Study of High-Transverse-Momentum Higgs Boson Production in Association with a Vector Boson in the qqbb Final State with the ATLAS Detector

This Letter presents the first study of Higgs boson production in association with a vector boson (V=W or Z) in the fully hadronic qqbb final state using data recorded by the ATLAS detector at the LHC in proton-proton collisions at sqrt[s]=13  TeV and corresponding to an integrated luminosity of 137  fb^{-1}. The vector bosons and Higgs bosons are each reconstructed as large-radius jets and tagged using jet substructure techniques. Dedicated tagging algorithms exploiting b-tagging properties are used to identify jets consistent with Higgs bosons decaying into bb[over ¯]. Dominant backgrounds from multijet production are determined directly from the data, and a likelihood fit to the jet mass distribution of Higgs boson candidates is used to extract the number of signal events. The VH production cross section is measured inclusively and differentially in several ranges of Higgs boson transverse momentum: 250-450, 450-650, and greater than 650 GeV. The inclusive signal yield relative to the standard model expectation is observed to be μ=1.4_{-0.9}^{+1.0} and the corresponding cross section is 3.1±1.3(stat)_{-1.4}^{+1.8}(syst)  pb.

Measurement of the Centrality Dependence of the Dijet Yield in p+Pb Collisions at sqrt[s_{NN}]=8.16 TeV with the ATLAS Detector

ATLAS measured the centrality dependence of the dijet yield using 165  nb^{-1} of p+Pb data collected at sqrt[s_{NN}]=8.16  TeV in 2016. The event centrality, which reflects the p+Pb impact parameter, is characterized by the total transverse energy registered in the Pb-going side of the forward calorimeter. The central-to-peripheral ratio of the scaled dijet yields, R_{CP}, is evaluated, and the results are presented as a function of variables that reflect the kinematics of the initial hard parton scattering process. The R_{CP} shows a scaling with the Bjorken x of the parton originating from the proton, x_{p}, while no such trend is observed as a function of x_{Pb}. This analysis provides unique input to understanding the role of small proton spatial configurations in p+Pb collisions by covering parton momentum fractions from the valence region down to x_{p}∼10^{-3} and x_{Pb}∼4×10^{-4}.

Distinguishment between high-grade gliomas and solitary brain metastases in peritumoural oedema: quantitative analysis using synthetic MRI at 3 T

AIM

To investigate the efficacy of synthetic magnetic resonance imaging (MRI) in distinguishing high-grade gliomas (HGGs) from solitary brain metastases (SBMs) in peritumoural oedema.

MATERIALS AND METHODS

Thirty-five patients with HGGs and 25 patients with SBMs were recruited and scanned using synthetic MRI using a 3 T scanner. Two radiologists measured synthetic MRI-derived relaxation values independently (T1, T2, proton density [PD]) in the peritumoural oedema, which was used to generate quantitative metrics before (T1native, T2native, and PDnative) and after (T1post, T2post, and PDpost) contrast agent injection. Student's t-test or the Mann-Whitney U-test was performed to detect statistically significant differences in the aforementioned metrics in peritumoural oedema between HGGs and SBMs. The receiver operating characteristic (ROC) curves were plotted to evaluate the efficacy of each metric in distinguishing the two groups, and the areas under the curves (AUCs) were compared pairwise by performing the Delong test.

RESULTS

The mean T1native, T2native, and T1post values in the peritumoural oedema of HGGs were significantly lower compared with SBMs (all p<0.05). The T1post value had a higher AUC (0.843) in differentiating HGGs and SBMs than all other individual metrics (all p<0.05). The combined T1native, T2native, and T1post model had the best distinguishing performance with an AUC, sensitivity, and specificity of 0.987, 94.3%, and 100%, respectively.

CONCLUSIONS

Synthetic MRI may be a potential supplement to the preoperative diagnosis of HGGs and SBMs in clinical practice, as the synthetic MRI-derived tri-parametric model in the peritumoural oedema showed significantly improved diagnostic performance in distinguishing HGGs from SBMs.

Steady state engineering of a two-level system by the mixed-state inverse engineering scheme

The mixed-state inverse engineering scheme is a control scheme used for engineering the quantum state of a driven open quantum system from an initial steady state to a final steady state. In this paper, we present an analytical study of this scheme applied to the driven two-level model coupled to a heat reservoir. Typically, when the purity of the quantum state varies, incoherent control techniques are required for mixed-state engineering. However, we show that for both Markovian and non-Markovian dynamics, coherent control protocols can transfer the quantum state into the target state. This simplification comes at a cost, as the evolution of the quantum state must be limited to restricted conditions, resulting in special trajectories in its Hilbert space that connect the initial and target states.

Mendelian Randomization Analysis Reveals Causal Factors behind Alzheimer's Disease Risk: Evidence, Opportunities, and Challenges

Alzheimer's disease and its comorbidities pose a heavy disease burden globally, and its treatment remains a major challenge. Identifying the protective and risk factors for Alzheimer's disease, as well as its possible underlying molecular processes, can facilitate the development of interventions that can slow its progression. Observational studies and randomized controlled trials have provided some evidence regarding potential risk factors for Alzheimer's disease; however, the results of these studies vary. Mendelian randomization is a novel epidemiological methodology primarily used to infer causal relationships between exposures and outcomes. Many Mendelian randomization studies have identified potential causal relationships between Alzheimer's disease and certain diseases, lifestyle habits, and biological exposures, thus providing valuable data for further mechanistic studies and the development and implementation of clinical prevention strategies. However, the results and data from Mendelian randomization studies must be interpreted based on comprehensive evidence. Moreover, the existing Mendelian randomization studies on the epidemiology of Alzheimer's disease have some limitations that are worth exploring. Therefore, the aim of this review was to summarize the available evidence on the potential protective and risk factors for Alzheimer's disease by assessing published Mendelian randomization studies on Alzheimer's disease, and to provide new perspectives on the etiology of Alzheimer's disease.

Combined Measurement of the Higgs Boson Mass from the H→γγ and H→ZZ^{*}→4ℓ Decay Channels with the ATLAS Detector Using sqrt[s]=7, 8, and 13 TeV pp Collision Data

A measurement of the mass of the Higgs boson combining the H→ZZ^{*}→4ℓ and H→γγ decay channels is presented. The result is based on 140  fb^{-1} of proton-proton collision data collected by the ATLAS detector during LHC run 2 at a center-of-mass energy of 13 TeV combined with the run 1 ATLAS mass measurement, performed at center-of-mass energies of 7 and 8 TeV, yielding a Higgs boson mass of 125.11±0.09(stat)±0.06(syst)=125.11±0.11  GeV. This corresponds to a 0.09% precision achieved on this fundamental parameter of the Standard Model of particle physics.

Exosomal miR-200c and miR-141 as cerebrospinal fluid biopsy biomarkers for the response to chemotherapy in primary central nervous system lymphoma

BACKGROUND

To improve early diagnosis and chemotherapy efficacy monitoring in primary central nervous system lymphoma (PCNSL), cerebrospinal fluid (CSF) exosomal microRNA (miRNA) studies were performed.

METHOD

Small RNA sequencing was performed to identify candidate exosomal miRNAs as CSF biopsy biomarkers from two patients with de novo PCNSL and two patients in remission after chemotherapy. miR-200c and miR-141 expression in CSF exosomes was further validated using relative quantitative real-time polymerase chain reaction in patients with PCNSL (n = 20), patients with other neurological diseases (n = 10), and normal subjects (n = 10). Receiver operating characteristic (ROC) curve analyses of miR-200c and miR-141 in the diagnosis and prediction of chemotherapy efficacy in PCNSL were performed in patients treated with methotrexate. Additionally, bioinformatics tools were utilized to predict the potential targets of miR-200c and miR-141.

RESULTS

Exosomal miR-200c and miR-141 levels in CSF from patients with PCNSL were significantly lower than those in control subjects. Importantly, miR-200c and miR-141 were upregulated in patients with PCNSL after chemotherapy (P = 0.002). There was a significant correlation between the levels of miR-141 and IL-10 in CSF (P = 0.04). The combination of miR-200c and miR-141 yielded an area under the ROC curve of 0.761 for distinguishing PCNSL with sensitivity and specificity of 60.0% and 96.7%, respectively. The potential target genes of miR-200c and miR-141 in PCNSL included ATP1B3, DYNC1H1, MATR3, NUCKS1, ZNF638, NUDT4, RCN2, GNPDA1, ZBTB38, and DOLK.

