The Origin and Course of the Blood Supply to the Lower Eyelid Orbital Fat: Anatomical Study and Clinical Significance

PURPOSE

The aim of this study is to investigate the origin and course of the orbital fat arterial supply in the lower eyelid using traditional anatomy and three-dimensional computed tomography (CT).

METHODS

Twenty-seven cadaver heads were infused with mercury sulfide contrast media through the ophthalmic artery, maxillary artery, transverse facial artery, and facial artery. CT images were obtained after contrast agent injection, three-dimensional CT scans were reconstructed, and the cadaver heads were dissected.

RESULTS

Forty-five qualified hemifaces showed that the orbital fat arterial supply in the lower eyelid originates primarily from the inferomedial muscular trunk (IMT) of the ophthalmic artery and the orbital branch of the infraorbital artery. The medial branch of the IMT terminated at the medial fat pad (35.6%) or the orbital floor (64.4%). The lateral branch terminated at the inferior oblique (IO) muscle (28.9%) or the central and lateral fat pads (17.8%). In 53.3%, the lateral branch extended to the anterior part of the lateral fat pad and terminated in the orbital wall or the zygomaticoorbital foramina. The orbital branch of the infraorbital artery coursed between the orbital floor and the orbital fat, providing supply to the IO muscle, inferior rectus (IR) muscle, nasolacrimal duct, and orbital fat.

CONCLUSION

This study elucidated the origin and course of the orbital fat arterial supply in the lower eyelid, which may help to avoid reducing the blood supply of the orbital fat pedicles during surgery.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

mir-150-5p inhibits the osteogenic differentiation of bone marrow-derived mesenchymal stem cells by targeting irisin to regulate the p38/MAPK signaling pathway

PURPOSE

To study the effect of miR-150-5p on the osteogenic differentiation of bone marrow-derived mesenchymal stem cells (BMSCs), and further explore the relationship between its regulatory mechanism and irisin.

METHODS

We isolated mouse BMSCs, and induced osteogenic differentiation by osteogenic induction medium. Using qPCR to detect the expression of osteogenic differentiation-related genes, western blot to detect the expression of osteogenic differentiation-related proteins, and luciferase reporter system to verify that FNDC5 is the target of miR-150-5p. Irisin intraperitoneal injection to treat osteoporosis in mice constructed by subcutaneous injection of dexamethasone.

RESULTS

Up-regulation of miR-150-5p inhibited the proliferation of BMSCs, and decreased the content of osteocalcin, ALP activity, calcium deposition, the expression of osteogenic differentiation genes (Runx2, OSX, OCN, OPN, ALP and BMP2) and protein (BMP2, OCN, and Runx2). And down-regulation of miR-150-5p plays the opposite role of up-regulation of miR-150-5p on osteogenic differentiation of BMSCs. Results of luciferase reporter gene assay showed that FNDC5 gene was the target gene of miR-150-5p, and miR-150-5p inhibited the expression of FNDC5 in mouse BMSCs. The expression of osteogenic differentiation genes and protein, the content of osteocalcin, ALP activity and calcium deposition in BMSCs co-overexpressed by miR-150-5p and FNDC5 was significantly higher than that of miR-150-5p overexpressed alone. In addition, the overexpression of FNDC5 reversed the blocked of p38/MAPK pathway by the overexpression of miR-150-5p in BMSCs. Irisin, a protein encoded by FNDC5 gene, improved symptoms in osteoporosis mice through intraperitoneal injection, while the inhibitor of p38/MAPK pathway weakened this function of irisin.

CONCLUSION

miR-150-5p inhibits the osteogenic differentiation of BMSCs by targeting irisin to regulate the/p38/MAPK signaling pathway, and miR-150-5p/irisin/p38 pathway is a potential target for treating osteoporosis.

Down-regulating nuclear factor of activated T cells 1 alleviates cognitive deficits in a mouse model of sepsis-associated encephalopathy, possibly by stimulating hippocampal neurogenesis

Sepsis-associated encephalopathy (SAE) is a common complication of sepsis, and has been associated with increased morbidity and mortality. Nuclear factor of activated T cells (NFATs) 1, a transcriptional factor that regulates T cell development, activation and differentiation, has been implicated in neuronal plasticity. Here we examined the potential role of NFAT1 in sepsis-associated encephalopathy in mice. Adult male C57BL/6J mice received intracerebroventricular injections of short interfering RNA against NFAT1 or sex-determining region Y-box 2 (SOX2), or a scrambled control siRNA prior to cecal ligation and perforation (CLP). A group of mice receiving sham surgery were included as an additional control. CLP increased escape latency and decreased the number of crossings into, and total time spent within, the target quadrant in the Morris water maze test. CLP also decreased the freezing time in context-dependent, but not context-independent, fear conditioning test. Knockdown of either NFAT1 or SOX2 attenuated these behavioral deficits. NFAT1 knockdown also attenuated CLP-induced upregulation of SOX2, increased the numbers of nestin-positive cells and newborn astrocytes, reduced the number of immature newborn neurons, and promoted the G1 to S transition of neural stem cells in hippocampus. These findings suggest that NFAT1 may contribute to sepsis-induced behavioral deficits, possibly by promoting SOX2 signaling and neurogenesis.

MiR-21-mediated Metabolic Alteration of Cancer-associated Fibroblasts and Its Effect on Pancreatic Cancer Cell Behavior: Retraction

[This retracts the article DOI: 10.7150/ijbs.22555.].

Non-line-of-sight ultraviolet transmission coverage in non-precipitating, foggy, and rainy weather

Sensitivity to weather conditions is the principal limitation of free-space optical communication. However, for the scattering based ultraviolet (UV) non-line-of-sight (NLOS) communication, the atmospheric scattering effect functions as an attenuation factor and potentially as a performance enhancer. To investigate the UV NLOS transmission coverage under different weather conditions, we employ the Mie Theory in conjunction with classical aerosol and hydrometeor particle models to estimate the absorption coefficient, the scattering coefficient, and the scattering phase function. We then use these atmospheric parameters combined with a range estimation model to determine the coverage of the UV NLOS communication for specified path loss. Simulation results reveal that in non-precipitating weather, poorer visibility correlates with broader coverage. In foggy conditions, the coverage range in light fog exceeds that in fog-free environments; however, as fog intensity increases, the coverage range decreases. Rain enhances the coverage range; and heavier precipitation results in a larger coverage area.

Ferroptosis: An Emerging Target for Bladder Cancer Therapy

Bladder cancer (BC), as one of the main urological cancers in the world, possesses the abilities of multiple-drug resistance and metastasis. However, there remains a significant gap in the understanding and advancement of prognosis and therapeutic strategies for BC. Ferroptosis, a novel type of iron-dependent regulated cell death, depends on lipid peroxidation, which has been proven to have a strong correlation with the development and treatment of BC. Its mechanism mainly includes three pathways, namely, lipid peroxidation, the antioxidant system, and the iron overload pathway. In this review, we reviewed the mechanism of ferroptosis, along with the related therapeutic targets and drugs for BC, as it might become a new anticancer treatment in the future.

Facile synthesis of hierarchical CdS nanoflowers for efficient piezocatalytic hydrogen evolution

Piezocatalytic hydrogen evolution has emerged as a promising field for the collection and utilization of mechanical energy, as well as for generating sustainable energy throughout the day. Hexagonal CdS, an established semiconductor photocatalyst, has been widely investigated for its ability to split water into H2. However, its piezocatalytic performance has received less attention, and the relationship between its structure and piezocatalytic activity remains unclear. In this study, we prepared 3D ultrathin CdS nanoflowers with high voltage electrical response and low impedance. In pure water, without the use of any cocatalyst, CdS exhibited a piezoelectric catalytic hydrogen production rate of 1.46 mmol h-1 g-1, which was three times higher than that of CdS nanospheres (0.46 mmol h-1 g-1). Furthermore, the value-added oxidation product H2O2 was produced during the process of piezoelectric catalysis. These findings provide new insights for the design of high-efficiency piezoelectric catalytic hydrogen production.

