Corrigendum: Therapeutic strategies targeting folate receptor α for ovarian cancer

[This corrects the article DOI: 10.3389/fimmu.2023.1254532.].

Risk factors for post-cerebral infarction cognitive dysfunction in older adults: a retrospective study

OBJECTIVE

Our research aims to elucidate the significance of type 2 diabetes (T2D) and provides an insight into a novel risk model for post-cerebral infarction cognitive dysfunction (PCICD).

METHODS

Our study recruited inpatients hospitalized with cerebral infarction in Xijing hospital, who underwent cognitive assessment of Mini-Mental State Examination (MMSE) from January 2010 to December 2021. Cognitive status was dichotomized into normal cognition and cognitive impairment. Collected data referred to Demographic Features, Clinical Diseases, scale tests, fluid biomarkers involving inflammation, coagulation function, hepatorenal function, lipid and glycemic management.

RESULTS

In our pooled dataset from 924 eligible patients, we included 353 in the final analysis (age range 65-91; 30.31% female). Multivariate logistic regression analysis was performed to show that Rural Areas (OR = 1.976, 95%CI = 1.111-3.515, P = 0.020), T2D (OR = 2.125, 95%CI = 1.267-3.563, P = 0.004), Direct Bilirubin (OR = 0.388, 95%CI = 0.196-0.769, P = 0.007), Severity of Dependence in terms of Barthel Index (OR = 1.708, 95%CI = 1.193-2.445, P = 0.003) that were independently associated with PCICD, constituting a model with optimal predictive efficiency.

CONCLUSION

To the best of our knowledge, this study provides a practicable map of strategical predictors to robustly identify cognitive dysfunction at risk of post-cerebral infarction for clinicians in a broad sense. Of note, our findings support that the decline in serum direct bilirubin (DBil) concentration is linked to protecting cognitive function.

Self-Balancing Exoskeleton Robots Designed to Facilitate Multiple Rehabilitation Training Movements

This study presents the biomimetic design of the structure and controller of AutoLEE-II, a self-balancing exoskeleton developed to assist patients in performing multiple rehabilitation movements without crutches or other supporting equipment. Its structural design is founded upon the human body structure, with an eliminated axis deviation and a raised CoM of the exoskeleton. The controller is a physical parameter-independent controller based on the CoM modification. Thus, the exoskeleton can adapt to patients with different physical parameters. Five subjects underwent exoskeleton-assisted rehabilitation training experiments, including squatting, tilting, and walking trainings. The results showed that the exoskeleton can assist patients in completing various rehabilitation exercises and help them maintain their balance during the rehabilitation training. This helpful role of the exoskeleton in rehabilitation training is analyzed through an electromyography (EMG) data analysis. The findings revealed that wearing the exoskeleton can reduce the activity of the lower limb muscles by approximately 20-30% when performing the same rehabilitation exercises.

Risk factors and current state of therapy for anemia after kidney transplantation

Post-transplant anemia is one of the most common complications in kidney transplant recipients, severely affecting patient prognosis and quality of life, and is an independent predictor of graft kidney loss and patient mortality. However, our clinical understanding and the attention given to post-transplant anemia are currently insufficient. This paper reviews the current status, risk factors, and therapeutic progress in anemia after transplantation in kidney transplant recipients. We recommend that clinical staff pay attention to anemia and its complications in kidney transplant recipients and intervene early for anemia.

[Progress in research of models for predicting the risk of readmission and mortality among patients with acute heart failure]

Heart failure is a serious and end-stage status of various heart diseases, characterized by comparatively high rate of readmission and mortality, and has become an important public health issue. The risk of readmission and mortality following discharge of an index hospitalization are key indicators to evaluate the quality of medical care among patients with acute heart failure. Therefore, it is important to carry out risk prediction research for patients with acute heart failure, quantify the disease risk, perform risk stratification, optimize clinical decision-making, elevate patients' quality of life and prognosis, and comprehensively improve the medical quality of acute heart failure. During the past 20 years, foreign researchers have developed dozens of models to predict the risk of acute heart failure readmission and mortality, and Chinese researchers have also developed up to 10 models applicable to the Chinese population. However, there is no recommended risk prediction model for acute heart failure in current clinical guidelines across China. In this report, we aim to introduce the major models for predicting the risk of acute heart failure readmission and mortality from home and abroad, focus on putting forward limitations of established models, and initiating potential directions for future studies from the following aspects: integrate multi-source data, mine emerging biomarkers, establish polygenic risk scores, optimize machine learning methods, promote flexible adjustment, and broaden approaches that applicable for various scenarios. Accordingly, this study will help facilitate domestic research in predicting the risk of readmission and mortality among patients hospitalized for acute heart failure.

Retracted: Resveratrol Derivative, Trans-3, 5, 4'-Trimethoxystilbene, Prevents the Developing of Atherosclerotic Lesions and Attenuates Cholesterol Accumulation in Macrophage Foam Cells

Mol. Nutr. Food Res.2020, 64, 1 901 115 https://doi.org/10.1002/mnfr.201901115. The above article, published online on 22 January 2020, in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal's Editor-in-Chief, Dr. Julia Reuter, and Wiley-VCH GmbH. Following publication, the journal was contacted by the University of Kansas who indicated that three of the co-authors, Jinke Li, Siying Li and Mohammed M. Almutairi, whose affiliations had been noted at the Department of Pharmacology & Toxicology, University of Kansas, were not affiliated with the university. In addition, the journal was made aware of concerns raised by third parties regarding this article which evidences image duplication between Figures 1, 2, 3, 4, 6, and 7, and Table 1 in this article and two other articles purporting to show different data. The authors were contacted to ask for their explanation of the concerns raised, but no response was received. The retraction has been agreed as the editorial team no longer have confidence in the reported results and conclusions given the significant overlap between the results reported in the Figures and other published articles.

Therapeutic strategies targeting folate receptor α for ovarian cancer

Epithelial ovarian cancer (EOC) is the deadliest gynecological cancer, and presents a major clinical challenge due to limited treatment options. Folate receptor alpha (FRα), encoded by the FOLR1 gene, is an attractive therapeutically target due to its prevalent and high expression in EOC cells. Recent basic and translational studies have explored several modalities, such as antibody-drug conjugate (ADC), monoclonal antibodies, small molecules, and folate-drug conjugate, to exploit FRα for EOC treatment. In this review, we summarize the function of FRα, and clinical efficacies of various FRα-based therapeutics. We highlight mirvetuximab soravtansine (MIRV), or Elahere (ImmunoGen), the first FRα-targeting ADC approved by the FDA to treat platinum-resistant ovarian cancer. We discuss potential mechanisms and management of ocular adverse events associated with MIRV administration.

Multimorbidity Patterns and Associations with Gait, Balance and Lower Extremity Muscle Function in the Elderly: A Cross-Sectional Study in Northwest China

Purpose

Fall is a common geriatric syndrome leading to various adverse outcomes in the elderly. Gait and balance disorders and decreased lower extremity muscle function are the major intrinsic risk factors of falls, and studies suggested that they were closely related to the underlying chronic conditions. This study aimed to explore the patterns of multimorbidity and determine the associations of these multimorbidity patterns with gait, balance and lower extremity muscle function.

Patients and Methods

A cross-sectional survey of 4803 participants aged ≥60 years in Shaanxi Province, China was conducted and the self-reported chronic conditions were investigated. The 6-m walk test, timed-up-and-go test (TUG) and 5-sit-to-stand test (5-STS) were conducted to evaluate gait, balance, and lower extremity muscle function respectively. Latent class analysis was used to explore patterns of multimorbidity, and multivariate regression analysis was used to determine the associations of multimorbidity patterns with gait, balance, and lower extremity muscle function.

Results

Five multimorbidity patterns were identified: Degenerative Disease Class, Cardio-metabolic Class, Stroke-Respiratory-Depression Class, Gastrointestinal Class, and Very sick Class, and they were differently associated with gait and balance disorders and decreased lower extremity muscle function. In particular, the multimorbidity patterns of Degenerative Disease Class and Stroke-Respiratory-Depression Class were closely associated with all the three risk factors of falls.

Conclusion

There are significant differences in the impact of different multimorbidity patterns on the major intrinsic risk factors of falls in the elderly population, and appropriate multimorbidity patterns are closely related to the prediction of falls and can help to develop fall prevention strategies in the elderly.

