Circ-0075305 hinders gastric cancer stem cells by indirectly disrupting TCF4-β-catenin complex and downregulation of SOX9

CircRNAs are covalently closed, single-stranded RNA that form continuous loops and play a crucial role in the initiation and progression of tumors. Cancer stem cells (CSCs) are indispensable for cancer development; however, the regulation of cancer stem cell-like properties in gastric cancer (GC) and its specific mechanism remain poorly understood. We elucidate the specific role of Circ-0075305 in GC stem cell properties. Circ-0075305 associated with chemotherapy resistance was identified by sequencing GC cells. Subsequent confirmation in both GC tissues and cell lines revealed that patients with high expression of Circ-0075305 had significantly better overall survival (OS) rates than those with low expression, particularly when treated with postoperative adjuvant chemotherapy for GC. In vitro and in vivo experiments confirmed that overexpression of Circ-0075305 can effectively reduce stem cell-like properties and enhance the sensitivity of GC cells to Oxaliplatin compared with the control group. Circ-0075305 promotes RPRD1A expression by acting as a sponge for corresponding miRNAs. The addition of LF3 (a β-catenin/TCF4 interaction antagonist) confirmed that RPRD1A inhibited the formation of the TCF4-β-catenin transcription complex through competitive to β-catenin and suppressed the transcriptional activity of stem cell markers such as SOX9 via the Wnt/β-catenin signaling pathway. This leads to the downregulation of stem cell-like property-related markers in GC. This study revealed the underlying mechanisms that regulate Circ-0075305 in GCSCs and suggests that its role in reducing β-catenin signaling may serve as a potential therapeutic candidate.

Transition-metal-free four-component reaction of nitriles and disulfides/diselenides

One-pot synthesis of structurally diverse sulfurized/selenated 4-aminopyrimidines has been reported via t-BuOK/K2S2O8-promoted four-component reaction of mixed nitriles and disulfides/diselenides. Mechanistic studies indicate that the reaction proceeds through radical and ionic pathways, and an alkenyl sulfide serves as a key intermediate.

[A study of the clinical curative effect of nucleos(t)ide analogues treated to pegylated interferon-α add-on therapy in patients with chronic hepatitis B]

Objective: To investigate the hepatitis B surface antigen (HBsAg) clearance condition and its predictive factors after treatment with nucleos(t)ide analogues to pegylated interferon-α add-on therapy in patients with chronic hepatitis B. Methods: Patients with chronic hepatitis B who visited the First Affiliated Hospital of Zhengzhou University from 2018~2019 were prospectively enrolled. HBsAg≤ 1500 IU/mL, hepatitis B e antigen-negative, HBV DNA undetectable, received antiviral treatment with nucleos(t)ide analogues for at least one year, and pegylated interferon-α add-on therapy for 48 weeks were included. The primary endpoint of study was to determine the proportion of HBsAg clearance at 72 weeks. Concurrently, the predictive factors for HBsAg clearance were analyzed. Quantitative and qualitative data were analyzed using a t-test or non-parametric test and a Fisher's exact test. Results: A total of 38 cases were included in this study, of which 13 cases obtained HBsAg clearance at 48 weeks of therapy and another six cases obtained HBsAg clearance throughout the extended treatment period of 72 weeks, accounting for 50.00% of all enrolled patients. There was a significant difference in HBsAg dynamics between the HBsAg clearance group and the non-clearance group (P < 0.05). Univariate logistic regression analysis showed that patients' age, baseline, 12-and 24-week HBsAg levels, and early HBsAg reduction were predictive factors for HBsAg clearance at 72 weeks of treatment. Multivariate logistic regression analysis showed that age (OR = 1.311; P = 0.016; 95% confidence interval: 1.051~1.635) and HBsAg levels at 24 weeks of treatment (OR = 4.481; P = 0.004; 95% confidence interval: 1.634~12.290) were independent predictors for HBsAg clearance. Conclusion: Hepatitis B e antigen-negative, nucleos(t)ide analogue treated, HBsAg ≤ 1500 IU/mL, and HBV DNA undetectable, peg-IFNα add-on treatment for 48 weeks could promote HBsAg clearance in patients with chronic hepatitis B. Six of the sixteen cases (37.50%) who did not obtain HBsAg clearance at week 48 did so with the course of therapy extended to week 72. Hence, the optimal individualized treatment strategy should be customized according to the predictors rather than the fixed 48-week course. Age (≤ 38), baseline HBsAg level (≤2.86 log(10)IU/ml), HBsAg level at 24 weeks (≤ 0.92 log(10)IU/ml), and 12-week HBsAg decrease from baseline (≥ 0.67 log(10)IU/ml) indicate that patients are highly likely to obtain HBsAg clearance at the 72 weeks of combination therapy, in which the combined indicator based on HBsAg level ≤0.92 log(10)IU/ml at 24 weeks will identify 85.0% to 100.0% of patients with HBsAg clearance.