Clinical study of magnetic resonance imaging-based texture analysis and fasciculation of the lateral pterygoid muscle in young patients with temporomandibular disorder

OBJECTIVE

We aimed to evaluate the effectiveness of clinical examination combined with texture analysis of magnetic resonance imaging (MRI) and fasciculation patterns of the lateral pterygoid muscle (LPM) in distinguishing among the different anatomic causes of temporomandibular disorder.

METHODS

We divided the patients into four groups: healthy control (HC), disk without displacement (DWoD), disk displacement with reduction (DDWR), and disk displacement without reduction (DDWoR). Demographic information and clinical symptoms of patients in each group were recorded. LPM textures were compared among groups. LPM fasciculation was examined. P<0.05 indicated significant difference.

RESULTS

Several clinical symptoms and signs, but not age or sex, differed significantly among groups. Oblique sagittal planar MRI revealed significant differences in the parameters of Angular Second Moment, Contrast, Correlation, Inverse Difference Moment, and Entropy between the healthy controls and the 3 patient groups. MRI of the patients, both without and with disk displacement, demonstrated relative uniformity in gray distribution and correlation of gray values, with greater complexity but an unclear texture and no obvious regularity. The proportion of type B LPM fascicles was significantly higher in the DDWR and DDWoR groups CONCLUSION: Temporomandibular disorder, without and with disk displacement, is associated with clinical symptoms and texture analysis values that differ from healthy muscle. The types of LPM fascicles are related to the position of the articular disk.

Global, regional, and national time trends in cancer mortality attributable to high fasting plasma glucose: an age-period cohort analysis

BACKGROUND

High fasting plasma glucose (HFPG) is the fastest-growing risk factor for cancer deaths worldwide. We reported the cancer mortality attributable to HFPG at global, regional, and national levels over the past three decades and associations with age, period, and birth cohort.

METHODS

Data for this study were retrieved from the Global Burden of Disease Study 2019, and we used age-period-cohort modelling to estimate age, cohort and period effects, as well as net drift (overall annual percentage change) and local drift (annual percentage change in each age group).

RESULTS

Over the past 30 years, the global age-standardized mortality rate (ASMR) attributable to HFPG has increased by 27.8%. The ASMR in 2019 was highest in the male population in high sociodemographic index (SDI) areas (8.70; 95% CI, 2.23-18.04). The net drift for mortality was highest in the female population in low SDI areas (2.33; 95% CI, 2.12-2.55). Unfavourable period and cohort effects were found across all SDI quintiles. Cancer subtypes such as "trachea, bronchus, and lung cancers", "colon and rectal cancers", "breast cancer" and "pancreatic cancer" exhibited similar trends.

CONCLUSIONS

The cancer mortality attributable to HFPG has surged during the past three decades. Unfavourable age-period-cohort effects on mortality were observed across all SDI quintiles, and the cancer mortality attributable to HFPG is expected to continue to increase rapidly in the future, particularly in lower SDI locations. This is a grim global public health issue that requires immediate attention.

The efficacy of ultrasonography on learning curve and inter-subject performance variability in radial artery cannulation in standardized training for residents: a randomized controlled trial

AIM

To evaluate the effect of ultrasound (US) on learning curve and inter-subject performance variability of residents in radial artery cannulation.

MATERIAL AND METHODS

Twenty non-anesthesiology residents who received standardized training in an anesthesiology department were selected and divided into two groups: anatomy group or US group. After training of relevant anatomy, US recognition and puncture skill, residents selected 10 patients either under US or anatomical localization performing radial artery catheterization. The number and time of successful cases of catheterization were recorded, success rate of first attempt and catheterization, as well as the total success rate of catheterization were calculated. The learning curve and inter-subject performance variability of residents were also calculated. Complications and the residents' satisfaction for teaching and self-confidence before puncture were also recorded.

RESULTS

Compared to the anatomy group, total success rate and the success rate at first attempt were higher in US-guided group (88% vs. 57%, 94% vs. 81%). The average performance time in the US group was significantly less (2.9±0.8 min vs. 4.2±2.1 min) and the mean number of attempts was 1.6, while 2.6 for the anatomy group. With performing cases increasing, the average puncture time of residents in the US group decreased by 19s, while 14s in the anatomy group. More local hematoma occurred in the anatomy group. The satisfaction and confidence degree of residents were higher in US group ([98.5±6.5] vs [68.5±7.3], [90.2±8.6] vs [56.3±5.5]).

CONCLUSION

US can significantly shorten the learning curve, reduce the inter-subject performance variability, improve the first attempt and total success rate of radial artery catheterization for non-anesthesiology residents.

Age, pelvic incidence, facet joint angle and pedicle-facet angle as correlative factors for isthmic spondylolisthesis: a retrospective case control study

BACKGROUND

Isthmic spondylolisthesis (IS) is a common clinical disease with a high incidence rate. However, most current researches explain the clear pathogenesis from a single perspective. The aim of our study was to explore the relationships between multiple parameters in patients and find the potential risk factors of this disease.

METHODS

Our study retrospectively included 115 patients who were diagnosed with isthmic spondylolisthesis and the same number of individuals without spondylolisthesis. The following parameters were measured or collected: age, pelvic incidence (PI), facet joint angle (FJA) and pedicle-facet angle (P-F angle). The radiographic files were imported into Mimics Medical 20.0 and all collected data were analyzed using SPSS, version 26.0, statistical software.

RESULTS

The age was higher in IS group than in control group. PI was also higher in the IS group (50.99 ± 7.67) than in the control group (43.77 ± 9.30) significantly (P = 0.009). There was significant difference in cranial and average FJA tropism in L3-L4 level (P = 0.002, P = 0.006, respectively) and in L4-L5 level (P < 0.001). P-F angle of L4-L5 level showed significantly larger in IS group than in control group (P = 0.007).The logistic regression analysis showed a larger age, a greater L3-L4 cranial FJA tropism, and a greater L4-L5 cranial FJA tropism were potential predictors of IS, with an OR of 1.07, 1.28, and 1.39 respectively. The thresholds of the predictors were 60 years, 5.67°, and 8.97° according to the ROC curve. The linear regression equation was established: degree of slippage (%) = 0.220*age - 0.327* L3-4 cranial FJA tropism - 0.346* L4-5 average FJA tropism (F = 3.460, P = 0.011, r = 0.659).

CONCLUSIONS

Our study revealed that isthmic spondylolisthesis may be related to multiple factors rather than a single factor. Age, PI, PJA and P-F angle are potentially associated with spondylolisthesis.

[Characteristics of Benthic Diatom Community Structure and Water Ecological Health Evaluation in the Lalin River Basin]

With the improvement of public requirements for the health status of aquatic ecosystems, there have been innovative assessment methods developed for aquatic ecosystems. In this study, benthic algae assemblages and water quality variables were analyzed to develop a benthic diatom-based index of biotic integrity (D-IBI) for the assessment of the aquatic environment in the Lalin River. In addition, using redundancy analysis (RDA) based on dominant species and physicochemical indexes, the ecological distribution characteristics of the benthic diatom community were revealed, and the key influencing factors were identified. The results showed that the benthic diatom community structure in the Lalin River basin had obvious spatial differences. The application of the index revealed that the water quality could be described as excellent condition in the upper reaches of the Lalin River, good to common condition in the middle of the sites, and moderate to poor condition in the downstream. The assessment further revealed that the main reason for the degradation of the Lalin River ecosystem was nutrient enrichment through agricultural land use.

