

Conclusions

This study highlights the role of negative and inaccurate public perceptions surrounding RS in impeding its widespread adoption. Greater emphasis must be placed on patient education in RS to mitigate misconceptions and ensure greater diffusion of its benefits

219 The Opportunities and Challenges of Robotic Surgery: A Surgeon and Robotic Company Perspective

Introduction

As an increasing number of specialties have begun to adopt robotic surgery (RS), its prevalence within the NHS is continually rising. This study aims to establish stakeholders’ opinions on the opportunities and challenges of the widespread adoption of RS.

Method

Participants were recruited through social media platforms such as LinkedIn or via university affiliations and current RS research. Semi-structured interviews of eight surgeons and five company representatives were conducted online. Transcripts were analysed to formulate themes surrounding the opportunities and challenges of RS.

Results

This study identified six common themes amongst shareholders: Perspective, Ethics, Impact of Robotics, Training, Adoption and Finances. The success rates and quality of results offered by RS make it a recognised future surgical staple amongst interviewees. However, the technology remains a contentious subject amongst surgeons, with many doubting whether the benefits outweigh the costs associated with implementation. Such reservations are further exacerbated by the absence of a formal training pathway. National guidelines are necessary to embed RS within the NHS infrastructure, allowing greater standardisation for patients and surgeons. The importance of patient education to address misconceptions was emphasised. Despite current high costs, robotic technology is forecasted to become cheaper with greater use and increased market competition. Interviewees stressed that responsibility for errors lies with the surgeon, but with the manufacturer for instrument malfunctions.

Conclusions

This study highlights stakeholders’ views on the opportunities and challenges of RS. The identified themes should form the basis of the proposed recommendations to facilitate a more widespread adoption of RS.

A 3D Grouped Convolutional Network Fused with Conditional Random Field and Its Application in Image Multi-target Fine Segmentation

Aiming at the utilization of adjacent image correlation information in multi-target segmentation of 3D image slices and the optimization of segmentation results, a 3D grouped fully convolutional network fused with conditional random fields (3D-GFCN) is proposed. The model takes fully convolutional network (FCN) as the image segmentation infrastructure, and fully connected conditional random field (FCCRF) as the post-processing tool. It expands the 2D convolution into 3D operations, and uses a shortcut-connection structure to achieve feature fusion of different levels and scales, to realizes the fine-segmentation of 3D image slices. 3D-GFCN uses 3D convolution kernel to correlate the information of 3D image adjacent slices, uses the context correlation and probability exploration mechanism of FCCRF to optimize the segmentation results, and uses the grouped convolution to reduce the model parameters. The dice loss that can ignore the influence of background pixels is used as the training objective function to reduce the influence of the imbalance quantity between background pixels and target pixels. The model can automatically study and focus on target structures of different shapes and sizes in the image, highlight the salient features useful for specific tasks. In the mechanism, it can improve the shortcomings and limitations of the existing image segmentation algorithms, such as insignificant morphological features of the target image, weak correlation of spatial information and discontinuous segmentation results, and improve the accuracy of multi-target segmentation results and learning efficiency. Take abdominal abnormal tissue detection and multi-target segmentation based on 3D computer tomography (CT) images as verification experiments. In the case of small-scale and unbalanced data set, the average Dice coefficient is 88.8%, the Class Pixel Accuracy is 95.3%, and Intersection of Union is 87.8%. Compared with other methods, the performance evaluation index and segmentation accuracy are significantly improved. It shows that the proposed method has good applicability for solving typical multi-target image segmentation problems, such as boundary overlap, offset deformation and low contrast.