CONCLUSION

Collectively, miR-200c and miR-141 are likely to be upregulated in CSF exosomes after chemotherapy in patients with PCNSL, highlighting their potential as reliable liquid biopsy biomarkers for PCNSL diagnosis and chemotherapy efficacy monitoring.

[Acceptance of pre-exposure prophylaxis and post-exposure prophylaxis against HIV and related factors in men who have sex with men in Shandong Province]

Objectives: To understand the use of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) and related factors in men who have sex with men (MSM) in Shandong Province, and provide reference for the promotion of PrEP and PEP in MSM. Methods: From April to July in 2022, MSM were recruited from 7 sentinel surveillance sites in Shandong Province for a questionnaire survey, and the sample size of each city site was 400. The information about sociodemographic characteristics, sexual behaviors, the uses of PrEP and PEP and others were collected from the MSM, and blood samples were collected from them for HIV and syphilis testing. Results: A total of 2 815 MSM were investigated, the majority of them were aged less than 30 years (55.7%, 1 569/2 815), unmarried (68.6%, 1 931/2 815) and had education background of college and above (56.5%, 1 590/2 815). Only 9.2% (258/2 815) had used PrEP and 10.8% (305/2 815) had used PEP. Multivariate logistic regression showed that factors associated with high likelihood of PrEP use in MSM included age ≤30 years (aOR=4.04, 95%CI:1.25-13.01), self-perceived lower risk of HIV infection (aOR=1.76, 95%CI:1.16-2.68), group sex and commercial sex in the past six months (aOR=1.51, 95%CI: 1.10-2.09; aOR=1.69, 95%CI: 1.16-2.47), new-type drug use (aOR=1.53, 95%CI: 1.11-2.11), receiving peer education (aOR=1.56, 95%CI: 1.03-2.37), other people using PrEP (aOR=3.29, 95%CI: 2.48-4.36), and being HIV negative (aOR=8.40, 95%CI:1.12-63.12). Factor associated with low likelihood of PrEP use in MSM was anal sex with casual partner (aOR=0.67, 95%CI:0.49-0.90). Factors associated with high likelihood of PEP use in MSM included age under 50 years (≤30 years old: aOR=2.41, 95%CI:1.02-5.69; 31-49 years old: aOR=3.33, 95%CI:1.42-7.85), no self-perceived risk for HIV infection (aOR=1.87, 95%CI:1.12-3.11), group sex in the past six months (aOR=1.68, 95%CI:1.23-2.29), new-type drug use (aOR=3.86, 95%CI:2.94-5.07) and receiving no peer education (aOR=1.54, 95%CI:1.12-2.12). Conclusions: In Shandong, a higher proportion of MSM used PrEP and PEP. Peer education and self-perceived HIV infection risk education should be strengthened to increase the rates of PrEP and PEP use in MSM.

[A study on quality of life and related factors among HIV-infected men who have sex with men based on latent profile analysis]

Objectives: To investigate the potential classification of quality of life in HIV-infected men who have sex with men (HIV-infected MSM) and to analyze possible influencing factors of different categories. Methods: A questionnaire survey was conducted among HIV-infected MSM who received antiretroviral treatment (ART) in an infectious disease hospital in Ji'nan, Shandong Province from October to December 2020. The quality of life scores in six domains were analyzed by latent profile analysis (LPA), and possible related factors of potential classification were explored by ordinal logistic regression analysis. Results: A total of 584 HIV-infected MSM were included in this study. LPA divided their quality of life into three categories, named low score, medium score and high score groups, accounting for 34.4% (201/584), 49.8% (291/584), and 15.8% (92/584), respectively. Multivariate ordinal logistic regression analysis showed that age above 40 years (aOR=1.77, 95%CI:1.11-2.80), monthly average income of 3 000 Yuan and below (aOR=3.15, 95%CI:1.72-5.76), monthly average income of 3 001-5 000 Yuan (aOR=2.26, 95%CI:1.41-3.62), distance to the hospital to receive drugs farer than 40 kms (aOR=1.76, 95%CI:1.07-2.89), and adverse reactions after taking drugs (aOR=2.31, 95%CI:1.65-3.23) were factors associated with low level of quality of life. Conclusions: The qualities of life of HIV-infected MSM showed group heterogeneity and were at high levels. Attention should be focused on HIV-infected MSM who are at older age, with low income, and long distance to access the health facilities. The measures should be taken to reduce the adverse reactions of ART drugs and improve the quality of life.

[Analysis of characteristics of types of primary sexual partners and related factors of not being tested for HIV among men who have sex with men]

Objective: To compare the characteristics of MSM with different types of primary sexual partners and to analyze the factors associated with MSM not being tested for HIV in the last six months. Methods: MSM were recruited in nine cities of Shandong Province from April to July 2021, and face-to-face questionnaires were conducted to collect information on sociodemographic characteristics, high-risk behaviors, and HIV testing of MSM. Blood samples were taken for serological tests of HIV and syphilis antibodies. Results: A total of 3 008 men who had anal sex with men in the last six months were divided into three groups according to the type of primary sexual partner in the last six months: the fixed sexual partner group (36.83%, 1 108/3 008), the commercial sexual partner group (3.06%, 92/3 008), and casual sexual partner group (60.11%, 1 808/3 008). There were statistically significant differences in the distribution of age, local residence time, education level, the primary place to find male sexual partners, use of new-type drugs in the last six months, consistent condom use every time during same-sex anal sex in the last six months, group sex in the last six months, no HIV testing in the last six months, having had a sexually transmitted disease in the last year, receiving peer education in the last year, and frequency of syphilis testing in the last year among different groups (P<0.05). Multivariable logistic regression analysis showed that related factors of not being tested for HIV in the last six months in MSM were those aged less than 30 years old (aOR=1.39, 95%CI: 1.06-1.83), married/cohabiting (aOR=1.74, 95%CI: 1.39-2.16), high school education or less (aOR=1.39, 95%CI: 1.15-1.67), had not used new-type drugs in the last six months (aOR=2.27, 95%CI: 1.89-2.71), had not received peer education in the last year (aOR=1.59, 95%CI: 1.28-1.98), had never been tested for syphilis (aOR=11.30, 95%CI: 8.15-15.66), had not been tested in the last year but had been previously tested for syphilis (aOR=5.65, 95%CI: 4.19-7.62), the type of primary sexual partner in the last six months being a commercial sexual partner (aOR=1.80, 95%CI: 1.01-3.20), and the type of primary sexual partner in the last six months being a casual sexual partner (aOR=1.50, 95%CI: 1.26-1.80). Conclusions: The characteristics of MSM with different types of primary sexual partners are different, and the proportion of HIV testing still needs to be improved. In the future, we should make full use of the Internet and peer education to expand the coverage of HIV testing for MSM, targeting the characteristics of MSM with different types of primary sexual partners.

Hepatitis C virus genotype diversity in Ningxia Hui autonomous region, Northwestern China

Hepatitis C virus (HCV) genotypes vary greatly in different regions. The aim of this study is to investigate the distribution of HCV genotypes in HCV infected patients, in Ningxia Hui Autonomous Region. Nucleic acid extraction and amplification were performed with test kits on 153 HCV infected patients serum samples. The HCV viral load was measured using reverse transcriptase PCR (RT-PCR) and HCV genotypes were determined. Among the 153 HCV-infected patients, 56 had genotype (GT)1b (36.60%), 45 had GT2a (29.40%), 23 had GT3a (15.00%), 14 had GT3b (9.20%),13 had GT6a (8.50%), 1 had GT1g (0.70%), 1 had GT6xa (0.70%). In GT1b, 21.40% were female and 78.60% were male; in GT2a, 42.20% were female and 57.80% were male;Males were most prevalent in genotypes 1b(39.30%), while female were most prevalent in genotype 2a(46.30%). Rare GT1g and GT6xa were also detected in males. The 41-50 year age group had the highest HCV prevalence of 32.00%. HCV GT1b is the predominant HCV genotype in Ningxia Hui Autonomous Region.