Dietary non-phytate phosphorus requirements for optimal productive and reproductive performance, and egg and tibial quality in egg-type duck breeders

Optimal dietary non-phytate phosphorus (NPP) is essential in poultry to maximise productive and reproductive performance, along with indices of egg and bone quality. This study aimed to establish the NPP requirements of egg-type duck breeders aged from 54 to 80 weeks on the following traits: egg production, egg incubation, egg quality, tibial characteristics, reproductive organ, plasma indices, and the expression of genes related to phosphorus absorption. Longyan duck breeders aged 54 weeks (n = 300) were randomly allotted to five treatments, each containing six replicates of 10 individually caged birds. Birds were fed corn-soybean meal-based diets containing 0.18, 0.25, 0.32, 0.38, and 0.45% NPP/kg for 27 weeks. The tested dietary NPP levels did not affect egg production or egg quality indices. The hatchling weight of ducklings increased (quadratic, P < 0.01) as dietary NPP level increased, and the highest value occurred with 0.25% NPP. The number of large yellow follicles (LYF), and the relative weights of LYF and ovary showed linear and quadratic responses to dietary NPP levels; the lowest number and relative weight of LYF occurred with 0.38% NPP, and the lowest ovarian weight was obtained with 0.25% NPP. There were no differences in tibial length, breaking strength, and mineral density in response to dietary NPP levels. In contrast, tibial content of Ca increased (linear, P < 0.01) with dietary NPP levels increasing from 0.18 to 0.45%, and the tibial content of P increased at 0.32% NPP and the higher dietary NPP levels. Plasma concentration of P showed a quadratic (P < 0.05) response to the dietary NPP levels, where the highest value was seen at 0.38% NPP. In conclusion, dietary NPP levels from 0.18 to 0.45% had no effects on egg production, and egg and tibial quality of duck breeders. The duck breeders fed a diet with 0.25% NPP showed the highest hatchling weight of their offspring, while those fed 0.38% NPP had the lowest number and relative weight of LYF. These results indicated that the diet with 0.25% NPP can be used in egg-type duck breeders to improve the hatchling weight of their offspring, without adverse effects on their productivity. The regression model indicated that the maximal hatchling weight of ducklings was obtained from duck breeders fed the diet with 0.30% NPP.

Indocyanine green fluorescence imaging-guided versus conventional laparoscopic lymphadenectomy for gastric cancer: long-term outcomes of a phase 3 randomised clinical trial

Indocyanine green (ICG) fluorescence imaging-guided lymphadenectomy has been demonstrated to be effective in increasing the number of lymph nodes (LNs) retrieved in laparoscopic gastrectomy for gastric cancer (GC). Previously, we reported the primary outcomes and short-term secondary outcomes of a phase 3, open-label, randomized clinical trial (NCT03050879) investigating the use of ICG for image-guided lymphadenectomy in patients with potentially resectable GC. Patients were randomly (1:1 ratio) assigned to either the ICG or non-ICG group. The primary outcome was the number of LNs retrieved and has been reported. Here, we report the primary outcome and long-term secondary outcomes including three-year overall survival (OS), three-year disease-free survival (DFS), and recurrence patterns. The per-protocol analysis set population is used for all analyses (258 patients, ICG [n = 129] vs. non-ICG group [n = 129]). The mean total LNs retrieved in the ICG group significantly exceeds that in the non-ICG group (50.5 ± 15.9 vs 42.0 ± 10.3, P < 0.001). Both OS and DFS in the ICG group are significantly better than that in the non-ICG group (log-rank P = 0.015; log-rank P = 0.012, respectively). There is a difference in the overall recurrence rates between the ICG and non-ICG groups (17.8% vs 31.0%). Compared with conventional lymphadenectomy, ICG guided laparoscopic lymphadenectomy is safe and effective in prolonging survival among patients with resectable GC.

Phylogeny and species diversity of the genus Helvella with emphasis on eighteen new species from China

Helvella is a widespread, frequently encountered fungal group appearing in forests, but the species diversity and molecular phylogeny of Helvella in China remains incompletely understood. In this work, we performed comprehensive phylogenetic analyses using multilocus sequence data. Six datasets were employed, including a five-locus concatenated dataset (ITS, nrLSU, tef1-α, rpb2, hsp), a two-locus concatenated dataset (ITS, nrLSU), and four single-locus datasets (ITS) that were divided based on the four different phylogenetic clades of Helvella recognized in this study. A total of I 946 sequences were used, of which 713 were newly generated, including 170 sequences of ITS, 174 sequences of nrLSU, 131 sequences of tef1-α, 107 sequences of rpb2 and 131 sequences of hsp. The phylogeny based on the five-locus concatenated dataset revealed that Helvellas. str. is monophyletic and four phylogenetic clades are clearly recognized, i.e., Acetabulum clade, Crispa clade, Elastica clade, and Lacunosa clade. A total of 24 lineages or subclades were recognized, II of which were new, the remaining 13 corresponding with previous studies. Chinese Helvella species are distributed in 22 lineages across four clades. Phylogenetic analyses based on the two-locus concatenated dataset and four single-locus datasets confirmed the presence of at least 93 phylogenetic species in China. Among them, 58 are identified as known species, including a species with a newly designated lectotype and epitype, 18 are newly described in this paper, and the remaining 17 taxa are putatively new to science but remain unnamed due to the paucity or absence of ascomatal materials. In addition, the Helvella species previously recorded in China are discussed. A list of 76 confirmed species, including newly proposed species, is provided. The occurrence of H. crispa and H. elastica are not confirmed although both are commonly recorded in China. Citation: Mao N, Xu YY, Zhang YX, Zhou H, Huang XB, Hou CL, Fan L (2023). Phylogeny and species diversity of the genus Helvella with emphasis on eighteen new species from China. Fungal Systematics and Evolution 12: 111-152. doi: 10.3114/fuse.2023.12.08.