Intakes of omega-3 fatty acids and risks of all-cause and cause-specific mortality in people with diabetes: a cohort study based on NHANES 1999-2014

AIMS

Intake of omega-3 fatty acids is associated with several health benefits, but the specific benefits in populations with diabetes have yet to be elucidated. Therefore, this study aimed to explore the relationship between intake of omega-3 fatty acids and mortality in people with diabetes.

METHODS

This was a prospective cohort study and included 4854 participants with diabetes (mean age, 57.92 years; 50.9% male) from the National Health and Nutrition Examination Survey (1999-2014). Eicosapentaenoic (EPA) and docosahexaenoic (DHA) acid intake were used as alternative markers of omega-3 fatty acids intake and calculated based on the sum of the 24-h dietary recall interviews and dietary supplements. Mortality data were ascertained by linkage to National Death Index records by December 31, 2015. Cox proportional hazard models and restricted cubic spline were used to assess the relationship between EPA and DHA intake and all-cause and cause-specific mortality. Statistical analyses were performed using R 4.2.0 software.

RESULTS

Compared with participants with a lower EPA + DHA intake, participants who had a higher EPA + DHA intake tended to be Non-Hispanic Black; were more likely to be obese; and had higher daily energy intake and family income. During 34,386 person-years of follow-up, 1102 deaths were documented, including 266 cardiovascular disease deaths and 152 cancer deaths. In multivariable regression analyses with adjustment of confounding factors, higher EPA + DHA intake was significantly and linearly related to lower all-cause mortality: there was a 25% reduced risk of all-cause mortality.

CONCLUSIONS

Higher omega-3 fatty acid intake was independently related to lower all-cause mortality in individuals with diabetes, suggesting an adequate intake of omega-3 fatty acids may prevent premature death among the population with diabetes.

Variability of body mass index and risks of prostate, lung, colon, and ovarian cancers

Objective

We investigated the association between cancer incidence and body mass index (BMI) variability calculated from the recall of weight at decades of age by participants in the USA Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial.

Methods

A total of 89,822 individuals' BMI were recorded as recalled the participant's aged 30, 40, 50, 60, 70 years, and baseline. BMI variability was assessed using four indices: SD, coefficient of variation (CV), variability independent of the mean (VIM), and average real variability (ARV). The multivariate Cox regression analysis was performed to calculate hazard ratios (HRs) of these measures for incident cancers and corresponding 95% CIs.

Results

During the median follow-up of 11.8 years, there were newly diagnosed 5,012 cases of prostate cancer, 792 cases of lung cancer, 994 cases of colon cancer, and 132 cases of ovarian cancer. Compared with the lowest quartile (Q1) group, the highest quartile (Q4) group of BMI variability indices was associated with increased lung cancer risk, including BMI_SD (HR, 1.58; 95% CI, 1.17-2.12), BMI_CV (HR, 1.46; 95% CI, 1.10-1.94), BMI_VIM (HR, 1.73; 95% CI, 1.33-2.25), and BMI_ARV (HR, 2.17; 95% CI, 1.62-2.91). Associations between BMI variability and prostate, colon, and ovarian cancer incidences were of limited significance.

Conclusion

The findings imply that maintaining a stable weight across adulthood is associated with a decreased incidence of lung cancer.

An affordable approach to classifying type 2 diabetes based on fasting plasma glucose, TyG index and BMI: a retrospective cohort study of NHANES Data from 1988 to 2014

BACKGROUND

The β-cell function and insulin resistance required by existing methods of classifying type 2 diabetes are not routinely adopted in most medical institutions of developing countries and regions. This study aims to propose a novel, affordable classification approach and evaluate its predictive ability for several health and mortality outcomes, including cardiovascular health (CVH), retinopathy, chronic kidney disease (CKD), nonalcoholic fatty liver disease (NAFLD), advanced liver fibrosis, and mortality caused by all-cause, cardiovascular disease (CVD), cancer.

METHODS

Based on 4060 participants with diabetes (aged ≥ 30 at the time of diagnosis) selected from the National Health and Nutrition Examination Survey III & 1999-2014, we proposed a novel, but simple classification approach based on the threshold of fasting plasma glucose (FPG), triglyceride-glucose (TyG) index and body mass index (BMI). We used logistic regression model to assess its predictability for diabetes complications, and Cox regression model to estimate the mortality risks.

RESULTS

By utilizing this approach, we characterized the subjects into four subgroups: subgroup A (obesity-related), which accounts for 37% of the total, subgroup B (age-related), 38%, subgroup C (insulin resistance), 20%, and subgroup D (severe insulin deficiency), 5%. Subjects in subgroup D had a higher risk of retinopathy, in subgroup B had a lower risk of poor cardiovascular health, nonalcoholic fatty liver disease, and advanced liver fibrosis, in subgroup C had a higher risk of all-cause mortality.

CONCLUSIONS

This study proposes an affordable and practical method for classifying patients with type 2 diabetes into different subgroups, with a view to yield a high predictability of patient outcomes and to assist clinicians in providing better treatment.

Retention of Intrafibrillar Minerals Improves Resin-Dentin Bond Durability

The concept of extrafibrillar demineralization involves selective removal of apatite crystallites from the extrafibrillar spaces of mineralized dentin without disturbing the intrafibrillar minerals within collagen. This helps avoiding activation of endogenous proteases and enables air-drying of partially demineralized dentin without causing collapse of completely demineralized collagen matrix that adversely affects resin infiltration. The objective of the present study was to evaluate the potential of quaternized carboxymethyl chitosan (QCMC)-based extrafibrillar demineralization in improving resin-dentin bond durability. Isothermal titration calorimetry indicated that QCMC synthesized by quaternization of O-carboxymethyl chitosan had moderate affinity for Ca²⁺ (binding constant: 8.9 × 10⁴ M^-1). Wet and dry bonding with the QCMC-based demineralization produced tensile bond strengths equivalent to the phosphoric acid (H₃PO₄)-based etch-and-rinse technique. Those bond strengths were maintained after thermocycling. Amide I and PO₄^3- mappings of QCMC-conditioned dentin were performed with atomic force microscope-infrared spectroscopy (AFM-IR). Whereas H₃PO₄-etched dentin exhibited an extensive reduction in PO₄^3- signals corresponding to apatite depletion, QCMC-conditioned dentin showed scattered dark areas and bright PO₄^3- streak signals. The latter were consistent with areas identified as collagen fibrils in the amide I mapping and were suggestive of the presence of intrafibrillar minerals in QCMC-conditioned dentin. Young's modulus mapping of QCMC-demineralized dentin obtained by AFM-based amplitude modulation-frequency modulation recorded moduli that were the same order of magnitude as those in mineralized dentin and at least 1 order higher than H₃PO₄-etched dentin. In situ zymography of the gelatinolytic activity within hybrid layers created with QCMC conditioning revealed extremely low signals before and after thermocycling, compared with H₃PO₄-etched dentin for both wet and dry bonding. Confocal laser scanning microscopy identified the antibacterial potential of QCMC against Streptococcus mutans and Enterococcus faecalis biofilms. Taken together, the QCMC-based demineralization retains intrafibrillar minerals, preserves the elastic modulus of collagen fibrils, reduces endogenous proteolytic activity, and inhibits bacteria biofilms to extend dentin bond durability.