Similarities Between Somatosensory Cortical Responses Induced via Natural Touch and Microstimulation in the Ventral Posterior Lateral Thalamus in Macaques

Lost sensations, such as touch, could be restored by microstimulation (MiSt) along the sensory neural substrate. Such neuroprosthetic sensory information can be used as feedback from an invasive brain-machine interface (BMI) to control a robotic arm/hand, such that tactile and proprioceptive feedback from the sensorized robotic arm/hand is directly given to the BMI user. Microstimulation in the human somatosensory thalamus (Vc) has been shown to produce somatosensory perceptions. However, until recently, systematic methods for using thalamic stimulation to evoke naturalistic touch perceptions were lacking. We have recently presented rigorous methods for determining a mapping between ventral posterior lateral thalamus (VPL) MiSt, and neural responses in the somatosensory cortex (S1), in a rodent model (Choi et al., 2016; Choi and Francis, 2018). Our technique minimizes the difference between S1 neural responses induced by natural sensory stimuli and those generated via VPL MiSt. Our goal is to develop systems that know what neural response a given MiSt will produce and possibly allow the development of natural “sensation.” To date, our optimization has been conducted in the rodent model and simulations. Here, we present data from simple non-optimized thalamic MiSt during peri-operative experiments, where we used MiSt in the VPL of macaques, which have a somatosensory system more like humans, as compared to our previous rat work (Li et al., 2014; Choi et al., 2016). We implanted arrays of microelectrodes across the hand area of the macaque S1 cortex as well as in the VPL. Multi and single-unit recordings were used to compare cortical responses to natural touch and thalamic MiSt in the anesthetized state. Post-stimulus time histograms were highly correlated between the VPL MiSt and natural touch modalities, adding support to the use of VPL MiSt toward producing a somatosensory neuroprosthesis in humans.

Identification of a Novel Immune-Related lncRNA CTD-2288O8.1 Regulating Cisplatin Resistance in Ovarian Cancer Based on Integrated Analysis

Ovarian cancer (OC) is the most lethal gynecological malignancy, in which chemoresistance is a crucial factor leading to the poor prognosis. Recently, immunotherapy has brought new light for the treatment of solid tumors. Hence, as a kind of immunologically active cancer, it is reasonably necessary to explore the potential mechanism between immune characteristics and cisplatin resistance in OC. Our study focused on the important role of cisplatin resistance-related lncRNAs on mediating the OC tumor immune microenvironment (TIME) using an integrative analysis based on the Cancer Genome Atlas (TCGA) database. First, the cisplatin resistance-related differentially expressed lncRNAs (DELs) and mRNAs (DEMs) were preliminarily screened to construct a DEL–DEM co-expression network. Next, the protein–protein interaction (PPI) network and pivot analysis were performed to reveal the relevance of these lncRNAs with tumor immune response. Second, the novel lncRNA CTD-2288O8.1 was identified as a key gene for the OC cisplatin resistance formation by qRT-PCR and survival analysis. Gain- and loss-of-function assays (Cell Counting Kit-8 (CCK-8) assay, wound-healing scratch assay, transwell assay, and colony formation assay) further verified the activity of CTD-2288O8.1 in OC progression as well. Third, gene set enrichment analysis (GSEA) was applied along with the correlation analyses of CTD-2288O8.1 with ImmuneScore, tumor-infiltrating immune cells (TICs), and immune inhibitory checkpoint molecules, illustrating that CTD-2288O8.1 was strongly associated with the TIME and has the potential to predict the effect of OC immunotherapy. In addition, basic experiments demonstrated that the expression of CTD-2288O8.1 impacted the EGFR/AKT signal pathway activity of OC tumor cells. Of greater significance, it promoted the M2 polarization of macrophage, which is a type of the most important components of the TIME in solid tumor. Taking together, our study revealed cisplatin resistance-related lncRNAs closely linked with tumor immunity in OC, underscoring the potential mechanism of the TIME in conferring cisplatin resistance, which provided the research basis for further clinical treatment. CTD-2288O8.1 was identified to mediate cisplatin resistance and affect the response of immunotherapy, which could serve as a promising biomarker for guiding clinical treatment and improving prognosis in OC.