Pseudo-pseudo Meigs syndrome in systemic lupus erythematosus misdiagnosed as pseudo-Meigs' syndrome: A case report

Symptoms of pelvic masses, elevated serum CA125 levels, massive ascites, and pleural effusion in female patients are usually associated with malignancy. Some benign ovarian tumors or other nonmalignant tumors may also produce similar symptoms, called Meigs syndrome or pseudo-Meigs' syndrome, which should be one of the differential diagnoses. However, there is an extremely rare form of SLE called pseudo-pseudo Meigs syndrome (PPMS), which may also present with the above symptoms, but is not associated with any of the tumors. In this paper, we report a case of a 47-year-old woman who presented with abdominal distention. The patient was found to have elevated serum CA125 levels to 182.9 U/mL before the operation. Her PET-CT suggested a large heterogeneous mass in the pelvis measuring 8.2 × 5.8 cm with a large amount of ascites. She was initially diagnosed with ovarian cancer and underwent exploratory laparotomy. Pathology of the surgical specimen revealed a uterine leiomyoma. Two months after discharge, the patient's ascites reappeared along with recurrent intestinal obstruction. After ascites and serological tests, she was eventually diagnosed with systemic lupus erythematosus and received systemic hormonal therapy.

Development and Evaluation of a Lumbar Assisted Exoskeleton with Mixed Lifting Tasks by Various Postures

A large number of the WRLSs (wearable robots lumbar support) research have been presented for working efficient increase and injure risk reduction in recent years. However, the previous research can only complete the sagittal-plane lifting task, which can not adapt to the mixed lifting tasks in the actual work scene. Therefore, we presented a novel lumbar assisted exoskeleton with mixed lifting tasks by various postures based on position control, which can not only carry out the lifting tasks of sagittal-plane, but also complete the lifting tasks of sides. First, we proposed a new generation method of raising reference curves that can generate assistance curve for each user with each task, which is very convenient in mixed lifting tasks. Then, an adaptive predictive controller was designed to track the reference curves of different users under different loads, the maximum tracking errors of the angles are 2.2° and 3.3° respectively at 5kg and 15kg, and all the errors are within 3%. Compared to the condition of no exoskeleton, the average RMS (root mean square) of EMG (electromyography) for six muscles are reduced by 10.33 ± 1.44%, 9.62±0.69%, 10.97±0.81% and 14.48±2.11% by lifting loads with stoop, squat, left-asymmetric and right-asymmetric respectively. The results demonstrate that our lumbar assisted exoskeleton presents outperformance in mixed lifting tasks by various postures.

Highly Efficient Refractive Index Sensor Based on a Dual-Side Polished SMS Fiber Enabled by Femtosecond Laser Writing

Fiber-optic refractive index (RI) sensors based on wavelength-shift-based interrogation continue to present a challenge in achieving high sensitivity for a wide detection range. In this paper, we propose a sensor for determining the RI of liquids based on femtosecond laser (fs-laser) writing of a dual-side polished singlemode-multimode-singlemode (SMS) fiber. The proposed sensor can determine the RI value of a surrounding liquid by detecting the dip wavelength in the transmission spectrum of the light propagating through the sensing area. The high RI sensitivity is attributed to the increased interaction area established by the fs-laser, which creates hydrophilic surfaces and maintains the wide detection range of the SMS structure. The results of the wavelength-shift-based interrogation reveal that the fabricated device exhibited a high sensitivity of 161.40 nm per refractive index unit (RIU) over a wide RI detection range of 0.062 RIU. The proposed device has high processing accuracy and a simple manufacturing process. Hence, it has the potential to be used as a lab-on-fiber sensing platform in chemical and biotechnological applications.

Knowledge Transmission and Skills Building Relating to Child Sexual Abuse in China

Parents play a key role in child CSA prevention, but the mechanisms underlying the intergenerational knowledge transmission are not fully understood. This study explores the role of two parenting practices - parent-child communication and parent's protective behavior - as mediating factors in the relation between parents' knowledge and their children's knowledge and skills. Four hundred and ten dyads of early adolescents and their mother or father from rural China participated in the study. Parents were surveyed on their knowledge, protective behaviors, and parent-child communication regarding CSA, while children answered questions on relevant knowledge and skills. Results revealed that parental knowledge was positively and significantly related to communication and protective behavior, protective behavior was positively related to children's knowledge and skills, but the coefficient between communication and children's knowledge and skills was insignificant. The findings highlight direct parental protection as one of the most important mechanism for intergenerational knowledge transmission.

Digital twin rehabilitation system based on self-balancing lower limb exoskeleton

BACKGROUND

The digital twin concept is the virtual model based on entity design measures, which is used in many enterprises' virtual workshop design models for workshop production scheduling and optimization. However, in the field of medical rehabilitation, the integration of digital twin technology started late compared to traditional industrial manufacturing. Many current digital models are not well suited for information interaction between patients and devices.

OBJECTIVE

In order to address the lack of interaction between patients and devices in the field of medical rehabilitation, this paper proposes an automatic gait data control system (AGDCS) for fully actuated lower limb exoskeleton digital twinning. This system improves the integration of digital twinning system with the medical rehabilitation field and analyzes the patient's gait data through simulation experiments.

METHODS

The digital twin system was designed in several steps. Firstly, the upper computer function module was designed and developed according to the rehabilitation treatment needs. After that, the combination of exoskeleton robot and software was carried out, and finally the real rehabilitation treatment environment of patients was simulated through experiments.

RESULTS

The proposed system was very reliable in the experimental tests of the host computer and exoskeleton robot. In the upper computer test, the patient specific gait can be generated, and the motion of the exoskeleton robot can be observed in real-time. During the walking test of the exoskeleton robot, the exoskeleton robot completed the specified gait. The result verified the superiority and effectiveness of the digital twin system AGDCS in the field of rehabilitation.

CONCLUSIONS

The digital twin system proposed in this paper improves the interaction between self-balancing exoskeleton robot and patients, and improves the autonomy and safety of patients in rehabilitation treatment.

Application and evaluation of transitory protective stoma in ovarian cancer surgery

Ovarian cancer is the most fatal of all female reproductive cancers. The fatality rate of OC is the highest among gynecological malignant tumors, and cytoreductive surgery is a common surgical procedure for patients with advanced ovarian cancer. To achieve satisfactory tumor reduction, intraoperative bowel surgery is often involved. Intestinal anastomosis is the traditional way to restore intestinal continuity, but the higher rate of postoperative complications still cannot be ignored. Transitory protective stoma can reduce the severity of postoperative complications and traumatic stress reaction and provide the opportunity for conservative treatment. But there are also many problems, such as stoma-related complications and the impact on social psychology. Therefore, it is essential to select appropriate patients according to the indications for the transitory protective stoma, and a customized postoperative care plan is needed specifically for the stoma population.

Reproductive and oncological outcomes of fertility-sparing surgery in patients with stage I epithelial ovarian cancer: A systematic review and meta-analysis

OBJECTIVE

We meta-analyzed available evidence on fertility, survival, and cancer recurrence in patients with stage I epithelial ovarian cancer (EOC) after fertility-sparing surgery (FSS).

METHODS

We systematically reviewed PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials to identify studies reporting reproductive and oncological outcomes of patients with stage I EOC who underwent FSS. Random-effects models were used to calculate pooled rates of disease outcomes, along with 95% confidence intervals (CIs). Subgroup and sensitivity analyses were conducted to identify sources of heterogeneity in the data.

RESULTS

We included 23 observational retrospective studies involving 1126 patients. The pooled pregnancy rate was 30% (95% CI, 0.26-0.34), while the pooled natural conception rate was 26% (95% CI, 0.20-0.33). The pooled live birth rate was 27% (95% CI, 0.22-0.32). The pooled rate of EOC recurrence was 12% (95% CI, 0.09-0.14), which did not differ significantly from the rate among patients who underwent radical surgery (odds ratio, 0.77; 95% CI, 0.45-1.33).

CONCLUSIONS

FSS is associated with good oncological outcomes but less than satisfactory reproductive outcomes. All in all, the procedure appears to be a safe alternative to radical surgery for EOC patients who want to preserve fertility.

Risk factors for cytomegalovirus infection and disease after kidney transplantation: A meta-analysis

OBJECTIVE

To investigate the risk factors for cytomegalovirus (CMV) infection and disease in kidney transplantation recipient, and provide references for the prevention and control of CMV infection and disease in kidney transplantation patients.

METHODS

Chinese and international literature related to risk factors for CMV infection and disease in renal transplant recipients was searched using databases, including China National Knowledge Infrastructure; WanFang Data; Wiper; Chinese Biomedical Literature database; PubMed; Embase; Web of Science, and the Cochrane Register of Controlled Trials. Two researchers independently screened the literature, extracted the data, and evaluated the quality of the literature according to published standards. A meta-analysis was performed using RevMan 5.4 software to extract the risk factors for CMV infection and disease in renal transplant recipients.