Gut-derived lipopolysaccharide promotes alcoholic hepatosteatosis and subsequent hepatocellular carcinoma by stimulating neutrophil extracellular traps through TLR4

Background/Aims

Binge drinking leads to many disorders, including alcoholic hepatosteatosis, which is characterized by intrahepatic neutrophil infiltration and increases the risk of hepatocellular carcinoma (HCC). Molecular mechanisms may involve the migration of bacterial metabolites from the gut to the liver and the activation of neutrophil extracellular traps (NETs).

Methods

Serum samples from both binge drinking and alcohol-avoiding patients were analyzed. Mouse models of chronic plus binge alcohol-induced hepatosteatosis and HCC models were used.

Results

A marker of NETs formation, lipopolysaccharide (LPS), was significantly higher in alcoholic hepatosteatosis and HCC patients and mice than in controls. Intrahepatic inflammation markers and HCC-related cytokines were decreased in mice with reduced NET formation due to neutrophil elastase (NE) deletion, and liver-related symptoms of alcohol were also alleviated in NE knockout mice. Removal of intestinal bacteria with antibiotics led to decreases in markers of NETs formation and inflammatory cytokines upon chronic alcohol consumption, and development of alcoholic hepatosteatosis and HCC was also attenuated. These functions were restored upon supplementation with the bacterial product LPS. When mice lacking toll-like receptor 4 (TLR4) received chronic alcohol feeding, intrahepatic markers of NETs formation decreased, and hepatosteatosis and HCC were alleviated.

Conclusions

Formation of NETs following LPS stimulation of TLR4 upon chronic alcohol use leads to increased alcoholic steatosis and subsequent HCC.

Validation of type 2 diabetes subgroups by simple clinical parameters: a retrospective cohort study of NHANES data from 1999 to 2014

OBJECTIVES

To verify whether a simplified method based on age, body mass index (BMI) and glycated haemoglobin (HbA1c) is feasible in classifying patients with type 2 diabetes (T2D), and evaluate the predictive ability of subgroups in several health and mortality outcomes.

DESIGN

Retrospective cohort study.

SETTING

The National Health and Nutrition Examination Survey 1999-2014 cycle.

PARTICIPANTS

A total of 1960 participants with diabetes and the age at diagnosis greater than 30.

PRIMARY AND SECONDARY OUTCOME MEASURES

Participants with T2D were assigned to previously defined (by Ahlqvist) subgroups based on five variables: age, BMI, HbA1c, homoeostasis model assessment (HOMA) 2 estimates of β-cell function (HOMA2-B), and insulin resistance (HOMA2-IR), and on three variables: age, BMI and HbA1c. The classification performances of the three variables were evaluated based on 10-fold cross validation, with accuracy, precision and recall as evaluation criteria. Outcomes were assessed using logistic regression and Cox regression analysis.

RESULTS

Without HOMA measurements, it is difficult to identify severe insulin-resistant diabetes, but other subgroups can be ideally identified. There is no significant difference between the five variables and the three variables in the ability to predict the prevalence of poor cardiovascular health (CVH), chronic kidney disease, non-alcoholic fatty liver disease and advanced liver fibrosis, and the risk of all-cause, cardiovascular disease and cancer-related mortality (p>0.05), except the prevalence of poor CVH in mild age-related diabetes (p<0.05).

CONCLUSIONS

A simple classification based on age, BMI and HbA1c could be used to identify T2D with several health and mortality risks, which is accessible in most individuals with T2D. Due to its simplicity and practicality, more patients with T2D can benefit from subgroup specific treatment paradigms.

Collagen type Ⅳ alpha 1 (COL4A1) silence hampers the invasion, migration and epithelial-mesenchymal transition (EMT) of gastric cancer cells through blocking Hedgehog signaling pathway

Gastric cancer (GC), which features high prevalence and mortality rate, remains the third most lethal cancer worldwide. The paper was designed to explore the impacts of collagen type Ⅳ alpha 1 (COL4A1) on GC, along with its potential mechanism. The mRNA and protein expressions of COL4A1 in GC cells were assessed by RT-qPCR and western blot. After depleting COL4A1, RT-qPCR and western blot were conducted again to check the transfection efficacy. With the application of CCK-8, wound healing and transwell, the capabilities of cells to proliferate, migrate and invade were appraised, respectively. Moreover, western blot tested the protein levels of factors involved in migration, proliferation, epithelial mesenchymal transition (EMT) and Hedgehog signaling. As a result, COL4A1 displayed elevated expression in GC tissues and cells while its knockdown inhibited the cell viability, migration, invasion and EMT in GC. According to Gene Set Enrichment Analysis (GSEA), COL4A1 was involved in the regulation of Hedgehog signaling pathway, which was then further verified by the detection of Hedgehog-related proteins. To figure out the relationship between COL4A1 and Hedgehog signaling pathway, we used purmorphamine, an agonist of Hedgehog, to treat GC cells, finding that COL4A1 blocked Hedgehog signaling to inhibit the aggressive phenotypes of GC cells. In short, COL4A1 silence was testified to exhibit suppressive effects on the malignant process of GC, suggesting that COL4A1 might be a potent hallmark for GC therapy.

Erratum: PD-L1 expression in colon cancer and its relationship with clinical prognosis

[This corrects the article on p. 1764 in vol. 12, PMID: 31933995.].

Fine-Grained Drug Interaction Extraction Based on Entity Pair Calibration and Pre-Training Model for Chinese Drug Instructions

Existing pharmaceutical information extraction research often focus on standalone entity or relationship identification tasks over drug instructions. There is a lack of a holistic solution for drug knowledge extraction. Moreover, current methods perform poorly in extracting fine-grained interaction relations from drug instructions. To solve these problems, this paper proposes an information extraction framework for drug instructions. The framework proposes deep learning models with fine-tuned pre-training models for entity recognition and relation extraction, in addition, it incorporates an novel entity pair calibration process to promote the performance for fine-grained relation extraction. The framework experiments on more than 60k Chinese drug description sentences from 4000 drug instructions. Empirical results show that the framework can successfully identify drug related entities (F1 ≥ 0.95) and their relations (F1 ≥ 0.83) from the realistic dataset, and the entity pair calibration plays an important role (~5% F1 score improvement) in extracting fine-grained relations.

CXCR5 down-regulation alleviates cognitive dysfunction in a mouse model of sepsis-associated encephalopathy: potential role of microglial autophagy and the p38MAPK/NF-κB/STAT3 signaling pathway

Background

Cognitive deficits are common in patients with sepsis. Previous studies in sepsis-associated encephalopathy (SAE) implicated the C-X-C chemokine receptor type (CXCR) 5. The present study used a mouse model of SAE to examine whether CXCR5 down-regulation could attenuate cognitive deficits.

Methods

Sepsis was induced in adult male C57BL/6 J and CXCR5^−/− mice by cecal ligation and puncture (CLP). At 14–18 days after surgery, animals were tested in a Morris water maze, followed by a fear conditioning test. Transmission electron microscopy of hippocampal sections was used to assess levels of autophagy. Primary microglial cultures challenged with lipopolysaccharide (LPS) were used to examine the effects of short interfering RNA targeting CXCR5, and to investigate the possible involvement of the p38MAPK/NF-κB/STAT3 signaling pathway.