Integrated Analysis of RNA Binding Protein-Related lncRNA Prognostic Signature for Breast Cancer Patients

Long non-coding RNAs (lncRNAs) have been well known for their multiple functions in the tumorigenesis, development, and prognosis of breast cancer (BC). Mechanistically, their production, function, or stability can be regulated by RNA binding proteins (RBPs), which were also involved in the carcinogenesis and progression of BC. However, the roles and clinical implications of RBP-related lncRNAs in BC remain largely unknown. Therefore, we herein aim to construct a prognostic signature with RBP-relevant lncRNAs for the prognostic evaluation of BC patients. Firstly, based on the RNA sequencing data of female BC patients from The Cancer Genome Atlas (TCGA) database, we screened out 377 differentially expressed lncRNAs related to RBPs. The univariate, least absolute shrinkage and selection operator (LASSO), and multivariate Cox regression analyses were then performed to establish a prognostic signature composed of 12-RBP-related lncRNAs. Furthermore, we divided the BC patients into high- and low-risk groups by the prognostic signature and found the overall survival (OS) of patients in the high-risk group was significantly shorter than that of the low-risk group. Moreover, the 12-lncRNA signature exhibited independence in evaluating the prognosis of BC patients. Additionally, a functional enrichment analysis revealed that the prognostic signature was associated with some cancer-relevant pathways, including cell cycle and immunity. In summary, our 12-lncRNA signature may provide a theoretical reference for the prognostic evaluation or clinical treatment of BC patients.

Latexin deficiency attenuates adipocyte differentiation and protects mice against obesity and metabolic disorders induced by high-fat diet

Obesity is a risk factor for many chronic diseases, and is associated with increased incidence rate of type 2 diabetes, hypertension, dyslipidemia and cardiovascular diseases. Adipocyte differentiation play critical role during development of obesity. Latexin (LXN), a mammalian carboxypeptidase inhibitor, plays important role in the proliferation and differentiation of stem cells, and highlights as a differentiation-associated gene that was significantly downregulated in prostate stem cells and whose expression increases through differentiation. However, it is unclear whether LXN is involved in adipocyte differentiation. The aim of this study was to evaluate the role of LXN on adipocyte differentiation, as well as its effects on high fat-induced obesity and metabolic disorders. In this study, we determine the expression of LXN in adipose tissue of lean and fat mice by Western blot, qPCR and immunohistochemistry. We found that LXN in fat tissues was continuous increased during the development of diet-induced obesity. We fed wild-type (WT) and LXN−/−mice with high-fat diet (HFD) to study the effects of LXN on obesity and related metabolic functions. We found that mice deficient in LXN showed resistance against high-fat diet (HFD)-induced obesity, glucose tolerance, insulin tolerance and hepatic steatosis. In vitro studies indicated that LXN was highly induced during adipocyte differentiation, and positively regulated adipocyte differentiation and adipogenesis in 3T3-L1 cells and primary preadipocytes. Functional analysis revealed that the expression of LXN was positively regulated by mTOR/RXR/PPARɤ signaling pathway during the differentiation of adipocytes, while LXN deletion decreased the protein level of PPARɤ in adipocyte through enhancing FABP4 mediated ubiquitination, which led to impaired adipocyte differentiation and lipogenesis. Collectively, our data provide evidence that LXN is a key positive regulator of adipocyte differentiation, and therapeutics targeting LXN could be effective in preventing obesity and its associated disorders in clinical settings.

The benefits and relevant risk factor assessment of neoadjuvant chemotherapy in combination with surgery in limited-stage small cell lung cancer

To illustrate the benefits of surgery in conjunction with neoadjuvant chemotherapy in patients with limited-stage small cell lung cancer (LS-SCLC), and to evaluate risk factors affecting patient's survival. Forty-six LS-SCLC patients who received surgery in our center from September 2012 to December 2018 were retrospectively analyzed. Twenty-five patients with LS-SCLC diagnosed after surgery who received postoperative adjuvant chemotherapy were classified into control group, and 21 patients with LS-SCLC who received preoperative neoadjuvant chemotherapy were classified into observation group. The observation group were divided into subgroup 1 (negative lymph nodes) and subgroup 2 (positive lymph nodes). Progression-free survival (PFS) and overall survival (OS) of patients were analyzed. Univariate and multivariate Cox regression were utilized to analyze independent risk factors affecting patient's survival. PFS and OS of patients in the control group and observation group had similar outcomes (P > 0.05). Subgroup 1 and subgroup 2 had similar PFS and OS (P > 0.05). PT2, pN2, BM, and two or more positive lymph nodes were significantly associated with poor PFS and OS (P < 0.05). Furthermore, the pT, number of lymph node positive stations and BM were independent risk factors affecting patient's survival (P < 0.05). Surgery combined with neoadjuvant chemotherapy can achieve long-term survival benefit for some patients with LS-SCLC. It is necessary to find a better plan that enables to select patients suitable for surgery after neoadjuvant chemotherapy.