RESULTS

A total of 59,847 subjects were included in 24 studies. The risk factors for CMV infection were ATG [OR = 2.76, 95% CI (2.10, 3.63), P < 0.00001], Donor (D) CMV-IgG(+) Receptor (R)(-): (D+/R-) [OR = 2.97, 95% CI (1.63, 5.44), P = 0.004 < 0.05], recipient age [OR = 1.96, 95% CI (1.50, 2.54), P < 0.00001], lymphocytopenia [OR = 3.26, 95% CI (1.46, 7.31), P < 0.00001], and mycophenolate [OR = 3.22, 95% CI (2.02, 5.46), P < 0.00001]. The protective factor for CMV infection was glomerular filtration rate (GFR) [OR = 0.98, 95% CI (0.97, 0.99), P < 0.00001], and the uncertain factors were the use of tacrolimus [OR = 0.91, 95% CI (0.64, 1.28), P = 0.58 > 0.05], rejection [OR = 1.32, 95% CI (0.49, 3.53), P = 0.58 > 0.05], donor age [OR = 1.00, 95% CI (0.99, 1.01), P = 0.67 > 0.5], and preemptive therapy [OR = 0.51, 95% CI (0.11, 2.36), P = 0.86 > 0.05]. The risk factors for CMV disease were D+/R- [OR = 4.78, 95% CI (3.76, 6.07), P < 0.00001], ATG [OR = 1.83, 95% CI (1.25, 2.67), P < 0.00001], rejection [OR = 1.42, 95% CI (1.26, 1.59), P < 0.00001], mycophenolate [OR = 1.67, 95% CI (1.38, 2.02), P < 0.00001], recipient age [OR = 1.03, 95% CI (1.02, 1.03), P < 0.00001], donor age [OR = 1.01, 95% CI (1.00, 1.01), P = 0.001 < 0.05], Donor (D) CMV-IgG(+) Receptor(R)(+): (D+/R+) [OR = 1.92, 95% CI (1.49, 2.46), P < 0.00001], the use of prednisolone [OR = 1.59, 95% CI (1.32, 1.92), P < 0.00001], and diabetes mellitus[OR = 1.18, 95% CI (1.01, 1.37), P = 0.03 < 0.05], and the uncertain factors were donor type [OR = 4.10, 95% CI (0.28, 59.79), P = 0.30 > 0.05], time of transplantation [OR = 0.95, 95% CI (0.78, 1.16), P = 0.64 > 0.05], and the use of cyclosporine [OR = 1.50, 95% CI (0.62, 3.64), P = 0.37 > 0.05].

CONCLUSION

There are many factors influencing CMV infection and disease in kidney transplant patients. Risk factors should be carefully monitored, protective factors strengthened, and more attention paid to uncertain factors.

[Research progress of LI-RADS categories and imaging features in predicting the prognosis of liver tumors]

The liver imaging reporting and data system (LI-RADS) is an imaging assessment system that standardizes the diagnosis of hepatocellular carcinoma (HCC), indicating the benign and malignant tumor through categories as well as major and ancillary features. The higher the LI-RADS category ranking, the higher the corresponding HCC likelihood and malignancy risk. Therefore, early diagnosis and prediction of the prognostic risk factors of liver tumors by preoperative imaging have important clinical significance for improving the survival rate and prognosis of patients. This article reviews the research progress of LI-RADS categories and related imaging features in predicting the prognosis of liver tumors.

Effect of K-Modified Blue Coke-Based Activated Carbon on Low Temperature Catalytic Performance of Supported Mn-Ce/Activated Carbon

To clarify the K modified effects over activated carbon (AC) supported Mn-Ce oxide catalysts, several Mn-Ce/AC and xK-Mn-Ce/AC mixed oxide catalysts prepared via an impregnation method supported on AC were investigated for low-temperature selective catalytic reduction (SCR) of NO with NH₃ in the simulated sintering flue gas. The Mn-Ce/AC catalyst with a K loading of 8% showed the highest catalytic activity, corresponding to 92.1% NO conversion and 92.5% N₂ selectivity at 225 °C with a space velocity of 12,000 h^-1. Furthermore, the 0.08K-Mn-Ce/AC catalyst exhibited better resistance to SO₂ and H₂O than Mn-Ce/AC, which could convert 72.3% and 74.1% of NO at the presence of 5% SO₂ and H₂O, respectively. After K modification, the relative ratios of Mn⁴⁺/Mn ⁿ⁺ as well as Ce³⁺/Ce ⁿ⁺ and surface adsorbed oxygen increased. Additionally, the reduction performance of the catalyst was improved obviously, and both acid strength and quantity of acid sites increased significantly after the K species were introduced in Mn-Ce/AC. Especially, the NO adsorption capacity of the catalyst was enhanced, which remarkably promoted the denitration efficiency and SO₂ resistance. The SCR of NO with NH₃ on K-Mn-Ce/AC catalysts followed the L-H mechanism.

Cervical Cancer Recurrence and Patient Survival After Radical Hysterectomy Followed by Either Adjuvant Chemotherapy or Adjuvant Radiotherapy With Optional Concurrent Chemotherapy: A Systematic Review and Meta-Analysis

Objective

To compare cervical cancer recurrence and patient survival after radical hysterectomy followed by either adjuvant chemotherapy (AC) or adjuvant radiotherapy with or without concurrent chemotherapy (AR/CCRT).

Methods

We systematically searched PubMed, EMBASE, the Cochrane Library and clinicaltrials.gov to identify studies reporting recurrence or survival of cervical cancer patients who received AC or AR/CCRT after radical hysterectomy. Data were meta-analyzed using a random-effects model, and heterogeneity was evaluated using the I² test. Subgroup and sensitivity analyses were performed to identify potential sources of heterogeneity.

Results

The meta-analysis included 14 non-randomized studies and two randomized controlled trials, altogether involving 5,052 cervical cancer patients. AC and AR/CCRT groups did not differ significantly in rates of total or local recurrence or mortality. Nevertheless, AC was associated with significantly lower risk of distant recurrence [odds ratio (OR) 0.67, 95% confidence interval (CI) 0.55-0.81] and higher rates of overall survival [hazard ratio (HR) 0.69, 95%CI 0.54-0.85] and disease-free survival rate (HR 0.77, 95%CI 0.62-0.92).

Conclusions

AC may be an effective alternative to AR/CCRT for cervical cancer patients after radical hysterectomy, especially younger women who wish to preserve their ovaries and protect them from radiation damage.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/, identifier PROSPERO (CRD42021252518).

Combined Schottky junction and doping effect in CdxZn1-xS@Au/BiVO4 Z-Scheme photocatalyst with boosted carriers charge separation for CO2 reduction by H2O

A Z-scheme photosystems combining Schottky junction and loading of applicable bandgap semiconductor is beneficial for enhancing the charge carriers' separation/transfer as well as maintain their excellent redox ability. Here, Cd_xZn_1-xS@Au was in-situ deposited on the (010) facets of BiVO₄ taking Au as a bridge for constructing a sandwich structure Cd_xZn_1-xS@Au/BiVO₄ Z-scheme photocatalyst. The electrons in BiVO₄ (010) migrate unidirectionally to Au nanoparticles across the Schottky junction and effectively suppress opposite electrons flow, then be captured by the excited holes in Cd_xZn_1-xS. Furthermore, Zn-doping also contributes to an appropriate redox ability and charge carriers separation. Benefiting from the dual-facilitated effects, the ternary Cd_xZn_1-xS@Au/BiVO₄ exhibited superior photocatalytic activity for CO₂ reduction under visible light irradiation using H₂O as a reducing agent, as compared with CdS and CdS@Au/BiVO₄. Furthermore, the intermediate product HCOO* fixed on the surface of Cd_xZn_1-xS@Au/BiVO₄ is identified by in-situ FT-IR, playing a key role in the conversion of CO₂ to CO and then improve photocatalytic selectivity.

[Research progress of cirrhotic portal hypertension in diagnostic imaging methods]

Hepatic venous pressure gradient measurement via jugular vein catheterization is still currently the gold standard for evaluating portal hypertension. However, how to accurately and reproducibly assess whether there is portal hypertension has always been a concern in patients with liver cirrhosis. In recent years, imaging methods have made significant progress in the non-invasive diagnosis of portal hypertension. This paper reviews the current different diagnostic value of imaging methods and related research progress in an attempt to evaluate patients with cirrhotic portal hypertension.