[Gasless submental approach endoscopic removal of thyroglossal cyst]

Objective: To explore the safety and feasibility of gasless submental approach endoscopic removal of thyroglossal cyst. Methods: This work prospectively included the clinical data of 13 patients who underwent the gasless submental approach endoscopic removal of thyroglossal cyst at the Department of Otolaryngology, the First Affiliated Hospital of Chongqing Medical University from August 2021 to February 2022. The operative time, bleeding volumes, postoperative complications, subjective pain levels, satisfaction with incisional scars, neck and facial deformities, and recurrences were prospectively evaluated by visual analogue scale(VAS) score. Results: All of 13 patients were successfully treated using this new technique. The patients had a median age of 38 years, ranging from 24 to 59 years, comprising of 3 males and 10 females. The length of the submental incision was about 3 cm and the median of operation time was 135 minutes. Postoperative complications were minimal. The median volume of blood loss was 10 ml. Surgical site swelling existed in 1 case and dysphagia for more than 1 week occurred in 2 cases. Patients were discharged from the hospital with a median of 3 days after surgery. On a VAS of 0-10 scores, the pain had a median of 2 on the first day after surgery, and the satisfaction with incision scars and neck and facial deformities showed a median of 8 at 6 months after surgery. There were no recurrences during the follow-up period of 9-15 months. Conclusion: Gasless submental approach endoscopic removal of thyroglossal cyst may be a reliable new surgical method that is safe and has cosmetic advantages.

Predictive value of peritumour radiomics in the diagnosis of benign and malignant pulmonary nodules with halo sign

AIM

To evaluate peritumour radiomics in predicting benign and malignant pulmonary nodules with halo sign.

MATERIALS AND METHODS

In this retrospective study, 305 pulmonary nodules with halo sign (benign, 120; adenocarcinoma, 185) were collected. Manual segmentation was used to mark the gross tumour volume (GTV) and the peritumour volume (PTV) was established by uniform dilation (1 cm) of the tumour area in three dimensions. The GTV and PTV radiomic features were combined to produce the gross tumour and peritumour volume (GPTV). The minimum-redundancy maximum-relevance (mRMR) feature ranking method and least absolute shrinkage and selection operator (LASSO) algorithm were used to eliminate redundant radiomic features. Predictive models combined with clinical features and radiomic signatures were established. Multivarible logistic regression analysis was used to establish the combined model and develop a nomogram. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive performance of the model.

RESULTS

In the testing cohort, the area under the ROC curve (AUC) of the GTV, PTV, and GPTV radiomic models was 0.701 (95% CI: 0.589-0.814), 0.674 (95% CI: 0.557-0.791) and 0.755 (95% CI: 0.643-0.867), respectively. The AUC of the nomogram model based on clinical and GPTV radiomic signatures was 0.804 (95% CI: 0.707-0.901).

CONCLUSION

The nomogram model based on clinical and GPTV radiomic signatures can better predict benign and malignant pulmonary nodules with halo signs, demonstrating that the model has potential as a convenient and effective auxiliary diagnostic tool for radiologists.

[Tajectories of the self-efficacy of HIV testing among MSM based on latent class growth model]

Objective: To analyze the trajectories of HIV testing self-efficacy among men who have sex with men (MSM) based on latent class growth model. Methods: From August 2019 to May 2021, 404 MSM were recruited in Shandong Province and subjected to a 1-year follow-up study with individual intervention (pushing intervention pictures and videos in WeChat and follow-up questionnaires) and community intervention (forwarding to friends and sharing and discussing HIV testing-related information in WeChat groups). The level of HIV testing self-efficacy among MSM was measured. The long-term trend of HIV testing self-efficacy was analyzed using the latent class growth model (LCGM), and the influencing factors of the trend were analyzed. Results: A total of 404 MSM were (28.25±8.95) years old, with the oldest being 58 and the youngest being 18. The scores of HIV testing self-efficacy M(Q₁, Q₃) at baseline and 4 follow-ups were 18.00 (17.00, 21.00), 19.00 (18.00, 22.00), 19.00 (18.00, 22.00), 19.00 (18.00, 22.00) and 19.00 (18.00, 22.00). The results of the freely estimated two-category LCGM model showed that the trend of HIV testing self-efficacy among MSM could be divided into two classes, "intervention response group" [255(63.1%)] and "intervention non-response group" [149(36.9%)]. The former had a higher level of HIV testing self-efficacy which tended to increase at first and then decrease over time, while the latter had a lower and more stable level. The results of the multifactorial logistic regression analysis showed that the OR values of MSM in business or service and jobless or unemployed were 0.261 (95%CI: 0.108-0.633) and 0.186 (95%CI: 0.057-0.610), respectively, using the students as the reference group. Conclusion: There is a group heterogeneity in the trend of HIV testing self-efficacy in the intervention conditions among MSM, and occupation may be an influencing factor.

[A preliminary exploration into the efficacy of personalized surgical schemes in the repair of maxillary sinus perforation and maxillary sinus fistula]

To explore the efficacy and value of personalized surgical schemes in the repair of maxillary sinus perforation and maxillary sinus fistula based on the size of the maxillary sinus perforation and maxillary sinus fistula. A total of 28 patients with maxillary sinus perforation and maxillary sinus fistula who were admitted to the Department of Oral and Maxillofacial Surgery, Stomatology Hospital of Kunming Medical University from July 2017 to May 2020 were included to conduct a prospective case clinical study. After the inflammation in the maxillary sinus was controlled, a proper surgical repair method was selected according to the size of the perforation and fistula based on the double-layer closure technique. The diameter of the perforation and fistula was measured with the assistance of cone-beam CT. After that, the platelet rich fibrin (PRF) repair was performed on the perforation and fistula with 3 mm≤diameter<7 mm in size in 14 patients. The PRF repair and buccal flap repair were performed on the perforation and fistula with 7 mm ≤diameter<15 mm in size in 7 patients. The adjacent buccal pad repair, palatine flap repair, and buccal flap repair were performed on the perforation and fistula with 15 mm≤ diameter<25 mm in size in 4 patients. The nasolabial axial flap repair and nasolabial free flap repair were performed on the perforation and fistula with a diameter ≥25 mm in size in 3 patients. The medical follow-up was conducted in all patients in the 1st, 2nd, and 4th week after surgery, with an overall success rate reaching 96.4% (27/28) after the initial intervention. The relapse of disease occurred in one patient (4.6%) with diabetes and a smoking history in the 2nd week after surgery. Identifying a proper surgical repair method according to the size of the oral and maxillary sinus perforation and maxillary sinus fistula based on the double-layer closure technique can improve the one-time cure rate in these patients under the premise that the inflammation in the maxillary sinus can be controlled.

[Is pre-oxygenation with high-flow nasal oxygen safe? randomized control trial of 56 cases of elderly patients during induction of general anesthesia with endotracheal intubation]

OBJECTIVE

To evaluate the safety of preoxygenation with high-flow nasal oxygenation in elderly patients during induction of general anesthesia with endotracheal intubation.

METHODS

Fifty-six elderly patients without difficult airway were randomized equally into high-flow nasal oxygen group (HF group) and conventional mask oxygen group (M group). Preoxygenation was performed for 5 min before induction of general anesthesia and endotracheal intubation. Oxygenation was maintained during laryngoscopy in HF group, and ventilation lasted until laryngoscopy in M group. For all the patients, the general data, cross-sectional area (CSA) of the gastric antrum measured by ultrasonography, arterial partial pressure of oxygen (PaO₂), arterial partial pressure of carbon dioxide (PaCO₂) and arterial oxygen saturation (cSO₂) were recorded before preoxygenation (T1), at 5 min of preoxygenation (T2) and immediately after intubation (T3). The safety time of asphyxia, intubation time, times of mask ventilation and postoperative complications were compared between the two groups.

RESULTS

The general data were comparable between the two groups. After 5 min of preoxygenation, PaO₂ and cSO₂ were significantly increased in both groups, and PaO₂ was significantly higher in HF group than in M group (F=118.108 vs 9.511, P < 0.05). Both PaO₂ and cSO₂ decreased after intubation, but PaO₂ decreased more slowly in HF group and still remained higher than that at T1; cSO₂ decreased significantly in M group to a lower level than that at T1. Compared with those in M group, the patients in HF group showed a significantly longer safety time of asphyxia (t=5.305, P < 0.05) with fewer times of mask ventilation (χ²= 6.720, P < 0.05). PaCO₂ increased after intubation in both groups but was comparable between the two groups (F=3.138, P > 0.05).