Rapid screening of glycosyltransferases in plants using a linear DNA expression template based cell-free transcription-translation system

Plants have an extensively large number of enzymes including glycosyltransferases that are important in the biosynthesis of natural products. However, it is time-consuming and challenging to study these enzymes and only a small percentage of them have been well-characterized. Here, we report a rapid method to screen plant glycosyltransferases using a linear DNA expression template (LET) based cell-free transcription-translation system (TX-TL). As a proof of concept, we amplified and tested glycosyltransferases from Arabidopsis thaliana and showed that the catalytic activity results of these glycosyltransferases from LET-based-TX-TL were consistent with previous studies. We then chose a local medicinal plant Anoectochilus roxburghii, acquired its transcriptome sequences, and applied this method to study its glycosyltransferases. We rapidly expressed all the putative UDP-glucose glycosyltransferases using LET-based-TX-TL and discovered 6 unreported active glycosyltransferases which can catalyze the glycosylation of quercetin into isoquercitrin. Thus, LET-based-TX-TL was shown to be a powerful tool for researchers to rapidly screen plant glycosyltransferases for the first time.

An algorithm-assisted automated identification and enumeration system for sensitive hydrogen sulfide sensing under dark field microscopy

A sensitive H2S sensing strategy has been developed based on the automated identification and enumeration algorithm.

A Generative Adversarial Network Fused with Dual-Attention Mechanism and Its Application in Multitarget Image Fine Segmentation

Aiming at the problem of insignificant target morphological features, inaccurate detection and unclear boundary of small-target regions, and multitarget boundary overlap in multitarget complex image segmentation, combining the image segmentation mechanism of generative adversarial network with the feature enhancement method of nonlocal attention, a generative adversarial network fused with attention mechanism (AM-GAN) is proposed. The generative network in the model is composed of residual network and nonlocal attention module, which use the feature extraction and multiscale fusion mechanism of residual network, as well as feature enhancement and global information fusion ability of nonlocal spatial-channel dual attention to enhance the target features in the detection area and improve the continuity and clarity of the segmentation boundary. The adversarial network is composed of fully convolutional networks, which penalizes the loss of information in small-target regions by judging the authenticity of prediction and label segmentation and improves the detection ability of the generative adversarial model for small targets and the accuracy of multitarget segmentation. AM-GAN can use the GAN's inherent mechanism that reconstruct and repair high-resolution image, as well as the ability of nonlocal attention global receptive field to strengthen detail features, automatically learn to focus on target structures of different shapes and sizes, highlight salient features useful for specific tasks, reduce the loss of image detail features, improve the accuracy of small-target detection, and optimize the segmentation boundary of multitargets. Taking medical MRI abdominal image segmentation as a verification experiment, multitargets such as liver, left/right kidney, and spleen are selected for segmentation and abnormal tissue detection. In the case of small and unbalanced sample datasets, the class pixels' accuracy reaches 87.37%, the intersection over union is 92.42%, and the average Dice coefficient is 93%. Compared with other methods in the experiment, the segmentation precision and accuracy are greatly improved. It shows that the proposed method has good applicability for solving typical multitarget image segmentation problems such as small-target feature detection, boundary overlap, and offset deformation.

[Epidemiological characteristics of imported Plasmodium ovale malaria in Jiangsu Province from 2012 to 2020]

OBJECTIVE

To analyze the epidemiological characteristics of imported cases with Plasmodium ovale infections in Jiangsu Province from 2012 to 2020, so as to provide insights into the development of the imported malaria control strategy in the province.