Populus euphratica Apyrases Increase Drought Tolerance by Modulating Stomatal Aperture in Arabidopsis

Stomatal regulation is crucial to reduce water consumption under drought conditions. Extracellular ATP (eATP) serves as a signaling agent in stomatal regulation; however, it is less known whether the eATP mediation of stomatal aperture is linked to apyrases (APYs), the principal enzymes that control the concentration of eATP. To clarify the role of APYs in stomatal control, PeAPY1 and PeAPY2 were isolated from Populus euphratica and transferred into Arabidopsis. Compared with the wild-type Arabidopsis and loss-of-function mutants (Atapy1 and Atapy2), PeAPY1- and PeAPY2-transgenic plants decreased stomatal aperture under mannitol treatment (200 mM, 2 h) and reduced water loss during air exposure (90 min). The role of apyrase in stomatal regulation resulted from its control in eATP-regulated stomatal movements and increased stomatal sensitivity to ABA. The bi-phasic dose-responses to applied nucleotides, i.e., the low ATP (0.3-1.0 mM)-promoted opening and high ATP (>2.0 mM)-promoted closure, were both restricted by P. euphratica apyrases. It is noteworthy that eATP at a low concentration (0.3 mM) counteracted ABA action in the regulation of stomatal aperture, while overexpression of PeAPY1 or PeAPY2 effectively diminished eATP promotion in opening, and consequently enhanced ABA action in closure. We postulate a speculative model of apyrase signaling in eATP- and ABA-regulated stomatal movements under drought.

NaCl-altered oxygen flux profiles and H+-ATPase activity in roots of two contrasting poplar species

Maintaining mitochondrial respiration is crucial for proving ATP for H+ pumps to continuously exclude Na+ under salt stress. NaCl-altered O2 uptake, mitochondrial respiration and the relevance to H+-ATPase activity were investigated in two contrasting poplar species, Populus euphratica (salt-tolerant) and Populus popularis 35-44 (salt-sensitive). Compared with P. popularis, P. euphratica roots exhibited a greater capacity to extrude Na+ under NaCl stress (150 mM). The cytochemical analysis with Pb(NO3)2 staining revealed that P. euphratica root cells retained higher H+ hydrolysis activity than the salt-sensitive poplar during a long term (LT) of increasing salt stress (50-200 mM NaCl, 4 weeks). Long-sustained activation of proton pumps requires long-lasting supply of energy (adenosine triphosphate, ATP), which is delivered by aerobic respiration. Taking advantage of the vibrating-electrodes technology combined with the use of membrane-tipped, polarographic oxygen microelectrodes, the species, spatial and temporal differences in root O2 uptake were characterized under conditions of salt stress. Oxygen uptake upon NaCl shock (150 mM) was less declined in P. euphratica than in P. popularis, although the salt-induced transient kinetics were distinct from the drastic drop of O2 caused by hyperosmotic shock (255 mM mannitol). Short-term (ST) treatment (150 mM NaCl, 24 h) stimulated O2 influx in P. euphratica roots, and LT-treated P. euphratica displayed an increased O2 influx along the root axis, whereas O2 influx declined with increasing salinity in P. popularis roots. The spatial localization of O2 influxes revealed that the apical zone was more susceptible than the elongation region upon high NaCl (150, 200 mM) during ST and LT stress. Pharmacological experiments showed that the Na+ extrusion and H+-ATPase activity in salinized roots were correspondingly suppressed when O2 uptake was inhibited by a mitochondrial respiration inhibitor, NaN3. Therefore, we conclude that the stable mitochondrial respiration energized H+-ATPase of P. euphratica root cells for maintaining Na+ homeostasis under salt environments.

Traditional Chinese medicines and their active ingredients sensitize cancer cells to TRAIL-induced apoptosis

The rapidly developing resistance of cancers to chemotherapy agents and the severe cytotoxicity of such agents to normal cells are major stumbling blocks in current cancer treatments. Most current chemotherapy agents have significant cytotoxicity, which leads to devastating adverse effects and results in a substandard quality of life, including increased daily morbidity and premature mortality. The death receptor of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) can sidestep p53-dependent pathways to induce tumor cell apoptosis without damaging most normal cells. However, various cancer cells can develop resistance to TRAIL-induced apoptosis via different pathways. Therefore, it is critical to find an efficient TRAIL sensitizer to reverse the resistance of tumor cells to TRAIL, and to reinforce TRAIL's ability to induce tumor cell apoptosis. In recent years, traditional Chinese medicines and their active ingredients have shown great potential to trigger apoptotic cell death in TRAIL-resistant cancer cell lines. This review aims to collate information about Chinese medicines that can effectively reverse the resistance of tumor cells to TRAIL and enhance TRAIL's ability to induce apoptosis. We explore the therapeutic potential of TRAIL and provide new ideas for the development of TRAIL therapy and the generation of new anti-cancer drugs for human cancer treatment. This study involved an extensive review of studies obtained from literature searches of electronic databases such as Google Scholar and PubMed. "TRAIL sensitize" and "Chinese medicine" were the search keywords. We then isolated newly published studies on the mechanisms of TRAIL-induced apoptosis. The name of each plant was validated using certified databases such as The Plant List. This study indicates that TRAIL can be combined with different Chinese medicine components through intrinsic or extrinsic pathways to promote cancer cell apoptosis. It also demonstrates that the active ingredients of traditional Chinese medicines enhance the sensitivity of cancer cells to TRAIL-mediated apoptosis. This provides useful information regarding traditional Chinese medicine treatment, the development of TRAIL-based therapies, and the treatment of cancer.

Contraceptive and reproductive health practices of unmarried women globally, 1999 to 2018: Systematic review and meta-analysis

BACKGROUND

Premarital sex practices and contraceptive prevalence rate (CPR) among unmarried women worldwide remain unclear, even though unmarried women tend to have multiple sex partners over time, which makes their sexual behaviors particularly important to the sexual and reproductive health of society more broadly.

METHODS

We searched the MEDLINE, PubMed, and Google Scholar databases for relevant articles published between January 1, 1999 and December 31, 2018. Data on prevalence of premarital sexual intercourse, use of highly prevalent contraceptive methods, as well as CPR overall and at first sexual intercourse were extracted and estimated using a DerSimonian- Laird random effects model.

RESULTS

Of the 3918 articles identified, 37 covering 19 countries were included. The estimated overall prevalence of premarital sexual intercourse was 41.9% (95%CI 34.2-49.6%). Pooled CPR was 57.0% (95%CI 44.3-69.8%) overall and 57.6% (95% CI 39.5- 75.6%) at first intercourse. The overall prevalence of condom use was 51.2% (95%CI 42.7-59.7%), followed by oral contraceptives (20.5%, 95%CI 13.7-27.3%), withdrawal (12.7%, 95%CI 9.4-15.9%), and rhythm (12.1%, 95%CI 6.7-17.4%).

CONCLUSION

The findings of this global study indicate worrying trends in unprotected intercourse and contraceptive practices, suggesting the need for greater attention and resources aimed at educating unmarried adolescent women about sexual and reproductive health.

SYSTEMATIC REVIEW REGISTRATION NUMBER

CRD42019132736.

Special acoustical role of pinna simplifying spatial target localization by the brown long-eared bat Plecotus auritus

Echolocating bats locate a target by sonar. The performance of this system is related to the shape of the binaural conformation in bats. From numerical predictions, it was found that in a central frequency band, the orientation of a strong sidelobe is shifted nearly linearly in the vertical direction. Inspired by this, the authors built an accurate wide-scope elevation estimation system by constructing a pair of erect artificial pinnae and realized simultaneous elevation and azimuth estimation by constructing a pair of orthogonal pinnae. By demonstrating the simplicity of spatial target echolocation, the authors showed that only two independent single-output neural networks were needed for either elevation or azimuth estimation. This method could be applied to imitate any other mammal species with similar pinna directivity patterns to facilitate and improve an artificial echolocation system.

A-EMCS for PHEV based on real-time driving cycle prediction and personalized travel characteristics

Energy management plays an important role in improving the fuel economy of plug-in hybrid electric vehicles (PHEV). Therefore, this paper proposes an improved adaptive equivalent consumption minimization strategy (A-ECMS) based on long-term target driving cycle recognition and short-term vehicle speed prediction, and adapt it to personalized travel characteristics. Two main contributions have been made to distinguish our work from exiting research. Firstly, online long-term driving cycle recognition and short-term speed prediction are considered simultaneously to adjust the equivalent factor (EF). Secondly, the dynamic programming (DP) algorithm is applied to the offline energy optimization process of A-ECMS based on typical driving cycles constructed according to personalized travel characteristics. The improved A-ECMS can optimize EF based on mileage, SOC, long-term driving cycle and real-time vehicle speed. In the offline part, typical driving cycles of a specific driver is constructed by analyzing personalized travel characteristics in the historical driving data, and optimal SOC consumption under each typical driving cycle is optimized by DP. In the online part, the SOC reference trajectory is obtained by recognizing the target driving cycle from Intelligent Traffic System, and short-term vehicle speed is predicted by Nonlinear Auto-Regressive (NAR) neural network which both adjust EF together. Simulation results show that compared with CD-CS, the fuel consumption of A-ECMS proposed in the paper is reduced by 8.7%.