CONCLUSION

High-flow nasal oxygen is safe, simple and effective for pre-oxygenation, which, as compared with the conventional oxygen mask, improves arterial oxygen partial pressure and prolongs the safety time of asphyxia to ensure the safety of airway management during induction of general anesthesia in elderly patients with endotracheal intubation.

Preoperative prediction of the degree of differentiation of lung adenocarcinoma presenting as sub-solid or solid nodules with a radiomics nomogram

AIM

To develop and validate a radiomics nomogram for prediction of degree of differentiation in lung adenocarcinoma presenting as sub-solid or solid nodules.

MATERIALS AND METHODS

A total of 438 patients with histopathologically confirmed adenocarcinoma (248 non-poorly differentiated and 190 poorly differentiated) were divided into training cohort (n=235) and internal validation cohort (n=203) according to surgery sequence. Sixty patients form public TCIA dataset were selected for external validation. One thousand, two hundred and eighteen radiomics features were extracted from each volumetric region of interest and a least absolute shrinkage and selection operator logistic regression was applied to select meaningful radiomic features for building a radiomics score (Rad-score) model. A nomogram model incorporating the Rad-score and type was established after multivariable logistic regression. The discrimination efficiency, calibration efficacy, and clinical utility value of the nomogram were evaluated.

RESULTS

The Rad-score model could predict the differentiation degree of lung adenocarcinoma with an area under the curve (AUC) of 0.83 (95% confidence interval [CI]: 0.78-0.89) in the internal validation cohort. The AUC of the nomogram and radiographic model was 0.86 (95% CI: 0.80-0.91), 0.78 (95% CI: 0.72-0.84) in the internal validation cohort respectively. The AUC of the nomogram in the external validation cohort was 0.73 (95% CI: 0.58-0.88). Delong's test showed that the nomogram performed better than radiographic features alone (p=0.001).

CONCLUSIONS

The proposed radiomics nomogram has the potential to predict the differentiation degree of lung adenocarcinoma preoperatively.

The long-term effect of dental treatment under general anaesthesia or physical restraints on children's dental anxiety and behaviour

AIM

Dental anxiety (DA) is a common problem worldwide because it renders dental treatment in children challenging. This study aimed to evaluate the long-term effect of dental treatment under general anaesthesia (GA) or physical restraints (PR) on children's DA and behaviour.

METHODS

A total of 103 children were recruited and divided into four groups: the GA group, PR group, cooperative (CO) group, and no experience (NE) group. The face version of the Modified Child Dental Anxiety Scale and modified Venham's Clinical Anxiety and Cooperative Behaviour Rating Scale were used to evaluate the level of DA and behaviour.

CONCLUSION

Dental treatment under GA is associated with a higher risk for DA when compared with that under PR in the long term. Increased DA may lead to uncooperative dental behaviour, although the agreement is only moderate.

A38 EVALUATING GLYCOCAGED DEXAMETHASONE IN SHIP-DEFICIENT MICE

Background

Corticosteroids systemically reduce immune system activity thereby limiting inflammation in the GI tract. Corticosteroid use is limited by deleterious systemic effects including immunosuppression and adverse effects on growth and development (Giles et al., 2018). The metabolism of dietary polysaccharides, such as plant cell wall xyloglucan, by gut symbionts has been demonstrated to be mediated by niche members of the human gut microbiota (Larsbrink et al., 2014). By caging corticosteroids like dexamethasone (DEX) with xyloglucans to be released by microbiota at the site of disease, there is potential to increase efficacy and limit adverse effects.

Mice deficient in Src homology 2 domain-containing inositol polyphosphate 5’-phosphatase (SHIP-/-) develop spontaneous CD-like ileal inflammation (Ngoh et al., 2016). We have used SHIP-/- mice to compare the efficacy of DEX versus caged DEX to reduce intestinal inflammation.

Aims

Caged DEX will reduce CD-like ileal inflammation in SHIP-/- mice at a lower dose than uncaged DEX because it is released and acts at the site of inflammation.

To assess this hypothesis we propose 3 aims:

Measure decaging activity along the GI tract of SHIP-/- mice ex vivo

Determine the minimum effective dose of DEX required to reduce ileal inflammation in SHIP-/- mice

Determine if equimolar and lower concentrations of caged DEX can reduce ileal inflammation in SHIP-/- mice

Methods

Intestinal contents and feces were harvested from SHIP-/- mice. Decaging activity was measured ex vivo, using caged resorufin (a fluorescent reporter).

SHIP-/- mice were orally gavaged with dexamethasone (or vehicle), or the molar equivalent of caged dexamethasone from 6–8 weeks of age. At 8 weeks of age, gross and histopathology were assessed and IL-1β concentrations were measured in full-thickness tissue homogenates.

Results

SHIP-/- mice demonstrated decaging activity in the cecal, colon, and fecal contents assayed. DEX treatment (3 or 1 mg/kg) of SHIP-/- mice eliminated CD-like gross pathology and histopathology, and reduced IL-1β concentrations in full-thickness ileal tissue homogenates from SHIP-/- mice compared to untreated or vehicle-treated mice. DEX did not have any harmful effects on the intestines of SHIP+/+ mice. 1 or 0.3 mg/kg molar equivalent of caged DEX (3-fold lower concentrations) eliminated CD-like gross pathology in SHIP-/- mice compared to treatment with vehicle control. Additionally, the mean IL-1β concentration in tissue homogenates of mice treated with the molar equivalent of 1 mg/kg caged DEX was reduced

Conclusions

SHIP-/- mice express decaging activity are effectively treated by DEX, and caged DEX shows similar efficacy at reducing SHIP-/- ileal pathology at lower concentrations than uncaged DEX. In future experiments, we will examine caged DEX at a lower concentration, and in 2nd mouse model of intestinal inflammation.

Funding Agencies

GlycoNet

[Effects of regional citrate anticoagulation in continuous veno-venous hemofiltration of severe burn patients]

Objective: To investigate the effects of regional citrate anticoagulation in continuous veno-venous hemofiltration (CVVH) of severe burn patients. Methods: A retrospective non-randomized controlled study was conducted. From January 2017 to August 2020, sixty-eight severe burn patients who met the inclusion criteria were treated with CVVH in Affiliated Hospital of Nankai University. According to the different methods of blood anticoagulation in CVVH treatment, patients were divided into citrate group (n=40) and heparin group (n=28). In the citrate group, 32 males and 8 females were (40±18) years old with total burn area of (62±14)% total body surface area (TBSA); in the heparin group, 22 males and 6 females were (38±16) years old with total burn area of (57±20)%TBSA. Creatinine level, C-reactive protein (CRP) value, and urea nitrogen level in serum of patients were recorded at 0 (immediately), 48, and 96 h after CVVH treatment in 2 groups, urea clearance index was calculated based on urea nitrogen level at 0, 48, and 96 h after CVVH treatment in 2 groups, platelet count (PLT), prothrombin time (PT), and activated partial thromboplastin time (APTT) in total coagulation of patients were recorded. The frequency of forced hemofiltration termination caused by adverse reactions such as severe hypocalcemia, aggravated wound bleeding, and new bleeding on non-wound surface of patients was recorded within 96 h of CVVH treatment. The duration of daily CVVH use from the beginning to the end was recorded. Data were statistically analyzed with chi-square test, analysis of variance for repeated measurement, independent samples t test, and Bonferroni correction. Results: There were no significant differences in urea nitrogen level, creatinine level, and CRP value in serum of patients between 2 groups at 0 h after treatment (P>0.05). At 48 and 96 h after treatment, urea nitrogen level, creatinine level, and CRP value in serum of patients in citrate group were significantly lower than those in heparin group (t=3.366, -2.315, 2.942, -2.657, 2.011, -2.441, P<0.05), and urea clearance index of patients in citrate group was significantly higher than that in heparin group (t=1.017, 2.233, P<0.05). There were no statistically significant differences in PLT, PT, and APTT of patients between 2 groups at 0 h after treatment (P>0.05). At 48 and 96 h, PLT of patients in citrate group was significantly higher than that in heparin group (t=-3.417, -4.143, P<0.05 or P<0.01), PT of patients in citrate group was significantly shorter than that in heparin group (t=2.760, -3.655, P<0.01), APTT of patients in citrate group was significantly shorter than that in heparin group (t=3.719, 5.146, P<0.05 or P<0.01). Within 96 h of treatment, there was 1 case of hypocalcemia and 1 case of aggravated wound bleeding resulting in forced hemofiltration termination in citrate group, but there was no new bleeding on non-wound surface; in heparin group, there was no hypocalcemia, but 7 cases of aggravated wound bleeding and 2 cases of new bleeding on non-wound surface (both at the tracheotomy site) resulting in forced hemofiltration termination. The use time of blood purification filter of patients in citrate group was (11.7±4.8) h, obviously longer than (6.6±2.5) h in heparin group (t=3.310, P<0.01). Conclusions: The use of regional citrate anticoagulation in CVVH treatment of severe burn patients has the advantages including little effect on coagulation function and high safety, can effectively prolong the use time of filter and improve the therapeutic effect, but this conclusion still needs to be further verified in clinical application.

