CXCL1-CXCR2 axis mediates inflammatory response after sciatic nerve injury by regulating macrophage infiltration

Macrophages play a crucial role in the inflammatory response following sciatic nerve injury. Studies have demonstrated that C-X-C motif chemokine (CXCL) 1 recruit macrophages by binding to C-X-C chemokine receptor (CXCR) 2 and participates in the inflammatory response of various diseases. Based on these findings, we aimed to explore the role of the CXCL1-CXCR2 axis in the repair process after peripheral nerve injury. Initially, we simulated sciatic nerve injury and observed an increased expression of CXCL1 and CXCR2 in the nerves of the injury group. Both in vivo and in vitro experiments confirmed that the heightened CXCL1 expression occurs in Schwann cells and is secreted, while the elevated CXCR2 is expressed by recruited macrophages. In addition, in vitro experiments demonstrated that the binding of CXCL1 to CXCR2 can activate the NLRP3 inflammasome and promote the production of interleukin-1 beta (IL-1β) in macrophages. However, after mice were subjected to sciatic nerve injury, the number of macrophages and the expression of inflammatory factors in the sciatic nerve were reduced following treatment with the CXCR2 inhibitor SB225002. Simultaneously, we evaluated the sciatic nerve function index, the expression of p75 neurotrophic factor receptor (p75NTR), and myelin proteins, and all of these results were improved with the use of SB225002. Thus, our results suggest that after sciatic nerve injury, the CXCL1-CXCR2 axis mediates the inflammatory response by promoting the recruitment and activation of macrophages, which is detrimental to the repair of the injured nerves. In contrast, treatment with SB225002 promotes the repair of injured sciatic nerves.

IL-36 Regulates Neutrophil Chemotaxis and Bone Loss at the Oral Barrier

Tissue-specific mechanisms regulate neutrophil immunity at the oral barrier, which plays a key role in periodontitis. Although it has been proposed that fibroblasts emit a powerful neutrophil chemotactic signal, how this chemotactic signal is driven has not been clear. The objective of this study was to investigate the site-specific regulatory mechanisms by which fibroblasts drive powerful neutrophil chemotactic signals within the oral barrier, with particular emphasis on the role of the IL-36 family. The present study found that IL-36γ, agonist of IL-36R, could promote neutrophil chemotaxis via fibroblast. Single-cell RNA sequencing data disclosed that IL36G is primarily expressed in human and mouse gingival epithelial cells and mouse neutrophils. Notably, there was a substantial increase in IL-36γ levels during periodontitis. In vitro experiments demonstrated that IL-36γ specifically activates gingival fibroblasts, leading to chemotaxis of neutrophils. In vivo experiments revealed that IL-36Ra inhibited the infiltration of neutrophils and bone resorption, while IL-36γ promoted their progression in the ligature-induced periodontitis mouse model. In summary, these data elucidate the function of the site-enriched IL-36γ in regulating neutrophil immunity and bone resorption at the oral barrier. These findings provide new insights into the tissue-specific pathophysiology of periodontitis and offer a promising avenue for prevention and treatment through targeted intervention of the IL-36 family.

Pathogenic Th17 cell-mediated liver fibrosis contributes to resistance to PD-L1 antibody immunotherapy in hepatocellular carcinoma

Understanding the mechanisms of resistance of hepatocellular carcinoma (HCC) to targeted therapies and immune checkpoint blockade is critical for the development of new combination therapies and improving patient survival. Here, we found that in HCC, anti-programmed cell death 1 ligand 1 (PD-L1) therapy reduces liver cancer growth, but the tumors eventually become resistant to continued therapy. Experimental analyses shows that the infiltration of pathogenic T helper 17 (pTh17) cells increases in drug-resistant HCC, and pTh17 cells secrete interleukin-17A (IL-17A), which promotes the expression of PD-L1 on the surface of HCC cells and produces resistance to anti-PD-L1 therapy. Anti-IL-17A combined with PD-L1 blockade significantly increased the infiltration of cytotoxic CD8+ T cells expressing high levels of interferon-γ and reduced treatment resistance in HCC. These results support the combination of anti-PD-L1 and anti-IL-17A as a novel strategy to induce effective T cell-mediated anti-tumor immune responses.

The CXCL12-CXCR4-NLRP3 axis promotes Schwann cell pyroptosis and sciatic nerve demyelination in rats

Studies have shown that the activation of the NOD-like receptor protein 3 (NLRP3) inflammasome is detrimental to the functional recovery of the sciatic nerve, but the regulatory mechanisms of the NLRP3 inflammasome in peripheral nerves are unclear. C-X-C motif chemokine 12 (CXCL12) can bind to C-X-C chemokine receptor type 4 (CXCR4) and participate in a wide range of nerve inflammation by regulating the NLRP3 inflammasome. Based on these, we explore whether CXCL12-CXCR4 axis regulates the NLRP3 inflammasome in the peripheral nerve. We found that CXCR4/CXCL12, NLRP3 inflammasome-related components, pyroptosis-related proteins and inflammatory factors in the sciatic nerve injured rats were markedly increased compared with the sham-operated group. AMD3100, a CXCR4 antagonist, reverses the activation of NLRP3 inflammasome, Schwann cell pyroptosis and sciatic nerve demyelination. We further treated rat Schwann cells with LPS (lipopolysaccharide) and adenosine triphosphate (ATP) to mimic the cellular inflammation model of sciatic nerve injury, and the results were consistent with those in vivo. In addition, both in vivo and in vitro experiments demonstrated that AMD3100 treatment reduced the phosphorylation of nuclear factor κB (NF-κB) and the expression of thioredoxin interacting protein (TXNIP), which contributes to activating NLRP3 inflammasome. Therefore, our findings suggest that, after sciatic nerve injury, CXCL12-CXCR4 axis may promote Schwann cell pyroptosis and sciatic nerve demyelination through activating NLRP3 inflammasome and slow the recovery process of the sciatic nerve.

Construction and validation of a risk assessment model for acute kidney injury in patients with acute pancreatitis in the intensive care unit

BACKGROUND

To construct and validate a risk assessment model for acute kidney injury (AKI) in patients with acute pancreatitis (AP) in the intensive care unit (ICU).

METHODS

A total of 963 patients diagnosed with acute pancreatitis (AP) from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database was included. These patients were randomly divided into training set (N = 674) and validation set (N = 289) at a ratio of 7:3. Clinical characteristics were utilized to establish a nomogram for the prediction of AKI during ICU stay. These variables were selected by the least absolute shrinkage and selection operation (LASSO) regression and included in multivariate logistic regression analysis. Variables with P-values less than 0.05 were included in the final model. A nomogram was constructed based on the final model. The predicted accuracy of the nomogram was assessed by calculating the receiver operating characteristic curve (ROC) and the area under the curve (AUC). Moreover, calibration curves and Hosmer-Lemeshow goodness-of-fit test (HL test) were performed to evaluate model performance. Decision curve analysis (DCA) evaluated the clinical net benefit of the model.

RESULTS

A multivariable model that included 6 variables: weight, SOFA score, white blood cell count, albumin, chronic heart failure, and sepsis. The C-index of the nomogram was 0.82, and the area under the receiver operating characteristic curve (AUC) of the training set and validation set were 0.82 (95% confidence interval:0.79-0.86) and 0.76 (95% confidence interval: 0.70-0.82), respectively. Calibration plots showed good consistency between predicted and observed outcomes in both the training and validation sets. DCA confirmed the clinical value of the model and its good impact on actual decision-making.

CONCLUSION

We identified risk factors associated with the development of AKI in patients with AP. A risk prediction model for AKI in ICU patients with AP was constructed, and improving the treatment strategy of relevant factors in the model can reduce the risk of AKI in AP patients.