Results

CLP impaired learning and memory and up-regulated CXCR5 in hippocampal microglia. CLP activated hippocampal autophagy, as reflected by increases in numbers of autophagic vacuoles, conversion of microtubule-associated protein 1 light chain 3 (LC3) from form I to form II, accumulation of beclin-1 and autophagy-related gene-5, and a decrease in p62 expression. CLP also shifted microglial polarization to the M1 phenotype, and increased levels of IL-1β, IL-6 and phosphorylated p38MAPK. CXCR5 knockout further enhanced autophagy but partially reversed all the other CLP-induced effects, including cognitive deficits. Similar effects on autophagy and cytokine expression were observed after knocking down CXCR5 in LPS-challenged primary microglial cultures; this knockdown also partially reversed LPS-induced up-regulation of phosphorylated NF-κB and STAT3. The p38MAPK agonist P79350 partially reversed the effects of CXCR5 knockdown in microglial cultures.

Conclusions

CXCR5 may act via p38MAPK/NF-κB/STAT3 signaling to inhibit hippocampal autophagy during sepsis and thereby contribute to cognitive dysfunction. Down-regulating CXCR5 can restore autophagy and mitigate the proinflammatory microenvironment in the hippocampus.

Structural and quantitative alterations of gut microbiota in experimental small bowel obstruction

OBJECTIVE

To investigate structural and quantitative alterations of gut microbiota in an experimental model of small bowel obstruction.

METHOD

A rat model of small bowel obstruction was established by using a polyvinyl chloride ring surgically placed surrounding the terminal ileum. The alterations of gut microbiota were studied after intestinal obstruction. Intraluminal fecal samples proximal to the obstruction were collected at different time points (24, 48 and 72 hours after obstruction) and analyzed by 16s rDNA high-throughput sequencing technology and quantitative PCR (qPCR) for target bacterial groups. Furthermore, intestinal claudin-1 mRNA expression was examined by real-time polymerase chain reaction analysis, and serum sIgA, IFABP and TFF3 levels were determined by enzyme-linked immunosorbent assay.

RESULTS

Small bowel obstruction led to significant bacterial overgrowth and profound alterations in gut microbiota composition and diversity. At the phylum level, the 16S rDNA sequences showed a marked decrease in the relative abundance of Firmicutes and increased abundance of Proteobacteria, Verrucomicrobia and Bacteroidetes. The qPCR analysis showed the absolute quantity of total bacteria increased significantly within 24 hours but did not change distinctly from 24 to 72 hours. Further indicators of intestinal mucosa damage and were observed as claudin-1 gene expression, sIgA and TFF3 levels decreased and IFABP level increased with prolonged obstruction.

CONCLUSION

Small bowel obstruction can cause significant structural and quantitative alterations of gut microbiota and induce disruption of gut mucosa barrier.

Characterizing Brain Tumor Regions Using Texture Analysis in Magnetic Resonance Imaging

Purpose

To extract texture features from magnetic resonance imaging (MRI) scans of patients with brain tumors and use them to train a classification model for supporting an early diagnosis.

Methods

Two groups of regions (control and tumor) were selected from MRI scans of 40 patients with meningioma or glioma. These regions were analyzed to obtain texture features. Statistical analysis was conducted using SPSS (version 20.0), including the Shapiro-Wilk test and Wilcoxon signed-rank test, which were used to test significant differences in each feature between the tumor and healthy regions. T-distributed stochastic neighbor embedding (t-SNE) was used to visualize the data distribution so as to avoid tumor selection bias. The Gini impurity index in random forests (RFs) was used to select the top five out of all features. Based on the five features, three classification models were built respectively with three machine learning classifiers: RF, support vector machine (SVM), and back propagation (BP) neural network.

Results

Sixteen of the 25 features were significantly different between the tumor and healthy areas. Through the Gini impurity index in RFs, standard deviation, first-order moment, variance, third-order absolute moment, and third-order central moment were selected to build the classification model. The classification model trained using the SVM classifier achieved the best performance, with sensitivity, specificity, and area under the curve of 94.04%, 92.3%, and 0.932, respectively.

Conclusion

Texture analysis with an SVM classifier can help differentiate between brain tumor and healthy areas with high speed and accuracy, which would facilitate its clinical application.

Magnolol Suppresses Pancreatic Cancer Development In Vivo and In Vitro via Negatively Regulating TGF-β/Smad Signaling

Magnolol, a hydroxylated biphenyl extracted from Magnolia officinalis, has recently drawn attention due to its anticancer potential. The present study was aimed to explore the effects of Magnolol on restraining the proliferation, migration and invasion of pancreatic cancer in vivo and in vitro. Magnolol showed significant anti-growth effect in an orthotopic xenograft nude mouse model, and immunohistochemical staining of the xenografts revealed that Magnolol suppressed vimentin expression and facilitated E-cadherin expression. The cytoactive detection using CCK-8 assay showed Magnolol inhibited PANC-1 and AsPC-1 concentration-dependently. Scratch healing assay and the Transwell invasion assay proved the inhibiting effects of Magnolol on cellular migration and invasion at a non-cytotoxic concentration. Western blot and rt-PCR showed that Magnolol suppressed epithelial-mesenchymal-transition by increasing the expression level of E-cadherin and decreasing those of N-cadherin and vimentin. Magnolol suppressed the TGF-β/Smad pathway by negatively regulating phosphorylation of Smad2/3. Moreover, TGF-β1 impaired the antitumor effects of Magnolol in vivo. These results demonstrated that Magnolol can inhibit proliferation, migration and invasion in vivo and in vitro by suppressing the TGF-β signal pathway and EMT. Magnolol could be a hopeful therapeutic drug for pancreatic malignancy.

Application of Artificial Intelligence in Dentistry

Artificial intelligence (AI) is a technology that utilizes machines to mimic intelligent human behavior. To appreciate human-technology interaction in the clinical setting, augmented intelligence has been proposed as a cognitive extension of AI in health care, emphasizing its assistive and supplementary role to medical professionals. While truly autonomous medical robotic systems are still beyond reach, the virtual component of AI, known as software-type algorithms, is the main component used in dentistry. Because of their powerful capabilities in data analysis, these virtual algorithms are expected to improve the accuracy and efficacy of dental diagnosis, provide visualized anatomic guidance for treatment, simulate and evaluate prospective results, and project the occurrence and prognosis of oral diseases. Potential obstacles in contemporary algorithms that prevent routine implementation of AI include the lack of data curation, sharing, and readability; the inability to illustrate the inner decision-making process; the insufficient power of classical computing; and the neglect of ethical principles in the design of AI frameworks. It is necessary to maintain a proactive attitude toward AI to ensure its affirmative development and promote human-technology rapport to revolutionize dental practice. The present review outlines the progress and potential dental applications of AI in medical-aided diagnosis, treatment, and disease prediction and discusses their data limitations, interpretability, computing power, and ethical considerations, as well as their impact on dentists, with the objective of creating a backdrop for future research in this rapidly expanding arena.

Modeling of ultraviolet omni-directional multiple scattering channel based on Monte Carlo method

Existing studies of ultraviolet (UV) communication channel models focus mainly on point-to-point scenarios. To analyze UV channel characteristics in omni-directional scenarios, we propose a multiple scattering omni-directional channel model based on the Monte Carlo method in this Letter, where we assume that the receiver can be anywhere in a certain area and all the receivers point to the vertical axis of the transmitter. Meanwhile, we validate the proposed model in comparison to the existing point-to-point Monte Carlo simulation model. Simulation results demonstrate that a single scattering model is not applicable to omni-directional analysis due to the difference in path loss between the single scattering model and the multiple scattering model. Furthermore, the transceiver configurations can affect the coverage area of the UV omni-directional communication system significantly. This work presents a new way to obtain UV path loss distribution and provides guidelines for the omni-directional communication system design.