[Quantitative myocardial perfusion parameters in subjects without coronary artery lesions based on computed tomography dynamic myocardial perfusion imaging]

Objective: To determinate the range of quantitative myocardial perfusion parameters (MBF, MBV) in subjects without coronary artery lesions by dynamic computed tomography myocardial perfusion imaging (CTP). Methods: Subjects with occasional chest tightness or family history of coronary artery disease coming to Fuwai Hospital underwent coronary computed tomography angiography (CCTA) were prospectively enrolled. A total of 34 subjects [mean age (50±7) years, range from 33 to 65 years; 15 male and 19 female] were enrolled. Coronary lesions were not confirmed in any subjects using CCTA and volunteered for stress and rest dynamic CTP examination. MBF and MBV values were calculated in each myocardial segment using a 17-segment model. The global ranges of MBF and MBV were analyzed, and the gender variability and regional variability were compared. Results: The mean global MBF and MBV at rest and under stress were (115.5±27.4) ml·100 g^-1·min^-1, (212.8±40.8) ml·100 g^-1·min^-1 and (17.6±4.0) ml/100 g, (25.8±4.6) ml/100 g, respectively. The absolute and resolute reserves of MBF and MBV [(102.8±41.5) ml·100 g^-1·min^-1, 107.7%±52.5%; (9.3±5.2) ml/100 g, 62.1%±47.4%] were highest in the right coronary artery territory, but without any significant differences. The stress MBF and absolute reserve of MBF in females were higher than those of males [(228.6±39.9) ml·100 g^-1·min^-1, (113.3±46.2) ml·100 g^-1·min^-1; (192.8±33.4) ml·100 g^-1·min^-1, (77.0±41.2) ml·100 g^-1·min^-1] (both P<0.05). The MBF resolute reserve, rest MBV, stress MBV and MBV absolute and resolute reserves were higher in females, but without significant differences (all P>0.05). Conclusion: The mean global MBF and MBV at rest and under stress were (115.5±27.4) ml·100 g^-1·min^-1, (212.8±40.8) ml·100 g^-1·min^-1 and (17.6±4.0) ml/100 g, (25.8±4.6) ml/100 g. The MBF under stress perfusion and MBF absolute reserve of females are higher than those of males.

Clinical features and survival in pulmonary Takayasu's arteritis associated pulmonary hypertension: a national registry study

Background

The clinical features and long-term outcomes of patients with pulmonary Takayasu's arteritis associated pulmonary hypertension (PTA-PH) have not been well studied.

Purpose

To assess the clinical characteristics and long-term survival outcome in patients with PTA-PH.

Methods

We conducted a multi-center cohort study using the clinical, functional, and hemodynamic data from the National Rare Diseases Registry System of China. Patients with Takayasu's arteritis and pulmonary artery involvement, who fulfilled the 1990 American College of Rheumatology and/or modified Ishikawa criteria, from 13 referral centers of China, were included. The diagnosis of pulmonary hypertension (PH) was confirmed by right heart catheterization findings. The primary outcome was time from diagnosis of PTA-PH to the occurrence of all-cause death.

Results

Between Jan. 2007 and Jan. 2019, a total of 140 patients with PTA-PH were included, with a mean age of 41.4±14.3 years at diagnosis, and a female predominance (81%). The most common symptoms were exertional dyspnea (91%) and hemoptysis (36%). The majority of patients (87%) exhibited bilateral pulmonary artery involvement. Pulmonary lobar artery was the most frequently affected vessel (100%), followed by segmental artery (82%) and left/right pulmonary artery trunk (49%). Severely compromised hemodynamic profiles were identified in these patients, indicating by elevated mean pulmonary artery pressure (48, interquartile range [IQR] 38–59 mm Hg) and pulmonary vascular resistance (9.4, IQR 5.7–13.3 Wood U). The overall 1-year, 3-year, and 5-year survival rates in PTA-PH were 94.0%, 83.2%, and 77.2%, respectively (Figure). Predictors associated with increased risk of all-cause death were the presence of syncope (hazard ratio [HR]: 4.88; 95% CI: 1.62–14.74; p=0.005), N-terminal pro-B type natriuretic peptide level (HR: 1.04; 95% CI: 1.02–1.06; p&lt;0.001), and right atrial pressure (HR: 1.07; 95% CI: 1.02–1.73; p=0.009).

Conclusions

In this national registry study, the reported clinical features and long-term prognosis of patients with PTA-PH are novel findings. These findings may provide new insights on this specific pulmonary hypertension entity.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The National Key Research and Development Program of China Kaplan-Meier plot for survival rate

Single-cell transcriptome analysis of diffuse large B cells in cerebrospinal fluid of central nervous system lymphoma

Diffuse large B cells in the cerebrospinal fluid (CSF-DLBCs) have offered great promise for the diagnostics and therapeutics of central nervous system lymphoma (CNSL) leptomeningeal involvement. To explore the phenotypic states of CSF-DLBCs, we analyzed the transcriptomes of more than one thousand CSF-DLBCs from six patients with CNSL diffuse large B-cell lymphoma (DLBCL) using Smart-seq2 single-cell RNA sequencing. CSF-DLBCs were defined based on abundant expression of B-cell markers, the active cell proliferation and energy metabolism properties, and immunoglobulin light chain restriction. We identified inherent heterogeneity of CSF-DLBCs, which were mainly manifested in cell cycle state, cancer-testis antigen expression, and classification based on single-cell germinal center B-cell signature. In addition, the 16 upregulated genes in CSF-DLBCs compared to various normal B cells showed great possibility in the homing effect of the CNS-DLBCL for the leptomeninges. Our results will provide insight into the mechanism research and diagnostic direction of CNSL-DLBCL leptomeningeal involvement.

MiR-30a-5p inhibits proliferation, migration and invasion of nasopharyngeal carcinoma cells by targeting NUCB2

BACKGROUND

Nasopharyngeal carcinoma (NPC) is a malignant head and neck tumor arising in the nasopharynx. MicroRNAs (miRNAs) are elucidated to exert tumor-suppressing function in human cancers. Numerous studies have manifested that miR-30a-5p serves as an anti-oncogene in various cancers.

OBJECTIVE

To research the biological function and molecular mechanism of miR-30a-5p in NPC.

METHODS

The morphology of NPC tissues was revealed by H&E staining. Transwell and wound healing assays were applied to investigate the effects of miR-30a-5p on NPC cell migration. The binding interaction between miR-30a-5p and nucleobindin 2 (NUCB2) was identified by luciferase reporter assay. Xenograft nude mice were used to detect the influence of miR-30a-5p on NPC tumor growth.

RESULTS

MiR-30a-5p was downregulated in NPC tissues and cells. The overexpression ofmiR-30a-5p inhibited proliferation, migration and invasion abilities of NPC cells. Moreover, NUCB2 was revealed to be a downstream target gene of miR-30a-5p, and knockdown of NUCB2 repressed the malignant behaviors of NPC cells and tumor growth. Additionally, rescue experiments revealed that miR-30a-5p suppressed the proliferation, migration and invasion of NPC cells via targeting NUCB2 in vitro. Meanwhile, in vivo assays depicted that NUCB2 overexpression rescued the effects induced by miR-30a-5p upregulation on tumor growth.

