Collagen type X expression and chondrocyte hypertrophic differentiation during OA and OS development

Chondrocyte hypertrophy and the expression of its specific marker, the collagen type X gene (COL10A1), constitute key terminal differentiation stages during endochondral ossification in long bone development. Mutations in the COL10A1 gene are known to cause schmid type metaphyseal chondrodysplasia (SMCD) and spondyloepiphyseal dyschondrodysplasia (SMD). Moreover, abnormal COL10A1 expression and aberrant chondrocyte hypertrophy are strongly correlated with skeletal diseases, notably osteoarthritis (OA) and osteosarcoma (OS). Throughout the progression of OA, articular chondrocytes undergo substantial changes in gene expression and phenotype, including a transition to a hypertrophic-like state characterized by the expression of collagen type X, matrix metalloproteinase-13, and alkaline phosphatase. This state is similar to the process of endochondral ossification during cartilage development. OS, the most common pediatric bone cancer, exhibits characteristics of abnormal bone formation alongside the presence of tumor tissue containing cartilaginous components. This observation suggests a potential role for chondrogenesis in the development of OS. A deeper understanding of the shifts in collagen X expression and chondrocyte hypertrophy phenotypes in OA or OS may offer novel insights into their pathogenesis, thereby paving the way for potential therapeutic interventions. This review systematically summarizes the findings from multiple OA models (e.g., transgenic, surgically-induced, mechanically-loaded, and chemically-induced OA models), with a particular focus on their chondrogenic and/or hypertrophic phenotypes and possible signaling pathways. The OS phenotypes and pathogenesis in relation to chondrogenesis, collagen X expression, chondrocyte (hypertrophic) differentiation, and their regulatory mechanisms were also discussed. Together, this review provides novel insights into OA and OS therapeutics, possibly by intervening the process of abnormal endochondral-like pathway with altered collagen type X expression.

Circulating Metabolites and Dental Traits: A Mendelian Randomization Study

It is of great importance to uncover causal biomarkers to gain insight into the pathogenesis of oral diseases and identify novel treatment targets for prevention and treatment thereof. This study aimed to systematically evaluate the causal effects of hundreds of metabolites on 10 dental traits using a 2-sample Mendelian randomization (MR) approach. Genetic variants from genome-wide association studies of 309 known metabolites were used as instrumental variables. We selected 10 dental traits, including clinical measures of dental diseases, from the Gene-Lifestyle Interactions in Dental Endpoints Consortium and self-reported oral health data from the UK Biobank. The causal relationships between metabolites and dental traits were inferred using the inverse variance-weighted approach and further controlled for horizontal pleiotropy using 5 additional MR methods. After correcting for multiple tests, 5 metabolites were identified as causal biomarkers. Genetically predicted increased levels of mannose were associated with lower risk of bleeding gums (odds ratio [OR] = 0.72; 95% confidence interval [CI], 0.61-0.85; P = 9.9 × 10-5). MR also indicated 4 metabolites on the causal pathway to dentures, with fructose (OR = 0.50; 95% CI, 0.36-0.70; P = 5.2 × 10-5) and 1-palmitoleoyl-glycerophosphocholine (OR = 0.67; 95% CI, 0.56-0.81; P = 4.8 × 10-5) as potential protective factors and glycine (OR = 1.22; 95% CI, 1.11-1.35; P = 5.6×10-5) and 1,5-anhydroglucitol (OR = 1.32; 95% CI, 1.14-1.52; P = 1.5 × 10-4) as risk factors. The causal associations were robust in various sensitivity analyses. We further observed some shared metabolites among different dental traits, implying similar biological mechanisms underlying the pathogenic processes. Finally, the pathway analysis revealed several significant metabolic pathways that may be involved in the development of dental disorders. Our study provides novel insights into the combination of metabolomics and genomics to reveal the pathogenesis of and therapeutic strategies for dental disorders. It highlighted 5 metabolites and several pathways as causal candidates, warranting further investigation.

Psychological effects of COVID-19 outbreak on mental health in parents of children with hematopathy

OBJECTIVE

We explored whether parents of children with hematopathy had more psychosocial problems than parents of healthy children during the COVID-19 outbreak.

SUBJECTS AND METHODS

An online survey was performed, and a total of 1,116 parents participated. The mental health variables were assessed via the Simplified Coping Style Questionnaire (SCSQ) and the Symptom Checklist-Revised (SCL-90-R).

RESULTS

Compared with parents of healthy children, parents of children with hematopathy have a higher possibility of negative coping style (70.9% vs. 33.2%, p=0.01) and are more concerned with media reports related to the pandemic (37.8% vs. 17.6%, p=0.02). In SCL-90-R somatization, obsessive-compulsive, and anxiety scale, the parents of children with hematopathy have higher scores than parents of healthy children (12.50±1.69 vs. 12.23±1.37, p<0.01; 13.42±6.69 vs. 10.47±2.25, p<0.01; 15.21±5.53 vs. 10.52±2.34, p<0.01, respectively). History of visiting Wuhan, and history of epidemics occurring in the community are independent risk factors of parental obsessive-compulsive and anxiety symptoms (p<0.01).

CONCLUSIONS

Parents of children with hematopathy had evident severe symptoms of obsessive-compulsive and anxiety during the outbreak of COVID-19. Providing psychological interventions and beneficial approaches to parents of children with hematopathy urgently needs to be realized.

Oncogenic and immunological values of RBM34 in osteosarcoma and its pan-cancer analysis

RNA binding proteins (RBPs) are increasingly recognized as potential factors influencing the advancement, prognostication, and immune response in various solid tumors. Nevertheless, the comprehensive understanding of RBM34's biological mechanisms within the tumor microenvironment remains incomplete, necessitating further systematic pan-cancer investigations to ascertain its diagnostic, prognostic, and immunological significance. In this study, the TCGA, CCLE, HPA, GTEX, and TARGET databases were employed to analyze the expression abundance and subcellular localization of RBM34 in diverse tumor types. Kaplan-Meier survival analyses were used to investigate the impact of RBM34 on clinical prognosis. We implemented the TISIDB portal, CIBERSORT, and ESTIMATE algorithms to assess the correlation between RBM34 expression and immunomodulators, chemokines, and tumor-infiltrating lymphocytes (TILs) in both pan-cancer and osteosarcoma. The CGP database was applied to evaluate the half-maximal inhibitory concentrations of targeted drugs, while TMB, MSI, and MMR were utilized to predict the efficacy of tumor immunotherapy. Furthermore, an RBM34-derived prognostic index (RDPI) was constructed for osteosarcoma patients and linked to outcomes and immune status. Finally, we examined the modulation of RBM34 knockdown on osteosarcoma proliferation and migration capacity. Our results indicate that RBM34 was predominantly localized in the nucleus and differentially expressed in most human cancer types. Kaplan-Meier curve analysis and Cox regression demonstrated that RBM34 expression affected four survival metrics including overall survival (OS) in multiple tumors and was an independent prognostic factor for osteosarcoma. In immunological characterization, RBM34 expression was significantly associated with pan-cancer immunomodulator-related molecules, lymphocyte subpopulation infiltration, and biomarkers of immunotherapy response. Subsequent in vitro experiments provided additional evidence that the suppression of RBM34 impeded the migratory and invasive capabilities of osteosarcoma. Moreover, the utilization of RDPI demonstrated its reliability in prognosticating patient outcomes and estimating the individual immune landscape. Marked differences in multiple TILs (including naive B cells, CD8+ T cells, resting dendritic cells, and activated CD4+ memory T cells) and cancer-associated fibroblast proportion were observed in diverse RDPI score subgroups. Generally, RBM34 exhibited associations with clinical prognosis, immune infiltration, and immunotherapy across various cancer types, and may also serve as a viable therapeutic target for osteosarcoma.

[Clinical observation on the efficacy and safety of dupilumab in the treatment of moderate to severe atopic dermatitis]

To investigate the clinical efficacy and safety of dupilumab in the treatment of moderate to severe atopic dermatitis (AD) in China. A small sample self-controlled study before and after treatment was conducted to retrospective analysis patients with moderate to severe AD treated with dupilumab in the department of dermatology of the First Affiliated Hospital of Chongqing Medical University from July 2020 to March 2022. Dupilumab 600 mg was injected subcutaneously at week 0, and then 300 mg was injected subcutaneously every 2 weeks. The condition was evaluated by SCORAD(severity scoring of atopic dermatitis), NRS(numerical rating scale), DLQI(dermatology life quality index) and POEM(patient-oriented eczema measure). The improvement of SCORAD, NRS, DLQI and POEM was analyzed by paired t test and non-parametric paired Wilcoxon. The results showed that a total of 67 patients with moderate to severe AD received dupilumab treatment, of which 41 patients (the course of treatment was more than 6 weeks) had reduced the severity of skin lesions, improved quality of life and reduced pruritus. A total of 23 patients completed 16 weeks of treatment. At 4, 8, 12 and 16 weeks, SCORAD, NRS, DLQI and POEM decreased compared with the baseline, and the differences were statistically significant. SCORAD (50.13±15.19) at baseline, SCORAD (36.08±11.96)(t=6.049,P<0.001) at week 4,SCORAD (28.04±11.10)(t=10.471,P<0.001) at week 8, SCORAD (22.93±9.72)(t=12.428,P<0.001) at week 12, SCORAD (16.84±7.82)(t=14.609,P<0.001) at week 16, NRS 7(6,8) at baseline, NRS 4(3,5)(Z=-3.861,P<0.001) at week 4, NRS 2(1,4)(Z=-4.088,P<0.001) at week 8, NRS 1(0,2)(Z=-4.206,P<0.001) at week 12, NRS 2(0,2)(Z=-4.222,P<0.001) at week 16, DLQI (13.83±5.71) at baseline, DLQI (8.00±4.02)(t=6.325,P<0.001) at week 4, DLQI (5.61±3.50)(t=8.060,P<0.001) at week 8, DLQI (3.96±1.99)(t=8.717,P<0.001) at week 12, DLQI (2.70±1.89)(t=10.355,P<0.001) at week 16, POEM (18.04±6.41) at baseline, POEM (9.70±4.70)(t=7.031,P<0.001) at week 4, POEM (7.74±3.48)(t=8.806,P<0.001) at week 8, POEM (6.35±3.33)(t=10.474,P<0.001) at week 12, POEM (4.26±2.51)(t=11.996,P<0.001) at week 16. In the 16th week, 100%(23 patients), 91.3%(21 patients), 34.8%(8 patients) and 8.7%(2 patients) of 23 patients reached SCORAD30, SCORAD50, SCORAD70, and SCORAD90 statuses, respectively. There were 82.6%(19 patients), 95.7%(22 patients) and 95.7%(22 patients) of 23 patients with NRS, DLQI and POEM improved by≥4 points compared with baseline. Twelve patients with AD who continued to receive dupilumab after 16 weeks showed further improvement in skin lesions. The adverse events were conjunctivitis and injection site reaction. In conclusion, dupilumab is an effective and safe treatment for moderate and severe AD. However, the longer-term efficacy and safety require further studies involving larger sample sizes and a longer follow-up time.