METHODS

All data pertaining to cases with definitive diagnosis of P. ovale malaria in Jiangsu Province from 2012 to 2020 were captured from the National Notifiable Disease Report System and the Information Management System for Parasitic Disease Control in China, including the date of going abroad and returning to China, time of malaria infections overseas, date of malaria onset, initial diagnosis and definitive diagnosis. All data pertaining to epidemic status were descriptively analyzed.

RESULTS

A total of 347 cases of P. ovale malaria were reported in Jiangsu Province from 2012 to 2020, with the highest number seen in 2015 (71 cases). All cases were laboratory-confirmed overseas imported malaria cases, accounting for 14.32% of all reported malaria cases in Jiangsu Province during the period from 2012 to 2020. The 5 cities with the highest number of imported P. ovale malaria cases included Lianyungang City (53 cases, 15.27%), Nantong City (44 cases, 12.68%), Huai'an (44 cases, 12.68%), Taizhou City (44 cases, 12.68%) and Yangzhou City (36 cases, 10.37%). The highest number of imported P. ovale malaria cases was reported in October (39 cases, 11.24%), and the lowest number was seen in December (21 cases, 6.05%). P. ovale infections mainly occurred in were Equatorial Guinea (97 cases, 37.95%), Angola (60 cases, 17.29%) and Nigeria (40 cases, 11.53%). The median duration between returning to China and malaria onset was 64 (144) days, and 7.49% (26/347) of all cases developed malaria one year after returning to China. The initial diagnosis of P. ovale malaria was mainly made at county-level medical institutions (117 cases, 33.72%), and the definitive diagnosis was mainly made at city-level medical institutions (122 cases, 35.16%). The correct rate of initial diagnosis of P. ovale malaria increased from 0 in 2012 to 78.26% in 2020, appearing a tendency towards a rise year by year (χ² = 50.90, P < 0.01).

CONCLUSIONS

Imported P. ovale malaria cases were reported in Jiangsu Province each year from 2012 to 2020, and P. ovale infections predominantly occurred in Africa. Initial and definitive diagnoses of P. ovale malaria were mainly made at city- and county-level medical institutions. Training on the detection ability of malaria parasites is recommended among grassroots microscopists to improve the diagnostic ability of P. ovale malaria, and consolidate the achievements of malaria elimination in Jiangsu Province.

Synthesis and biological evaluation of celastrol derivatives as potent antitumor agents with STAT3 inhibition

Using STAT3 inhibitors as a potential strategy in cancer therapy have attracted much attention. Recently, celastrol has been reported that it could directly bind to and suppress the activity of STAT3 in the cardiac dysfunction model. To explore more effective STAT3 inhibiting anti-tumour drug candidates, we synthesised a series of celastrol derivatives and biologically evaluated them with several human cancer cell lines. The western blotting analysis showed that compound 4 m, the most active derivative, could suppress the STAT3's phosphorylation as well as its downstream genes. SPR analysis, molecular docking and dynamics simulations' results indicated that the 4m could bind with STAT3 protein more tightly than celastrol. Then we found that the 4m could block cell-cycle and induce apoptosis on HCT-116 cells. Furthermore, the anti-tumour effect of 4m was verified on colorectal cancer organoid. This is the first research that discovered effective STAT3 inhibitors as potent anti-tumour agents from celastrol derivatives.

[Adult myofibroma: a clinicopathological analysis of 15 cases]