M2‑TAM subsets altered by lactic acid promote T‑cell apoptosis through the PD‑L1/PD‑1 pathway

The aim of the study was to investigate the effects of lactic acid on the phenotypic polarization and immune function of macrophages. The human monocyte/macrophage cell line, THP-1, was selected and treated with lactic acid. Immunofluorescence staining, laser confocal microscopy, reverse-transcription polymerase chain reaction (RT-PCR), western blot, siRNA, and ELISA analyses were used to observe changes in the levels of cluster of differentiation (CD)68, CD163, hypoxia inducible factor (HIF)-1α, and programmed death ligand-1 (PD-L1) as well as those of cytokines, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-12, and IL-10. THP-1 macrophages and T cells were co-cultured in vitro to observe the changes in proliferation and apoptosis of T cells. The results showed that, lactic acid (15 mmol/l) significantly upregulated the expression of the macrophage M₂ marker CD163 (P<0.05), cytokines, IFN-γ and IL-10, secreted by M₂-tumor-associated macrophages (TAM, P<0.05), and HIF-1α and PD-L1 (P<0.05), and downregulated the expression of cytokines, TNF-α and IL-12, secreted by M₁-TAM (P<0.05). Redistribution of M₂-TAM subsets and PD-L1 expression was reversed after further transfection of THP-1 cells with HIF-1α siRNA (P<0.05). After co-culturing, T-cell proliferation was inhibited and apoptosis was promoted. In summary, modulation of lactic acid level can redistribute M₂-TAM subsets and upregulate PD-L1 to assist tumor immune escape. The HIF-1α signaling pathway may participate in this process, revealing that macrophages, as ‘checkpoints’ in organisms, are links that connect the immune status and tumor evolution, and can be used as a target in tumor treatment.

The analysis of differential diagnosis of benign and malignant thyroid nodules based on ultrasound reports

Background

Thyroid cancer is a common endocrine tumor, the incidence of which is increasing each year. Early diagnosis and treatment can effectively prevent thyroid cancer. This article uses Chinese's ultrasound reports to determine the value of early diagnosis.

Methods

The clinical data center of the First Affiliated Hospital of Nanjing Medical University was screened for patients diagnosed with a thyroid nodule, who had undergone a thyroid function test, ultrasound records and pathological assessment. A total of 811 patients with a total of 1,290 pathologically confirmed nodules (506 benign and 784 malignant) were enrolled. Logistic regression was used to analyze the variables that significantly affected malignant nodules. The sensitivity and specificity of ultrasound thyroid imaging-reporting and data system (TI-RADS) classification results for benign and malignant tumors were calculated.

Results

The age of the patients had a very significant difference in the classification of benign and malignant nodules (P<0.001), and the marital status was significantly different (P<0.05). Gender and medical insurance had no significant effect (P>0.05). Thyroglobulin (TG), free thyroxine (FT4), and free triiodothyronine (FT3) had significant effects (P=0.003) on the incidence of malignant nodules in patients, while thyroid-stimulating hormone (TSH) had no significant effect (P>0.05). Ultrasound analysis showed a Youden's index of 78.97%, a positive predictive value of 93.20%, and a negative predicted value of 84.10% at the most excellent classification effect. The sensitivity was 89.0%, the specificity was 89.9%; much greater than the classification model based on the thyroid function test (sensitivity =80.6%, specificity =55.8%).

Conclusions

The present study verifies the effectiveness of using TI-RADS classification for diagnosis of benign and malignant thyroid nodules, and explores the use of new analysis methods for clinical data. To reduce dependence on the doctors, ultrasound image data and clinical phenotypic data can be further used to assist clinical decision making.

MicroRNA-4516 suppresses pancreatic cancer development via negatively regulating orthodenticle homeobox 1

Pancreatic cancer remains one of the most lethal human cancers without efficient therapeutic strategy. MicoRNAs (miRNAs) are a group of small non-coding RNAs involved in multiple biological processes including tumor development and progression. In this study, we investigated the expression and function of miR-4516 in pancreatic cancer. MiR-4516 was low-expressed in pancreatic cancer tissues and cell lines. Overexpression of miR-4516 inhibited pancreatic cancer cell proliferation, migration and invasion, while promoted cell apoptosis in vitro. Further, overexpression of miR-4516 suppressed xenograft pancreatic tumor growth in vivo. Bioinformatics analysis was performed and miR-4516 was predicted to negatively regulate orthodenticle homeobox 1 (OTX1) expression by binding to its 3'-UTR. Consistently, OTX1 was highly expressed in pancreatic cancer tissues and cell lines. Knockdown of OTX1 expression suppressed pancreatic cancer cell migration and invasion, with down-regulated MMP2 and MMP9 expression. Moreover, we demonstrated that miR-4516 regulated pancreatic cancer cell growth, migration, invasion and apoptosis via targeting OTX1. Overexpression of OTX1 could partially abrogate the inhibitory effect of miR-4516. Taken together, we conclude that miR-4516 could function as a tumor suppressor via targeting OTX1. These findings suggest that miR-4516/OTX1 axis might be a novel therapeutic target for miRNA-based therapy for pancreatic cancer patients.

Breed difference and regulatory role of CRTC3 in porcine intramuscular adipocyte

The cAMP responsive element binding protein (CREB)-regulated transcription coactivator 3 (CRTC3) is a member of the CRTC protein family and plays an important role in energy metabolism. The aim of this study was to determine if the expression of porcine CRTC3 is related to intramuscular fat (IMF) deposition and meat quality in Heigai pigs (a local fatty breed in China) and Duroc × Landrace × Yorkshire (DLY) pigs (a lean crossbred pig widely cultured in China). In addition, the effect of ectopic expression of CRTC3 on gene expression in porcine IMF adipocytes was also examined. Our results showed that Heigai pigs had lower lean percentage, thicker back fat thickness and smaller loin muscle area than DLY pigs. Compared with DLY pigs, Heigai pigs had higher marbling scores, better meat color and higher IMF contents and triglyceride concentrations. Higher levels of oxidative metabolic enzyme and expression of the slow oxidative muscle fiber-related genes were observed in longissimus dorsi muscle and psoas major muscle (P < 0.05) from Heigai pigs. Notably, CRTC3 and adipocyte-specific marker genes were highly expressed in muscle tissues of Heigai pigs. The expression of lipolysis-related genes ATGL and HSL were lower in Heigai muscles. Moreover, forced expression of CRTC3 promoted lipid accumulation and increased the expression of PPARγ, C/EBPα, leptin and FABP4 (P < 0.05), whereas it decreased the expression of ATGL and HSL in IMF adipocytes. These results suggest that CRTC3 expression is associated with lipid accumulation and IMF deposition in pigs.

Association between type 2 diabetes and cancer incidence in China: data in hospitalized patients from 2006 to 2013

Background

Evidence of a role for type 2 diabetes in overall cancer risk is limited in ethnic Chinese populations. We therefore investigated whether there is an association between diabetes and cancer incidence.

Methods

All type 2 diabetes and cancer hospitalized patients from the First Affiliated Hospital of Nanjing Medical University between 2006.01 and 2013.12 were eligible for the study. Our research used healthcare information technology and statistical methods to analyze the clinical data of hospitalized patients and explored the relationship between diabetes and cancer. Participants with fasting glucose ≥126 mg/dL, or taking hypoglycemic medications, were classed as having type 2 diabetes. Cancer incidence was established through regular follow-up interviews and medical records. Data were entered into Excel and a database was set up with ACCESS software. Clinical information such as demographics like gender, age, occupation, marriage, insurance and etc., diagnoses, and prescription record were chosen and analyzed. SPSS software was also used for statistical analysis.