Quality Assurance of Protocol Compliance in a Multicenter Randomized Trial Investigating the Role of Hypofractionated Comprehensive Reginal Nodal Irradiation in Node-Positive Breast Cancer (HARVEST)

PURPOSE/OBJECTIVE(S)

The HARVEST trial (NCT03829553) is a phase III, multicenter, randomized clinical trial to explore efficacy and safety of hypofractionated irradiation (HFI) involving regional nodal irradiation (RNI, including internal mammary nodes, IMN) in N+ breast cancer patients treated with mastectomy or breast conserving surgery (BCS). Current study aims to analyze the dosimetric quality assurance so as to evaluate the compliance to the trial protocol.

MATERIALS/METHODS

Eligible patients were randomly assigned (1:1) to receive conventional fractionated irradiation (CFI: 50 Gy/25Fx) or HFI (40.05 Gy/15Fx), which is delivered to ipsilateral chest wall or whole breast (CW/WB) with tumor bed boost (HFI: 10.68 Gy/4Fx; CFI: 10 Gy/5Fx) and comprehensive RNI (supra/infraclavicular nodes and IMN in each patient, lower axilla if indicated) by using IMRT technique. The plan quality was evaluated based on dose distribution, dose volume histogram (DVH) and field parameters. The target coverage, including planning target volume of CW/WB (PTV1) and tumor bed (PTV2) and doses of the organs at risk (OARs) were evaluated. The LQ model was used to convert doses of OARs in HFI group using α/β = 3 Gy (EQD23) for comparison.

RESULTS

Between Feb 21, 2019 and Feb 14, 2022, 801 patients were enrolled at 8 centers with 401 and 400 in CFI and HFI group, respectively. There were 182 patients received BCS and 387 patients were with more than three positive lymph nodes. In the CFI group, the D90 and V45 of PTV1 reached the prescribed dose in 70.6% and 96.0% of the patients, respectively. In the HFI group, the D90 and V36 of PTV1 reached the prescribed dose in 87.8% and 95.5% of the patients, respectively. When the tumor bed was irradiated, the D90 of PTV2 reached the prescribed dose in 95.6% in the CFI group and 100% in the HFI group, respectively. The mean D90 of PTV1 and PTV2 were 50.09±0.65 Gy and 60.63±0.91 Gy in CFI group while 40.11±0.56 Gy and 50.79±2.03 Gy in HFI group. For OARs constraints, protocol compliance was all above 95% (heart: 95.3%; ipsilateral lung: 95.5%; contralateral lung: 97.1%; humeral head: 98.2% and spinal cord: 100%) with no significant difference between CFI and HFI groups. For patients with left-sided breast cancer, the Dmean of the heart was 5.10±1.75 Gy vs. 4.59±1.86 Gy (EQD23) in CFI and HFI groups (p = 0.51), respectively. No significant differences in Dmean of the heart (1.45±0.71 Gy vs. 1.33±0.77 Gy (EQD23), p = 0.40) was found either between two groups in right-sided patients. The differences were significant in the Dmean of the ipsilateral lung (13.37±1.99 Gy vs. 11.17±3.50 Gy (EQD23), p<0.01), contralateral lung (0.88±0.73 Gy vs. 0.74±0.61 Gy (EQD23), p<0.01) and the ipsilateral humeral head (15.27±7.62 Gy vs. 13.05±6.19 Gy (EQD23), p<0.01) and the Dmax of spinal cord (21.40±8.82 Gy vs. 19.47±7.99 Gy (EQD23), p = 0.05) between CFI and HFI groups.

CONCLUSION

A high degree of compliance with protocol dose constraints was found for treatment plans in the HARVEST trial and doses to the most of OARs decreased in HFI group.

Recurrence Risk Score Model for Evaluating the Impact of Postmastectomy Radiotherapy in Breast Cancer Patients with Pathologic Nodal Negative after Neoadjuvant Chemotherapy and Mastectomy

PURPOSE/OBJECTIVE(S)

Recurrence risk score model was established to distinguish the recurrent risk of patients with pathologic nodal negative (ypN0) after neoadjuvant chemotherapy (NACT) and mastectomy and determine the impact of postmastectomy radiotherapy (PMRT).

MATERIALS/METHODS

This multicenter retrospective study reviewed 766 patients who underwent mastectomy and NACT with ypN0 from 2000 to 2014. Recurrent risk score model was assigned proportionally to the relative contribution of independent prognostic factors in the multivariate Cox model of disease-free survival (DFS). Decision tree analysis was conducted to determine two optimal cutoff points for stratification.

RESULTS

The median follow-up time was 74 months. The 5-year locoregional control (LRC), DFS, and overall survival (OS) rates for the entire group were 96.5%, 89.1% and 95.3%, respectively. 353 (46.1%) patients received PMRT and 413 (53.9%) patients did not. Patients with PMRT have more high-risk factors, including age <40 years, clinical stage III, grade III, or ER and PR negative. Chest wall and regional nodal region were irradiated in 307 (87.0%) and chest wall only in 46 (13.0%). The median radiation dose was 50 Gy (range: 36-60 Gy) in 25 fractions (range: 15-30 fractions). There were no significant differences between the PMRT and No-PMRT groups in the LRC, DFS and OS rates. Recurrent risk score model consisted of five factors and used a range of zero to eleven scoring points: age <40 years and clinical N1 stage for one point; clinical N2, NACT ≥4 cycles, lymphovascular invasion and ypT1-2 for two points; ypT3-4 for four points. 456 (59.5%) patients scoring zero to four points, 188 (24.5%) scoring five points and 122 (15.9%) scoring six to eleven points were assigned to the low-, intermediate-, and high-risk group. LRC, DFS and OS rates in three risk groups were significantly distinct from each other (5yr-LRC: 98.6% vs. 95.5% vs. 89.8%, p < .001; 5yr-DFS: 94.4% vs. 87.4% vs. 71.5%, p < .001; 5yr-OS: 97.6% vs. 93.2% vs. 90.0%, p < .001). PMRT had no impact on the LRC, DFS and OS rates in either low-, intermediate-, or high-risk group.