IL-17A functions and the therapeutic use of IL-17A and IL-17RA targeted antibodies for cancer treatment

Interleukin 17A (IL-17A) is a major member of the IL-17 cytokine family and is produced mainly by T helper 17 (Th17) cells. Other cells such as CD8+ T cells, γδ T cells, natural killer T cells and innate lymphoid-like cells can also produce IL-17A. In healthy individuals, IL-17A has a host-protective capacity, but excessive elevation of IL-17A is associated with the development of autoimmune diseases and cancer. Monoclonal antibodies (mAbs) targeting IL-17A (e.g., ixekizumab and secukinumab) or IL-17A receptor (IL-17RA) (e.g., brodalumab) would be investigated as potential treatments for these diseases. Currently, the application of IL-17A-targeted drugs in autoimmune diseases will provide new ideas for the treatment of tumors, and its combined application with immune checkpoint inhibitors has become a research hotspot. This article reviews the mechanism of action of IL-17A and the application of anti-IL-17A antibodies, focusing on the research progress on the mechanism of action and therapeutic blockade of IL-17A in various tumors such as colorectal cancer (CRC), lung cancer, gastric cancer and breast cancer. Moreover, we also include the results of therapeutic blockade in the field of cancer as well as recent advances in the regulation of IL-17A signaling.

Unilateral biportal endoscopic spine surgery for lumbar spinal stenosis: a systematic review and meta-analysis

OBJECTIVE

Lumbar spinal stenosis is the most common spinal degenerative disease in patients over 60 years, and the unilateral biportal endoscopic (UBE) spine surgery treatment of lumbar spinal stenosis (LSS) has achieved preliminary clinical results. This systematic review and meta-analysis aimed to reveal the clinical efficacy of UBE for LSS and provide evidence for clinical practice.

MATERIALS AND METHODS

PubMed, Embase, Web of Science, and Cochrane databases were searched for literature. The papers selected were those published from inception till October 2021. The selected pieces of literature were graded for evidence using the Oxford Centre for Evidence-Based Medicine: Levels of Evidence (March 2009). Outcomes measures were operation time, blood loss, complication rate, admission period, Visual Analogue Scale (VAS)-back, VAS-leg, and Oswestry Disability Index (ODI) score, and radiological outcomes. The mean comparisons were based on VAS and ODI scores.

RESULTS

A total of 823 patients with a single LSS segment were included from the selected nine studies. There were nine studies comparing UBE clinical outcomes and micro-endoscopic unilateral laminotomy for bilateral decompression (M-ULBD). The meta-analysis revealed that the UBE group had better VAS-leg and -back scores in the first week postoperatively [total: mean difference (MD) = -0.96, 95% confidence interval (CI): -1.19, -0.74, p < 0.00001; total: MD = -1.69, 95% CI: -1.93, -1.45, p < 0.00001], 1st month postoperatively (total: MD = -0.35, 95% CI: -0.61, -0.08, p = 0.01; total: MD = -0.40, 95% CI: -0.68, -0.12, p = 0.005), 6th month postoperatively (total: MD = -0.22, 95% CI: -0.35, -0.08, p = 0.002; total: MD = -0.24, 95% CI: -0.40, -0.07, p = 0.005), and UBE group also performed better in ODI score at 1st month postoperatively (total: MD = -3.36, 95% CI: -4.26, -2.46, p < 0.00001). There was no significant difference in VAS-leg and -back scores between both groups at the 3rd and 12th month postoperatively, and ODI scores did not significantly differ between both groups at 3, 6, and 12 months postoperatively (all p > 0.05).

CONCLUSIONS

UBE has achieved good preliminary clinical results and may be a minimally invasive alternative surgery for patients with single segmental LSS.

[Effects of interleukin-17A on liver and kidney injury and prognosis in septic mice]

OBJECTIVE

To explore the effect of interleukin-17A (IL-17A) on liver and kidney injury and prognosis in septic mice.

METHODS

A total of 84 SPF male C57BL/6 mice were randomly divided into sham operation group (Sham group), cecal ligation and puncture (CLP) induced sepsis model group (CLP group), and IL-17A intervention group. IL-17A intervention group were then divided into five subgroups according to the dose of IL-17A (0.25, 0.5, 1, 2, 4 μg). Mice in the IL-17A intervention group were intraperitoneally injected with the corresponding dose of IL-17A 100 μL immediately after surgery. The other groups were intraperitoneally injected with 100 μL phosphate buffer solution (PBS). The survival rate of mice was observed at 7 days, and peripheral blood and liver, kidney and spleen tissues were collected. According to the 7-day survival, another 18 mice were randomly divided into Sham group, CLP group, and 1 μg IL-17A intervention group. Peripheral blood samples were collected at 12 hours and 24 hours after CLP, and the mice were sacrificed to obtain liver, kidney, and spleen tissues. The behavior and abdominal cavity of each group were observed. The levels of peripheral blood liver and kidney function indexes and inflammatory factors were detected. The histopathological changes of liver and kidney were observed under light microscope. The peripheral blood and spleen tissues were inoculated in the medium, the number of bacterial colonies was calculated, and the bacterial migration of each group was evaluated in vitro.

RESULTS

Except for the Sham group, the 7-day survival rate of mice in the 1 μg IL-17A intervention group was the highest (75.0%), so this condition was selected as the intervention condition for the subsequent study. Compared with Sham group, the liver and kidney functions of CLP group were significantly damaged at each time point after operation. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN) and serum creatinine (SCr) reached the peak at 24 hours after operation, and the liver and kidney pathological scores reached the peak at 7 days after operation, the levels of inflammatory cytokines interleukin (IL-17A, IL-6, IL-10) reached the peak at 12 hours after operation, and tumor necrosis factor-α (TNF-α) reached the peak at 24 hours after operation. In addition, a large number of bacteria proliferated in the peripheral blood and spleen, which reached the peak on day 7. Compared with the CLP group, exogenous administration of 1 μg IL-17A significantly delayed the rising trend of each index in the early stage of sepsis [24-hour ALT (U/L): 166.95±5.20 vs. 271.30±6.11, 24-hour AST (U/L): 599.42±7.25 vs. 1 013.27±3.37, 24-hour BUN (mg/L): 815.4±26.3 vs. 1 191.2±39.4, 24-hour SCr (μmol/L): 29.34±0.87 vs. 60.75±3.83, 7-day liver pathological score: 2.50 (2.00, 3.00) vs. 9.00 (8.50, 9.00), 7-day kidney pathological score: 1.00 (1.00, 2.00) vs. 5.00 (4.50, 5.00), 12-hour IL-17A (ng/L): 105.21±0.31 vs. 111.28±1.37, 12-hour IL-6 (ng/L): 83.22±1.01 vs. 108.88±0.99, 12-hour IL-10 (ng/L): 731.54±3.04 vs. 790.25±2.54, 24-hour TNF-α (μg/L): 454.67±0.66 vs. 576.18±0.76, 7-day peripheral blood colony count (CFU/mL): 600 (400, 600) vs. 4 200 (4 200, 4 300), 7-day spleen tissue colony count (CFU/g): 4 600 (4 400, 4 600) vs. 23 400 (23 200, 23 500), all P < 0.05].

CONCLUSIONS

Appropriate dose (1 μg) of exogenous IL-17A can reduce the lethal inflammatory response induced by CLP and improve the ability of bacterial clearance, thereby alleviating liver and kidney injury and improving the 7-day survival rate of septic mice.

YAP activation inhibits inflammatory signalling and cartilage breakdown associated with reduced primary cilia expression

OBJECTIVE

To clarify the role of YAP in modulating cartilage inflammation and degradation and the involvement of primary cilia and associated intraflagellar transport (IFT).

METHODS

Isolated primary chondrocytes were cultured on substrates of different stiffness (6-1000 kPa) or treated with YAP agonist lysophosphatidic acid (LPA) or YAP antagonist verteporfin (VP), or genetically modified by YAP siRNA, all ± IL1β. Nitric oxide (NO) and prostaglandin E2 (PGE2) release were measured to monitor IL1β response. YAP activity was quantified by YAP nuclear/cytoplasmic ratio and percentage of YAP-positive cells. Mechanical properties of cartilage explants were tested to confirm cartilage degradation. The involvement of primary cilia and IFT was analysed using IFT88 siRNA and ORPK cells with hypomorphic mutation of IFT88.

RESULTS

Treatment with LPA, or increasing polydimethylsiloxane (PDMS) substrate stiffness, activated YAP nuclear expression and inhibited IL1β-induced release of NO and PGE2, in isolated chondrocytes. Treatment with LPA also inhibited IL1β-mediated inflammatory signalling in cartilage explants and prevented matrix degradation and the loss of cartilage biomechanics. YAP activation reduced expression of primary cilia, knockdown of YAP in the absence of functional cilia/IFT failed to induce an inflammatory response.