Genipin suppression of growth and metastasis in hepatocellular carcinoma through blocking activation of STAT-3

BACKGROUND

The signal transducer and activator of transcription-3 (STAT-3) can facilitate cancer progression and metastasis by being constitutively active via various signaling. Abundant evidence has indicated that STAT-3 may be a promising molecular target for cancer treatment.

METHODS

In this study, a dual-luciferase assay-based screening of 537 compounds for STAT-3 inhibitors of hepatocellular carcinoma (HCC) cells was conducted, leading to the identification of genipin. Effects of genipin on HCC were assessed in a patient-derived xenograft nude mice model. Western blotting assay, chromatin immunoprecipitation (ChIP) assay, molecular docking study, tube formation assay, three-dimensional top culture assay, histological examination, and immunofluorescence were utilized to evaluate the regulatory signaling pathway.

RESULTS

Our research demonstrated that genipin suppresses STAT-3 phosphorylation and nuclear translocation, which may be attributed to the binding capacity of this compound to the Src homology-2 (SH2) domain of STAT-3. In addition, the therapeutic effects of genipin in a patient-derived HCC xenograft nude mice model were also demonstrated.

CONCLUSIONS

In conclusion, genipin showed therapeutic potential for HCC treatment by interacting with the SH2-STAT-3 domain and suppressing the activity of STAT-3. In the future, further research is planned to explore the potential role of genipin in combination with chemotherapy or radiotherapy for HCC.

Ovarian metastasis in women with cervical carcinoma in stages IA to IIB: A systematic review and meta-analysis

BACKGROUND

Cervical cancer is one of the common malignancies that afflict women worldwide. In rare cases, cervical cancer leads to ovarian metastasis (OM), resulting in poor outcomes. We conducted a systematic review and meta-analysis to evaluate the incidence and risk factors of OM in patients with adenocarcinoma (ADC) or squamous cell carcinoma (SCC) of the cervix.

METHODS

We searched articles focused on OM in cervical carcinoma in PubMed, Embase, and the Cochrane Central Register of Controlled Trials. A meta-analysis was performed including selected publications. Pooled odds ratio (OR) and 95% confidence interval (95% CI) were calculated using random-effects models. The heterogeneity was evaluated by the I test. I > 50% was considered high heterogeneity.

RESULTS

A total of 12 studies with 18,389 patients with cervical cancer in International Federation of Gynecology and Obstetrics stages IA to IIB were included in the meta-analysis. The overall incidence of OM was 3.61% among patients with ADC and 1.46% among patients with SCC (ADC vs SCC: OR 3.89, 95% CI 2.62-5.78; P < .001). Risk factors for OM were age >40 years (OR 1.79, 95% CI 1.02-3.13), bulky tumor (OR 2.65, 95% CI 1.77-3.95), pelvic lymph node involvement (PLNI; OR 9.33, 95% CI 6.34-13.73), lymphovascular space involvement (LVSI; OR 4.38, 95% CI 1.86-10.31), parametrial invasion (PMI; OR 7.87, 95% CI 5.01-12.36), and corpus uteri invasion (CUI; OR 7.64, 95% CI 2.51-23.24). PLNI, LVSI, and PMI were the leading risk factors, contributing to OM with respective population attributable fractions of 64.8%, 58.8%, and 51.5%.

CONCLUSION

The incidence of OM is relatively low in ADC and SCC patients. Risk factors for OM include PLNI, LVSI, PMI, bulky tumor, CUI, or age over 40 years, with the first 3 contributing more to risk of OM.

CFTR Regulates the Proliferation, Migration and Invasion of Cervical Cancer Cells by Inhibiting the NF-κB Signalling Pathway

Background

The cystic fibrosis transmembrane conductance regulator (CFTR) and nuclear factor κB (NF-κB) signalling pathways are currently regarded as co-regulators of the occurrence of cervical cancer. However, the detailed mechanism of CFTR- and NF-κB-mediated effects in cervical cancer remains to be elucidated. This study aimed to investigate the mechanism by which CFTR and NF-κB influence the development of cervical cancer.

Patients and Methods

CFTR ΔF508 mutation and CFTR promoter methylation were detected in cervical tissue samples. NF-κB p65 and IκBα protein levels were tested in HeLa cells with CFTR overexpression and knockdown by Western blotting. The effects of CFTR on cell proliferation, migration, and invasion were examined in HeLa cells by WST-1 and soft agar assays, cell wound scratch assay, and Matrigel invasion assays, respectively. The protein–protein interaction (PPI) network was constructed by using GeneMANIA. GeneCoDis3 was used to perform Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional enrichment analysis on genes in the PPI network.

Results

CFTR mutation and CFTR promoter methylation were not associated with the occurrence of cervical cancer. NF-κB p65 protein levels were decreased in CFTR overexpression lines and increased in CFTR knockdown lines, and IκBα levels were affected in the opposite manner, indicating that CFTR inhibited the NF-κB signalling pathway. CFTR also regulated the cell proliferation, migration, and invasion ability of cervical cancer cells. When CFTR was overexpressed, cell proliferation, migration, and invasion ability were decreased. There were 20 genes that interacted with CFTR. KEGG pathway analysis showed enrichment in the gastric acid secretion, chemokine signalling, bile secretion and apoptosis pathways.

Conclusion

CFTR plays an important role in cancer cell proliferation, migration and invasion by inhibiting the NF-κB signalling pathway in cervical cancer.

Kandelia candel Thioredoxin f Confers Osmotic Stress Tolerance in Transgenic Tobacco

Water deficit caused by osmotic stress and drought limits crop yield and tree growth worldwide. Screening and identifying candidate genes from stress-resistant species are a genetic engineering strategy to increase drought resistance. In this study, an increased concentration of mannitol resulted in elevated expression of thioredoxin f (KcTrxf) in the nonsecretor mangrove species Kandelia candel. By means of amino acid sequence and phylogenetic analysis, the mangrove Trx was classified as an f-type thioredoxin. Subcellular localization showed that KcTrxf localizes to chloroplasts. Enzymatic activity characterization revealed that KcTrxf recombinant protein possesses the disulfide reductase function. KcTrxf overexpression contributes to osmotic and drought tolerance in tobacco in terms of fresh weight, root length, malondialdehyde (MDA) content, and hydrogen peroxide (H2O2) production. KcTrxf was shown to reduce the stomatal aperture by enhancing K+ efflux in guard cells, which increased the water-retaining capacity in leaves under drought conditions. Notably, the abscisic acid (ABA) sensitivity was increased in KcTrxf-transgenic tobacco, which benefits plants exposed to drought by reducing water loss by promoting stomatal closure. KcTrxf-transgenic plants limited drought-induced H2O2 in leaves, which could reduce lipid peroxidation and retain the membrane integrity. Additionally, glutathione (GSH) contributing to reactive oxygen species (ROS) scavenging and transgenic plants are more efficient at regenerating GSH from oxidized glutathione (GSSG) under conditions of drought stress. Notably, KcTrxf-transgenic plants had increased glucose and fructose contents under drought stress conditions, presumably resulting from KcTrxf-promoted starch degradation under water stress. We conclude that KcTrxf contributes to drought tolerance by increasing the water status, by enhancing osmotic adjustment, and by maintaining ROS homeostasis in transgene plants.

Resveratrol Derivative, Trans-3, 5, 4'-Trimethoxystilbene, Prevents the Developing of Atherosclerotic Lesions and Attenuates Cholesterol Accumulation in Macrophage Foam Cells

SCOPE

Recent studies have demonstrated that trans-3, 5, 4'-Trimethoxystilbene (TMS), a novel derivative of resveratrol, may suppress the foam cells formation and restrain atherosclerosis in vitro and in vivo. Herein, the molecular mechanisms underlying the protective effects of TMS against atherosclerosis are further delineated.