CONCLUSION

The recurrence risk score model can effectively distinguish patients with different recurrent risk stratification. PMRT in patients with ypN0 after NAC and mastectomy cannot improve LRC, DFS or OS. Table 1. Survival outcomes and comparison between PMRT and No-PMRT arms in different groups.

Porcine reproductive and respiratory syndrome virus upregulates SMPDL3B to promote viral replication by modulating lipid metabolism

Porcine reproductive and respiratory syndrome virus (PRRSV) poses a severe threat to the health of pigs globally. Host factors play a critical role in PRRSV replication. Using PRRSV as a model for genome-scale CRISPR knockout (KO) screening, we identified a host factor critical to PRRSV infection: sphingomyelin phosphodiesterase acid-like 3B (SMPDL3B). Our findings show that SMPDL3B restricted PRRSV attachment, entry, replication, and secretion and that its depletion significantly inhibited PRRSV proliferation, indicating that SMPDL3B plays a positive role in PRRSV replication. Our data also show that SMPDL3B deficiency resulted in an accumulation of intracellular lipid droplets (LDs). The expression level of key genes (ACC, SCD-1, and FASN) involved in lipogenesis was increased, whereas the fundamental lipolysis gene, ATGL, was inhibited when SMPDL3B was knocked down. Overall, our findings suggest that SMPDL3B deficiency can effectively inhibit viral infection through the modulation of lipid metabolism.

Comparison of efficacy of conbercept, aflibercept, and ranibizumab ophthalmic injection in the treatment of macular edema caused by retinal vein occlusion: a Meta-analysis

AIM

To evaluate and compare the anatomical and functional outcomes and negative effects of the three anti-vascular endothelial growth factor (VEGF) drugs in the treatment of macular edema (ME) due to retinal vein occlusion (RVO) based on the evidence pooled from current clinical trials and observational studies.

METHODS

A systematic literature search was conducted on nine online databases from inception until April 30, 2022. The main endpoints were best corrected visual acuity (BCVA), central macular thickness (CMT), and adverse events (AEs). Cumulative Meta-analysis was conducted to synthesize the outcomes of the drugs. The retrieved data were analyzed using Stata software (version 12.0).

RESULTS

A total of 20 studies comprising 1674 eyes met the inclusion criteria to the Meta-analysis. It was observed that conbercept and aflibercept had better visual acuity effects compared with ranibizumab at 1mo [weight mean difference (WMD)=-0.03, P=0.001; WMD=-0.05, P=0.019], but the effects were not different from that of ranibizumab at 6mo. Moreover, there was not statistically significant difference in the proportion of patients gaining ≥15 letters at 12-24mo between aflibercept and ranibizumab [odds ratio (OR)=1.16, P=0.427]. Conbercept had higher mean CMT change effects at 1mo (WMD=-14.43, P=0.014) and 6mo (WMD=-35.63, P≤0.001) compared with ranibizumab. Meanwhile, the mean CMT change effects at 1mo (WMD=-10.14, P=0.170), 6mo (WMD=-26.98, P=0.140) and 12-24mo (WMD=-12.34, P=0.071) were comparable among the groups. Similarly, AEs were not significantly different among the treatments (OR=0.75, P=0.305; OR=1.04, P=0.89). The stability of effect size of mean BCVA and CMT improved with the increase in sample size. Aflibercept and conbercept required fewer injections compared with ranibizumab.

CONCLUSION

This is the first study to evaluate the efficacy and AEs of intravitreal administration of conbercept, ranibizumab, and aflibercept in the treatment of RVO-ME. Intravitreal aflibercept or conbercept results in better mean change in vision and CMT reduction compared with ranibizumab. Conbercept can be considered to be a promising and innovative drug with good anti-VEGF effects.

Immunogenicity and protective efficacy of a multi-epitope recombinant toxin antigen of Pasteurella multocida against virulent challenge in mice

Pasteurella multocida (P. multocida) infection frequently results in porcine atrophic rhinitis and swine plague, leading to large economic losses for the swine industry worldwide. P. multocida toxin (PMT, 146 kDa) is a highly virulent key virulence factor that plays a vital role in causing lung and turbinate lesions. This study developed a multi-epitope recombinant antigen of PMT (rPMT) that showed excellent immunogenicity and protection in a mouse model. Using bioinformatics to analyse the dominant epitopes of PMT, we constructed and synthesized rPMT containing 10 B-cell epitopes, 8 peptides with multiple B-cell epitopes and 13 T-cell epitopes of PMT and a rpmt gene (1,974 bp) with multiple epitopes. The rPMT protein (97 kDa) was soluble and contained a GST tag protein. Immunization of mice with rPMT stimulated significantly elevated serum IgG titres and splenocyte proliferation, and serum IFN-γ and IL-12 were upregulated by 5-fold and 1.6-fold, respectively, but IL-4 was not. Furthermore, the rPMT immunization group exhibited alleviated lung tissue lesions and a significantly decreased degree of neutrophil infiltration compared with the control groups post-challenge. In the rPMT vaccination group, 57.1% (8/14) of the mice survived the challenge, similar to the bacterin HN06 group, while all the mice in the control groups succumbed to the challenge. Thus, rPMT could be a suitable candidate antigen for developing a subunit vaccine against toxigenic P. multocida infection.