Chemoradiotherapy Combined with Nab-Paclitaxel plus Cisplatin in Patients with Locally Advanced Borderline Resectable or Unresectable Esophageal Squamous Cell Carcinoma: A Phase I/II Study

PURPOSE/OBJECTIVE(S)

To evaluate the efficacy and safety of nanoparticle albumin-bound paclitaxel (nab-PTX) plus cisplatin as the regimen of conversional chemoradiotherapy (cCRT) in locally advanced borderline resectable or unresectable esophageal squamous cell carcinoma (ESCC).

MATERIALS/METHODS

Patients with locally advanced ESCC (cT3-4, Nany, M0-1, M1 was limited to lymph node metastasis in the supraclavicular area) were enrolled. All the patients received the cCRT of nab-PTX plus cisplatin. After the cCRT, those resectable patients received esophagectomy; those unresectable patients continued to receive the definitive chemoradiotherapy (dCRT). The locoregional control (LRC), overall survival (OS), progression-free survival (PFS), distant metastasis free survival (DMFS), pathological complete response (pCR), R0 resection rate and adverse events (AEs) were calculated.

RESULTS

A total of 45 patients with ESCC treated from October 2019 to May 2021 were finally included. The median follow-up time was 30.3 months. The LRC, OS, EFS, DMFS at 1and 2 years were 81.5%, 86.6%, 64.3%, 73.2% and 72.4%, 68.8%, 44.8%, 52.7% respectively. 21 patients (46.7%) received conversional chemoradiotherapy plus surgery (cCRT+S). The pCR rate and R0 resection rate were 47.6% and 84.0%. The LRC rate at 1 and 2 years were 95.0%, 87.1% in cCRT+S patients and 69.3%, 58.7% in dCRT patients respectively (HR, 5.14; 95% CI, 1.10-23.94; P = 0.021). The OS rate at 1 and 2 years were 95.2% and 84.2% in resectable patients compared to 78.8% and 54.4% in unresectable patients (HR, 3.41; 95% CI, 1.10-10.61; P = 0.024). The toxicities during chemoradiotherapy were tolerated, the most common grade 3-4 toxicities were radiation esophagitis (15.6%).

CONCLUSION

Nab-PTX plus cisplatin were effective and safe as the regimen of conversional chemoradiotherapy of ESCC. The patients receiving conversional chemoradiotherapy plus surgery (cCRT+S) were prone to have a better survival.

[Untargeted metabolomics study of dexamethasone-induced congenital cleft palate in New Zealand rabbits]

Objective: To investigate the metabolic disorders in placental tissues of dexamethasone induced cleft palate mode. Methods: Twelve pregnant rabbits were randomly divided into dexamethasone group (experimental group, 8) and saline control group (4), and a certain amount of dexamethasone and saline were administered intramuscularly to the experimental and control groups respectively from embryonic days (ED) 13 to 16, and placental tissue samples were collected on day 21 of gestation. The corresponding profiles of the embryonic placental tissue samples were obtained by liquid chromatography-triple tandem quadrupole(LC-MS), and the metabolites of the embryonic placental tissues were characterized by principal component analysis among the dexamethasone-treated group with cleft palate (D-CP group), the dexamethasone-treated group without cleft palate (D-NCP group) and the control group. Results: There were significant metabolic differences among the D-CP group, D-NCP group and control group, with a total of 133 differential metabolites (VIP>1, P<0.05) involving in important metabolic pathways including vitamin B6 metabolism, lysine metabolism, arginine anabolic metabolism, and galactose metabolism. The four metabolites, vitamin B6, galactose, lysine and urea, differed among the three groups (P<0.05). There were significant differences in vitamin B6 (0.960±0.249, 0.856±0.368, 1.319±0.322), galactose (0.888±0.171, 1.033±0.182, 1.127±0.127), lysine (1.551±0.924, 1.789±1.435, 0.541±0.424) and urea (0.743±0.142, 1.137±0.301, 1.171±0.457, respectively) levels among control group, D-NCP group and D-CP group (F=5.90, P=0.008; F=5.59, P=0.009; F=4.26, P=0.025; F=5.29, P=0.012). Conclusions: The results indicated that dexamethasone induced cleft palate may be highly correlated with metabolic disorders including vitamin B6 metabolism, lysine metabolism, arginine anabolic metabolism and galactose metabolism.

CircCRIM1 suppresses osteosarcoma progression via sponging miR146a-5p and targeting NUMB

CircCRIM1 (hsa_circ_0002346) is a circular RNA derived from gene CRIM1 (the cysteine rich transmembrane BMP regulator 1 circRNAs) by back-splicing. Recent studies have suggested the diverse function of CircCRIM1 in the tumorigenesis of multiple malignancies, including osteosarcoma (OS). Here, we investigated the role and mechanism of circCRIM1 during OS progression. Differentially expressed circRNAs (including circCRIM1) in OS and human osteoblast (hFOB1.19) cell lines were selected by searching the circRNA expression microarray dataset of GSE96964. The expression levels of circCRIM1 and its sponging miRNAs and target genes were examined by RT-qPCR. The effects of circCRIM1 on the proliferation, migration, and invasion of OS cells were investigated by in vitro gain of function experiments. The in vivo function of circCRIM1 on OS was evaluated by measuring the subcutaneous and in situ tumor growth in nude mice. In addition, dual-luciferase reporter assay and in situ hybridization (FISH) were performed to explore the underlying mechanisms of circCRIM1 and its sponging miRNAs and target genes in OS. CircCRIM1 is downregulated in human OS cell lines and predominantly presents in the cytoplasm as demonstrated by RT-qPCR and FISH assays. Overexpression of circCRIM1 suppressed the migration, invasion, proliferation of OS cells in vitro and OS tumor growth in vivo. Mechanistically, we identified miR146a-5p as a sponge miRNA of circCRIM1 through bioinformatic prediction and confirmed their interaction and colocalization via reporter gene assay and FISH analysis. This interaction leads to increase expression of the downstream target gene NUMB, which will cause inhibition of the Notch signal pathway. We further demonstrated that miR146a-5p overexpression could reverse the antitumor effect induced by circCRIM1 in OS cells. Our results support that circCRIM1 acts as a tumor suppressor in OS by sponging miR146a-5p and its downstream target NUMB.

The splicing factor proline and glutamine rich promotes the growth of osteosarcoma via the c-Myc signaling pathway

Splicing factor proline- and glutamine-rich (SFPQ) regulates transcripts in skeletal muscle metabolism and tumorigenesis. As osteosarcoma (OS) is the most common malignant bone tumor characterized by genome instability, such as MYC amplification, this study aimed to investigate the role and mechanism of SFPQ in OS. Expression of SFPQ in OS cell lines and human OS tissues was detected using quantitative real-time PCR, western blot, and fluorescence in situ hybridization (FISH) analyses. The oncogenic role of SFPQ in OS cells and murine xenograft models and the underlying mechanism of SFPQ on the c-Myc signaling pathway were assessed in vitro and in vivo. Results showed that SFPQ expression was upregulated and correlated with poor prognosis in OS patients. SFPQ overexpression promoted the malignant biological behavior of OS cells, while its knockdown markedly reduced the oncogenic function of OS. Additionally, depletion of SFPQ inhibited OS growth and bone destruction in nude mice. SFPQ overexpression induced malignant biological behaviors, which could be rescued by the depletion of c-Myc. These results suggest an oncogenic role of SFPQ in OS, possibly through the c-Myc signaling pathway.

Mef2a is a positive regulator of Col10a1 gene expression during chondrocyte maturation

BACKGROUND

The type X collagen gene (Col10a1) is a signature gene of hypertrophic chondrocytes that are known as the main engine of long bone growth. Multiple transcription factors (TFs), including myocyte enhancer factor 2A (Mef2a), have previously been identified by in silico analysis as potential Col10al gene regulators.

OBJECTIVES

In this study, we aimed to investigate the correlation between Mef2a and Col10a1 expression and the possible effects on chondrocyte proliferation and hypertrophic differentiation in vitro.