CONCLUSIONS

We demonstrate that both pharmaceutical and mechanical activation of YAP blocks pro-inflammatory signalling induced by IL1β and prevents cartilage breakdown and the loss of biomechanical functionality. This is associated with reduced expression of primary cilia revealing a potential anti-inflammatory mechanism with novel therapeutic targets for treatment of osteoarthritis (OA).

[Research advances of stem cell-based tissue engineering repair materials in promoting the healing of chronic refractory wounds on the body surface]

Repairing chronic refractory wounds on the body surface is a complex medical problem involving all stages of wound healing. In recent years, stem cells (SCs) and tissue engineering (TE) have brought hope for repairing chronic refractory wounds. SCs have excellent regenerative and paracrine effects; various TE strategies have the potential to repair chronic refractory wounds on the body surface and also improve the delivery efficiency of SCs. This article reviews the pathological characteristics of chronic refractory wounds, SCs used to repair chronic refractory wounds, and SC-based TE wound repair strategies.

Chemokine-like factor-like MARVEL transmembrane domain containing 6: Bioinformatics and experiments in vitro analyze in glioblastoma multiforme

Introduction

Chemokine-like factor (CKLF)-like MARVEL transmembrane domain containing 6 (CMTM6) is a protein localized to the cell membrane and is known for its ability to co-localize with PD-L1 on the plasma membrane, prevent PD-L1 degradation, and maintain PD-L1 expression on the cell membrane. CMTM6 is highly expressed and plays an important role in various tumors such as oral squamous cell carcinoma (OSCC) and colorectal cancer (CRC), however, its role in Glioblastoma multiforme (GBM) is unclear.

Methods

In this paper, to investigate the role of CMTM6 in GBM, we analyzed the expression of CMTM6 in GBM, the interaction with CMTM6 and the associated genes by bioinformatics. Importantly, we analyzed the expression of CMTM6 in GBM in relation to tumor-infiltrating lymphocytes (TILs), immunoinhibitors, immunostimulators, chemokines and chemokine receptors. We further analyzed the function of CMTM6 and performed in vitro experiments to verify it. Finally, the sensitivity of CMTM6 to drugs was also analyzed and the relationship between CMTM6 and the anticancer drug Piperlonguminine (PL) was verified in vitro.

Results

The results showed that CMTM6 was highly expressed in GBM and correlated with multiple genes. Furthermore, CMTM6 is closely related to the immune microenvironment and inflammatory response in GBM. Bioinformatic analysis of CMTM6 correlated with the function of GBM, and our experiments demonstrated that CMTM6 significantly promoted the migration of GBM cells and epithelial-mesenchymal transition (EMT), but had no significant effect on other functions. Interestingly, we found that in GBM, PL promotes the expression of CMTM6.

Discussion

In this paper, we have performed a detailed analysis and validation of the role of CMTM6 in GBM using bioinformatics analysis and in vitro experiments to demonstrate that CMTM6 may be a potential target for glioma therapy.

The role of the sex hormone-gut microbiome axis in tumor immunotherapy

Accumulating evidence suggested that both gut microbiome and sex play a critical role in the efficacy of immune checkpoint blockade therapy. Considering the reciprocal relationship between sex hormones and gut microbiome, the sex hormone-gut microbiome axis may participate in the regulation of the response to immune checkpoint inhibitors (ICIs). In this review, it was attempted to summarize the current knowledge about the influences of both sex and gut microbiome on the antitumor efficacy of ICIs and describe the interaction between sex hormones and gut microbiome. Accordingly, this review discussed the potential of enhancing the antitumor efficacy of ICIs through regulating the levels of sex hormones through manipulation of gut microbiome. Collectively, this review provided reliable evidence concerning the role of the sex hormone-gut microbiome axis in tumor immunotherapy.

Railway accident prediction strategy based on ensemble learning

Railway accident prediction is of great significance for establishing an early warning mechanism and preventing the occurrences of accidents. Safety agencies rely on prediction models to design railroad risk management strategies. Based on historical railway accident data, an ensemble learning strategy for accident prediction is proposed. Firstly, an improved K-nearest neighbors (KNN) data imputation algorithm is proposed to solve the problem of missing data in the dataset. Then, to reduce the impact of imbalanced data on prediction performance, an AdaBoost-Bagging method is presented. Finally, according to the feature importance in the prediction model, accident features are ranked to identify new insights into the cause of the accident. The AdaBoost-Bagging prediction method is applied to the Federal Railroad Administration (FRA) dataset. The application results show that, compared with Artificial Neural Network (ANN), XGBoost, GBDT, Stacking and AdaBoost methods, AdaBoost-Bagging method has a smaller prediction error and faster inference time in predicting railway accidents. Accuracy, Precision, Recall and F1-score are 0.879, 0.879, 0.883 and 0.881 respectively, and the inference time is reduced by 23.38%, 12.15%, 6.66%, 3.17% and 11.41% respectively. The prediction method can well mine important features of railway accidents without knowing the accident mechanism or the relationship between various railway accidents and factors, e.g., the critic risk factors related to derailment and collision accidents are investigated in the prediction. The findings will be helpful to the prevention and management of railway accidents.

[The relationship between peripheral blood mitochondrial DNA copy number and incident risk of liver cancer: a case-cohort study]

Objective: To investigate the association between peripheral blood mitochondrial DNA copy number (mtDNAcn) and incident risk of liver cancer. Methods: At the baseline of Dongfeng-Tongji (DFTJ) cohort, 27 009 retirees were recruited from Dongfeng Motor Corporation in 2008. After excluding people without baseline DNA, with current malignant tumor and loss of follow-up, 1 173 participants were randomly selected into a sub-cohort by age-and gender-stratified sampling method at a proportion of 5% among all retirees. A total of 154 incident liver cancer cases identified from the cohort before December 31, 2018 (4 cases had been selected into the sub-cohort) were selected to form the case cohort of liver cancer. For the above 1 323 participants, their baseline levels of mtDNAcn in peripheral blood cells were measured by using quantitative real-time PCR method. The restricted cubic spline analysis was used to fit the shape of the association between baseline mtDNAcn and incident risk of liver cancer. The weighted Cox proportional hazards model was used to estimate the hazard ratio (HR) and 95%CI. Results: In this case-cohort study, the median follow-up time was 10.3 years. The restricted cubic spline analysis indicated that the relationship between peripheral blood mtDNAcn and incident risk of liver cancer followed a U-shaped pattern (P_non-linear<0.05). All case-cohort population were divided into four subgroups by sex-specific quartiles of mtDNAcn levels among sub-cohort participants, when compared to participants in the Q₂ subgroup of mtDNAcn, those in the Q₁ subgroup (HR=2.00,95%CI:1.08-3.70) and Q₄ subgroup (HR=4.11,95%CI:2.32-7.26) both had a significantly elevated risk of liver cancer, while those in the Q₃ subgroup (HR=1.05,95%CI:0.54-2.05) had not. There were no significant multiply interaction effects of aging, gender, tobacco smoking, alcohol drinking and history of chronic hepatitis on the above association (P_interaction>0.05). Conclusion: Both extremely low and high baseline level of mtDNAcn in peripheral blood cells are associated with an increased risk of incident liver cancer, but the underlying mechanisms need to be further clarified.

Two-year outcomes of Roux-en-Y gastric bypass vs medical treatment in type 2 diabetes with a body mass index lower than 32.5 kg/m2: a multicenter propensity score-matched analysis

BACKGROUND

Roux-en-Y gastric bypass (RYGB) has been widely reported to be safe and feasible, and has a powerful effect on improving metabolism and weight loss in patients with a high body mass index (BMI). A few studies have focused on the comparison of RYGB with medical treatment in type 2 diabetes (T2D) patients with a lower BMI.

OBJECTIVES

To compare the metabolic effects and safety of RYGB versus medical treatment during a 2 years follow-up in T2D patients with a BMI of 25 to 32.5 kg/m².

METHODS

This retrospective and multicenter cohort study participants were extracted from the T2D patients with a lower BMI (25-32.5 kg/m²) from three bariatric centers between 2009 and 2018. Propensity score matching (PSM) was used to minimize bias, and each patient in the surgical group was matched 1:2 to the patients in the medical group with the closest propensity score. Finally, 71 patients who received RYGB and 142 patients who underwent medical treatment with a 2 years follow-up were enrolled to compare the effects of RYGB and medical treatment. The primary endpoint was achievement of the triple endpoint (the simultaneous achievement of hemoglobin A1c (HbA1c) < 7.0%, fasting low-density lipoprotein cholesterol (LDL-C) < 100 mg/dL (2.6 mmol/L), and systolic blood pressure (SBP) < 130 mmHg at the year-1 visit). Changes in weight, BMI, medication usage, complications, and adverse events were assessed.