Pseudorabies virus exploits N6-methyladenosine modification to promote viral replication

Introduction

Pseudorabies virus (PRV) is the pathogenic virus of porcine pseudorabies (PR), belonging to the Herpesviridae family. PRV has a wide range of hosts and in recent years has also been reported to infect humans. N⁶-methyladenosine (m⁶A) modification is the major pathway of RNA post-transcriptional modification. Whether m⁶A modification participates in the regulation of PRV replication is unknown.

Methods

Here, we investigated that the m⁶A modification was abundant in the PRV transcripts and PRV infection affected the epitranscriptome of host cells. Knockdown of cellular m⁶A methyltransferases METTL3 and METTL14 and the specific binding proteins YTHDF2 and YTHDF3 inhibited PRV replication, while silencing of demethylase ALKBH5 promoted PRV output. The overexpression of METTL14 induced more efficient virus proliferation in PRV-infected PK15 cells. Inhibition of m⁶A modification by 3-deazaadenosine (3-DAA), a m⁶A modification inhibitor, could significantly reduce viral replication.

Results and Discussion

Taken together, m⁶A modification played a positive role in the regulation of PRV replication and gene expression. Our research revealed m⁶A modification sites in PRV transcripts and determined that m⁶A modification dynamically mediated the interaction between PRV and host.

The prevalence of obesity-related hypertension among middle-aged and older adults in China

Objective

The aim of our study was to assess the prevalence and geographic variation of obesity-related hypertension in China among adults aged 45 years or older.

Methods

Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015. Stratified sample households covered 150 counties/districts and 450 villages/urban communities from 28 provinces by using household questionnaires, clinical measurements, and blood-based bioassays. A multivariable non-conditional logistic regression model was used to analyze the risk factors correlated with obesity-related hypertension.

Results

The prevalence of obesity-related hypertension was 22.7%, ~120 million people, among adults aged 45 years or older in China. For people in the age ranges of 45-54, 55-64, 65-74, and ≥75 years, the prevalence of obesity-related hypertension was 16.7, 24.3, 27, and 26.7%, respectively, and the prevalence of obesity-related hypertension among hypertensive participants was 66.0, 60.9, 54.2, and 47.3%, respectively. Compared with non-obesity-related hypertension, the obesity-related hypertensive patients had a higher prevalence of diabetes mellitus, dyslipidemia, and hyperuricemia (all P < 0.0001). The prevalence of obesity-related hypertension showed a decreasing gradient from north to south and from east to west. Multivariate logistic regression analysis showed that female gender, living in urban areas, diabetes mellitus, dyslipidemia, and hyperuricemia were positively correlated with obesity-related hypertension.

Conclusion

The prevalence of obesity-related hypertension among adults aged 45 years or older was high in China. Among hypertensive participants, older age was negatively correlated with obesity-related hypertension. Obesity-related hypertensive participants are more prone to aggregation of risk factors of atherosclerotic cardiovascular disease.

Exosomes derived from hypoxia-induced alveolar epithelial cells stimulate interstitial pulmonary fibrosis through a HOTAIRM1-dependent mechanism

Pulmonary fibrosis is the result of various diseases with no satisfactory treatment approaches. The exosome-mediated transfer of long noncoding RNAs (lncRNAs) has been implicated in the pathological process of lung diseases. Herein, we investigated the therapeutic potential of HOTAIRM1 transferred by alveolar epithelial cell (AEC)-derived exosomes in interstitial pulmonary fibrosis (IPF) and the potential molecular mechanisms. Next-generation sequencing-based gene expression profiling was employed to identify lncRNAs related to IPF. Exosomes were isolated from hypoxia-induced AECs (AEC-exosomes) and identified before use. HOTAIRM1 expression was examined in bleomycin-induced IPF mouse models and the isolated exosomes, and the miRNA downstream of HOTAIRM1 was analyzed. HOTAIRM1 expression was increased in the lung tissues of IPF mice and AEC exosomes. HOTAIRM1 delivered by AEC-exosomes promoted the proliferation and transdifferentiation of lung fibroblasts (LFs). Mechanistically, HOTAIRM1 competitively bound to miR-30d-3p and recruited YY1 to upregulate HSF1 expression. In addition, miR-30d-3p targeted HSF1 by binding to its 3'-UTR and reduced its expression. In vivo assays confirmed the promoting effect of exosomes-HOTAIRM1 on extracellular matrix remodeling by regulating the miR-30d-3p/HSF1/YY1 axis. Overall, HOTAIRM1 loaded by AEC exosomes can accelerate IPF by disrupting miR-30d-3p-mediated inhibition of HSF1 and inducing recruitment of HSF1 by YY1. These results highlight a promising strategy to overcome IPF.