METHODS

First, Mef2a expression in proliferating and hypertrophic chondrocytes were detected by quantitative real-time PCR (qRT-PCR) and Western blotting in two chondrocytic models, ATDC5 and MCT cells, as well as in mouse chondrocytes in situ. Transfection with Mef2a small interfering fragments or Mef2a overexpression plasmids in the above chondrocytic models were performed to determine how Mef2a knockdown or overexpression may influence Col10a1 expression. The binding between Mef2a and its putative binding site within the 150 bp Col10a1 cis-enhancer which was evaluated by the dual luciferase reporter assay. The effect of Mef2a on chondrocyte differentiation was determined by examining the chondrogenic marker gene expression by qRT-PCR and by alcian blue, alkaline phosphatase (ALP), and alizarin red staining of the ATDC5 cells stably knocked down by Mef2a.

RESULTS

The expression of Mef2a in hypertrophic chondrocytes was significantly higher than that in proliferative chondrocytes in both chondrocytic models as well as in mouse chondrocytes in situ. Interference with Mef2a caused decreased Col10a1 expression, while overexpression of Mef2a upregulated Col10a1. The result of the dual luciferase reporter assay showed that Mef2a enhanced Col10a1 gene enhancer activity via its putative Mef2a binding site. For the staining of ATDC5 stable cell lines, although no significant differences were seen in ALP staining, significantly weaker alcian blue staining intensity was noticed in Mef2a knockdown stable cell lines compared to the control cells at day 21, while slightly weaker alizarin red staining was seen in the stable cell lines at days 14 and 21. Correspondingly, we detected decreased runt-related transcription factor 2 (Runx2), increased SRY-box transcription factor 9 (Sox9), as well as differential expression of other chondrogenic markers in ATDC5 stable cell lines compared with the controls.

CONCLUSIONS

In conclusion, our results support that Mef2a upregulates Col10a1 expression possibly by interaction with its cis-enhancer. Altered levels of Mef2a affects the expression of chondrogenic marker genes, such as Runx2 and Sox9, but may only play an insignificant role during chondrocyte proliferation and maturation.

Stat5a promotes Col10a1 gene expression during chondrocyte hypertrophic differentiation

OBJECTIVES

Multiple transcription factors (TFs) have previously been shown to control hypertrophic chondrocyte-specific mouse type X collagen gene (Col10a1) expression via interaction with Col10a1 promoters. This study aims to investigate the role and mechanism of the potential binding factor signal transduction and transcription activator 5a (Stat5a) of Col10a1 cis-enhancer, in controlling Col10a1 gene expression and chondrocyte hypertrophic differentiation.

METHODS

The potential Col10a1 regulator was predicted by the transcription factor affinity prediction (TRAP) analysis of the 150-bp Col10a1 cis enhancer. Stat5a was screened and verified by qRT-PCR, western blot and IHC analyses. Transfection of Stat5a siRNA or expression plasmid into MCT and ATDC5 cells was performed to either knockdown or over-express Stat5a and to investigate the influence of Stat5a on Col10a1 gene expression during the chondrocyte hypertrophy. Dual-luciferase reporter assay was performed to explore the mechanism of Stat5a affecting Col10a1 transcription. Alcian blue, alkaline phosphatase, and alizarin red staining, as well as qRT-PCR analyses of related marker genes were performed to investigate the effect and possible mechanism of Stat5a on chondrocyte differentiation.

RESULTS

The potential binding factor of Col10a1 cis-enhancer Stat5a and Col10a1 were both highly expressed and positively correlated within hypertrophic chondrocytes in vitro and in situ. Knockdown of Stat5a reduced Col10a1 expression, while overexpression of Stat5a enhanced Col10a1 expression in hypertrophic chondrocytes, suggesting Stat5a as a positive Col10a1 regulator. Mechanistically, Stat5a was shown to potentiate the reporter activity mediated by Col10a1 promoter/enhancer. In addition, Stat5a increased the intensity of alkaline phosphatase staining of ATDC5 cells and the expression of relevant hypertrophic marker genes including Runx2, which was consistent with the expression of Stat5a and Col10a1.

CONCLUSIONS

Our results support that Stat5a promoted Col10a1 expression and chondrocyte hypertrophic differentiation, possibly via interaction with the 150-bp Col10a1 cis-enhancer.

Deep-learning measurement of intracerebral haemorrhage with mixed precision training: a coarse-to-fine study

AIM

To develop a unified deep-learning-based method for automated intracerebral haemorrhage (ICH) segmentation on computed tomography (CT) images with different layer thickness parameters.

MATERIALS AND METHODS

A total of 134 patients from an internal database (67 patients) and an external database (called CQ500, 67 patients) were employed. The CT examinations included multiple layer thicknesses such as 0.625, 1.25 and 5 mm. ICH segmentation was performed by a coarse-to-fine strategy, including three stages of three-dimensional (3D) skull-stripping segmentation, 3D ICH localisation segmentation, and two-dimensional (2D) ICH fine segmentation. The three stages shared the same sICHNet for segmentation and employed mixed precision training to speed up the training process. In addition, the 3D contextual information from CT was maintained by formatting the consecutive slices into a three-channel image in the 2D ICH fine segmentation.

RESULTS

Experimental results demonstrated that the coarse-to-fine segmentation strategy achieved the best performance with a mean Dice coefficient of 0.887. ICH volume consistency was observed (p<0.05) between manual and automatic segmentations, and between segmentations of same individual but with different layer thicknesses in internal dataset and external database. Automated segmentation achieved a relatively consistent segmentation time of 20.01 ± 2.03 seconds no matter the layer thickness of the CT images and the extent of ICH. Longitudinal studies with conservative management and surgical treatment were also visualised.

CONCLUSIONS

The coarse-to-fine deep learning strategy achieved the best ICH segmentation performance on CT images. The automated segmentation was 5-42 times faster than manual segmentation given ICH of different extents and using different layer thickness parameters.

DLX5 promotes Col10a1 expression and chondrocyte hypertrophy and is involved in osteoarthritis progression

Osteoarthritis (OA) has been considered non-reversible as articular cartilage wears down with limited repair capacity. Enhanced chondrocyte hypertrophy and increased type X collagen gene (COL10A1) expression have been associated with OA. Therefore, regulators controlling collagen X expression and chondrocyte hypertrophy may play a role in OA intervention. Here, we investigated how Distal-less homeobox 5 (DLX5), the distal-less homeobox family member, controls murine Col10a1 gene expression and chondrocyte hypertrophy in chondrogenic cell models and its role in a murine OA model. Through qRT-PCR and Western blot analyses, we detected significantly increased levels of COL10A1 and DLX5 in hypertrophic MCT and ATDC5 cells compared to their proliferative stage. Forced expression of Dlx5 further increases, while knockdown of Dlx5 decreases COL10A1 expression in hypertrophic MCT cells. We have performed dual-luciferase reporter and ChIP assays and demonstrated that DLX5 promotes reporter activity through direct interaction with Col10a1 cis-enhancer. We established a murine OA model and detected markedly increased COL10A1 and DLX5 in the articular cartilage and subchondral bone of the OA mice compared with the controls. Notably, forced overexpression of DLX5 in hypertrophic MCT cells up-regulates RUNX2, and adjacent DLX5 and RUNX2 binding sites have previously been found within the Col10a1 cis-enhancer. Together, our data suggest that DLX5 may cooperate with RUNX2 to control cell-specific Col10a1 expression and chondrocyte hypertrophy and is involved in OA pathogenesis.

[Changes of intestinal wall barrier function and its correlation with susceptibility to infection in patients with cirrhotic portal hypertension]

Objective: To investigate the changes of intestinal wall barrier function and its correlation with infection occurrence in patients with cirrhotic portal hypertension. Methods: 263 patients with cirrhotic portal hypertension were split into: the clinically evident portal hypertension (CEPH) combined with infection group (n = 74); CEPH group (n = 104); and Non-CEPH group (n = 85). Among them, 20 CEPH patients and 12 non-CEPH patients in non-infection status were subjected to sigmoidoscopy. Immunohistochemical staining was used to detect the expression of trigger receptor-1 (TREM-1), CD68, CD14, the inducible nitric oxide synthase molecule, and Escherichia coli (E.coli) in the medullary cells of the colon mucosa. An enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of soluble myeloid cell trigger receptor-1 (sTREM-1), soluble leukocyte differentiation antigen-14 subtype (sCD14-ST) and intestinal wall permeability index enteric fatty acid binding protein (I-FABP). Fisher's exact probability method, one-way ANOVA, Kruskal-Wallis-H test, Bonferroni method, and Spearman correlation analysis were used for statistical analysis. Results: The serum sTREM-1 and I-FABP levels were higher in CEPH patients than those of non-CEPH patients in the non-infectious state (P < 0.05), but the difference in blood sCD14-ST levels was not statistically significant (P > 0.05). Serum levels of sTREM-1, sCD14-ST, and I-FABP in infected patients were higher than those in patients without a concurrent infection (P < 0.05). Serum sCD14-ST levels were positively correlated with serum sTREM-1, C-reactive protein (CRP), and procalcitonin (PCT), and sTREM-1 levels were also positively correlated with CRP and PCT (r > 0.5, P < 0.001). The rates of CD68, inducible nitric oxide synthase, CD14-positive cells, and E.coli-positive glands were higher in the intestinal mucosa of the CEPH group than those of the control group (P < 0.05). Spearman's correlation analysis showed that the rate of E.coli-positive glands in CEPH patients was positively correlated with the expression of molecular markers CD68 and CD14 in the lamina propria macrophages. Conclusion: Patients with cirrhotic portal hypertension have increased intestinal permeability and inflammatory cells, accompanied by bacterial translocation. Serum sCD14-ST and sTREM-1 can be used as indicators to predict and evaluate the occurrence of infection in patients with cirrhotic portal hypertension.