CONCLUSION

MiR-30a-5p modulates NPC progression by targeting NUCB2. These findings lay a foundation for exploring the clinical treatment of NPC.

Successful Application of a Galanin-Coated Scaffold for Periodontal Regeneration

The nervous system exerts finely tuned control over all aspects of the life of an organism, including pain, sensation, growth, and development. Recent developments in tissue regeneration research have increasingly turned to small molecule peptides to tailor and augment the biological response following tissue loss or injury. In the present study, we have introduced the small molecule peptide galanin (GAL) as a novel scaffold-coating agent for the healing and regeneration of craniofacial tissues. Using immunohistochemistry, we detected GAL and GAL receptors in healthy periodontal tissues and in the proximity of blood vessels, while exposure to our periodontal disease regimen resulted in a downregulation of GAL. In a 3-dimensional bioreactor culture, GAL coating of collagen scaffolds promoted cell proliferation and matrix synthesis. Following subcutaneous implantation, GAL-coated scaffolds were associated with mineralized bone-like tissue deposits, which reacted positively for alizarin red and von Kossa, and demonstrated increased expression and protein levels of RUNX2, OCN, OSX, and iBSP. In contrast, the GAL receptor antagonist galantide blocked the effect of GAL on Runx2 expression and inhibited mineralization in our subcutaneous implantation model. Moreover, GAL coating promoted periodontal regeneration and a rescue of the periodontal defect generated in our periodontitis model mice. Together, these data demonstrate the efficacy of the neuropeptide GAL as a coating material for tissue regeneration. They are also suggestive of a novel role for neurogenic signaling pathways in craniofacial and periodontal regeneration.

[Macular buckling for highly myopic traction maculopathy]

Objective: To observe the efficacy of macular buckling in the treatment of highly myopic traction maculopathy. Methods: Retrospective case series study. The patients with high myopia who underwent macular buckling at the Zhongshan Ophthalmic Center of Sun Yat-sen University from June 2014 to June 2019 were enrolled, including 136 males and 212 females. The age was (56.68±11.59) years old. The outcomes measured included retinal reattachment rate, foveoschisis recovery rate, macular hole closure rate, postoperative best corrected visual acuity (BCVA), axial length (AL), and complications. The measurements were recorded preoperatively and at 1 month, 6 months, 1 year, 2 years, and 3 years postoperatively. The data was statistically analyzed using paired t test. Results: A total of 378 eyes were included, including 216 eyes with foveoschisis and macular detachment and 162 eyes with macular holes and macular detachment. Among them, 296 eyes underwent macular buckling, and the other 82 eyes underwent macular buckling combined with pars plana vitrectomy. During the follow-up period, 373 eyes (98.68%) achieved retinal reattachment; in patients with foveoschisis, 204 eyes (94.44%) were recovered; in patients with macular holes, 89 eyes (54.09%) achieved closure. All the postoperative results of BCVA were better than the preoperative value (1.459±0.841). BCVA continued to increase from postoperative month 1, remained stable at 1 year, and reached 0.908±0.606 at 3 years (t=6.896, P<0.01). All the postoperative results of AL were shorter than the preoperative value. The AL shortened by (4.423±1.740)mm at one month (t=33.144, P<0.01), increased gradually thereafter, remained stable at 1 year, and shortened by (2.101±1.643) mm at three years (t=6.392, P<0.01). The common complications included transient high intraocular pressure in 98 eyes (25.92%), epiretinal hemorrhage in 67 eyes (17.72%), and vitreous hemorrhage in 9 eyes (2.38%), which all resolved spontaneously within 1 month. In the early postoperative period, all patients had a certain degree of eye movement limitation, and 39 eyes (10.31%) had diplopia which resolved within 6 months without treatment. The strabismus surgery was arranged to treat esotropia in 6 eyes (1.58%). The macular buckle was removed from 1 eye (0.26%) because of the inability to tolerate diplopia. There were 8 eyes (2.11%) requiring a second operation to adjust the position of the buckle. The macular buckle was also removed from 4 eyes (1.05%) due to the implant rejection. Conclusion: Macular buckling can effectively shorten the AL, resolve posterior scleral staphyloma, and improve vision in the treatment of highly myopic traction maculopathy. (Chin J Ophthalmol, 2021, 57: 433-439).

[Correlation between intimate partner-related violence and high-risk sexual behavior among men who have sex with men]

Objective: To explore the experience of intimate partner-related violence (IPV) and its correlation with high-risk sexual behaviors among MSM. Methods: MSM were recruited in Ji'nan, Qingdao, and Jining of Shandong province from April to July 2019. Information on socio-demographic characteristics, AIDS prevention and control knowledge, IPV experience in the last year and high-risk sexual behaviors in the previous six months was collected by face-to-face questionnaire. EpiData 3.1 and SPSS 24.0 software were used for data cleansing and statistical analysis. Results: The average age of the 1 122 MSM was (29.80±8.78) years, with 68.1% (764/1 122) unmarried. 9.8% (110/1 122) had IPV experiences in the past year. MSM who came from Jining and Qingdao, living in the local area for more than two years, met their sexual partners in bar/bathroom/park, having no basic knowledge about AIDS, being drug users, and diagnosed with STD in the previous year, had a higher proportion of IPV experiences in the last year (P<0.05). 49.0% (550/1 122) and 20.9% (234/1 122) had unprotected anal intercourse and group sex behavior during the past six months, respectively. The results of multivariate logistic regression showed that MSM who experienced IPV were likely to have unprotected anal intercourse and group sex behavior during the past six months (aOR = 1.82, 95%CI: 1.14-2.91;aOR = 3.30, 95%CI: 2.10-5.20) than those did not experience IPV. Conclusions: IPV exists in the MSM population, and the IPV experience is positively associated with high-risk sexual behaviors. Targeted intervention to reduce the risk of high-risk sexual behaviors should be taken among MSM who experienced IPV.

[Comparison of the clinical outcomes of haploidentical and matched-sibling donor stem cell transplantation for T cell acute lymphoblastic leukemia in complete remission]

目的

比较亲缘单倍型造血干细胞移植（HIDT）和同胞相合造血干细胞移植（MSDT）治疗完全缓解期（CR）急性T淋巴细胞白血病（T-ALL）的疗效。

方法

回顾性分析2012年5月至2017年5月间在河北燕达陆道培医院接受HIDT（81例）和MSDT（17例）的CR期T-ALL患者的临床特点和预后。

结果

HIDT组、MSDT组移植后100 d Ⅱ～Ⅳ度急性GVHD发生率分别为51.9％（95％CI42.0％～64.0％）、29.4％（95％CI 14.1％～61.4％）（P＝0.072），Ⅲ/Ⅳ度急性GVHD发生率分别为9.8％（95％CI 5.1％～19.1％）、11.8％（95％CI 3.2％～43.3％）（P＝1.000），巨细胞病毒（CMV）血症发生率分别为53.1％（95％CI 43.3％～65.2％）、29.4％（95％CI 14.1％～61.4％）（P＝0.115），EB病毒（EBV）血症发生率分别为35.8％（95％CI 26.8％～47.9％）、11.8％（95％CI 3.2％～43.3％）（P＝0.048）。HIDT、MSDT两组移植后5年总生存（OS）率分别为60.5％（95％CI 5.4％～49.0％）、68.8％（95％CI 11.8％～40.0％）（P＝0.315），无白血病生存（LFS）率分别为58.0％（95％CI 5.5％～46.5％）、68.8％（95％CI11.8％～40.0％）（P＝0.258），累积复发率分别为16.1％（95％ CI 9.8％～26.4％）、11.8％（95％ CI3.2％～43.3％）（P＝0.643），非复发死亡率（NRM）分别为25.9％（95％CI 17.9％～37.5％）、19.4％（95％CI6.9％～54.4％）（P＝0.386）。

结论

对于CR期T-ALL患者，当缺乏合适供者时，HIDT可作为替代选择。

[Feasibility multi-center study of artificial intelligence assistance in cervical fluid-based cytology diagnosis]

Objective: To propose a method of cervical cytology screening based on deep convolutional neural network and compare it with the diagnosis of cytologists. Method: The deep segmentation network was used to extract 618 333 regions of interest (ROI) from 5, 516 cytological pathological images. Combined with the experience of physicians, the deep classification network with the ability to analyze ROI was trained. The classification results were used to construct features, and the decision model was used to complete the classification of cytopathological images. Results: The sensitivity and specificity were 89.72%, 58.48%, 33.95% and 95.94% respectively. Among the smears derived from four different preparation methods, this algorithm had the best effect on natural fallout with a sensitivity of 91.10%, specificity of 69.32%, positive predictive rate of 41.41%, and negative predictive rate of 97.03%. Conclusion: Deep convolutional neural network image recognition technology can be applied to cervical cytology screening.