RESULTS

In total, 213 patients (mean age of 47.4 ± 9.5 years, 70.4% male, mean BMI of 28.6 ± 2.2 kg/m²) were included in this study. At the end of the first year, 17 patients (23.9%) in the surgical group and 10 (7.0%) in the medical group had achieved the composite triple endpoint (OR 4.64; 95% CI 1.82-11.81; p = 0.001). Additionally, 43 patients (60.6%) in the surgical group and 11 patients (19.7%) in the medical group experienced remission of T2D. However, more complications were observed in the surgical group (36 vs. 22, p < 0.01).

CONCLUSIONS

Among T2D patients with a BMI between 25.0 and 32.5 kg/m², RYGB was more effective than medical treatment in resolving metabolic disorders and also resulted in more complications. The risk for complications should be considered in the clinical decision-making process for T2D patients with a low BMI.

111 Adipose Tissue-Derived Mesenchymal Stem Cells as a Potential Restorative Treatment for Cartilage Defects: A PRISMA Review and Meta-Analysis

Aim

Joint damage through trauma or degeneration causes cartilage defects, leading to osteoarthritis (OA). Current therapies relieve symptoms or replaces damaged joint, which is costly and fraught with complications. Mesenchymal stem cells (MSCs) have immunomodulatory properties and low immunogenicity, making them a novel avenue for research for OA treatment. This systematic review investigates whether adipose derived MSC (AMSCs) can treat cartilage defects.

Method

A systematic search was performed on MEDLINE, EMBASE, Cochrane Library, Scopus, Web of Science. Clinical, imaging, functional outcomes were extracted from nineteen included studies. Inclusion criteria was studies conducted on human populations that compared effects of AMSCs on cartilage regeneration to non-exposed controls. Studies conducted on animals, ex vivo studies, in vitro studies were excluded.

Results

Nine studies reported improved Visual Analogue Scale (VAS) scores (mean difference -3.30; 95% CI:-3.72,-2.89; p&lt;0.001). Eight studies reported improved Knee injury and Osteoarthritis Outcome Score (KOOS) in five subscales. Pooled analysis of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in seven studies revealed an improvement (mean difference -25.52; 95% CI:-30.93,-20.10; p&lt;0.001). Cartilage regeneration was assessed using Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score. All studies reported improved regeneration, with a pooled end-point score of 68.12 (95% CI:62.18–74.05; p&lt;0.001).

Conclusions

AMSCs are effective therapeutic agents for cartilage defects. We recommend researchers to determine roles of biochemical components that facilitate AMSC-mediated cartilage repair. Establishing the most efficient methods for MSC extraction, culture, delivery, and performing studies with long follow-up times enable future research to provide evidence needed to bring AMSC-based therapies into the market.

POS0625 VASCULAR EFFECT OF INFLAMMATORY BURDEN IN EARLY RHEUMATOID ARTHRITIS PATIENTS - A 5-YEAR PROSPECTIVE STUDY

Background

Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are associated with accelerated atherosclerosis driven by chronic Inflammation. We have previously reported that cumulative inflammatory burden, as reflected by cumulative averages of repeated measures of erythrocyte sedimentation rate (ca-ESR), was associated with increased arterial stiffness in PsA patients (1).

Objectives

To ascertain whether inflammatory burden over time is associated with long-term vascular outcome in early RA (ERA) patients.

Methods

In this 5-year prospective study, consecutive ERA patients without overt cardiovascular disease were recruited. All patients received tight-control treatment in the first year followed by stand-of-care management subsequently. Subclinical atherosclerosis and arterial stiffness progression were assessed using high-resolution carotid ultrasound (US) and brachial-ankle pulse wave velocity (PWV) respectively at baseline, year 1 and year 5. The primary outcome was subclinical atherosclerosis progression (AP+), defined as incident plaque in a segment without plaque before, or an increased number of plaques in a segment, and/or maximum carotid intima-media thickness (max cIMT) over 0.9 mm at year 5. Secondary outcome was the change in PWV over a period of 5 years. ESR level was measured during each clinic visit. Inflammatory burden was measured by cumulative averages of the area under the curve for erythrocyte sedimentation rate (ESR) over a period of 5 years.

Results

One-hundred and four ERA patients (age: 52±11 years, 81(78%) female) who completed 5 years of follow-up were included in this analysis. Significant improvement in disease activity was observed (DAS-ESR at baseline: 5.8±0.9 vs 3.2±1.2 at year 5, p<0.001). Forty-two patients (40.4%) had AP+. The AP+ group had higher ca-ESR (37.6±16.4 vs 32.0±17.1, p=0.106) and baseline Framingham risk score (FRS) (13.3±12.5 vs 5.5±6.6, p<0.001). Multivariate logistic regression analysis revealed that a higher ca-ESR was associated with AP+ (OR=1.03, 95%CI: 1.00-1.06, p=0.038) after adjustment for baseline high risk Framingham risk score (FRS≥20%) and baseline triglycerides level (Table 1). Similarly, PWV increased from 1461±285cm/s to 1559±309cm/s (p<0.001) after 5 years. Higher ca-ESR correlated with PWV progression (r=-0.211, p=0.032). Using multivariate logistic regression analysis, ca-ESR was associated with arterial stiffness progression ((β=2.94, 95%CI: 0.80 to 5.08, p=0.007) after adjusting for symptom duration, presence of rheumatoid factor and FRS.

Table 1.

Univariable analysis on baseline clinical characters and progression of subclinical atherosclerosis parameters

AP+ba PWV changeUnivariate modelMultivariate modelUnivariate modelMultivariate modelORp ValueORp Valueβp Valueβp Value95% CI95% CI95% CI95% CISymptom duration0.990.7045.620.089*0.92-1.06-0.88-12.131RF positive0.990.69284.040.068*84.250.0490.92-1.06-6.48-174.550.38-168.12Baseline Triglycerides3.190.009*3.480.008*-39.050.2661.34-7.611.38-8.76-108.25-30.14FRS, 20%5.970.031*5.650.500-164.110.013*-149.480.017*1.17-30.391.00-31.80-292.67- -35.55-1.25-10.87ca-ESR1.020.1061.030.038*3.120.005*2.780.008*1.00-1.041.00-1.060.97-5.270.73-4.82

*Statistically significant at p < 0.05.

RF positive: Rheumatoid factor positive, FRS, 20%: Framingham risk score ≥20%, caESR: cumulative average-Erythrocyte sedimentation rate.

Conclusion

Persistent inflammation was an independent predictor of subclinical atherosclerosis and arterial stiffness progression in ERA. Effective long-term suppression of inflammation is required to minimize cardiovascular risk.

References

[1]Shen J, Shang Q, Li EK, Leung Y-Y, Kun EW, Kwok L-W, et al. Cumulative inflammatory burden is independently associated with increased arterial stiffness in patients with psoriatic arthritis: a prospective study. Arthritis research & therapy. 2015;17(1):75.

Acknowledgements

I have no acknowledgments to declare.

Disclosure of Interests

None declared

POS0323 RISK FACTORS FOR MAJOR CARDIOVASCULAR EVENTS (MACE) IN INFLAMMATORY ARTHRITIS: A TIME-DEPENDENT ANALYSIS ON INFLAMMATORY BURDEN, USE OF NSAIDs, STEROID AND DMARDs

Background

Inflammatory arthritis (IA) including rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylarthritis (AS) are associated with accelerated atherosclerosis due to systematic inflammation.

Objectives

To elucidate whether inflammatory burden (c-reactive protein [CRP] and erythrocyte sedimentation rate [ESR] levels) and drugs used to suppress inflammation (disease modifying anti-rheumatic drugs [DMARDs] and non-steroidal anti-inflammatory drugs [NSAIDs]) over time are independently associated with major cardiovascular events (MACE) in patients with IA.