Silence of URI in gastric cancer cells promotes cisplatin-induced DNA damage and apoptosis

URI, a prefoldin family member, has been implicated roles in cancer development. We have previously shown that URI can attenuate DNA damage in gastric cancer cells treated with potassium dichromate. The aim of this study was to investigate how URI involves cisplatin-induced DNA damage response (DDR) in gastric cancer cells and its possible mechanism relating to the ATM/CHK2 pathway. Here, MGC-803 and SGC-7901 gastric cancer cells were treated with different concentrations of cisplatin. Comet assay was used to detect DNA damage and the results confirmed the dose-effect of cisplatin-induced DNA damage in gastric cancer cells. URI knockdown cell lines were established with siRNA transfection. Cell viability and proliferation were detected by counting kit 8 (CCK-8) and 5-ethynyl-2'-deoxyuridine (EdU) assays respectively. Apoptosis and cell cycle were analyzed by flow cytometry. The results indicated that URI knockdown increased the sensitivity of cells to cisplatin by inhibiting proliferation and promoting apoptosis. The levels of P-ATM, P-CHK2 and γH2AX were detected by Western blot. Increased levels of P-ATM, P-CHK2, and γH2AX were observed in cisplatin treated cells, indicating that cisplatin induced a DNA damage response (DDR). URI knockdown in cisplatin-treated cells significantly decreased the levels of P-ATM and P-CHK2 at 12 hours, but not at 0 and 6 hours after drug withdrawal, while significantly increased γH2AX levels were detected at 6 hours, but not at 0 and 12 hours after drug withdrawal compared with the control cells. However, the levels of γH2AX were significantly increased in URI knockdown cells after cisplatin treatment for 12 hours. The cell cycle analysis showed that the number of cells entering S phase was significantly reduced and the cells were arrested in the G1 phase in URI-silenced cisplatin-exposed cells, indicating that cell cycle progression was inhibited. In conclusion, our results suggest that URI is involved in the cisplatin-induced DNA damage response via the ATM/CHK2 pathway, and silencing URI can increase cisplatin-induced DNA damage and enhance drug sensitivity in gastric cancer cells.

[Analysis of FBN1 genemutations in a pedigree with Marfan syndrome]

Mutations in fibrillin-1 (FBN1) were detected in an autosomal dominant Marfan syndrome (MFS) pedigree. The related phenotypes and the significance of mutation screening were discussed. Complete medical and cardiovascular examinations for all pedigree members were performed. Whole exons sequencing (WES) was used to sequence the DNA of the patients and their relatives. The potential pathogenic mutation sites were screened by bioinformatics method. Sanger sequencing was used to verify the mutation sites in the pedigree. The results showed that FBN1 missense mutation was c.6806 T>C in exon 56, resulting in isoleucine being replaced by threonine (p. Ile2269Thr). This mutation has not been reported in Chinese Han population. The occurrence of the mutations strongly correlated with the phenotypes of the patients. The results expand the mutation spectrum of FBN1, and it is helpful to further explore the molecular pathogenesis of MFS and MFS related diseases.

[Clinicopathological features and HER2 expression of metaplastic squamous cell carcinoma of the breast]

Objective: To investigate the clinicopathological features and HER2 expression of metaplastic squamous cell carcinoma (MSCC) of the breast. Methods: A total of 47 MSCC cases diagnosed in the Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China from January 2010 to December 2021 were reviewed. The clinical information (including the follow-up data of HER2 positive patients) and pathological features were collected and analyzed. Results: All of the patients were female. Among the 47 cases, 25 were pure squamous cell carcinoma (PSCC) and 22 were mixed metaplastic carcinoma with squamous cell component (MMSC). The median age of the patients was 54 years (range, 29-84 years). The maximum diameter of the mass ranged from 0.8 to 10.0 cm, with a mean value of 3.3 cm, 85.7% (24/28) of the cases were smaller than 5 cm, and only 4 cases were larger than or equal to 5 cm. 89.5% of the MMSC presented with a solid mass. Cystic changes were more commonly found in the PSCC group (50%, P<0.05) than the MMSC group. 36.7% (11/30) of the patients had lymph node metastasis at the time of diagnosis. The squamous cell carcinoma component in all cases showed diffuse or patchy expression of p63, p40 and CK5/6. 55.3% (26/47) of the cases showed triple-negative phenotype. Among the 7 HER2-positive patients, 6 were MMSC group, which had a significantly higher rate of HER2-positivity than that in the PSCC group (1 case). In 1 MMSC case, immunohistochemistry showed HER2 2+in the invasive ductal carcinoma component and HER2 negativity (0) in the squamous cell carcinoma component, but HER2 FISH was negative in invasive ductal carcinoma and positive in squamous cell carcinoma component. Six HER2-positive MSCC patients received anti-HER2-targeted therapy, including two patients who received neoadjuvant chemotherapy combined with anti-HER2-targeted therapy before surgery. One patient achieved pathological complete remission, while the other achieved partial remission (the residual tumors were squamous cell carcinoma components). After 9-26 months of follow-up, four patients had no disease progression, two patients developed pulmonary metastases, and one patient showed local recurrence. Conclusions: MSCC is a group of heterogeneous diseases. PSCC and MMSC may be two different entities. Most of the MSCC are triple-negative and HER2 positivity is more commonly seen in MMSC with invasive ductal carcinoma component. Some HER2-positive MSCC patients can achieve complete remission or long-term progression-free survival after receiving anti-HER2 targeted therapy, but the squamous cell carcinoma component may be less sensitive to targeted therapy than the invasive ductal carcinoma component.

[Auditory response patterns of mouse primary auditory cortex to sound stimuli]

OBJECTIVE

To investigate the auditory response patterns of mouse primary auditory cortex (A1) neurons.

METHODS

In vivo cell-attached recordings and neural network modeling were performed to detect the changes in response patterns of A1 neurons of awake C57BL/6J mice to sound stimulation with varying lengths. A1 neuron signals were recorded for 216 neurons in 20 awake mice using a target sound stimulation sequence, and the classification and response characteristics of A1 neuron response patterns were examined using post-stimulus spike time histograms. To simulate the diversity of the A1 neuron response patterns, an A1 neuron model was established based on the Wilson-Cowan model and integral-firing model. The neuron connection weight parameters in the model were calculated by examining the micro loop structure of the pyramidal neurons, parvalbumin neurons, and somatostatin neurons in the A1 region, and the A1 neural network information coding model was constructed.

RESULTS

The Onset response neurons only had fast spike response within 10 to 40 ms after the beginning of noise stimulation (122 neurons). The Sustained response neurons had spike response continuously during the noise stimulation (26 neurons). The On-off response neurons had fast spike response after the beginning and the end of noise stimulation (40 neurons). The Offset response neurons only had fast spike response within 10 to 40 ms after the end of noise stimulation (22 neurons). In the neural network model, the Onset peak neural activities of A1 pyramidal neurons, parvalbumin neurons, and somatostatin neurons were 0.7483, 0.5236 and 0.9427, respectively, and their response half peak widths were 18.5 ms, 12 ms and 31 ms during the 100 ms noise stimulation, respectively. By changing the feedforward excitation and synaptic inhibition time constants in the model, the neurons generated numerous different types of spike train.

CONCLUSION

The auditory response of mouse A1 neurons to sound stimuli shows mainly the Onset, Sustained, On-off, and Offset response patterns.

Otoacoustic emission and its application in anesthesia

OBJECTIVE

An otoacoustic emission (OAE) is a low-level sound emitted by the cochlea. OAEs are able to objectively evaluate the auditory perception and reflect the functional status of the auditory system. With the characteristics of non-invasiveness, high reliability, and easy manipulation, OAEs have gained wide popularity in clinical audiology and anesthesiology. This review aims to summarize the application of OAE in anesthesia.

MATERIALS AND METHODS

This study collected data from the databases Web of Science-Clarivate Analytics, PubMed, and Google Scholar in English, covering research in the last 40 years. The keywords were defined as anesthesia, cochlea, OAEs, distortion product otoacoustic emissions, transient evoked otoacoustic emissions, bispectral index, auditory evoked potentials, and depth of anesthesia. Documents that matched defined keywords were selected and reviewed.

RESULTS

Research showed that the types and doses of anesthetic drugs impacted OAEs. Ketamine-based anesthesia has a greater effect on OAE sensitivity over time compared to isoflurane. A higher dose of ketamine-xylazine significantly reduced the amplitude of OAEs. According to those characteristics, OAEs could be used as an objective evaluation method for the effect of anesthetics and have great potential to be applied for anesthetic drug dose control during surgery. OAEs also have been used to detect the cochlear function during anesthesia, which may cause irreversible damage to the cochlea.

CONCLUSIONS

Studies reported that OAEs have been used in anesthesia. However, the existing studies have mainly focused on the influence of anesthetic types or dosages on OAEs. Considering the characteristics of OAEs, such as a convenient measurement, less susceptibility to interference, and fast detection speed, the application of OAE has a great potential in the anesthesia field.

miR-1297 inhibits osteosarcoma cell proliferation and growth by targeting CCND2

Cyclin D2 (CCND2) is abnormally overexpressed in many tumor types and has been associated with tumor cell proliferation. Although the important role of miR-1297 is well established, the molecular mechanism between CCND2 and miR-1297 in osteosarcoma (OS) has not been determined. In the present study, we found CCND2 was highly expressed in OS cells, and its downregulation suppressed cell proliferation, resulting in G1 phase cell cycle arrest. In contrast, miR-1297 was lowly expressed in OS compared to normal tissue. Several data platforms predicted that CCND2 was a target of miR-1297, which was validated by a dual-luciferase reporter assay that revealed miR-1297 could bind with CCND2-3'UTR. miR-1297 overexpression greatly inhibited CCND2 protein expression and exerted the same phenotypic effect as CCND2 downregulation in OS cells. Furthermore, miR-1297 inhibition could also be rescued by CCND2. Nude mice injected cells stable overexpressing miR-1297 OS cells showed lower size and tumor weight. Moreover, lower fluorescence activity recorded by in vivo imaging system and bone erosion revealed by microCT in the miR-1297 group demonstrated miR-1297 inhibited OS tumor growth via CCND2. Our findings demonstrated that miR-1297 can inhibit proliferation and tumor growth in OS by directly targeting CCND2, which indicates that miR-1297 may represent a novel therapeutic target for OS.