Results

The number of patients with both diabetes and cancer rose from 220 cases in 2006 to 1,623 cases in 2013. The proportion of cancer patients with diabetes has also increased every year. Younger participants (aged ≤50 years) with diabetes had a greater risk of all cancers [P<0.005, odds ratio (OR) >3.4]. And cancer patients with diabetes occurs more frequently in male patients than in female patients, especially since 2009 the proportion has increased more evidently (P<0.005, OR >1.4). Further analysis showed that the level of blood lipid in patients with diabetes mellitus and cancer was significantly different from that in patients with simple diabetes mellitus (P<0.05).

Conclusions

Our results clearly demonstrate a positive association between diabetes and cancer, especially in younger individuals aged less than 50 years. This finding highlights a need for greater awareness among public health workers and physicians of the importance of effective control of diabetes in the younger population.

Automated detection of cardiovascular disease by electrocardiogram signal analysis: a deep learning system

Automated electrocardiogram (ECG) diagnosis could be a useful aid for clinical use. We applied a deep learning method to build a system for automated detection and classification of ECG signals. We first trained a convolutional neural network (CNN) to detect cardiovascular disease in ECG signals using a training data set of 259,789 ECG signals collected from the cardiac function rooms of a tertiary care hospital. The CNN classification was validated using an independent test data set of 18,018 ECG signals. The labels used covered >90% of clinical diagnoses. The system grouped ECGs into 18 classifications-17 different types of abnormalities and normal ECG. The overall accuracy of the model was tested and found to be close to 95%; the accuracy for diagnosis of normal rhythm/atrial fibrillation was 99.15%. The proposed CNN model could help reduce misdiagnosis and missed diagnosis in primary care settings and also improve efficiency and save manpower cost for large general hospitals.

[Curative effect comparison for fixation of fibula or not for the treatment of middle and lower 1/3 fractures of tibia and fibula with intramedullary nail]

OBJECTIVE

To analyze and compare the effect of fibular plate fixation on the treatment of tibial and fibular fractures.

METHODS

From July 2016 to September 2018, 65 cases of middle and lower 1/3 fractures of tibia and fibula were retrospectively analyzed, including 46 males and 19 females, aged 22 to 61 years old. There were 37 cases in fibular fixation group (27 males and 10 females) , 28 cases in fibular non fixation group (19 males and 9 females) . By comparing the operation time, intraoperative bleeding, fracture healing time, ankle rotation and valgus angle, postoperative complications, last follow-up ankle mobility and Baird Jackson score, the operation effect was evaluated.

RESULTS

All patients were followed up for 12 to 16 months with an average of (13.67±1.23) months. There were 3 cases of infection of the fibular incision, all of which healed in the first stage without incision dehiscence, and 4 cases of delayed union without nonunion. In the fibula fixation group, the external rotation of ankle joint increased (7.16±1.36) ° and the valgus angle increased (3.35±1.16) °; while in the non fixation group, the external rotation increased (10.25±1.58) ° and the valgus angle increased (6.46±1.23) ° with statistical significance (P<0.05) . There was no significant difference in ankle joint activity, fracture healing time and complication rate between two groups (P>0.05) ; there was significant difference in operation time, intraoperative hemorrhage and Baird Jackson score at the latest follow-up (P<0.05) .

CONCLUSION

The fibular plate fixation can prevent the ankle joint from malrotation and valgus deformity, and can obtain better surgical effect and functional prognosis.

Modeling of ultraviolet scattering propagation and its applicability analysis: erratum

This erratum provides corrections to Fig. 1, Eqs. (1b) and (6b), and Case (e) of Opt. Lett.44, 4953 (2019)OPLEDP0146-959210.1364/OL.44.004953.

Modeling of ultraviolet scattering propagation and its applicability analysis

The existing ultraviolet (UV) single scattering models do not incorporate the applicability of transceiver geometry, which makes them have certain errors even in short-range cases. To solve this issue, we propose a single scattering model in this Letter, which is suitable for the case where the transceiver field of view is above ground. This meets the requirements of general UV communication. For tractable analysis, we utilize the number of intersections between special rays on a transceiver cone to classify communication scenarios. Calculation results show that when the transceiver elevation angle exceeds certain values, the path loss difference between the single scattering model and Monte Carlo simulation model increases rapidly, which implies that single scattering approximation is not applicable to these conditions even in short-range cases. This work presents a new way to obtain the path loss of the UV channel and provides guidelines for experimental system design.

Prevalence of hypertension, diabetes, and dyslipidemia, and their additive effects on myocardial infarction and stroke: a cross-sectional study in Nanjing, China

Background

This study aimed to investigate the prevalence and risk factors for hypertension, diabetes, and dyslipidemia, and to evaluate their additive effects on myocardial infarction (MI) and stroke in Nanjing in East China.

Methods

A multistage, stratified random cluster sampling method was used to select representative participants. All eligible participants completed questionnaires, physical measurements, and blood tests. Multivariable and univariable logistic regression analyses were used to identify associated risk factors and evaluate additive effects on cardiovascular events, respectively.

Results

Hypertension was the most prevalent chronic disease among 11,036 participants enrolled (18.5%), followed by dyslipidemia (8.3%) and diabetes (6.0%). The prevalence of hypertension was higher in men than in women while no sex-related difference was observed in the prevalence of diabetes and dyslipidemia. Older age and higher body mass index were risk factors for all three diseases. Sex, central obesity, smoking, number of family members, salt intake, and family history of hypertension were associated with hypertension; central obesity, smoking, alcohol assumption, and family history of diabetes correlated with diabetes; and female sex, higher education, and alcohol assumption were risk factors for dyslipidemia. Hypertension complicated with dyslipidemia conferred more risk of MI and stroke than independent effects. Diabetes also contributed to risk based on hypertension or dyslipidemia.

Conclusions

The burden of hypertension and diabetes has stopped increasing. However, total cholesterol (TC) concentration in the population has not been well controlled. A more comprehensive approach to managing dyslipidemia, hypertension, and diabetes needs to be developed, especially for individuals with multiple cardiovascular risk factors.

Awareness of interventional radiology before professional training and outcome measurement of an interventional radiology curriculum: a survey of third-year undergraduates in a Chinese medical college

PURPOSE

We aimed to assess the awareness of interventional radiology (IR) among medical students, and to evaluate an IR curriculum in China.

METHODS

Between the academic years of 2008 and 2016, 517 third-year medical undergraduates, who successfully applied for an IR curriculum, received a survey related to IR before taking the course. Final exams were conducted after the IR course.

RESULTS

A total of 355 of the 517 medical students (68.67%) answered the survey; 81.97% of the respondents had heard of IR, 40.28% believed they understood what IR is, but no one was familiar with IR. The four most common pathways for medical students to acquire IR knowledge were via new media (e.g., internet, apps) (42.82%), a teacher/textbook (36.90%), a friend (32.68%), and traditional media (26.48%). The most familiar interventional procedures to respondents were percutaneous transluminal coronary angioplasty (PTCA, 78.59%) and transcatheter arterial chemoembolization (TACE, 44.51%). The results of the survey also indicated that 68.45% of the respondents wanted to learn about IR, but that only 47 male students (13.24%) considered a career in IR. The pass rate of the IR course final exam was 87.04%, i.e., 87.04% of the students successfully completed the course and final exam.