Objective: To investigate the clinicopathological features and immunophenotype of adult myofibroma with emphasis on its differential diagnosis. Methods: The clinical, pathologic data and immunohistochemical profiles were analyzed in 15 cases of adult myofibroma diagnosed between 2014 and 2020 in Department of Pathology, Fudan University Shanghai Cancer Center. The literature was reviewed. Results: There were seven males and eight females, with age at presentation ranging from 22 to 74 years (mean 54 years; median 57 years). Tumor occurred principally in the extremities (n=9), less frequently involved the head and neck region (n=3) and trunk (n=2); one case was located in the vertebral canal of C6-7. Fourteen cases were solitary; one case was multifocal. Most patients presented with a slowly growing painless subcutaneous nodule, about 1 to 2 cm in size. One patient with multifocal disease and the patient with spinal lesion complained of intermittent pain. The duration of symptoms ranged from 2 months to 10 years. Microscopically, they were well circumscribed. All cases showed biphasic growth pattern, consisting of relatively well-differentiated eosinophilic nodules alternating with dark-staining primitive-appearing areas. The light-staining hypocellular nodules were composed of myofibroblast-like plump spindle cells within an eosinophilic stroma, which assumed pale blue myxochondroid appearance and hyalinization of varying degree. The dark-staining areas were composed of compact short spindled to ovoid cells with hyperchromatic nuclei and low mitotic activity, frequently showing a distinctive hemangiopericytoma-like architecture. By immunohistochemistry, the myoid spindled cells and the primitive cells stained variably for α-SMA, MSA and calponin, but were consistently negative for desmin and β-catenin. Conclusions: Adult myofibroma tends to occur in the middle to old aged patients with a predilection for the dermis or subcutis of the extremities. It is a benign neoplasm which can be cured by excision in most cases. Familiarity with its distinctive clinicopathological features helps in the distinction from other myofibroblastic neoplasms.

Knockdown of Sirt1 Gene in Mice Results in Lipid Accumulation in the Liver Mediated via PGC-1α-Induced Mitochondrial Dysfunction and Oxidative Stress

The study demonstrated the crucial role of Sirt1 gene in the pathogenesis of non-alcoholic fatty liver disease (NAFLD) related to the influence of Sirt1 on oxidative stress and glycolipid metabolism. The 16-week-old genetically diabetic db/db mice were characterized with downregulated expression of Sirt1 in the liver accompanied by hepatomegaly and a larger size of fat vacuoles in hepatocytes. In db/m mice, silencing Sirt1 gene induced hepatic steatosis and significantly increased serum AST. Additionally, the levels of triglycerides in blood and liver of these mice were elevated. However, all pathological changes in the liver of Sirt1-knockdown db/m mice were less pronounced than in 16-week-old db/db mice. Further experiments showed that oxidative stress and PGC-1α-mediated mitochondrial dysfunction are implicated in pathological changes of lipid metabolism in T2DM-induced NAFLD provoked by Sirt1 silencing. This study showed that down-regulation of Sirt1 expression plays the key role in pathological processes developed during T2DM-induced abnormalities of lipid metabolism in the liver. Thus, up-regulation of Sirt1 expression seems to be a promising strategy in early prevention of T2DM-induced NAFLD.

CO2 Capture, Separation and Reduction on Boron-Doped MoS2 , MoSe2 and Heterostructures with Different Doping Densities: A Theoretical Study

Designing high-performance materials for CO₂ capture and conversion is of great significance to reduce the greenhouse effect and alleviate the energy crisis. The strategy of doping is widely used to improve activity and selectivity of the materials. However, it is unclear how the doping densities influence the materials' properties. Herein, we investigated the mechanism of CO₂ capture, separation and conversion on MoS₂ , MoSe₂ and Janus MoSSe monolayers with different boron doping levels using density functional theory (DFT) simulations. The results indicate that CO₂ , H₂ and CH₄ bind weakly to the monolayers without and with single-atom boron doping, rendering these materials unsuitable for CO₂ capture from gas mixtures. In contrast, CO₂ binds strongly to monolayers doped with diatomic boron, whereas H₂ and CH₄ can only form weak interactions with these surfaces. Thus, the monolayers doped with diatomic boron can efficiently capture and separate CO₂ from such gas mixtures. The electronic structure analysis demonstrates that monolayers doped with diatomic doped are more prone to donating electrons to CO₂ than those with single-atom boron doped, leading to activation of CO₂ . The results further indicate that CO₂ can be converted to CH₄ on diatomic boron doped catalysts, and MoSSe is the most efficient of the surfaces studied for CO₂ capture, separation and conversion. In summary, the study provides evidence for the doping density is vital to design materials with particular functions.