P-378 Effect of luteinized unruptured follicle on the pregnancy outcomes of single high-quality frozen-thawed blastocyst transfer cycles

Study question

Does luteinized unruptured follicle affect the clinical outcome of natural cycles for single high-quality frozen-thawed blastocyst transfer (FBT) cycles?

Summary answer

Luteinized unruptured follicle negatively affects the pregnancy outcomes of single high-quality FBT.

What is known already

Recent evidence revealed that natural ovulation cycle with a corpus luteum for frozen-thawed embryo transfer is superior to hormone replacing therapy cycle in preventing early miscarriage and preeclampsia. However, it remains controversial whether a luteinized unruptured follicle of the natural cycle affect the pregnancy outcomes of FBT.

Study design, size, duration

This was a retrospective cohort study comparing the pregnancy outcomes of singe high-quality FBT among 283 cases of LUF cycles and 1083 cases of ovulation cycles between January 2015 to December 2020 in a private fertility center. The study was approved by the hospital's Ethics Committee.

Participants/materials, setting, methods

A natural cycle for FBT was performed for all included patients, and was categorized into LUF or ovulation group based on the continuously monitoring of transvaginal ultrasound. Pregnancy outcomes were compared between the two groups. Logistic regression analysis was performed to adjust for important confounders. P &lt; 0.05 was considered statistically significant.

Main results and the role of chance

Compared to ovulation group, the LUF group was associated with higher proportion of female indication of IVF treatment. There were no statistically significant differences regarding the parental age at oocyte retrieval, body mass index (BMI), cycle rank, infertility duration, proportion of nulliparity and fertilization method, endometrial thickness, and estrogen levels. P levers were higher in the ovulation group than those of LUF (P =0.028). Logistic regression indicated that after controlling for potential confounders, ovulation group was associated with higher incidence of ongoing pregnancy (aOR 1.460, 95% CI: 1.107-1.924) and live birth (aOR 1.455, 95% CI: 1.102-1.919). Ovulation group also had higher clinical pregnancy rate (aOR 1.255, 95% CI: 0.952-1.656) and lower early miscarriage rate (aOR 0.654, 95% CI: 0.394-1.087), but not reach statistical significance. Our results suggested that LUF negatively affected pregnancy outcomes of single high-quality FBT.

Limitations, reasons for caution

The primary limitation of this study was its retrospective nature, and it was difficult to distinguish some confounding factors.

Wider implications of the findings

Clinicians should counsel couples about the negative effect of LUF on the pregnancy outcome of FBT, particularly for those with few high-quality embryos.

Trial registration number

2018YFC1003900/2018YFC1003904, SZSM201502035

P-620 Hormone replacement therapy with GnRH agonist pretreatment improves pregnancy outcomes in patients with previous intrauterine adhesions

Study question

Is there an optimal endometrial preparation protocol of frozen-thawed embryo transfer (FET) for patients with history of intrauterine adhesions (IUAs)?

Summary answer

Hormone replacement therapy with GnRH agonist pretreatment (HRT+GnRHa) is superior to conventional HRT protocol to improve pregnancy outcomes in patients with IUAs.

What is known already

FET follow hysteroscopic adhesiolysis or therapeutic treatment is being widely adopted in patients with IUAs. Proper endometrial preparation plays a key role to maximize IVF success rate and improve pregnancy results. However, it remains unclear whether there is an optimal endometrial preparation protocol for patients with history of IUAs.

Study design, size, duration

This was a retrospective cohort study of 1002 FET cycles with history IUAs in our fertility center between January 2015 to December 2020. The study was approved by the hospital's Ethics Committee.

Participants/materials, setting, methods

Eight hundred and forty-two conventional HRT cycles and 160 HRT+GnRHa cycles met the inclusion criteria were enrolled. Pregnancy outcomes were compared between the two groups. Logistic regression analysis was performed to adjust for important confounders. P &lt; 0.05 was considered statistically significant.

Main results and the role of chance

The HRT+GnRHa group was associated with higher cycle rank (1.79 vs 2.17, P =0.026) and longer infertility duration (3.04 vs 3.69, P =0.000) compared with conventional HRT group. While the latter had a higher proportion of blastocyst embryo transferred (P =0.024). There were no statistically significant differences regarding the parental age at oocyte retrieval, body mass index (BMI), number of total embryos transferred and top embryo transferred, proportion of nulliparity, indication of IVF treatment and fertilization method, and endometrial thickness. Logistic regression indicated that after controlling for potential confounders, the HRT+GnRHa group achieved higher incidence of clinical pregnancy (aOR 1.474, 95% CI: 1.002-2.170, P =0.049), ongoing pregnancy (aOR 1.823, 95% CI: 1.207-2.753, P =0.004), and live birth (aOR 1.975, 95% CI: 1.306-2.988, P =0.000) than the conventional HRT group. The miscarriage rate was comparable between the two groups (aOR 0.613, 95% CI: 0.293-1.283, P =0.194). Our results suggested that HRT+GnRHa is over conventional HRT protocol to improve pregnancy outcomes of patients with previous IUAs.

Limitations, reasons for caution

The primary limitation of this study was its retrospective nature, and it was difficult to distinguish some confounding factors. Besides, there was no grading of IUA severity as most adhesion separation surgeries were not performed in our hospital, and the detailed medical history was not available.

Wider implications of the findings

Our study offers evidence for the superiority of HRT with GnRH-a pretreatment to conventional HRT protocol in improving the pregnancy prognosis of patients with previous IUAs. Our finding deserves further confirmation in clinical practice.

Trial registration number

2018YFC1003900/2018YFC1003904, SZSM201502035

Comprehensive Analysis of a Ferroptosis-Related lncRNA Signature for Predicting Prognosis and Immune Landscape in Osteosarcoma

Research on the implications of ferroptosis in tumors has increased rapidly in the last decades. There are evidences that ferroptosis is involved in several aspects of cancer biology, including tumor progression, metastasis, immunomodulation, and therapeutic response. Nonetheless, the interaction between ferroptosis-related lncRNAs (FRLs) and the osteosarcoma immune microenvironment is poorly understood. In this study, a risk model composed of FRLs was developed using univariate and LASSO Cox regression analyses. On the basis of this model, FRL scores were calculated to systematically explore the role of the model in predicting the prognosis and immune characteristics of osteosarcoma patients. Survival analysis showed that osteosarcoma samples with lower FRL-score had better overall survival. After predicting the abundance of immune cells in osteosarcoma microenvironment by single-sample gene-set enrichment analysis (ssGSEA) and ESTIMATE analysis, we found that the FRL-score could distinguish immune function, immune score, stromal score, tumor purity, and tumor infiltration of immune cells in different osteosarcoma patients. In addition, FRL-score was also associated with immune checkpoint gene expression and half-maximal inhibitory concentration of chemotherapeutic agents. Finally, we confirmed that knockdown of RPARP-AS1 suppressed the malignant activity of osteosarcoma cells in vitro experiments. In general, the FRL-based prognostic signature could promote our understanding of the immune microenvironment characteristics of osteosarcoma and guide more effective treatment regimens.

CircNRIP1 acts as a sponge of miR-1200 to suppress osteosarcoma progression via upregulation of MIA2

Circular RNAs (circRNAs), a class of non-coding RNAs, play an essential role in embryo development and carcinogenesis, circNRIP1 was recently identified to promote development of multiple human cancers. This study investigated the role of circNRIP1 in osteosarcoma (OS) cells and the potential mechanisms relating to the sponging miRNAs and their target genes. OS cell lines and normal human osteoblasts were grown for qRT-PCR analysis of circNRIP1 expression and functions of circNRIP1 expression in OS cell proliferation, migration, and invasion in vitro. Bioinformatics analysis was then performed to predict the sponge miRNA of circNRIP1 and the target gene, which was confirmed by using the dual-luciferase reporter assay. The in vivo functions of circNRIP1 was evaluated in OS cell xenograft models, while levels of relevant marker genes were examined using immunohistochemistry. CircNRIP1 was mainly localized in OS cell cytoplasm and significantly lower in OS cell lines than in normal human osteoblasts. CircNRIP1 overexpression significantly inhibited OS cell proliferation, migration, and invasion in vitro. miR-1200 was predicted as the sponge miRNA of circNRIP1 and directly interacted with circNRIP1 confirmed by the dual-luciferase reporter assay. Moreover, miR-1200 overexpression significantly alleviated the inhibitory effect of circNRIP1 on OS cells. A protein-coding gene MIA2 was identified as the miR-1200 targeting gene and reversely associated with miR-1200 expression in OS cells. Increase in MIA2 expression in a murine OS cell xenograft model was associated with circNRIP1 expression in inhibition of OS cell xenograft growth in vivo. These data support the circNRIP1 OS-suppressive role by sponge of miR-1200 expression and in turn to upregulate MIA2 expression.

Menopausal hormone therapy: what are the problems in the perception of Chinese physicians?

OBJECTIVE

This study aimed to investigate Chinese physicians' perception and attitudes toward menopausal hormone therapy (MHT).