[Oncomelania hupensis control strategy during the stage moving towards elimination of schistosomiasis in China]

Oncomelania hupensis is the only intermediate host of Schistosoma japonicum, and O. hupensis control is an important measure for schistosomiasis control. With the progress of national schistosomiasis control program, the prevalence of schistosomiasis is low in China; however, there are still multiple challenges for O. hupensis breeding and schistosomiasis transmission risk. Considering the target of the national schistosomiasis elimination program and environmental protection in the new era, the introduction of precision identification, precision interventions and precision assessment into O. hupensis control may facilitate the progress towards elimination of schistosomiasis in China.

Effects of dietary inclusion of cassava starch-extraction-residue meal on egg production, egg quality, oxidative status, and yolk fatty acid profile in laying ducks

This study was designed to evaluate the effects of different dietary levels of cassava starch extraction residue meal (CReM) on egg production, egg quality, oxidative status, egg yolk fatty acid profile, and hepatic expression of fatty acid metabolism-related genes. In total, 288 Longyan laying ducks aged 21 wk with similar BW were randomly assigned to 4 dietary treatments, each consisting of 6 replicates of 12 birds. The birds were fed a typical corn-soybean meal diet, which contained 0% (control), 5%, 10%, and 15% CReM, mainly replacing wheat bran, and the experiment lasted for 16 wk. The tested CReM levels did not show significant effects on the egg production, nonmarketable egg percentage, egg weight, daily egg mass, and FCR (g feed: g egg), but daily feed intake was reduced with increased CReM level (linear P < 0.001, quadratic P < 0.05). Yolk color increased (linear and quadratic, P < 0.01) with the increase in CReM level, but the Haugh unit, yolk proportion, albumen proportion, shell proportion, eggshell thickness, and eggshell strength were unaffected. Yolk contents of C11:0 and C12:0 (linear, quadratic, P < 0.01) and total saturated fatty acids increased, and the C22:1 level decreased (linear P < 0.01, quadratic P < 0.05) with the increase in CReM level, but the total monounsaturated fatty acids, the individual and total polyunsaturated fatty acids and n−6 and n−3 fatty acids, triglycerides, and total cholesterol in egg yolk were not affected. Hepatic gene expression revealed a significant increase in peroxisome proliferators-activated receptors γ (linear, quadratic, P < 0.001), but the expression of fatty acid synthase, sterol regulatory element binding protein 1 and apolipoprotein A1 genes were unaffected by CReM level. In conclusion, the results of the current study indicated that the CReM could be included up to 15% in laying duck diets without negative effects on the egg-laying rate, egg quality, and oxidative status. Dietary inclusion of CReM increased the yolk content of total saturated fatty acids and SOD activity in the liver.

Different Effects of Antibiotics on Klebsiella pneumoniae and Escherichia coli Resistance Induced by Antibiotics: A Retrospective Study from China

Objective: The main objective was to assess the correlation between antibiotic use and carbapenem-resistant Klebsiella pneumoniae (CRKP) and carbapenem-resistant Escherichia coli (CREC) induction by antibiotics. Materials and Methods: A retrospective cohort study was conducted from January 2017 to December 2020. This study included patients with K. pneumoniae and E. coli. Kaplan-Meier analysis and Cox proportional hazard model were used to estimate the hazard of carbapenem-resistant Enterobacterales (CRE), whereas restricted cubic spline regression was used to visualize the hazard of CRE by antibiotics at different doses. Results: Two thousand fifty-six K. pneumoniae patients and 3,243 E. coli patients were included. After Cox proportional hazard model analysis, carbapenems or 1st-cephalospoins or penicillin monotherapy, male and ICU admission were associated with CRKP. CREC was associated with quinolone monotherapy. Time-to-event analysis indicated that carbapenem, β-lactamase inhibitor mixtures, and quinolones were associated with higher 30-day CRKP hazards than other antibiotics (χ² = 33.670, p < 0.001). Further restricted cubic spline regression analysis found that the hazard of CRKP induction decreased with the increased dose of β-lactamase inhibitor mixtures, but there was no significant change in the hazard ratio of CRKP induction with the increased dose of quinolones. Moreover, there was an obvious characteristic of "parabolic curve" for the hazard of CREC induction due to β-lactamase inhibitor mixtures, and the hazard value gradually increased with the dose, reached the maximum at 24 g, and finally gradually decreased from 26 g. Conclusions: Rational use of antibiotics should be implemented and antimicrobial stewardship policies should be adjusted according to the characteristics of each hospital.

The Plaque Microbiota Community of Giant Panda (Ailuropoda melanoleuca) Cubs With Dental Caries

Dental caries severely hinders efficient access to adequate energy in wildlife. Different food supplies will develop characteristic plaque, and the microorganisms of these plaque are closely related to dental health. Here, plaque samples from panda cubs with caries and caries-free were collected for 16S rRNA high-throughput sequencing. All sequences clustered into 337 operational taxonomic units (OTUs; 97% identity), representing 268 independent species belonging to 189 genera, 98 families, 51 orders, 24 classes, and 13 phyla. Two groups shared 218 OTUs, indicating the presence of a core plaque microbiome. α diversity analysis showed that the microbial diversity in plaques with caries exceeded that of caries-free. The dominant phyla of plaque microbiota included Proteobacteria, Bacteroidetes, Firmicutes, Fusobacteria, and Actinobacteria. The dominant genera included unclassified Neisseriaceae, Actinobacillus, Lautropia, Neisseria, Porhyromonas, unclassified Pasteurellaceae, Moraxella, Streptococcus, Bergeywlla and Capnocytophaga. β diversity analysis showed that the plaque microbial community structure was different between two groups. Using LEfSe analysis, 19 differentially abundant taxa were identified as potential biomarkers. Finally, function predictions analysis showed All the energy related metabolic pathways on KEGG level 2 were enriched in caries-active group. Consistent with the mainstream caries-causing narrative, our results illuminate the lack of information regarding the oral microflora composition and function within giant panda cubs.