METHODS AND RESULTS

In the present study, the cholesterol-lowering effects of TMS in macrophage-derived foam cell by animal studies, Oil Red O staining, and lipid uptake as well as efflux analysis, are explored. Real-time PCR, western blotting analysis, luciferase reporter assay, electrophoretic mobility shift assay, and immunofluorescent staining are applied for investigating the mechanism involved in atherosclerosis prevention by TMS. Herein, it is revealed that TMS, at a dosage of 10 mg kg-1  day-1 , may suppress atherosclerotic plaques within the aorta and arterial intima in apolipoprotein Edeficient mice (ApoE)-/- mice by reducing cholesterol level and macrophages content. Exposure of macrophages to TMS (10 µM) can suppress foam cells formation via regulating oxidized low density lipoprotein and cholesterol content in human macrophages through inhibiting scavenger receptors expression and activator protein-1(AP-1) activity. In addition, TMS can activate ERK/Nrf2/HO-1 signaling which increases the expression of ATP-binding cassette transporters.

CONCLUSION

In conclusion, TMS may inhibit the progress of atherosclerosis through regulating cholesterol homeostasis and inhibiting macrophage-derived foam cells formation.

Wogonin inhibits cell cycle progression by activating the glycogen synthase kinase-3 beta in hepatocellular carcinoma

BACKGROUND

Wogonin has been reported to exhibit various biological activities such as anti-inflammation, anti-microbial, and anti-tumor. Previous studies have demonstrated that wogonin could down-regulate Cyclin D1 activity on multiple cancers. However, the related mechanisms have not been fully elucidated so far.

PURPOSE

The aim of the current study was to explore whether wogonin can suppress hepatocellular carcinoma (HCC) progression and the mechanism of wogonin in inhibiting Cyclin D1 expression.

METHODS

Herein, we assessed the anti-tumor activity of wogonin against hepatocellular carcinoma (HCC) by MTT assay, clonogenic assay, cell cycle analysis and orthotopic xenograft mouse models. Western blot, immunofluoscence assay, co-immunoprecipitation assay, docking program, surface plasmon resonance, site-directed mutagenesis assay and immunohistochemical assay were performed for exploring the underlying mechanisms of wogonin-induced growth inhibition in HCC.

RESULTS

Our results showed that non-toxic dosage of wogonin (10, 20 µM) could inhibit cells proliferation and suppress cells cycle progression in MHCC97L and HepG2 cell. Moreover, the findings from the western blot and immunofluoscence assay confirmed the inhibition action of wogonin (10, 20 µM) on Cyclin D1 expression in MHCC97L cells, and wogonin (10, 20 µM) pre-treatment was capable of promoting Cyclin D1 ubiquitination and degradation in MHCC97L cell. In addition, wogonin promoted phosphorylation of Cyclin D1 on threonine-286 site, the mutation of threonine-286 to alanine-286A blocked Cyclin D1 proteolysis induced by wogonin. Wogonin-promoted Cyclin D1 phosphorylation and subsequent proteolysis may associate with the activation of GSK3beta in cancer cells. The phosphorylated form of GSK3beta (active form) expression was significantly increased after wogonin (20 µM) exposure. Molecular docking study and Biacore SPR analysis of GSK3beta mutant further validated the high-affinity wogonin binding site on GSK3beta. Moreover, in vivo studies further confirmed that phospho-GSK3beta Tyr216 was over-expressed in HCC specimens after wogonin treatment while the amount of Cyclin D1 was significantly decreased.

CONCLUSION

In summary, our data reveal a novel molecular mechanism by which wogonin induces HCC cells cycle arrest and suppresses tumor proliferation.

Insights into P2-Type Layered Positive Electrodes for Sodium Batteries: From Long- to Short-Range Order

P2-type Fe- and Mn-based layered sodium transition metal oxides are promising positive electrode materials for sodium batteries due to their high energy density and low costs of the constituting transition metals. However, poor structural reversibility and fast capacity decay have prevented their breakthrough so far. Herein, the real-time dynamic phase transitions and capacity fading mechanism of the P2 Na_0.67Fe_0.5Mn_0.5O₂ positive electrode are revealed by operando X-ray diffraction, operando/ex situ X-ray absorption spectroscopy, neutron powder diffraction, and neutron pair distribution functions. Upon the desodiation process, a layered OP4 phase with long-range order is found as an intermediate state. With further deep desodiation, the formation of a Na-depleted ramsdellite phase with a short coherent length of 30 Å is observed for the first time. However, the transition from OP4 to ramsdellite is considered to be irreversible due to the breakdown of the layered structural characteristics, resulting in poor cycling performance in a variety of Fe-based layered sodium transition metal oxides. This work suggests that stabilizing the crystal structure by substitution or chemical modification can be a favorable strategy to avoid the degradation of positive electrodes and thus to improve the cycling performance.

Airborne Transmission of Influenza Virus in a Hospital of Qinhuangdao During 2017-2018 Flu Season

The 2017-2018 flu season is considered to be one of the most severe, with numerous influenza outbreaks worldwide. In an infectious disease hospital of Qinhuangdao, air samples were collected daily from outpatient hall, clinical laboratory, fever clinic, children's ward (Children's Ward I/Children's Ward II), and adult ward during 23-29 January 2018 (peak flu activity) and 9-15 April 2018 (low flu activity). The air samples were collected with SLC-SiOH magnetic beads using impingement samplers. Real-time PCR assay was used to detect the RNA of airborne influenza (IFVA and IFVB) in the 91 collected aerosol samples. The results indicated that the air samples collected from the children's wards, adult ward and fever clinic were detected with airborne influenza viruses. However, the samples collected from outpatient hall and clinical laboratory were absence of influenza viruses. In addition, the subtypes of pH1N1/IFVA, H3N2/IFVA, yamagata/IFVB, and victoria/IFVB were detected among the samples with positive IFVA and IFVB. Notably, a new developed subtype of pH1N1 (an epidemic in 2018) was detected in the aerosol samples. In summary, this study profiled the distribution of airborne influenza in an infectious hospital in Qinhuangdao during 2017-2018 flu season. Patients infected with influenza could release airborne particles containing the virus into their environment. Healthcare workers and visitors in those places might have frequent exposure to airborne influenza virus. Therefore, we recommend some protective measures such as air disinfection and mask wearing to prevent and control the transmission of airborne influenza in hospital.

Acetylshikonin Sensitizes Hepatocellular Carcinoma Cells to Apoptosis through ROS-Mediated Caspase Activation

The tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) has shown strong and explicit cancer cell-selectivity, which results in little toxicity toward normal tissues, and has been recognized as a potential, relatively safe anticancer agent. However, several cancers are resistant to the apoptosis induced by TRAIL. A recent study found that shikonin b (alkannin, 5,8-dihydroxy-2-[(1S)-1-hydroxy-4-methylpent-3-en-1-yl]naphthalene-1,4-dione) might induce apoptosis in TRAIL-resistant cholangiocarcinoma cells through reactive oxygen species (ROS)-mediated caspases activation. However, the strong cytotoxic activity has limited its potential as an anticancer drug. Thus, the current study intends to discover novel shikonin derivatives which can sensitize the liver cancer cell to TRAIL-induced apoptosis while exhibiting little toxicity toward the normal hepatic cell. The trypan blue exclusion assay, western blot assay, 4′,6-diamidino-2-phenylindole (DAPI) staining and the terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay as well as the ‘comet’ assay, were used to study the underlying mechanisms of cell death and to search for any mechanisms of an enhancement of TRAIL-mediated apoptosis in the presence of ASH. Herein, we demonstrated that non-cytotoxic doses of acetylshikonin (ASH), one of the shikonin derivatives, in combination with TRAIL, could promote apoptosis in HepG2 cells. Further studies showed that application of ASH in a non-cytotoxic dose (2.5 μM) could increase intracellular ROS production and induce DNA damage, which might trigger a cell intrinsic apoptosis pathway in the TRAIL-resistant HepG2 cell. Combination treatment with a non-cytotoxic dose of ASH and TRAIL activated caspase and increased the cleavage of PARP-1 in the HepG2 cell. However, when intracellular ROS production was suppressed by N-acetyl-l-cysteine (NAC), the synergistic effects of ASH and TRAIL on hepatocellular carcinoma (HCC) cell apoptosis was abolished. Furthermore, NAC could alleviate p53 and the p53 upregulated modulator of apoptosis (PUMA) expression induced by TRAIL and ASH. Small (or short) interfering RNA (siRNA) targeting PUMA or p53 significantly reversed ASH-mediated sensitization to TRAIL-induced apoptosis. In addition, Bax gene deficiency also abolished ASH-induced TRAIL sensitization. An orthotopical HCC implantation mice model further confirmed that co-treated ASH overcomes TRAIL resistance in HCC cells without exhibiting potent toxicity in vivo. In conclusion, the above data suggested that ROS could induce DNA damage and activating p53/PUMA/Bax signaling, and thus, this resulted in the permeabilization of mitochondrial outer membrane and activating caspases as well as sensitizing the HCC cell to apoptosis induced by TRAIL and ASH treatment.