Methods

A population-based cohort of IA patients were identified in the citywide Clinical Data Analysis and Reporting System (CDARS) of the Hong Kong Hospital Authority. IA patients recruited from 2006 to 2016 were followed until the end of 2018. The outcome was occurrence of a first MACE, defined as unstable angina, acute myocardial infarction, stroke/transient ischemic attack or death from cardiovascular causes. Cox proportional hazard models with time-varying CRP and ESR levels and drugs used were analyzed to identify the risk of having MACE in IA patients.

Results

A total of 17,732 (12050 RA patients, 1789 PsA patients and 3893 AS patients) patients with IA were recruited. After a mean follow-up of 8.7 ± 3.1 years, 1,069 (6.0 %) patients developed a first MACE. At baseline, the MACE group were older (68±12 vs 53±15, p<0.001), had more traditional cardiovascular risk factors, higher levels of CRP (2.7±1.5 vs 1.7±1.3, p<0.001) and ESR (57.8±32.4 vs 42.5±29.2, p<0.001), and less exposure to biologic DMARDs (bDMARDs) (1.0% vs 3.0%, p<0.001) and non-selective NSAIDs (nsNSAIDs) (63.4% vs 71.1%, p<0.001). After adjusting for age, sex, baseline cardiovascular comorbidities using multivariable Cox regression analysis, IA patients with higher inflammatory burden (as reflected by the time-varying CRP [hazard ratio {HR} 1.11, 95% confidence interval {CI} 1.10-1.12, p<0.001] and ESR levels (HR 1.02, 95% CI 1.01-1.01, p<0.001) and the use of steroid (HR 1.79-1.88) were independently associated with a higher risk of developing MACE (Table 1). In contrast, exposure to nsNSAIDs had a protective effect against MACE (HR 0.76, 95% CI 0.66-0.89, p<0.001), while bDMARDs were not associated with MACE.

Table 1.

Multivariable time-varying Cox regression models for the predictors of incidence of MACE in the IA patients (n=17732)

Model 1 †Model 2 ‡VariablesHR (95% CI)p valueHR (95% CI)p valueMale1.92 (1.65-2.23)<0.001*1.52 (1.33-1.76)<0.001*Age1.06 (1.05-1.06)<0.001*1.06 (1.05-1.06)<0.001*Disease duration1.04 (0.97-1.08)0.0561.04 (1.01-1.08)0.016*Baseline DM1.25 (0.95-1.64)0.1081.44 (1.13-1.84)0.003*Baseline HT1.77 (1.52-2.08)<0.001*1.85 (1.59-2.16)<0.001*Baseline LP1.14 (0.92-1.41)0.2321.19 (0.98-1.46)0.081Time-varying inflammatory markersESR1.02 (1.01-1.01)<0.001*CRP1.11 (1.10-1.12)<0.001*Time-varying treatmentbDMARDs0.93 (0.68-1.27)0.6570.89 (0.65-1.22)0.478CoxII0.71 (0.53-0.96)0.027*0.79 (0.59-1.04)0.104nsNSAIDs0.76 (0.66-0.89)<0.001*0.76 (0.66-0.88)<0.001*Steroids1.88 (1.63-2.17)<0.001*1.79(1.56-2.04)<0.001*

*Statistically significant at p < 0.05.

† and ‡ Adjusted for Age, Sex, Hypertension at baseline, diabetes mellitus at baseline, dyslipidemia at baseline, bDMARDs, CoxII, non-selective NSAIDs, Steroids.

CRP, C-reactive protein; ESR: Erythrocyte sedimentation rate; HT: hypertension; DM: diabetes mellitus; LP: Dyslipidemia; bDMARD, biological disease-modifying anti-rheumatic drug; COXII: cyclooxygenase -2 inhibitors; nsNSAIDs: non-selective nonsteroidal anti-inflammatory drugs.

Conclusion

Increased inflammatory burden as reflected by elevated ESR and CRP level over time, and increased exposure to steroid were independently associated with increased risk of MACE, while the risk was significantly reduced with non-selective NSAIDs use in IA patients.

Disclosure of Interests

None declared

[Effect of CXC chemokine receptor 7 on cell cycle of neuronal cells in ischemic stroke]

OBJECTIVE

To investigate the function and mechanism of CXC chemokine receptor 7 (CXCR7) in neuronal cells of ischemic stroke.

METHODS

The expression of CXCR7 in human neuroblastoma SH-SY5Y cells was interfered by small interfering RNA (si-RNA) technique. Oxygen-glucose deprivation/reoxygenation (OGD/R) injury model was constructed in SH-SY5Y cells. CXCR7 protein expression and cell cycle were detected by flow cytometry (FCM). The protein expression of CXCR7 and Akt signaling pathway was detected by Western blotting.

RESULTS

After 6 hours of OGD/R, the expression of CXCR7 was significantly decreased compared with OGD/R 0 hour (CXCR7/GAPDH: 0.483±0.098 vs. 1.000±0.000 by Western blotting and 0.686±0.0524 vs. 1.000±0.000 by FCM, both P < 0.01), cell cycle arrest in G0/G1 phase (1.190±0.040 vs. 1.000±0.000, P < 0.01). After CXCR7 si-RNA interference with SH-SY5Y cells, OGD/R was constructed again for 6 hours. Compared with negative control group (si-NC group) under the same environment, the expression of CXCR7 and phosphorylated Akt (p-Akt) was significantly decreased (CXCR7/GAPDH: 0.471±0.051 vs. 1.000±0.000, p-Akt/GAPDH: 0.616±0.027 vs. 1.000±0.000, both P < 0.001) and cell cycle arrest in G0/G1 phase (1.105±0.033 vs. 1.000±0.000, P < 0.05).

CONCLUSIONS

The CXCR7 could regulate the cycle of neuronal cells in ischemic stroke through Akt signaling pathway, which has a protective effect on neuronal cells.

Prospective evaluation of first-trimester screening strategy for preterm pre-eclampsia and its clinical applicability in China

OBJECTIVES

To evaluate, in a Chinese population, the performance of a screening strategy for preterm pre-eclampsia (PE) using The Fetal Medicine Foundation (FMF)'s competing-risks model and to explore its clinical applicability in mainland China.

METHODS

This was a prospective, multicenter, observational cohort study including 10 899 women with singleton pregnancy who sought prenatal care at one of 13 hospitals, located in seven cities in mainland China, between 1 December 2017 and 30 December 2019. Mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI) and maternal serum levels of placental growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A) at 11 + 0 to 13 + 6 weeks' gestation were measured and converted into multiples of the median using Chinese reference ranges. Individualized risk for preterm PE was calculated using the FMF algorithm. Prior risk was calculated based on maternal demographic characteristics and obstetric history. We evaluated the efficiency of the screening strategy using various combinations of biomarkers and analyzed its predictive performance for a composite of placenta-associated adverse pregnancy outcomes, including PE, placental abruption, small-for-gestational age (SGA) and preterm birth, at fixed false-positive rates for preterm PE.

RESULTS

We identified 312 pregnancies that developed PE, of which 117 cases were diagnosed as preterm PE (< 37 weeks' gestation). There were 386 pregnancies complicated by severe composite placenta-associated adverse outcome, including preterm PE, 146 cases of severe SGA (birth weight < 3^rd percentile) neonate, 61 cases with placental abruption and 109 cases of early preterm birth < 34 gestational weeks. The triple-marker model containing biomarkers MAP, UtA-PI and PAPP-A achieved, at fixed false-positive rates of 10%, 15% and 20%, detection rates for preterm PE of 65.0%, 72.7% and 76.1%, respectively, and detection rates for severe composite placenta-associated adverse outcome of 34.7%, 41.7% and 46.4%, respectively. Replacing PAPP-A with PlGF or adding PlGF to the model did not improve the performance. Of women screening positive for preterm PE at a fixed 5% false-positive rate, an estimated 30% developed at least one placenta-associated adverse pregnancy outcome, including PE, placental abruption, SGA (birth weight < 10^th percentile) and preterm birth < 37 weeks.