METHODS

This nationwide online survey was conducted in China. Physicians registered in the WeChat groups of the Gynecological Endocrinology Committee of China's Maternal and Child Health Care Association received a message invitation to complete this anonymous online survey from April 2020 to July 2020. Physicians' knowledge of and attitudes toward MHT were surveyed.

RESULTS

In total, 4672 questionnaires were submitted; only completed questionnaires could be submitted. The message was sent to 6021 doctors, so the response rate was 77.6%. Overall, 77.9-92.9% of physicians knew the common indications and contraindications to MHT. Additionally, 90.6%, 85.4%, 80.7% and 37.5% of physicians thought that MHT would increase the risk of venous thrombosis, breast cancer, endometrial cancer and weight gain, respectively. In total, 58.1% of the physicians mistakenly believed that a sex hormone test was one of the necessary examinations to reassess MHT prescription during follow-up visits. We found that 68.5% of physicians would consider using MHT themselves or recommend MHT to their partners in the future, and 11.4% were currently using MHT.

CONCLUSIONS

Most Chinese physicians have basic knowledge of MHT. Their misunderstandings about MHT mainly centered on the risks of endometrial cancer, weight gain and the necessary examinations during follow-up visits. These misunderstandings need to be clarified in future professional training programs.

Integrated analyses of an RNA binding protein-based signature related to tumor immune microenvironment and candidate drugs in osteosarcoma

OBJECTIVE

Osteosarcoma is the most frequent primary bone malignancy, associated with frequent recurrence and lung metastasis. RNA-binding proteins (RBPs) are pivotal in regulating several aspects of cancer biology. Nonetheless, interaction between RBPs and the osteosarcoma immune microenvironment is poorly understood. We investigated whether RBPs can predict prognosis and immunotherapy response in osteosarcoma patients.

METHODS

We constructed an RBP-related prognostic signature (RRPS) by univariate coupled with multivariate analyses and verified the independent prognostic efficacy of the signature. Single-sample Gene Set Enrichment Analysis (ssGSEA) along with ESTIMATE analysis were carried out to investigate the variations in immune characteristics between subgroups with various RRPS-scores. Furthermore, we investigatedpossible small molecule drugs using the connectivity map database and validated the expression of hub RBPs by qRT-PCR.

RESULTS

The RRPS, consisting of seven hub RBPs, was an independent prognostic factor compared to traditional clinical features. The RRPS could distinguish immune functions, immune score, stromal score, tumor purity and tumor infiltration by immune cells in different osteosarcoma subjects. Additionally, patients with high RRPS-scores had lower expression of immune checkpoint genes than patients with low RRPS-scores. We finally identified six small molecule drugs that may improve prognosis in osteosarcoma patients and substantiated notable differences in the contents of these RBPs.

CONCLUSION

We evaluated the prognostic value and clinical application of an RBPs-based prognostic signature and identified promising biomarkers to predict immune cell infiltration and immunotherapy response in osteosarcoma.

A comparative evaluation of chemical composition and antimicrobial activities of essential oils extracted from different chemotypes of Cinnamomum camphora (L.) Presl

The purpose of this study is to determine the chemical composition of the essential oils of Cinnamomum camphora (L.) Presl leaves (CCPL) from 5 different habitats in China by GC-MS, and to evaluate their antimicrobial activities against 3 foodborne pathogens, using a paper disc diffusion method. A total of 30 compounds were identified with a predominance of oxygenated monoterpenes, including linalool (42.65%-96.47%), eucalyptol (39.07%-55.35%) and camphor (26.08%) as well as monoterpene hydrocarbons such as sabinene (6.18%-12.93%) and α-terpineol (8.19%-13.81%). Through cluster analysis, CCPL from 5 different habitats can be well divided into 2 categories. Combining with principal component analysis, the habitats can be better correlated with the chemical constituents of the essential oils. The antimicrobial activities of 5 extracted essential oils against 2 gram-negative bacteria and one gram-positive bacteria were assessed. It showed that the essential oil extracted from the CCPL harvested in Jinxi had the strongest antibacterial property. The results of this study provided basis for resource identification of CCPL and quality difference identification of essential oils. Research on the antibacterial properties of several pathogenic strains has proved its application value as a natural food preservative.

A Novel Pyroptosis-Related Signature for Predicting Prognosis and Indicating Immune Microenvironment Features in Osteosarcoma

Osteosarcoma is a common malignant bone tumor with a propensity for drug resistance, recurrence, and metastasis. A growing number of studies have elucidated the dual role of pyroptosis in the development of cancer, which is a gasdermin-regulated novel inflammatory programmed cell death. However, the interaction between pyroptosis and the overall survival (OS) of osteosarcoma patients is poorly understood. This study aimed to construct a prognostic model based on pyroptosis-related genes to provide new insights into the prognosis of osteosarcoma patients. We identified 46 differentially expressed pyroptosis-associated genes between osteosarcoma tissues and normal control tissues. A total of six risk genes affecting the prognosis of osteosarcoma patients were screened to form a pyroptosis-related signature by univariate and LASSO regression analysis and verified using GSE21257 as a validation cohort. Combined with other clinical characteristics, including age, gender, and metastatic status, we found that the pyroptosis-related signature score, which we named “PRS-score,” was an independent prognostic factor for patients with osteosarcoma and that a low PRS-score indicated better OS and a lower risk of metastasis. The result of ssGSEA and ESTIMATE algorithms showed that a lower PRS-score indicated higher immune scores, higher levels of tumor infiltration by immune cells, more active immune function, and lower tumor purity. In summary, we developed and validated a pyroptosis-related signature for predicting the prognosis of osteosarcoma, which may contribute to early diagnosis and immunotherapy of osteosarcoma.

Identification and preliminary validation of a four-gene signature to predict metastasis and survival in osteosarcoma

Osteosarcoma is a primary malignant bone tumor that occurs frequently in children and adolescents and has a propensity for drug resistance, recurrence, and metastasis. The purpose of this study was to identify potential target genes to predict metastasis and survival in patients with osteosarcoma. We analyzed gene expression profiles and corresponding clinical data of patients with osteosarcoma in the Gene Expression Omnibus database and identified 202 genes that were differentially expressed between osteosarcoma cells and normal osteoblasts. Univariate and multivariable Cox regression analyses identified four risk genes that affected osteosarcoma prognosis: MCAM, ENPEP, LRRC1, and CPE. Independent prognostic analyses and clinical correlation studies showed that the four risk genes constituted an independent prognostic signature that correlated with survival and clinical parameters including age and distant metastasis. In a single-sample Gene Set Enrichment Analysis, risk scores based on the prognostic signature correlated with tumor infiltration by immune cells and immune functions in osteosarcoma. A subsequent analysis showed that the expression levels of the four genes in the prognostic signature were predictive of overall survival and metastasis-free survival of patients with osteosarcoma. Furthermore, Human Cancer Metastasis Database and qRT-PCR analyses demonstrated that the four risk genes are overexpressed in osteosarcoma tissues and cell lines. In summary, we developed and validated a four-gene prognostic signature that may be useful in osteosarcoma diagnosis and metastasis prediction.

Deliver protein across bio-barriers via hexa-histidine metal assemblies for therapy: a case in corneal neovascularization model

Because of their high specificity and low side effects, protein drugs possess a substantial global market. However, the low bioavailability of protein is still a major obstacle to their expanded applications, which is expected to be answered with proper protein formulations. Taking corneal neovascularization (CNV) as an example, we demonstrated a co-assembled system of hexa-histidine and Ava (Avastin) with metal ions (HmA@Ava) could cross the cornea, the most important bio-barrier during the treatment of most diseases of the anterior segment in clinics. We found that the nanosized HmA@Ava efficiently encapsulated Ava with impressive loading capacity without destroying the bioactivity of Ava and assisted Ava penetration through the corneal barriers to effectively inhibit CNV development in an alkali burn rat model with sustained and pH-dependent Ava release. Our results suggested that the co-assembled strategy of protein and HmA is a proper formulation to protein drugs, with promising penetration ability to deliver protein across bio-barriers, which could open a path for topical administration of protein drugs for treatment of various ocular diseases and hold enormous potential for delivery of therapeutic proteins not only for ocular diseases but also for other diseases that require protein treatment.

•

HmA@Ava can bring protein drug, Ava, across over the primary bio-barrier of the anterior segment ​and efficiently treat CNV.

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HmA@Ava was nanoparticles, with impressive loading capacity without destroying bioactivity of Ava ​and strong pH-dependent release.

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HmA can open a path for the treatment of eye diseases and hold huge potential to protein drugs to other diseases.

[Study on the feature of cortical auditory evoked potential under different auditory tasks in cochlear implant children]

Objective: To investigate the variation regularity and influencing factors of cortical auditory evoked potential (CAEP) evoked by pure tone, syllable and tone stimuli in cochlear implant (CI) children. Methods: Cortical auditory evoked potential (CAEP) responses were collected from 46 CI children in the sound field. Pure tones with frequencies of 1 kHz and 2 kHz were used as the standard and the deviant respectively in the pure tone stimulation condition. The Chinese Mandarin tokens/ba/-/pa/and/ba1/-/ba4/pairs were used as the stimuli respectively in the syllable and tone stimulation condition. The latency, amplitude and presence rate of P1 and mismatch negative(MMN) were obtained and the correlation between the difficulty of auditory task, the age of hearing month, the duration of severe-profound hearing loss, the wearing history of hearing aid before CI, the hearing threshold of the better ear before CI and the latency and amplitude of P1 and MMN were analyzed. All statistical analyses and figures were conducted using SPSS 25.0. Results: The P1 presence rate of pure tone, syllable and tone group was 100% (17/17), 100% (13/13) and 75.0% (12/16), respectively, with significant difference (χ²=8.214, P=0.016). There was significant difference between pure tone group and tone group (χ²=4.836, P=0.028), but no significant difference between pure tone group and syllable group, syllable group and tone group. The MMN presence rate of pure tone, syllable and tone group was 94.1% (16/17), 84.6% (11/13) and 62.5% (10/16), respectively, but no significant difference among the three groups with different auditory tasks(χ²=0.066, P=0.066). No significant difference was observed among the three groups of different auditory tasks in the latency and amplitude of P1 and MMN. Multiple linear regression analysis showed that the latency of P1 was positively correlated with the difficulty of auditory task and the hearing threshold of the better ear before CI, and negatively correlated with hearing age and the history of hearing aid before CI. The latency of MMN was positively correlated with the difficulty of auditory task, and negatively correlated with hearing age. Conclusions: The P1 presence rate of pure tone auditory task is significantly higher than that of tone auditory task. The difficulty of auditory task, hearing age, the history of hearing aid before CI, and the hearing threshold of the better ear before CI has significant effects on the P1 latency. The difficulty of auditory task and hearing age has significant effects on the MMN latency.