Synchronous co‑expression of Id‑1 and nuclear NF‑κB p65 promotes cervical cancer progression and malignancy, and is associated with a poor prognosis and chemosensitivity

Although inhibitor of differentiation 1 (Id‑1) and NF‑κB have been shown have play a role in tumorigenesis, their mechanisms and exact roles in cervical cancer have not yet been addressed. This study aimed to investigate the clinical significance of Id‑1 and NF‑κB p65 in cervical cancer and to elucidate their roles in malignant properties. Paraffin‑embedded cervical tissue specimens (n=85) were collected for immunohistochemistry and survival analysis. Targeting Id‑1 with lentivirus in vitro allowed the examination of the NF‑κB signaling pathway and cell survival. The results demonstrated the elevated co‑expression of Id‑1 and nuclear NF‑κB p65 was more frequently associated with aggressive cervical cancer behavior and poorer clinical outcomes. Targeting Id‑1 with short hairpin RNA or Id‑1 overexpression lentivirus in SiHa cells demonstrated that Id‑1 is associated with nuclear NF‑κB p65 expression and cell survival capacity. The physical interaction between Id‑1 and NF‑κB p65 was validated in SiHa cells. Moreover, the survival‑promoting or chemoresistant effects of Id‑1 may be attributed to the subsequent activation of NF‑κB signaling. On the whole, the synchronous co‑expression of Id‑1 and nuclear NF‑κB p65 has a prominent role in cervical cancer, suggesting a combined analysis of Id‑1 and NF‑κB may help to predict malignant properties and prognosis. Aside from NF‑κB, Id‑1 may also be developed as a promising therapeutic strategy for cervical cancer.

[Research progress of magnetic resonance imaging in hepatocellular carcinoma]

Hepatocellular carcinoma (HCC) is the most common malignant tumors of liver. Rational treatment in early stage of HCC can significantly increase the survival rate of patients. Detection of early-stage liver lesions through diffusion-weighted imaging, diffusion kurtosis imaging, incoherent motion within voxels, magnetic resonance spectroscopy imaging, dynamic contrast-enhanced imaging, or other functional imaging can accurately evaluate grade of malignancy and guide towards the curative effect of different treatment schemes. Volumetric interpolated breath-hold examination (VIBE) with three techniques, namely, CAIPIRINHA, Dixon, and TWIST, i.e., CDT-VIBE sequence can provide multiple sets of arterial phase images in a short time, and detect small foci transient enhancement that cannot be detected by other examinations, and the differences in initial enhancement phase of apparent lesions are of great significance for suggesting hemodynamic characteristics. In addition, magnetic resonance imaging predicts microvascular invasion of HCC, i.e., indirectly predicts HCC lesions recurrence rate, and overall survival time after liver transplantation. This article reviews the current research progress of magnetic resonance imaging technology in HCC.

Adjuvant gonadotropin-releasing hormone analogues for the prevention of chemotherapy-induced premature ovarian failure in premenopausal women

BACKGROUND

This is an update of the original review published in the Cochrane Database of Systematic Reviews 2011, Issue 11, and updated in 2015, Issue 4.Chemotherapy has significantly improved prognosis for women with malignant and some non-malignant conditions. This treatment, however, is associated with ovarian toxicity. The use of gonadotropin-releasing hormone (GnRH) analogues, both agonists and antagonists, may have a protective effect on the ovaries. The primary mechanism of action of GnRH analogues is to suppress the gonadotropin levels to simulate pre-pubertal hormonal milieu and subsequently prevent primordial follicles from maturation and therefore decrease the number of follicles that are more vulnerable to chemotherapy.

OBJECTIVES

To assess the efficacy and safety of GnRH analogues given before or in parallel to chemotherapy to prevent chemotherapy-related ovarian damage in premenopausal women with malignant or non-malignant conditions.

SEARCH METHODS

The search was run for the original review in July 2011, and for the first update in July 2014. For this update we searched the following databases in November 2018: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and the Chinese Biomedicine Database (CBM).

SELECTION CRITERIA

Randomised controlled trials (RCTs), in all languages, which examined the effect of GnRH analogues for chemotherapy-induced ovarian failure in premenopausal women, were eligible for inclusion in the review.

DATA COLLECTION AND ANALYSIS

Two review authors independently extracted data and assessed trial quality using the Cochrane 'Risk of bias' tool. We analysed binary data using risk ratios (RRs) with 95% confidence intervals (CI) and for continuous data, we used the standardized mean difference (SMD) to combine trials. We applied the random-effects model in our analyses. We used the GRADE approach to produce a 'Summary of findings' table for our main outcomes of interest.

MAIN RESULTS

We included 12 RCTs involving 1369 women between the ages of 12 and 51.1 years. Participants were diagnosed with breast malignancy, ovarian malignancy, or Hodgkin's lymphoma, and most of them received alkylating, or platinum complexes, based chemotherapy. The included studies were funded by a university (n = 1), research centres (n = 4), and pharmaceutical companies (n = 1). Trials were at high or unclear risk of bias.Comparison 1: GnRH agonist plus chemotherapy versus chemotherapy aloneThe incidence of menstruation recovery or maintenance was 178 of 239 (74.5%) in the GnRH agonist group and 110 of 221 (50.0%) in the control group during a follow-up period no longer than 12 months (RR 1.60, 95% CI 1.14 to 2.24; 5 studies, 460 participants; I² = 79%; low-certainty evidence), with an overall effect favouring treatment with GnRH agonist (P = 0.006). However, we observed no difference during a follow-up period longer than 12 months between these two groups (P = 0.24). In the GnRH agonist group, 326 of 447 participants had menstruation recovery or maintenance (72.9%) in comparison to the control group, in which 276 of 422 participants had menstruation recovery or maintenance (65.4%) during a follow-up period longer than 12 months (RR 1.08, 95% CI 0.95 to 1.22; 8 studies, 869 participants; I² = 56%; low-certainty evidence).The incidence of premature ovarian failure was 43 of 401 (10.7%) in the GnRH agonist group and 96 of 379 (25.3%) in the control group (RR 0.44, 95% CI 0.31 to 0.61; 4 studies, 780 participants; I² = 0%; moderate-certainty evidence), with an overall effect favouring treatment with GnRH agonist (P < 0.00001).The incidence of pregnancy was 32 of 356 (9.0%) in the GnRH agonist group and 22 of 347 (6.3%) in the control group (RR 1.59, 95% CI 0.93 to 2.70; 7 studies, 703 participants; I² = 0%; low-certainty evidence), with no difference between groups (P = 0.09). However, we are cautious about this conclusion because there were insufficient data about whether the participants intended to become pregnant.The incidence of ovulation was 29 of 47 (61.7%) in the GnRH agonist group and 12 of 48 (25.0%) in the control group (RR 2.47, 95% CI 1.43 to 4.26; 2 studies, 95 participants; I² = 0%; low-certainty evidence) with an overall effect favouring treatment with GnRH (P = 0.001).The most common adverse effects of GnRH analogues included hot flushes, vaginal dryness, urogenital symptoms, and mood swings. The pooled analysis of safety data showed no difference in adverse effects between GnRH agonist group and control group.Comparison 2: GnRH agonist-antagonist cotreatment plus chemotherapy versus chemotherapy aloneOnly one RCT discussed GnRH agonist-antagonist cotreatment. The limited evidence showed the incidence of menstruation recovery or maintenance was 20 of 25 (80%) in both cotreatment group and control group during a 12-month follow-up period (RR 1.00, 95% CI 0.76 to 1.32; 50 participants; very low-certainty evidence), with no difference between groups (P = 1.00). In the cotreatment group, 13 of 25 participants had menstruation recovery or maintenance (52.0%) in comparison to the control group, in which 14 of 25 participants had menstruation recovery or maintenance (56.0%) during a follow-up period longer than 12 months (RR 0.93, 95% CI 0.56 to 1.55; 50 participants; very low-certainty evidence), with no difference between groups (P = 0.78). The incidence of pregnancy was 1 of 25 (4.0%) in the cotreatment group and 0 of 25 (0%) in the control group (RR 3.00, 95% CI 0.13 to 70.30; 50 participants; very low-certainty evidence), with no difference between groups (P = 0.49).