CONCLUSIONS

The FMF competing-risks model for preterm PE was found to be effective in screening a mainland Chinese population. Women who screened positive for preterm PE had increased risk for other placenta-associated pregnancy complications. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Effect of low temperature and high humidity stress on physiology of cucumber at different leaf stages

Low temperature (LT) and high humidity (HH) are important environmental factors in greenhouses and plastic tunnels during the cold season, as they hamper plant growth and development. Here, we studied the effect of LT (day/night: 9/5 °C, 25/18 °C as control) and HH (95%, 80% as control) on young cucumber plants at the 2, 4 or 6 leaf stages. LT+HH stress resulted in a decline in shoot, root and total fresh and dry weights, and decreased P_n , g_s , T_r , F_v /F_m , qP, ETR and chlorophyll, and increased MDA, H₂ O₂ , O₂ ^- , NPQ and C_i as compared to the control at the 2 leaf stage. SOD, POD, CAT, APX and GR were upregulated under LT+HH stress as compared to the control at the 6 leaf stage. ABA and JA increased under LT+HH stress as compared to the control at the 6 leaf stage, while IAA and GA decreased under LT+HH stress as compared to the control at the 2 leaf stage. Our results show that LT+HH stress affects young cucumber plant photosynthetic efficiency, PSII activity, antioxidant defence system, ROS and hormone profile. Plants at the 6 leaf stage were more tolerant than at the 2 and 4 leaf stages under stress conditions.

Cellular viability and death biomarkers enables the evaluation of ocular irritation using the bovine corneal opacity and permeability assay

The BCOP assay is used in the identification of chemicals that cause no ocular irritation or serious damage. However, this method has not been found to adequately discriminate between mild from moderate ocular irritation (category 2A/2B), based upon the animal data. In this study, we aimed to establish methods for discerning ocular irritation by chemicals. We used the BCOP assay and the fluorescence staining methods based on biomarkers for cellular viability and death. The potential for ocular irritation by 12 chemicals from different UN GHS categories was assessed by the BCOP assay. Cryosections of bovine corneas were obtained. The necrotic nucleus was TUNEL labeled, cytoplasmic f-actin was stained by phalloidin while the nucleus was stained by DAPI. The depth of injury (DOI) was then measured. According to BCOP assay, in vivo data of Draize eye test and DOI, the results showed that category NC irritants caused ≤ 10 % epithelial DOI, irritants of category 2B caused >10 % epithelial DOI and showed no stromal damage, while category 2A showed damage to the stroma. Based on these results, the GHS prediction model could distinguish between GHS 2A and 2B. Authenticating the viability of BCOP by DOI measurements can provide a more reliable basis for classifying ocular irritants.

Activation of TRPV4 by mechanical, osmotic or pharmaceutical stimulation is anti-inflammatory blocking IL-1β mediated articular cartilage matrix destruction

OBJECTIVE

Cartilage health is maintained in response to a range of mechanical stimuli including compressive, shear and tensile strains and associated alterations in osmolality. The osmotic-sensitive ion channel Transient Receptor Potential Vanilloid 4 (TRPV4) is required for mechanotransduction. Mechanical stimuli inhibit interleukin-1β (IL-1β) mediated inflammatory signalling, however the mechanism is unclear. This study aims to clarify the role of TRPV4 in this response.

DESIGN

TRPV4 activity was modulated glycogen synthase kinase (GSK205 antagonist or GSK1016790 A (GSK101) agonist) in articular chondrocytes and cartilage explants in the presence or absence of IL-1β, mechanical (10% cyclic tensile strain (CTS), 0.33 Hz, 24hrs) or osmotic loading (200mOsm, 24hrs). Nitric oxide (NO), prostaglandin E₂ (PGE₂) and sulphated glycosaminoglycan (sGAG) release and cartilage biomechanics were analysed. Alterations in post-translational tubulin modifications and primary cilia length regulation were examined.

RESULTS

In isolated chondrocytes, mechanical loading inhibited IL-1β mediated NO and PGE₂ release. This response was inhibited by GSK205. Similarly, osmotic loading was anti-inflammatory in cells and explants, this response was abrogated by TRPV4 inhibition. In explants, GSK101 inhibited IL-1β mediated NO release and prevented cartilage degradation and loss of mechanical properties. Upon activation, TRPV4 cilia localisation was increased resulting in histone deacetylase 6 (HDAC6)-dependent modulation of soluble tubulin and altered cilia length regulation.

CONCLUSION

Mechanical, osmotic or pharmaceutical activation of TRPV4 regulates HDAC6-dependent modulation of ciliary tubulin and is anti-inflammatory. This study reveals for the first time, the potential of TRPV4 manipulation as a novel therapeutic mechanism to supress pro-inflammatory signalling and cartilage degradation.

Copy number variation in HOXB7 and HOXB8 involves in the formation of beard trait in chickens

The derived feathering phenotype beard in domestic birds is an ideal resource to investigate the genetic mechanisms controlling feather development and differentiation. In the present study, we performed a GWAS and QTL linkage analysis on the trait of beard in Beijing fatty chicken. One major QTL (1.2-1.9 Mb) was identified that could explain 34% of the phenotypic variation. The copy number variation that was copied from the region (GGA27:3 578 409-3 592 890 bp) containing homebox B7 (HOXB7) and homebox B8 (HOXB8) was validated to be only exhibited in the genome of bearded chickens. Protein-protein interaction analysis indicated that HOXB7 and HOXB8 proteins could highly interact with the HOXB family members, including HOXB4, HOXB5 and HOXB6, whose genomic locations near HOXB7 and HOXB8 suggested that they may regulate their family members to involve in the formation of the beard trait in chickens. Overall, our work provides basic data for understanding the mechanisms regulating beard development and differentiation.

MiRNA-93-5p promotes the biological progression of gastric cancer cells via Hippo signaling pathway

OBJECTIVE

To clarify the influence of microRNA-93-5p (miRNA-93-5p) on biological behaviors of gastric cancer (GC) cells and its regulatory effect on Hippo pathway.

MATERIALS AND METHODS

SGC-7901 and HGC-27 cells were used for establishing miRNA-93-5p overexpression and downregulation model through transfection of miRNA-93-5p mimics or inhibitor, respectively. Relative levels of genes in Hippo pathway were determined in GC cells transfected with miRNA-93-5p mimics or inhibitor by quantitative Real-time polymerase chain reaction (qRT-PCR). Regulatory effects of miRNA-93-5p on proliferative, migratory and invasive abilities of GC cells were evaluated by cell counting kit-8 (CCK-8), colony formation and transwell assay, respectively.

RESULTS

MiRNA-93-5p was markedly upregulated by transfection of miRNA-93-5p mimics into SGC-7901 cells, which was downregulated by transfection of miRNA-93-5p inhibitor into HGC-27 cells. Overexpression of miRNA-93-5p accelerated GC cells to proliferate, migrate and invade. Meanwhile, miRNA-93-5p overexpression in GC cells upregulated downstream genes in Hippo pathway, including CDX2, FOXM1 and CTGF.

CONCLUSIONS

MiRNA-93-5p enhances proliferative, migratory and invasive abilities of GC cells by activating Hippo pathway, which may serve as a diagnostic and therapeutic target for GC.

Humidity sensor based on a graphene oxide-coated few-mode fiber Mach-Zehnder interferometer

A relative humidity sensor based on a graphene oxide-coated few-mode fiber Mach-Zehnder interferometer (MZI) is proposed in this paper. The MZI was made by splicing a segment of the few-mode fiber (FMF) between two segments of a no-core fiber (NCF) and two segments of a single mode fiber (SMF) located outside the two NCFs. The core and cladding of the FMF acted as interferometric arms, while the NCFs acted as couplers for splitting and recombining light due to mismatch of mode field diameter. The cladding of the FMF was corroded with hydrofluoric acid, and a layer of graphene oxide (GO) film was coated on the corroded cladding of FMF via the natural deposition method. The refractive index of GO varied upon absorption the water molecules. As a result, the phase difference of the MZI varied and the wavelength of the resonant dip shifted with a change in the ambient relative humidity (RH). High humidity sensitivity of 0.191 and 0.061 nm/%RH in the RH range of 30-55% and 55-95%, respectively, were achieved experimentally. The high sensitivity, compact size, and simple manufacturing of the proposed sensor could offer attractive applications in fields of chemical sensors and biochemical detection.

0341 Preliminary Effects of a Music Intervention on Actigraphy-Measured Sleep Among Older Adults with Dementia

Introduction

Music may benefit sleep and daytime alertness by decreasing stress, increasing attention, and potentially, slowing the progression of dementia. This study examined preliminary effects of a group-based music intervention on sleep health among older adults with dementia.