P–194 Impact of cryopreservation duration on pregnancy outcomes of vitrified-warmed blastocysts transfer using an open-device system

Study question

Is there a negative effect of long-term cryopreservation upon pregnancy outcomes after transfer of vitrified-warmed blastocysts stored in an open-device system?

Summary answer

Prolonged cryopreservation of vitrified blastocysts up to 24 months increased the incidences of clinical pregnancy, ongoing pregnancy, and live birth, while decreased early miscarriage rate.

What is known already

Vitrification is adopted as the dominant approach for cryopreservation of human oocytes and embryos. However, little is known about the potential effect of prolonged storage after vitrification on the genomic integrity and metabolism of embryos. Several studies have sought to decipher the effect of cryopreservation duration on IVF pregnancy outcomes, but few were confined to vitrification and the results were inconsistent.

Study design, size, duration

This retrospective study included 6722 patients undergoing their first vitrified-warmed blastocyst transfer (VBT) cycles from January 2015 to June 2019 in a single fertility center in South China. The study was approved by the hospital’s Ethics Committee.

Participants/materials, setting, methods

A total of 6722 eligible patients were divided into five groups according to the storage duration after vitrification: Group I: 0–3 months; Group II: 3–6 months; Group III: 6–12 months; Group IV: 12–24 months; Group V: 24–36 months. The IVF pregnancy outcomes were compared between groups. Multivariate logistic regression was conducted to evaluate the independent effect of storage duration on pregnancy outcomes.

Main results and the role of chance

The odds of clinical pregnancy outcomes were similar from Group 1 to 4. However, the chance of clinical pregnancy (Group 1 as reference; Group 2: adjusted odds ratio (aOR)= 1.04, 95% CI 0.93–1.17; Group 3: aOR = 1.02, 95% CI 0.84–1.25; Group 4: aOR = 0.93, 95% CI 0.66–1.31; Group 5: aOR = 0.54, 95% CI 0.38–0.76) , ongoing pregnancy (Group 2: aOR=0.99, 95% CI 0.89–1.11; Group 3: aOR = 0.94, 95% CI 0.77–1.14; Group 4: aOR = 0.87, 95% CI 0.62–1.22; Group 5: aOR = 0.41, 95% CI 0.29–0.60), and live birth rate (Group 2: aOR=1.00, 95% CI 0.89–1.12; Group 3: aOR = 0.98, 95% CI 0.81–1.19; Group 4: aOR = 0.91, 95% CI 0.65–1.27; Group 5: aOR = 0.46, 95% CI 0.32–0.66) significantly decreased, while the early miscarriage rate (Group 2: aOR=1.11, 95% CI 0.92–1.35; Group 3: aOR =1.25, 95% CI 0.92–1.70; Group 4: aOR = 1.33, 95% CI 0.77–2.31; Group 5: aOR = 2.42, 95% CI 1.36–4.31) significantly increased as the storage duration increased up to 24–36 months.

Limitations, reasons for caution

The primary limitation of this study was its retrospective nature. Besides, as all these data come from a single IVF treatment center, the results should be confirmed by a larger multicenter study.

Wider implications of the findings: Our study provides more evidence about the negative impact of long-term storage of vitrified embryos on the clinical outcome. Clinicians should adapt FET strategies based on the embryo storage duration.

Trial registration number

Not applicable

[Clinicopathological features and molecular genetic changes of lung salivary gland-type clear cell carcinoma]

Objective: To investigate the clinicopathological features, immunophenotype, differential diagnosis, molecular genetic changes and prognosis of salivary gland-type clear cell carcinoma (CCC) of the lung. Methods: Eight cases of salivary gland-type CCC of the lung diagnosed at Fudan University Shanghai Cancer Center and Shanghai Pulmonary Hospital, China from March 2017 to December 2020 were retrieved and analyzed. The pathological sections of these cases were studied using immunohistochemical staining, fluorescence in situ hybridization (FISH), and RNA-seq fusion gene detection based on next generation sequencing technique. The patients were followed up and the relevant literature was reviewed. Results: The 8 patients included 3 males and 5 females, with age ranging from 43 to 64 years (average, 58 years). All patients underwent radical lobectomy and lymph node dissection, while only one had lymph node metastases. The eight patients were followed up for 6 to 45 months, and were all recurrence-free. Histopathologically, the tumor was mainly composed of eosinophilic and clear cells arranged in trabecular, ribbon and nest patterns. Hyalinization was often observed in the stroma around the nest. Immunohistochemical staining showed that 8/8 cases were positive for EMA and CK7; 5/8 cases were positive for p63 and p40; 4/8 cases were positive for SOX10; and the cases were all negative for S-100, SMA and calponin. EWSR1 gene fusion was detected in all cases by FISH. RNA-seq fusion gene was detected in 6 cases based on next generation sequencing. The EWSR1-ATF1 gene fusion was detected in 5 cases, among which one case also had the ATF1-SPTLC2 gene fusion. All 5 cases with EWSR1-ATF1 gene fusion showed that EWSR1 exon 12/13 fused with ATF1 exon 3. And EWSR1-CREM gene fusion was detected in one case. Conclusions: Salivary gland-type CCC of the lung is an extremely rare primary lung tumor arising from the bronchial mucosa. The diagnosis and differential diagnosis of this tumor depend on classic histomorphology, especially the auxiliary detection of EWSR1 fusion gene. The primary treatment choice of this tumor is complete surgical resection. Lymph node metastases may occur, but the overall prognosis is good.

Baicalin Promotes Mammary Gland Development via Steroid-Like Activities

Baicalin, the main flavonoid component extracted from Scutellaria roots, has a variety of biological activities and is therefore used in the treatment of many kinds of diseases. However, whether baicalin affects the normal development of tissues and organs is still unclear. Here, using a mouse mammary gland model, we investigated the effects of baicalin on the expansion of mammary stem cells (MaSCs) and mammary development, as well as breast cancer progression. Interestingly, we found that baicalin administration significantly accelerates duct elongation at puberty, and promotes alveolar development and facilitates milk secretion during pregnancy. Furthermore, self-renewal of MaSCs was significantly promoted in the presence of baicalin. Moreover, in a tumor xenograft model, baicalin promoted tumor growth of the MDA-MB-231 cell line, but suppressed tumor growth of the ZR-751 cell line. Mechanistically, baicalin can induce expression of the protein C receptor, while inhibiting the expression of the estrogen receptor. Transcriptome analysis revealed that baicalin is involved in signaling pathways related to mammary gland development, immune response, and cell cycle control. Taken together, our results from comprehensive investigation of the biological activity of baicalin provide a theoretical basis for its rational clinical application.

Expression Profiling and Functional Analysis of Candidate Col10a1 Regulators Identified by the TRAP Program

Hypertrophic chondrocytes and their specific marker, the type X collagen gene (Col10a1), are critical components of endochondral bone formation during skeletal development. We previously found that Runx2 is an indispensable mouse Col10a1 gene regulator and identified many other transcription factors (TFs) that potentially interact with the 150-bp Col10a1 cis-enhancer. However, the roles of these candidate TFs in Col10a1 expression and chondrocyte hypertrophy have not been elucidated. Here, we focus on 32 candidate TFs recently identified by analyzing the 150-bp Col10a1 enhancer using the transcription factor affinity prediction (TRAP) program. We found that 12 TFs (Hoxa3, Lsx, Evx2, Dlx5, S8, Pax2, Egr2, Mef2a, Barhl2, GKlf, Sox17, and Crx) were significantly upregulated and four TFs (Lhx4, Tbx5, Mef2c, and Hb9) were significantly downregulated in hypertrophic MCT cells, which show upregulation of Col10a1 expression. Most of the differential expression pattern of these TFs conformed with the results obtained from ATDC5 cell model and primary mouse chondrocytes. Notably, Tbx5 was downregulated upon Col10a1 upregulation, overexpression of Tbx5 decreased Col10a1 expression, and knock-down of Tbx5 increased Col10a1 expression in hypertrophic chondrocytes, suggesting that Tbx5 is a negative regulator of Col10a1. We further generated a stable Tbx5-overexpressing ATDC5 cell line and ColX-Tbx5 transgenic mice driven by Col10a1-specific enhancers and promoters. Tbx5 overexpression decreased Col10a1 expression in ATDC5 cells cultured as early as day 7 and in limb tissue on post-natal day 1. Slightly weaker alkaline phosphatase staining was also observed in cell culture on day 7 and in limb digits on embryonic day 17.5, indicating mildly delayed ossification. Further characterization of these candidate Col10a1 transcriptional regulators could help identify novel therapeutic targets for skeletal diseases associated with abnormal chondrocyte hypertrophy.