[Analysis of whole-mouth taste function test results in 584 healthy adults]

Objective: To assess the taste function of healthy Chinese adults with the reliable whole-mouth taste test, and to analyze the correlation of taste function with age and gender. Methods: The clinical data of 584 participants reporting the normal sense of smell and taste from March 2019 to January 2020 in the Physical Examination Center of Beijing Anzhen Hospital were analyzed in the study, including 297 males and 287 females, aging (46.9±16.6) years. The subjects were divided into youth group (19-35 years old), middle aged group (36-50 years old), middle-elderly aged group (51-65 years old) and elderly group (66-80 years old). The taste test involved 5 tastants (sour, sweet, salty, umami and bitter) and 7 concentrations. The perception and recognition scores of five tastes were obtained through the whole-mouth taste test. SPSS 22.0 software was used for statistical analysis. Results: The intra-class correlation coefficients of the whole-mouth taste test were 0.751 to 0.828, which showed high test-retest reliability. The total score of perception and recognition of five tastes showed the significant negative correlation with age (r value was -0.49 and -0.44, respectively, both P<0.001). Compared with the other two groups, taste function of middle-elderly aged and elderly group decreased significantly (all P<0.001). There was no significant difference in total perception scores and total recognition scores between youth and middle aged group (all P>0.05). The perception scores and recognition scores of sour, salty, umami, bitter and total scores in females were higher than those in males (all P<0.05), but there was no significant difference in perception scores and recognition scores for sweet between them (P value was 0.584 and 0.223, respectively). Conclusions: The taste function is significantly negatively correlated with age. Except the sweet, females are more sensitive to the sour, salty, umami and bitter tastes than males.

The crystal structure of 4,4′-diselanediylbis(8-(hexyloxy)-3,6-dimethyl-1-(piperidin-1-yl)isoquinoline-7-carbonitrile), C46H60N6O2Se2

C46H60N6O2Se2, triclinic, P 1 ‾ $\bar{1}$ (no. 2), a = 10.4701(7) Å, b = 10.6331(7) Å, c = 20.4665(14) Å, α = 92.079(2)°, β = 97.937(2)°, γ = 95.848(2)°, V = 2242.0(3) Å3, Z = 2, R gt (F) = 0.0487, wR ref (F 2) = 0.1183, T = 293(2) K.

[Evaluation of chemosensory function in patients with upper respiratory tract post-viral olfactory dysfunction]

Objective: To observe the changes of olfactory function, intranasal trigeminal nerve function and taste function in patients with upper respiratory tract post-viral olfactory dysfunction (PVOD), and to explore the correlation of chemosensory function. Methods: The clinical data of 42 patients with PVOD who visited to the Olfactory and Taste Center of Otorhinolaryngology Head and Neck Surgery Department of Beijing Anzhen Hospital from January to December of 2019 were analyzed retrospectively, including 20 males and 22 females, aging (48.86±11.47) years (x¯). Twenty subjects in normal control group were selected according to the sex ratio of PVOD patients. Sniffin' Sticks olfactory tests were performed on the subjects, including threshold test (T), discrimination test (D) and identification test (I), and the sum of the above three test scores was the TDI value. At the same time, olfactory event-related potentials (oERPs), trigeminal event-related potentials (tERPs) and taste function test were performed. According to the taste function test, the patients were divided into normal gustation (NG) group and gustatory dysfunction (GD) group. The results of olfaction, taste and intranasal trigeminal nerve function tests were compared among different groups, and the correlation analysis was carried out. SPSS statistical software was used for statistical analysis. Results: GD was present in 14 (33.3%) of 42 PVOD patients with a course of PVOD of 5 (3, 6) months (M (Q₁, Q₃)). The gustatory function of patients with PVOD was related to gender (r=0.565, P<0.001), smoking status (r=-0.512, P=0.001), duration (r=-0.357, P=0.020) and olfactory function (all P<0.05). The olfactory function of GD group was worse than that of NG group, and the differences of TDI value and T value between the two groups were statistically significant (10.25±4.58 vs 13.35±3.61, 1.54±0.66 vs 2.10±0.88, t value was 2.40 and 2.10 respectively, both P<0.05). The amplitudes of oERPs and tERPs were significantly lower in GD group than those in NG group (all P<0.05). Conclusion: In patients with PVOD, the subjective and objective olfactory function, intranasal trigeminal nerve function and taste function were decreased, and there was a correlation, suggesting that there was a synergistic effect between the chemosensory functions of PVOD patients.

High prevalence and low awareness of hyperuricemia in hypertensive patients among adults aged 50-79 years in Southwest China

Introduction

This study was aimed to assess the prevalence of hyperuricemia and its associated risk factors among hypertensive patients in Southwest China.