Methods

Participants were older adults with dementia living in an assisted living facility (n=9; Mage=80.11; Mrange=63−89 years). Cohort 1 (n=4) received the intervention in the morning and cohort 2 (n=5) received the intervention in the afternoon. Participants completed a 4-week intervention protocol (12 sessions) along with a one-week actigraphy sleep assessment before and after the intervention. Informed by sleep literature, we constructed a composite sleep health score encompassing Regularity, Satisfaction or quality, Alertness, Timing, Efficiency, and Duration (higher scores indicating more daily sleep problems). Using descriptive statistics and multilevel modeling, we evaluated preliminary effects of the intervention on overall sleep health and each of the sleep dimensions.

Results

Six out of nine participants exhibited a decrease in overall sleep problems at post-intervention. All 4 participants in cohort 1 showed improvement in overall sleep health at post-intervention. Specifically, in cohort 1, participants exhibited a decline in nightly sleep problems, decreased daytime nap duration, and number of naps. In contrast, while two out of five participants in cohort 2 exhibited improvement in overall sleep health, the remainder of the participants exhibited no improvement in daily sleep problems, especially in nap domains. Across cohorts, those younger in age, with vascular dementia, lower weight, and not taking sleep or hypertension related medications tended to respond better to the intervention.

Conclusion

Our preliminary results demonstrate the feasibility and potential benefit of a group-based music intervention in improving overall sleep health among older patients with dementia. Implications for conducting community-based non-pharmacological interventions to improve sleep and daytime functioning among older adults with dementia will be discussed.

Support

This work was supported, in part, by the Florida Department of Health Ed and Ethel Moore Alzheimer’s Disease Research Award (PI: Meng, Grant #9AZ28).

Research Progress on Age Estimation Based on DNA Methylation

Abstract

Age estimation is of great significance in the fields of criminal investigation and forensic identification. It can provide the age information of individuals to judicial departments to facilitate the development of judicial work. In recent years, age estimation methods expanded from the morphological level to the molecular biology level. With the rapid development of epigenetics represented by DNA methylation, and the advancement of DNA methylation detection technology together with the detection platform, many age estimation methods based on DNA methylation biomarkers, or using several biological fluids, such as blood, blood stains, saliva, semen stains, etc. are developed. Currently, researches related to age estimation based on DNA methylation are relatively widely carried out. This paper summarizes the researches on age estimation based on DNA methylation, in order to provide references for related studies and forensic applications.

miR-449a Is Related to Short-Term Recurrence of Hepatocellular Carcinoma and Inhibits Migration and Invasion by Targeting Notch1

PURPOSE

To explore the effect of miR-449a inhibits migration and invasion by targeting Notch1 and regulating epithelial-mesenchymal transition (EMT) in hepatocellular carcinoma (HCC), and further study on the molecular mechanism.

PATIENTS AND METHODS

The expression of miR-449a and Notch1 in HCC cells and tissues was detected by qRT-PCR. The HCC cell line HCCLM3 and SMMC-7721 were transfected with miR-449a. The invasion and migration of HCC cell lines were detected by transwell assay and wound healing assay. The Notch pathway and EMT related protein were detected with Western Blotting. The specific binding site of mir-449a on notch1 gene was detected by luciferase assay.

RESULTS

We found the expression of miR-449a was related to short-term recurrence of hepatocellular carcinoma after hepatectomy and acted as independent risk factors of DFS and OS. The expression of miR-449a decreased in tumor tissues and HCC cell lines, but the expression of Notch1 increased. The overexpressed miR-449a promoted the invasiveness in vitro by regulating EMT via Notch pathway. Mechanically, miR-449a inhibited the translation of Notch1 protein by binding to 3' UTR of its mRNA directly.

CONCLUSION

miR-449a is short-term recurrence-related miRNA and inhibits the invasion and metastasis ability of HCC cells by regulating EMT via Notch pathway. miR-449a may be a new effective therapeutic target for HCC.

Novel Models for Identification of the Ruptured Aneurysm in Patients with Subarachnoid Hemorrhage with Multiple Aneurysms

BACKGROUND AND PURPOSE

In patients with SAH with multiple intracranial aneurysms, often the hemorrhage pattern does not indicate the rupture source. Angiographic findings (intracranial aneurysm size and shape) could help but may not be reliable. Our purpose was to test whether existing parameters could identify the ruptured intracranial aneurysm in patients with multiple intracranial aneurysms and whether composite predictive models could improve the identification.

MATERIALS AND METHODS

We retrospectively collected angiographic and medical records of 93 patients with SAH with at least 2 intracranial aneurysms (total of 206 saccular intracranial aneurysms, 93 ruptured), in which the ruptured intracranial aneurysm was confirmed through surgery or definitive hemorrhage patterns. We calculated 13 morphologic and 10 hemodynamic parameters along with location and type (sidewall/bifurcation) and tested their ability to identify rupture in the 93 patients. To build predictive models, we randomly assigned 70 patients to training and 23 to holdout testing cohorts. Using a linear regression model with a customized cost function and 10-fold cross-validation, we trained 2 rupture identification models: RIM_C using all parameters and RIM_M excluding hemodynamics.

RESULTS

The 25 study parameters had vastly different positive predictive values (31%-87%) for identifying rupture, the highest being size ratio at 87%. RIM_C incorporated size ratio, undulation index, relative residence time, and type; RIM_M had only size ratio, undulation index, and type. During cross-validation, positive predictive values for size ratio, RIM_M, and RIM_C were 86% ± 4%, 90% ± 4%, and 93% ± 4%, respectively. In testing, size ratio and RIM_M had positive predictive values of 85%, while RIM_C had 92%.

CONCLUSIONS

Size ratio was the best individual factor for identifying the ruptured aneurysm; however, RIM_C, followed by RIM_M, outperformed existing parameters.

Effect of high-intensity exercise on cardiorespiratory fitness in stroke survivors: A systematic review and meta-analysis

BACKGROUND

Knowledge of the optimal protocol and safety of particularly high-intensity exercise applied to individuals with stroke is lacking.

OBJECTIVE

This systematic review and meta-analysis aimed to investigate the effect of high-intensity exercise on cardiorespiratory fitness in stroke survivors.

METHODS

We performed a systematic electronic search for articles in MedLine via PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, and SPORTSDiscus up to April 1, 2019. Peak oxygen consumption (VO₂peak), 6-min walk test (6MWT), fastest 10-m walk test (10MWT), and adverse events were assessed. The standardized mean difference (SMD), weighted mean difference (WMD), and odds ratios (ORs) were used to compute the effect size, and subgroup analysis was conducted to test the consistency of results as well as sensitivity analysis to assess the robustness of the results. The quality of evidence was assessed with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system.

RESULTS

We included 17 studies (PEDro score≥4) in the meta-analysis. Post-intervention, high-intensity exercise had a significant effect on peak oxygen uptake (VO₂peak; SMD=0.56, P<0.01, I²=8%; WMD=2.53mL/kg/min; high quality of evidence) and 6MWT (SMD=0.26, P<0.01, I²=40%; WMD=17.08m; moderate quality of evidence) but not fastest 10MWT (SMD=0.33, P=0.27, I²=77%; WMD=0.05m/s; low quality of evidence). Subgroup analysis showed better effects of higher-intensity treadmill training (≥70% heart rate reserve/VO₂peak) for a longer duration (≥12 weeks) on VO₂peak and 6MWT in sub-acute or chronic stroke survivors. The high-intensity exercise and control groups did not differ in adverse events including falls [odds ratio (OR) 1.40, P=0.35, I²=11%; low quality of evidence], pain (OR 3.34, P=0.09, I²=0%; moderate quality of evidence), or skin injuries (OR 1.08, P=0.90, I²=0%; low quality of evidence).

CONCLUSIONS

Our meta-analysis suggests that high-intensity exercise is beneficial for cardiorespiratory fitness in stroke survivors and might be safe as a novel intervention in cardiopulmonary rehabilitation after stroke.

NEDD9 promotes invasion and migration of colorectal cancer cell line HCT116 via JNK/EMT

Neural precursor cell-expressed, developmentally-downregulated 9 (NEDD9) is a multi-domain skeleton protein that serves an important role in the cell signaling process via modulating invasion, metastasis, proliferation and apoptosis of tumor cells. The present study identified that the expression levels of NEDD9 in colorectal cancer were elevated. Therefore, the effect of downregulating the expression of NEDD9 in terms of invasion and migration of colorectal cancer cells was investigated and the role of the JNK pathway in these processes was also investigated. The data revealed that downregulation of NEDD9 and JNK inhibitors suppressed invasion and migration, decreased expression levels of phosphorylated JNK, increased the expression levels of E-cadherin and decreased the expression levels of vimentin. In summary, NEDD9 promotes invasion and migration of colorectal cancer cells via the JNK pathway.