CircTP53 promotes the proliferation of thyroid cancer via targeting miR-1233-3p/MDM2 axis

BACKGROUND

Follicular cells give rise to thyroid cancer. Worldwide thyroid cancer incidence continues to rise in recent decades but the mortality rate remains at a stable level. The discovery of novel molecular mechanisms in the pathogenesis of thyroid cancer will promote new diagnostic or therapeutic strategies. Circular RNA (circRNA) is a type of noncoding RNA which is characterized by the covalently closed loop and non-protein coding capacity. The abnormal expression of circRNAs is an important part during the pathogenesis and development of thyroid cancer. CircTP53 is a novel circRNA, and we aimed to investigate its function in the pathogenesis of thyroid cancer and to further demonstrate the underlying molecular mechanism.

METHODS

The levels of circTP53, miR-1233-3p, and other relative mRNA were analyzed by qRT-PCR. Protein levels were shown by Western blot. RNA-pulldown assay and luciferase assay were employed to examine the interaction between circTP53 and miR-1233-3p. Cell proliferation was analyzed by the MTT assay.

RESULTS

CircTP53 was a circRNA highly expressed in thyroid cancer tissues. CircTP53 promoted cell proliferation and cell viability of TPC-1 cells. Knockdown of circTP53 inhibited the expression of Mouse double minute 2 (MDM2) and increased the protein level of p53. CircTP53 acted as a target of miR-1233-3p to increase MDM2 expression. p53 expression in thyroid cancer tissue exhibited a negative correlation with circTP53 expression.

CONCLUSION

In thyroid cancer, overexpressed circTP53 decreased the protein level of p53 via targeting miR-1233-3p/MDM2 axis and promoted cancer cell proliferation.

[Relationship between new-type drug use and high risk sex behavior in men who have sex with men]

Objective: To understand the relationship between new-type drug use and high risk behavior in men who have sex with men (MSM) in Shandong province. Methods: Cross-sectional surveys was conducted to collect the information about demographics, sexual and drug use behaviors of MSM and HIV-related services in MSM in three sentinel surveillance sites in Shandong from April to July in 2019. Blood samples were taken from the MSM for serological tests of HIV antibody and syphilis antibody. Results: A total of 1 203 MSM were included in this study. The average age of the MSM was 30.2±8.9 years. Among these MSM, 67.7% (815) were unmarried; 66.9% (805) had education level of college or above; 62.2% (721/1 160) had unprotected sex behaviors and 16.3% (189/1 160) had group sex behavior in the past six months and 54.2% (652/1 203) ever used new-type drugs. HIV infection and syphilis prevalence rates were 3.1% (37/1 203) and 4.7% (56/1 203), respectively. Multivariable logistic analysis indicated that MSM who had unprotected anal sex in the past six months were more likely to be from Qingdao (aOR=1.59, 95%CI:1.13-2.23), with education level of high school or below (aOR=1.61, 95%CI: 1.20-2.16), with male sex partners from bars/dance halls or other venues (aOR=1.69, 95%CI: 1.06-2.69), with HIV knowledge awareness score <6 (aOR=1.55, 95%CI: 1.01-2.37), with ≥2 sex partner in the past week (aOR=1.48, 95%CI: 1.12-1.95), to have group sex behaviors in the past six months (aOR=2.43, 95%CI:1.61-3.67) and to use new-type drugs (aOR=1.46, 95%CI: 1.11-1.91). MSM who had group sex were more likely to have following features: being from Qingdao (aOR=2.21, 95%CI: 1.45-3.38), non-Shandong residents (aOR=2.13, 95%CI: 1.28-3.55), HIV knowledge awareness score ≥6 (aOR=3.11, 95%CI: 1.55-6.25), ever having unprotected anal sex behaviors (aOR=2.60, 95%CI: 1.71-3.96) and ever having male commercial sex (aOR=3.38, 95%CI: 1.92-5.95) in the past six months, ever using new-type drugs (aOR=2.71, 95%CI: 1.82-4.04), and never having HIV testing in the past year (aOR=2.66, 95%CI: 1.59-4.43). Conclusion: New-type drug use is common in MSM in Shandong. The use of new-type drugs promotes unprotected sex and group sex in MSM. Surveillance and intervention measures targeting this population should be strengthened.

Circulating tumor cell characterization of lung cancer brain metastases in the cerebrospinal fluid through single-cell transcriptome analysis

BACKGROUND

Brain metastases explain the majority of mortality associated with lung cancer, which is the leading cause of cancer death. Cytology analysis of the cerebrospinal fluid (CSF) remains the diagnostic gold standard, however, the circulating tumor cells (CTCs) in CSF (CSF-CTCs) are not well defined at the molecular and transcriptome levels.

METHODS

We established an effective CSF-CTCs collection procedure and isolated individual CSF cells from five lung adenocarcinoma leptomeningeal metastases (LUAD-LM) patients and three controls. Three thousand seven hundred ninety-two single-cell transcriptomes were sequenced, and single-cell RNA sequencing (scRNA-seq) gene expression analysis was used to perform a comprehensive characterization of CSF cells.

RESULTS

Through clustering and expression analysis, we defined CSF-CTCs at the transcriptome level based on epithelial markers, proliferation markers, and genes with lung origin. The metastatic-CTC signature genes are enriched for metabolic pathway and cell adhesion molecule categories, which are crucial for the survival and metastases of tumor cells. We discovered substantial heterogeneity in patient CSF-CTCs. We quantified the degree of heterogeneity and found significantly greater among-patient heterogeneity compared to among-cell heterogeneity within a patient. This observation could be explained by spatial heterogeneity of metastatic sites, cell-cycle gene, and cancer-testis antigen (CTA) expression profiles as well as the proportion of CTCs displaying mesenchymal and cancer stem cell properties. In addition, our CSF-CTCs transcriptome profiling allowed us to determine the biomarkers during the progression of an LM patient with cancer of unknown primary site (CUP).

CONCLUSIONS

Our results will provide candidate genes for an RNA-based digital detection of CSF-CTCs from LUAD-LM and CUP-LM cases, and shed light on the therapy and mechanism of LUAD-LM.

[Etiological analysis and short-term efficacy evaluation of acute liver failure in children]

Objective: To explore etiology, optimize the search direction of etiology, and short-term efficacy evaluation of acute liver failure in children. Methods: Children with acute liver failure who were diagnosed in the First Affiliated Hospital of Zhengzhou University from November 2011 to November 2019 were collected. Gender difference, age, living environment, etiological factors on the seasonal onset and different etiological profile of short-term prognosis were statistically analyzed. Chi-square test or Fisher's exact probability method was used to compare the rate and the constituent ratio between groups. Results: Among the 236 cases, 114 (48.31%) had unknown etiology and 122 (51.69%) had definite etiology. In the definite etiology group, 38 (16.10%), 27 (11.44%), 22 (9.32%), 15 (6.36%), 17 (7.20%), and 3 (1.27%) cases were related to drugs/toxicants, infection, congenital/vascular/biliary diseases, genetic metabolic diseases, tumor-related, and autoimmune diseases. In addition, the overall etiological distribution did not change statistically with factors such as gender, age, and seasonal onset (P > 0.05), while the difference in different living environments was statistically significant (P < 0.05). Different initial-diagnosed departments had different etiological rates, with liver transplantation department being the highest (78.26%), and pediatrics department the lowest (26.09%). In 122 children with definite etiology, there was no significant difference in gender ratio between the different etiology groups (P>0.05), but there were significant differences in age, living environment and seasonal onset (P < 0.05). Among them, congenital development/vascular/biliary tract and infectivity were the main factors in children < 3 years old, and drug/toxin-related factors were the main factors in children > 3 years old. Most of the rural children had drug/toxin and infection-related etiology, while most of the urban children had tumor and drug/toxin-related etiology. In summer and autumn, drug/toxicant correlation was dominant, while in winter and spring, infection correlation was dominant. In the unknown etiology group, the clinical cure + improvement rate between the medical treatment group and the surgical treatment group was not statistically significant (37.50% vs. 20.00%, P > 0.05), while in the definite etiology group, the above differences were statistically significant (43.96% vs. 83.87%, P < 0.05). Among the different etiology groups, the congenital/vascular/biliary group had the best short-term efficacy (72.72%, 16/22), followed by the drug/toxicity-related group (60.53%, 23/38), and the tumor-related group had the worst (23.53%, 4/17). Conclusion: The definite etiology of acute liver failure in about half of children is still vague. The population distribution of children with definite etiology is related to age, living environment and season, but not to gender. However, the different ages, different living environments, and different seasonal onsets have definite etiology, and the short-term clinical efficacy of the treatment is significantly improved after the definite etiology is identified.