CONCLUSION

The IR knowledge of medical students in China is worse than that of European medical students. We suggest that providing medical students with general information about IR in the media, as well as via teaching and textbooks in medical school, requires prompt and significant attention. An IR curriculum is beneficial for increasing the IR knowledge of undergraduates.

Association of treRNA with lymphatic metastasis and poor prognosis in colorectal cancer

BACKGROUND

There is an emerging concept that long noncoding RNAs (lncRNAs) are involved in tumorigenesis and could be used as biomarkers. However, the clinical significance of human translational regulatory lncRNA (treRNA) in CRC is largely unknown. The purpose of the study was to examine the value of treRNA as a biomarker in colorectal cancer patients.

METHODS

treRNA expression was studied in 78 tumors and adjacent tissues in colorectal cancer patients using quantitative real-time PCR.

RESULTS

treRNA was found to be highly expressed in colorectal cancer tissue in contrast to adjacent tissue (P<0.05). Moreover, positive correlation was found between high treRNA expression and lymph node metastasis (P<0.05). Patients with high treRNA expression were found with compromised overall survival (OS) compared with the low treRNA expression group, according to Kaplan-Meier analysis. Moreover, Cox regression model analysis suggested high expression of treRNA as an independent poor prognostic factor for CRC patients.

CONCLUSIONS

Overexpression of treRNA could be associated with lymphatic metastasis and compromised survival of CRC. treRNA has potential to be used as a new biomarker for CRC lymphatic metastasis and survival.

PD-L1 expression in colon cancer and its relationship with clinical prognosis

OBJECTIVES

PD-L1 is closely associated with tumorigenesis and development. However, expression of PD-L1 protein in colon cancer and its significance in clinical prognosis are yet to be fully clarified. This study examined the relationship between PD-L1 expression with the clinicopathological features and prognosis of colon cancer.

METHODS

This study collected cases of primary colon cancer that had not undergone preoperative chemotherapy and had complete clinical data. Eighty specimens each were obtained from cancer tissues, paracancer tissues, and normal tissues. Immunohistochemical assays were performed to detect PD-L1 expression. The relationship between PD-L1 expression and clinicopathologic features was compared. This was combined with follow-up data, to analyze the relationship between positive or negative PD-L1 expression and prognosis.

RESULTS

Among 80 tumor specimens, 22 cases (27.5%) showed high PD-L1 expression, 24 cases (30.0%) showed moderate expression, and 34 cases (42.5%) showed weak or no PD-L1 staining. High expression of PD-L1 in paracancer and normal tissues were 9 (11.3%) and 5 (6.3%) cases, respectively. PD-L1 expression was also positively correlated with TNM stage (P=0.009), lymph node metastasis (P=0.000), distant metastasis (P=0.014). There were no significant differences in different age, gender, histologic grade, and tumor size groups (P>0.05). Regression analysis revealed that poorer tumor differentiation, later TNM stages, presence of lymph node metastasis, and positive PD-L1 expression were factors that influenced prognosis. Multivariate analysis indicated that late TNM stage and positive PD-L1 expression were independent risk factors that influenced prognosis.

CONCLUSION

PD-L1 expression is significantly elevated in colon cancer tissues, and is closely associated with lymph node metastasis, prognosis, and survival.

Bladder regeneration in a canine model using a bladder acellular matrix loaded with a collagen-binding bFGF

Bladder reconstruction remains challenging for urological surgery due to lack of suitable regenerative scaffolds. In a previous study, we had used a collagen-binding basic fibroblast growth factor (CBD-bFGF) to bind bFGF to the collagen scaffold, which could promote bladder regeneration in rats. However, the limited graft size in rodent models cannot provide enough evidence to demonstrate the repair capabilities of this method for severely damaged bladders in humans or large animals. In this study, the CBD-bFGF was used to activate a bladder acellular matrix (BAM) scaffold, and the CBD-bFGF/BAM functional scaffold was assessed in a canine model with a large segment defect (half of the entire bladder was resected). The results demonstrated that the functional biomaterials could promote bladder smooth muscle, vascular, and nerve regeneration and improve the function of neobladders. Thus, the CBD-bFGF/BAM functional scaffold may be a promising biomaterial for bladder reconstruction.

[Expression and clinical significance of long non-coding RNA CCAT1 in gastric cancer]

Objective: To investigate the expression and clinical significance of long non-coding RNA colon cancer associated transcript-1 (CCAT1) in gastric cancer (GC), and to further explore the effect of CCAT1 on cell proliferation of GC. Methods: The mRNA expressions of CCAT1 in GC tissues and matched adjacent normal tissues from 62 patients who received resection for gastric carcinoma between January 2013 and May 2015 in Nanjing Medical University Affiliated Wuxi Second Hospital and expressions in GC cell lines were assessed by quantitative real-time PCR (qRT-PCR). The clinical significance of CCAT1 expression was then analyzed. The expressions of CCAT1 in MGC-803 and SGC-7901 cells were inhibited by small interfering RNA (siRNA) transfection. The effect of CCAT1 on cell proliferation was studied by cell counting kit (CCK)-8 assay. Results: The expressions of CCAT1 mRNA in GC tissues were significantly higher than in the normal tissues (3.39±2.37 vs 1.28±0.74, P<0.05). Compared with immortalized human gastric epithelial cell line (GES-1), the expressions of CCAT1 mRNA were significantly higher in GC cell lines MGC-803 and SGC-7901 (3.07±0.69, 2.23±0.32 vs 1.01±0.12, both P<0.05). Besides, the expression of CCAT1 varied significantly among patients with different TNM stage, depth of invasion, and lymph node metastasis (χ(2) =5.199, 5.395, 9.239, all P<0.05). The results of CCK-8 assay showed that down-regulation of CCAT1 in MGC-803 and SGC-7901 cells significantly inhibited the cell proliferation (both P<0.05). Conclusions: CCAT1 is up-regulated in GC and may be significantly correlated with the progression of GC. Decreased expression of CCAT1 can suppress the proliferation of GC cells. CCAT1 might be used as a novel target for GC early diagnosis and treatment.

Conversion of epithelial-to-mesenchymal transition to mesenchymal-to-epithelial transition is mediated by oxygen concentration in pancreatic cancer cells

Tumor metastasis is accompanied by a two-stage process of epithelial-to-mesenchymal transition (EMT) and mesenchymal-to-epithelial transition (MET). Currently, the exact mechanisms underlying EMT-MET conversion are unclear. In the present study, the mechanisms by which primary sites (hypoxic) and homing sites (normoxic or hyperoxic) participate in EMT-MET conversion were evaluated. Pancreatic cancer cells were grown under different oxygenation conditions. Cell morphology and epithelial (E)-cadherin and vimentin expression were examined. Transwell chambers were used to examine tumor invasiveness, and scratch assays were performed to examine cell migration. Reverse transcription-polymerase chain reaction and western blot analysis were used to quantitate the mRNA and protein expression of E-cadherin, vimentin, Snail and hypoxia-inducible factor (HIF)-1α. BxPc-3 and Panc-1 cells grown under hypoxic conditions demonstrated increased partial EMT, reduced E-cadherin expression, and increased vimentin expression, compared with cells grown under normoxic or hyperoxic conditions. Cells grown under hypoxic conditions also indicated increased migration and invasiveness. HIF-1α mRNA and protein expression was increased in cells grown under hypoxic conditions. These changes were reversed when a specific inhibitor of the HIF-1α receptor was used to block HIF-1α signaling. Differences in oxygen concentration at primary sites and homing sites are important in the EMT-MET process, and the underlying mechanism may involve HIF-1α-Snail signaling.