Efficacy and safety of mesenchymal stem cell injections for patients with osteoarthritis: a meta-analysis and review of RCTs

INTRODUCTION

Osteoarthritis (OA), which has a high incidence in the elderly, brings a huge economic burden to society. MSCs (Mesenchymal Stem Cells) have shown great multidirectional differentiation potential which are expected to treat OA, and numerous clinical trials have been conducted. However, the efficacy and safety of the MSCs still need to be further integrated and analyzed.

MATERIALS AND METHODS

We searched several databases (PubMed, EMBASE, Scopus, Web of Science, Cochrane Library, Ovid, and ScienceDirect) for assessing eligible trials that randomized controlled trials, hyaluronic acid as control, and MSCs injection to treat OA. Vitro studies and animal studies were excluded. Search terms were: "cartilage," "clinical trial," "mesenchymal," "stromal" and "stem cell", "osteoarthritis". The preliminary guidelines and study protocol were published online at PROSPERO.

RESULTS

Many assessment scales could not be improved significantly after 6 months. However, most of the scales were significantly improved after 12 months, indicating that compared with hyaluronic acid, stem cells could relieve OA symptoms significantly. No serious adverse effect was found.

CONCLUSION

There are significant therapeutic effects on joint function, symptoms, and no permanent adverse effect has been found after stem cell treatment. It is promising to apply intro-articular injection of stem cells for OA to clinical application. More researches are needed to supplement present deficiencies.

LncRNA PSMA3-AS1 promotes colorectal cancer cell migration and invasion via regulating miR-4429

OBJECTIVE

Many studies have revealed that long non-coding RNAs (lncRNAs) are related to various cancers, including colorectal cancer (CRC). This study aims to explore the biological function of lncRNA PSMA3-AS1 in CRC progression.

MATERIALS AND METHODS

The expression levels of PSMA3-AS1 and miR-4429 were assessed by RT-qPCR. CRC progression was explored by cell viability, migration, and invasion using CCK-8 and transwell assays. The interaction between PSMA3-AS1 and miR-4429 was verified by bioinformatics analysis, Dual-Luciferase assay, and RIP assay.

RESULTS

It was found that PSMA3-AS1 expression was increased and miR-4429 expression was decreased in CRC tissues and cells. In addition, PSMA3-AS1 interference markedly hindered the proliferation, migration, and invasion of CRC cells. MiR-4429 was a direct target of PSMA3-AS1, and the knockdown of PSMA3-AS1 significantly suppressed miR-4429 expression. The depletion of PSMA3-AS1 inhibited CRC progression, which was neutralized by miR-4429 inhibitor.

CONCLUSIONS

PSMA3-AS1 accelerated CRC progression by regulating miR-4429 expression, which could be used as a potential therapeutic target for CRC patients.

DLX5 promotes osteosarcoma progression via activation of the NOTCH signaling pathway

The distal-less (dlx) homeobox transcription factors have been implicated roles in bone development. DLX5, in particular, was shown to play essential roles in osteoblast differentiation by targeting RUNX2, a master transcription factor for bone development. Interestingly, DLX5 has also been shown to play an oncogenic role in lung and other cancers, possibly via regulation of MYC expression. Given its dual roles in bone and cancer, this study aimed to investigate the effect of DLX5 on progression of osteosarcoma (OS), the primary bone cancer that is characterized by abnormal bone formation and osteoblast activity. Expression of DLX5 in OS cell lines was detected by quantitative real-time PCR (qRT-PCR) and western blot (WB). In vitro and in vivo assays were performed to investigate the oncogenic function of DLX5 in OS cells and xenograft models. Luciferase reporter assay was performed to determine the underlying mechanism of DLX5-mediated OS aggressiveness. The results showed that DLX5 was differentially expressed in OS cell lines, with significantly upregulated levels in HOS and MG-63 and relatively low levels in U2OS and 143B cell lines, compared with the normal bone cell line. DLX5 knockdown in HOS and MG-63 cell lines by siRNA inhibited OS cell growth and progression, and induced cell apoptosis and cell cycle changes both in vitro and in vivo. Meanwhile, DLX5 overexpression had the opposite effect on U2OS and 143B cell lines. Notably, a positive correlation between the expression patterns of NOTCH1 and DLX5 was also observed. The expression levels of NICD (NOTCH1 intracellular domain) and HES1 (classical target of NOTCH) were closely associated with DLX5 expression. Whereas knockdown of DLX5 in OS cells resulted in decreased expression of NOTCH1 and reduced cell proliferation and migration, which were rescued by overexpression of NOTCH1. We further analyzed DLX5 and NOTCH1 genes using JASPAR software and found two potential DLX5 binding sites within the NOTCH1 promoter. Dual-luciferase assay demonstrated that DLX5 specifically activates the NOTCH1 promoter and controls its expression. Taken together, our results support that DLX5 plays an oncogenic role in OS development, which can at least partially, be attributed to activation of the NOTCH signaling pathway.

HPV16 infection promotes an M2 macrophage phenotype to promote the invasion and metastasis of esophageal squamous cell carcinoma

OBJECTIVES

High-risk human papillomavirus (HR-HPV) is an important risk factor for esophageal cancer. Macrophages constitute a crucial immune medium for regulating HPV-related tumors; however, the specific regulatory mechanisms remain unknown. Therefore, the purpose of our current study was to investigate the mechanism by which HPV16E6 regulates macrophages to promote the invasion and metastasis of esophageal cancer.

METHODS

HPV16E6 infection was detected by polymerase chain reaction. Immunohistochemistry was used to verify the distribution of tumor-associated macrophages (TAMs) and MMP-9 expression in esophageal squamous cell carcinoma tissues (ESCCs), and cancer adjacent normal tissues (CANs) from Kazakh patients. ESCC cells were transfected with a plasmid over-expressing HPV16E6 and non-contact cocultured with macrophages.

RESULTS

The infection rate of HPV16E6 in Kazakh ESCCs was clearly higher than that in CANs (P < 0.05). The density of CD163-positive TAMs was significantly positively correlated with HPV16E6 infection in ESCCs (P < 0.05). After coculturing macrophages and EC9706 cells transfected with the HPV16E6 plasmid, the phenotype of macrophages transformed into M2 macrophages. The migration and invasion ability of ESCC cells were higher in the HPV16E6-transfected and coculture group than in the HPV16E6 empty vector-transfected and non-cocultured HPV16E6-transfected groups (all P < 0.05). The density of M2-like TAMs in ESCCs was positively correlated with the level of MMP-9 expression. MMP-9 expression in the HPV16E6-ESCC coculture macrophages group was substantially higher than that in controls (all P < 0.05).

CONCLUSIONS

HPV16 infection mediates tumor-associated macrophages to promote ESCC invasion and migration.

CDK inhibitors in cancer therapy, an overview of recent development

Dysregulated cell division, which leads to aberrant cell proliferation, is one of the key hallmarks of cancer. Therefore, therapeutic targets that block cell division would be effective for cancer treatment. Cell division is mainly controlled by a complex composed of cyclin and cyclin dependent kinases (CDKs). To date, the CDK inhibitors (CDKIs), specifically the ones that block the enzyme activity of CDK4 and CDK6 (CDK4/6), have been approved by FDA for the treatment of metastatic hormone receptor positive breast cancer. However, due to the non-selectivity and significant toxicity, most of the first generation CDK inhibitors (so called pan-CDK inhibitors that target several CDKs), have not been approved for clinical application. Despite this, great efforts and progress have been made to enable pan-CDK inhibitors application in the clinical setting. Notably, the development of combination therapy strategies in recent years has made it possible to reduce the toxicity and side effects of pan-CDK inhibitors. Thus, as a combination therapy approach, pan-CDK inhibitors regain great potential in clinical application. In this review, we introduced the CDK family members and discussed their major functions in cell cycle controlling. Then, we summarized the research progress regarding CDK inhibitors, especially those other than CDK4/6 inhibitors. We reviewed first-generation pan-CDKIs Flavopiridol and Roscovitine, and second-generation CDKIs Dinaciclib, P276-00, AT7519, TG02, Roniciclib, RGB-286638 by focusing on their developing stages, clinical trials and targeting cancers. The specific CDKIs, which targets to increase specificity and decrease the side effects, were also discussed. These CDKIs include CDK4/6, CDK7, CDK9, and CDK12/13 inhibitors. Finally, the efficacy and discrepancy of combination therapy with CDK inhibitors and PD1/PDL1 antibodies were analyzed, which might give insights into the development of promising strategy for cancer treatment.

The value of MRI in identifying pancreatic neuroendocrine tumour G3 and carcinoma G3

AIM

To explore the magnetic resonance imaging (MRI) differences between pancreatic neuroendocrine tumour grade 3 (pNET-G3) and pancreatic neuroendocrine carcinoma grade 3 (pNEC-G3).

MATERIALS AND METHODS

Between 2009 and 2019, 31 patients underwent pNEN-G3 resection with preoperative MRI in two local hospitals in China. The 31 patients were assigned to a pNET-G3 group (n=13) or a pNEC-G3 group (n=18). The MRI findings between the groups were compared.

RESULTS

There was no statistically significant difference between the two groups in lesion size, clinical characteristics, or laboratory indexes. The lesions showed high or slightly higher signal on diffusion-weighted imaging and decreased apparent diffusion coefficient (ADC) values, which differed between the two groups (p=0.013). The difference between the groups regarding positive enhancement integral, arterial phase and portal phase signal enhancement ratio were statistically significant; however, the delayed phase signal enhancement ratio was not significantly different.

CONCLUSIONS

pNET-G3 and pNEC-G3 showed different characteristics on MRI. In particular, the ADC value and dynamic enhanced imaging could have an important role in distinguishing between the two.