AUTHORS' CONCLUSIONS

GnRH agonist appears to be effective in protecting the ovaries during chemotherapy, in terms of maintenance and resumption of menstruation, treatment-related premature ovarian failure and ovulation. Evidence for protection of fertility was insufficient and needs further investigation. Evidence was also insufficient to assess the effect of GnRH agonist and GnRH antagonist cotreatment on ovarian protection against chemotherapy. The included studies differed in some important aspects of design, and most of these studies had no age-determined subgroup analysis. Large and well-designed RCTs with longer follow-up duration should be conducted to clarify the effects of GnRH analogues in preventing chemotherapy-induced ovarian failure, especially on different age groups or different chemotherapy regimens. Furthermore, studies should address the effects on pregnancy rates and anti-tumour therapy.

Characterization of bacterial microbiota diversity in Tibetan pigs fed with green forage in Linzhi of the Tibet autonomous region

The acute shortage of forage resources is a serious problem for Tibetan pigs in the Tibet region, and the composition of feed can change the structure of the intestinal flora. This study first reported the effect of Alfalfa and Chenopodium glaucum feeding on the microbial diversity in Tibetan pigs, contributing to the forage exploitation of Tibetan pigs in the Tibet region.

[The expression of P19ink4d in the pathogenesis and development of hearing loss]

Objective: This study aimed to investigate the P19ink4d expression in cochlea of mice model with noise induced hearing loss and the role of P19ink4d in the degeneration of inner ear cells. It also searched for P19ink4d gene alterations in patients with profound sensorineural deafness.Method: CBA/J mice were exposed to broad band noise at 101 dB SPL for 2 hours, auditory brainstem response (ABR) were examined to confirm noise lead to the permanent threshold shift. Immunohistochemical staining, Western blotting, and real-time polymerase chain reaction (PCR) were performed on cochlear tissues, to elucidate changes in P19ink4d expression in mice after noise exposure. For clinical evaluation, 400 children from unrelated families with severe or profound sensorineural hearing loss (SNHL) were recruited, genomic DNA was obtained from the patients and was subjected to DNA microarray to screen mutations in 4 most common genes. The sample that carried none of the common mutant alleles were subjected to PCR and sequenced to detect mutations in P19ink4d gene.Result: The ABR threshold shift of mice in the experimental group significantly increased after noise exposure and was higher than that in the null-noise group. The ABR of 1 day post noise was least among experimental groups and there is no statistical different between ABR of 7 days and 14 days post noise. The missing of outer hair cells occurred after noise exposure, while the inner hair cells hardly miss. It was found that the P19ink4d expression increased significantly in the inner ear cells 3 hours after noise exposure, then recovered in 24 hours. Western blot indicated that the amount of P19ink4d increased transitorily 3-6 h after the noise. However, no mutation existed within the coding exons of P19ink4d in the patients with profound sensorineural deafness.Conclusion: The results support the concept that P19ink4d may play an important role in the pathogenesis and development of noise induced hearing loss.

Isolation and identification of pathogenic Aeromonas veronii from a dead Yangtze finless porpoise

Diseases caused by Aeromonas veronii in freshwater fish have been widely reported, but other species such as aquatic mammals have probably been overlooked. Here, we identified one isolate of A. veronii from a Yangtze finless porpoise Neophocaena asiaeorientalis asiaeorientalis exhibiting disease and mortality, and subsequently confirmed its virulence in artificial infection of BALB/c mice. The bacterial isolate was identified as A. veronii based on physiological, biochemical, and phenotypic features, and homology of the 16S rRNA, cpn60, rpoB, dnaJ and gyrB genes. Our results expand the known host spectrum of A. veronii, which is of great importance for the etiology of porpoise, dolphin, and other cetacean diseases.

Cyclin D1 silencing impairs DNA double strand break repair, sensitizes BRCA1 wildtype ovarian cancer cells to olaparib

OBJECTIVE

Poly(ADP-ribose) polymerase inhibitors (PARPi) are active in cancer cells that have impaired repair of DNA by the homologous recombination (HR) pathway. Strategies that disrupt HR may sensitize HR-proficient tumors to PARP inhibition. As a component of the core cell cycle machinery, cyclin D1 has unexpected function in DNA repair, suggesting that targeting cyclin D1 may represent a plausible strategy for expanding the utility of PARPi in ovarian cancer.

METHODS

BRCA1 wildtype ovarian cancer cells (A2780 and SKOV3) were treated with a combination of CCND1 siRNA and olaparib in vitro. Cell viability was assessed by MTT. The effects of the combined treatment on DNA damage repair and cell cycle progression were examined to dissect molecular mechanisms. In vivo studies were performed in an orthotopic ovarian cancer mouse model. Animals were treated with a combination of lentivirus-mediated CCND1 shRNA and olaparib or olaparib plus scrambled shRNA. Molecular downstream effects were examined by immunohistochemistry.

RESULTS

Silencing of cyclin D1 sensitized ovarian cancer cells to olaparib through interfering with RAD51 accumulation and inducing cell cycle G0/G1 arrest. Treatment of lentivirus-mediated CCND1-shRNA in nude mice statistically significantly augmented the olaparib response (mean tumor weight ± SD, CCND1-shRNA plus olaparib vs scrambled shRNA plus olaparib: 0.172 ± 0.070 g vs 0.324 ± 0.044 g, P< 0.05).

CONCLUSIONS

Silencing of cyclin D1 combined with olaparib may lead to substantial benefit for ovarian cancer management by mimicking a BRCAness phenotype, and induction of G0/G1 cell cycle arrest.

Different regimens of penicillin antibiotics given to women routinely for preventing infection after cesarean section: A systematic review and meta analysis

BACKGROUND

Varied regimens of penicillin antibiotics were given to women for preventing infection after cesarean section, but there is no study compares the effectiveness and safety of them.

METHODS

We searched MEDLINE, Embase, CENTRAL, CNKI, Wanfang, VIP, and CBM Database, and contacted experts in the field and searched reference lists of retrieved studies. We included randomized controlled trials comparing different regimens of penicillin antibiotics given to women after cesarean section. Two review authors independently assessed the studies for inclusion, assessed risk of bias, and carried out data extraction.

RESULTS

A total of 18 randomized controlled trails (involving 3287 pregnant women) were eligible. Compared with after umbilical cord clamping, penicillin antibiotics prophylaxis before skin incision could reduce the risk of endometritis for women undergoing cesarean. Compared with using penicillin antibiotics alone, using antibiotic-inhibitor combination could reduce the risk of endometritis or fever. No statistically significant difference was present between single-dose versus multidose, short term versus long term, intravenous injection versus lavag in the risk of reported outcomes.

CONCLUSION

There is insufficient evidence to draw certain conclusions on which regimen of penicillin antibiotics is the best in this review. Further studies should pay attention to the study design, and besides the outcomes of pregnant women, researchers should focus on the outcomes of newborns.

Hypertensive disorders in pregnancy and stillbirth rates: a facility-based study in China

Objective

To assess the association between hypertensive disorders in pregnancy and the stillbirth rate.

Methods

We obtained all data from China's National Maternal Near Miss Surveillance System for 2012 to 2016. Associations between hypertensive disorders in pregnancy and stillbirths, stratified by fetus number and gestational age, were assessed using Poisson regression analysis with a robust variance estimator.

Findings

For the period, 6 970 032 births, including 66 494 stillbirths, were reported to the surveillance system. The weighted stillbirth rate in women with a hypertensive disorder in pregnancy was 21.9 per 1000 births. The risk was higher in those who had received few antenatal care visits or who were poorly educated. For singleton pregnancies, the adjusted risk ratio (aRR) for a stillbirth among women with hypertensive disorders in pregnancy compared with normotensive women was 3.1 (95% confidence interval, CI: 2.85-3.37). The aRR for hypertensive disorder subtypes was: 6.66 (95% CI: 5.57-7.96) for superimposed preeclampsia; 4.15 (95% CI: 3.81-4.52) for preeclampsia or eclampsia; 2.32 (95% CI: 1.87-2.88) for chronic hypertension; and 1.21 (95% CI: 1.08-1.36) for gestational hypertension. For multiple pregnancies, the association between stillbirths and hypertensive disorders in pregnancy was not significant, except for superimposed preeclampsia (aRR: 1.95; 95% CI: 1.28-2.97).

Conclusion

To minimize the incidence of stillbirths, more attention should be paid to chronic hypertension and superimposed preeclampsia in singleton pregnancies and to superimposed preeclampsia in multiple pregnancies. Better quality antenatal care and improved guidelines are needed in China.