[Correlation between alcohol drinking and high risk sexual behaviors in HIV negative clients of female sex workers]

Objective: To explore the correlation between alcohol drinking and high-risk sexual behaviors in HIV negative clients of female sex workers and provide scientific evidence for prevention of HIV sexual transmission. Methods: A cross-sectional survey was conducted in HIV negative clients in Ji'nan and Haikou from December 2018 to May 2019. The estimated sample size was 337, the information about their demographic characteristics, AIDS knowledge awareness, sexual behaviors and alcohol drinking habit were collected through convenience sampling. The data were analyzed by using SPSS 24.0 software. Results: A total of 381 clients were included in this study. Most of them were less than 40 years old, accounting for 89.2% (340/381); 85.3% of them (325/381) reported an education level of high school and above; the clients who were married, had cohabitation with females or had girl friends accounted for 53.2% (202/380). The overall awareness rate of AIDS knowledge was 83.7% (318/380). Of all participants, 80.8% (308/381) had commercial sex in the past year, 79.8% (304/381) had non-commercial sex partners, 62.7% (239/381) had high-risk sexual behaviors. The results of logistic regression showed that compared with those with alcohol drinking frequency ≤2 times per month in last year, the clients with alcohol drinking frequency more than once a week (aOR=3.22, 95%CI: 1.25-8.27) were more likely to have high risk sexual behaviors after adjustment for age, living area, location type of residence, time of local residence, education level, monthly income level, occupation, marital status, knowledge awareness of AIDS and HIV related services, the number of commercial or non-commercial sexual partners in the past year, cost of commercial sex and HIV test frequency. Conclusions: Alcohol drinking is related to high risk sexual behaviors in HIV negative clients, and will increase the risk of HIV transmission. To control AIDS, the intervention of alcohol drinking should be combined with other preventions to improve the correct use of condoms.

MiR-1-3p suppresses cell proliferation and invasion and targets STC2 in gastric cancer

OBJECTIVE

MiR-1 has been reported to act as an inhibitory microRNA in gastric cancer (GC). This study aimed to investigate the regulatory mechanism by which miR-1-3p blocks the progression of GC by targeting stanniocalcin 2 (STC2).

PATIENTS AND METHODS

The expression level of miR-1-3p in GC was assessed via quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Expressions of STC2 were measured by qRT-PCR and Western blot analysis. Proliferation and invasion assays were detected by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) and transwell assays, respectively. Moreover, the dual-luciferase reporter assay was used to confirm the binding sites between miR-1-3p and STC2.

RESULTS

MiR-1-3p was significantly down-regulated in GC. Moreover, abnormal expression of miR-1-3p was correlated with GC tumor size. Functionally, overexpression of miR-1-3p inhibited proliferation and invasion in GC by inhibiting stanniocalcin 2 (STC2) expressions. In contrast, STC2 was significantly up-regulated in GC. Furthermore, miR-1-3p negatively regulated STC2 expression in GC. The upregulation of STC2 weakened the inhibitory effect of miR-1-3p in GC.

CONCLUSIONS

MiR-1-3p suppressed cell proliferation and invasion by targeting STC2 in GC, providing a novel therapeutic target for GC.

MRI findings of central nervous system involvement in children with haemophagocytic lymphohistiocytosis: correlation with clinical biochemical tests

AIM

To investigate the brain magnetic resonance imaging (MRI) features of children with haemophagocytic lymphohistiocytosis (HLH) with central nervous system (CNS) involvement, and to investigate the correlation with clinical biochemical tests.

MATERIAL AND METHODS

Clinical and MRI data were collected from 118 children with HLH-CNS between January 2012 and June 2019. Patients were grouped according to their MRI findings, and statistical methods were used to test for correlations between the MRI findings and biochemical variables.

RESULTS

Patients were divided into three groups, including normal appearance (Group 1, 17/118), diffuse parenchymal volume loss (Group 2, 44/118), and brain parenchyma lesions (Group 3, 57/118) containing three subtypes of brain lesions and HLH-CNS complications. Comparing biochemical values among the three groups revealed a significant difference for all values (p<0.05), except for cell counts in the cerebrospinal fluid (CSF). A pairwise comparison further showed significant inter-group differences for most of the variables. Spearman's rank correlation coefficient also demonstrated that CSF cell counts (r=0.193, p=0.036), CSF microprotein content (r=0.379, p<0.001), serum aspartate aminotransferase (AST; r=0.521, p<0.001), serum lactate dehydrogenase (LDH; r=0.514, p<0.001) and activated partial thromboplastin time (APTT; r=0.326, p<0.001) correlated positively with the MRI groups, while platelet count (PLT; r=-0.633, p<0.001) and plasma fibrinogen (FIB; r=-0.258, p=0.005) correlated negatively.

CONCLUSION

Classification of brain MRI findings of HLH-CNS correlates well with the results of several key biochemical tests. Brain MRI is a promising method to elucidate illness severity and clinical outcomes.

[Prognostic analysis of allogeneic hematopoietic stem cell transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia in complete remission in the era of tyrosine kinase inhibitors]

目的

探讨在酪氨酸激酶抑制剂（TKI）时代Ph染色体阳性急性淋巴细胞白血病（Ph⁺ALL）在完全缓解（CR）状态下行异基因造血干细胞移植（allo-HSCT）的预后和影响因素。

方法

回顾性分析2012年5月至2017年5月河北燕达陆道培医院收治的116例在CR状态下行allo-HSCT的Ph⁺ALL患者的预后及其影响因素。

结果

116例患者中男72例，女44例。中位年龄20（4～64）岁。同胞全相合移植21例，亲缘单倍型移植77例，非血缘移植18例。5年总生存（OS）率为73.2％（95％CI 63.8％～80.5％），其中诊断至移植间隔时间<180 d的亚组5年OS率为87.5％。5年无病生存（DFS）率为61.4％（95％CI 51.8％～69.7％）。5年细胞形态及分子学水平复发累积发生率为18.5％（95％CI 12.6％～27.3％）。5年移植相关死亡率（TRM）为19.9％（95％CI 13.8％～28.7％）。多因素分析显示，15～39岁（HR＝2.730，P＝0.044）、诊断至移植间隔时间≥180 d（HR＝4.534，P＝0.010）、发生Ⅲ～Ⅳ度急性移植物抗宿主病（aGVHD）（HR＝7.558，P＝0.000）是影响患者OS的不利因素；发生局限型慢性移植物抗宿主病（cGVHD）是影响患者OS的有利因素（HR＝0.300，P＝0.034）。而性别、起病时WBC（<30×10⁹/L，≥30×10⁹/L）、BCR-ABL融合基因类型、体细胞突变类型、移植前状态（CR₁，>CR₁）、移植前微小残留病（MRD）水平（MRD阴性，MRD阳性）、预处理方案（全身照射方案，白消安为基础方案）、预处理方案强度、移植类型、GVHD预防方案（环孢素A，他克莫司）、抗胸腺细胞免疫球蛋白的种类、巨细胞病毒和EB病毒血症的有无对OS的影响无统计学意义。

结论

TKI时代Ph⁺ALL在CR状态下行allo-HSCT时，影响生存的因素有年龄、诊断至移植间隔时间和发生重度aGVHD。