Three-dimensional resonating metamaterials for low-frequency vibration attenuation

Recent advances in additive manufacturing have enabled fabrication of phononic crystals and metamaterials which exhibit spectral gaps, or stopbands, in which the propagation of elastic waves is prohibited by Bragg scattering or local resonance effects. Due to the high level of design freedom available to additive manufacturing, the propagation properties of the elastic waves in metamaterials are tunable through design of the periodic cell. In this paper, we outline a new design approach for metamaterials incorporating internal resonators, and provide numerical and experimental evidence that the stopband exists over the irreducible Brillouin zone of the unit cell of the metamaterial (i.e. is a three-dimensional stopband). The targeted stopband covers a much lower frequency range than what can be realised through Bragg scattering alone. Metamaterials have the ability to provide (a) lower frequency stopbands than Bragg-type phononic crystals within the same design volume, and/or (b) comparable stopband frequencies with reduced unit cell dimensions. We also demonstrate that the stopband frequency range of the metamaterial can be tuned through modification of the metamaterial design. Applications for such metamaterials include aerospace and transport components, as well as precision engineering components such as vibration-suppressing platforms, supports for rotary components, machine tool mounts and metrology frames.

MiR-449a regulates the cell migration and invasion of human non-small cell lung carcinoma by targeting ADAM10

Background: MicroRNAs (miRNAs) are non-coding small RNAs that have been shown to play a key role in the development of many tumors. However, its specific mechanism of action in non-small cell lung cancer (NSCLC) is not very clear. Purpose: This study was to identify the effect of miRNA-449a on NSCLC invasion and migration. Methods: We used quantitative real-time PCR experiments to demonstrate that miRNA-449a is down-regulated in NSCLC tissues and cell lines. We also used the Transwell assay to detect cell invasion and migration, and the Western Blot assay  was used to detect protein expression. The dual luciferase assay was used to detect the targeting relationship between miR-449a and A Disintegrin And Metalloproteinases 10 (ADAM10). Results: Our experiments demonstrated that miRNA-449a was down-regulated in NSCLC tissues and cell lines. When miRNA-449a was up-regulated in NSCLC cells, the invasion and migration ability of the cells was weakened, and the expression of ADAM10 was decreased. After down-regulation of miRNA-449a, the cell's invasion and migration ability was enhanced, and the expression of ADAM10 was increased. Through dual luciferase assays, we also found that miRNA-449a can target ADAM10 to delay the progression of epithelial-mesenchymal transition (EMT) and inhibit invasion and migration. Conclusion: Our experiments demonstrated that miRNA-449a acted as a tumor suppressor gene through inhibiting the expression of ADAM10 in NSCLC.

Genome-wide association study identified genes in the response to Salmonella pullorum infection in chickens

Pullorum is a bacterial disease that threatens the modern poultry industry. Over the years, research on this topic has focused mainly on its epidemiology, whereas the hosts' genetic basis of infection is still vague. In order to identify chickens' genes associated with pullorum, we sequenced 300 New Pudong chicken by double digest genotyping-by-sequencing. We obtained 1 527 953 SNPs for a genome-wide association analysis, which identified 43 genome-wide significant markers. Most of the significant SNPs were in the interval of 57.7-59.0 Mb on chromosome 5. The gene set enrichment analysis suggests a potential manner for bacterial infection and remaining inside the host. This work provides basic data for the purification, prevention and treatment of pullorum disease.

Neural stem cells promote glioblastoma formation in nude mice

PURPOSE

Neural stem cells (NSCs) have been characterized with the ability of self-renewal and neurogenesis, which has inspired lots of studies to clarify the functions of NSCs in neural injury, ischemic stroke, brain inflammation and neurodegenerative diseases. We focused on the relationship of NSCs with glioblastoma, since we have discovered that recurrent glioblastomas were inclined to be derived from subventricular zone (SVZ), where NSCs reside. We want to clarify whether NSCs are involved in glioblastoma relapse.

METHODS

Immunocytochemistry was used to confirm the stemness of NSCs. The Cell Counting Kit-8 was used to measure the proliferation of cells. Migration abilities were examined by wound healing and transwell assays, and tumor formation abilities were confirmed in nude mice.

RESULTS

We found in experiments that NSCs promoted proliferation of a glioblastoma cell line-Ln229, the migration ability of Ln229 cells was motivated by co-cultured with NSCs. Tumor formation of Ln229 cells was also accelerated in nude mice when co-transplanted with NSCs. In immunohistochemistry, we found that the Sox2- and Ki67-positive cells were much higher in co-transplanted groups than that of control groups.

CONCLUSIONS

These results imply the potential role that NSCs play in speeding up tumor formation in the process of glioblastoma relapse, providing the basis for dealing with newly diagnosed glioblastoma patients, which may help postpone the recurrence of glioblastoma as far as possible through preprocessing the tumor-adjacent SVZ tissue.

Graphene oxide-film-coated splitting ratio-adjustable Mach-Zehnder interferometer for relative humidity sensing

In this paper, a splitting ratio-adjustable Mach-Zehnder interferometer (MZI) for the measurement of relative humidity (RH) is proposed and experimentally demonstrated. The sensing head contains three sections of single mode fiber (SMF) and two sections of multimode fiber (MMF), in which the two MMFs are spliced among the three SMFs. The MMFs are corroded with hydrofluoric acid and act as mode couplers to split and recombine light owing to the core diameter mismatch with the SMF. A layer of graphene oxide (GO) is coated on the MMFs by dip-coating and natural evaporation. The effective refractive index of the GO will vary when it absorbs the water molecules. As a result, the intensity of the transmission light in the core and cladding of the single mode fiber can be adjusted. Thus, the intensity of the resonant dip will vary when the relative humidity changes. The experimental results show that a humidity sensitivity of 0.263 dB/RH% with a linear correlation coefficient of 99% can be achieved in a relative humidity range of 35% to 85%.

Ostium Ratio and Neck Ratio Could Predict the Outcome of Sidewall Intracranial Aneurysms Treated with Flow Diverters

BACKGROUND AND PURPOSE

Incompletely occluded flow diverter treated aneurysms remain at risk of rupture and thromboembolic complications. Our aim was to identify the potential for incomplete occlusion of intracranial aneurysms treated by flow diverters. We investigated whether aneurysm ostium size in relation to parent artery size affects angiographic outcomes of flow diverter-treated sidewall aneurysms.

MATERIALS AND METHODS

Flow diverter-treated sidewall aneurysms were divided into "occluded" and "residual" (incomplete occlusion) groups based on 6-month angiographic follow-up. We calculated the ostium ratio, a new parameter defined as the aneurysm ostium surface area versus the circumferential surface area of the parent artery. We also calculated the neck ratio, defined as clinical aneurysm neck diameter versus parent artery diameter from pretreatment 2D DSA, as a 2D surrogate. We compared the performance of these ratios with existing aneurysm morphometrics (size, neck diameter, volume, aspect ratio, size ratio, undulation index, nonsphericity index, ellipticity index, bottleneck factor, aneurysm angle, and parent vessel angle) and flow diverter-related parameters (metal coverage rate and pore density). Statistical tests and receiver operating characteristic analyses were performed to identify significantly different parameters between the 2 groups and test their predictive performances.

RESULTS

We included 63 flow diverter-treated aneurysms, 46 occluded and 17 residual. The ostium ratio and neck ratio were significantly higher in the residual group than in the occluded group (P < .001 and P = .02, respectively), whereas all other parameters showed no statistical difference. As discriminating parameters for occlusion, ostium ratio and neck ratio achieved areas under the curve of 0.912 (95% CI, 0.838-0.985) and 0.707 (95% CI, 0.558-0.856), respectively.

CONCLUSIONS

High ostium ratios and neck ratios could predict incomplete occlusion of flow diverter-treated sidewall aneurysms. Neck ratio can be easily calculated by interventionists to predict flow-diverter treatment outcomes.