Methods

From September 2013 to March 2014, a multistage, stratified sampling was conducted on 3505 hypertensive people aged 50–79 years who lived in urban communities within Chengdu and Chongqing, using a questionnaire and performing physical and biochemical measurements.

Results

In the study population, approximately 18.2% of all hypertensive participants had hyperuricemia (638/3505), with a prevalence rate of 21.5% in men and 16.2% in women (p < 0.05). Multivariate logistic regression analysis showed that aging, without spouse, current drinking, preferring hotpot, hypertriglyceridemia, BMI ≥ 25 kg/ m², and central obesity were all positively correlated with hyperuricemia, whereas female gender was negatively correlated with hyperuricemia. The prevalence of hyperuricemia among hypertensive patients in urban adults aged 50–79 years in southwestern China was high, while levels of awareness were extremely low.

Discussion

Improved hyperuricemia health knowledge should be delivered to improve public awareness of the disease and it may need aggressive strategies aiming at the prevention and treatment of hyperuricemia. It is may necessary to encourage people to check blood uric acid levels when they first time to be diagnosed with hypertension, especially in the elderly.

[Analysis of community intervention effects for diabetic eye diseases in Shanghai Xinjing community from 2016 to 2018]

Objective: To analyze the effects of community-based interventions for diabetic eye diseases in Xinjing community, Shanghai from 2016 to 2018. Methods: Based on the project of "Establishment of Service Model for Comprehensive Prevention and Treatment of Diabetic Eye Diseases in Shanghai", the participants were not suffering diabetic retinopathy (DR) in Xinjing community in 2016 before interventions and received community-based interventions for diabetic eye diseases. The incidence of DR, visual acuity and awareness of DR were used as evaluation indicators to analyze the effects of interventions for diabetic eye diseases in the community. Results: A total of 537 patients were included in this study, the incidence of DR among diabetic patients in Xinjing community was 7.6% after interventions. The duration of diabetes (OR= 1.065) and HbA1c (OR= 1.090) were the risk factors of DR. Before and after the interventions, the patients with monocular low vision and binocular low vision were 27 cases (5.0%), 8 cases (1.5%), 19 cases (3.5%) and 7 cases (1.3%) respectively. After interventions, the awareness on the prevention and treatment of DR increased significantly, and the proportion of regular visits to ophthalmology examination, diet control and physical exercise also increased significantly. Conclusion: Community-based interventions for diabetic eye diseases are helpful to improve the awareness of DR prevention and control, reduce the incidence of DR.

The crystal structure of 2-(2-methyl-6-phenyl-4H-pyran-4-ylidene)-1H-indene-1,3(2H)-dione, C21H14O3

C21H14O3, monoclinic, P21/c (no. 14), a = 4.8318(8) Å, b = 26.590(4) Å, c = 11.821(2) Å, β = 91.050(4)°, V = 1518.4(4) Å3, Z = 4, R gt (F) = 0.0401, wR ref (F) = 0.1038, T = 296(2) K.

CCDC no.: 2122345

Synthesis of novel 3/5(3,5)-(di)nitropaeonol hydrazone derivatives as nematicidal agents

Eighteen novel 3/5(3,5)-(di)nitropaeonol hydrazone derivatives were prepared, and their structures well characterized by ¹H NMR, HRMS, and mp. Due to the steric hindrance, the substituents on the C = N double bond of all hydrazine compounds (except E/Z = 4/1 for IV-1g, IV-1l, IV-2b, and E/Z = 3/2 for IV-1n, IV-3a) adopted E configuration. Among all compounds, four compounds 2, 4, IV-1j, and IV-1n exhibited potent nematicidal activity than their precursor paeonol, especially 5-nitropaeonol (2) and 3,5-dinitropaeonol (4) displayed the most potent nematicidal activity Heterodera glycines in vivo with LC₅₀ values of 32.3307 and 36.7074 mg/L, respectively.

Direct dilithiation of N-aryl heterocycles for the construction of condensed N-heterocycles

A 1,4-dilithio intermediate generated from N-aryl heterocycles reacts well with acyl chlorides to afford condensed N-heterocycles in good yields.

The peroxisome proliferator-activated receptor agonist rosiglitazone specifically represses tumour metastatic potential in chromatin inaccessibility-mediated FABP4-deficient gastric cancer

Background: Efforts to prevent recurrence in gastric cancer (GC) patients are limited by current incomplete understanding of the pathological mechanisms. The present study aimed to identify novel tumour metastasis-associated genes and investigate potential value of these genes in clinical diagnosis and therapy.

Methods: RNA sequencing was performed to identify differentially expressed genes related to GC metastasis. The expression and prognostic significance of fatty acid binding protein 4 (FABP4) were evaluated in two independent cohorts of GC patients. Chromatin immunoprecipitation sequencing, diverse mouse models and assays for transposase-accessible chromatin with high-throughput sequencing were used to investigate the roles and mechanisms of action of FABP4.

Results: The results of the present multicentre study confirmed an association between a decrease in the expression of FABP4 and poor outcomes in GC patients. FABP4 inhibited GC metastasis but did not influence tumour growth in vitro and in vivo. Mechanistically, FABP4 binding with peroxisome proliferator-activated receptor γ (PPAR-γ) facilitated the translocation of PPAR-γ to the nucleus. FABP4 depletion suppressed PPAR-γ-mediated transcription of cell adhesion molecule 3 (CADM3), which preferentially governed GC metastasis. Notably, the PPAR-γ agonist rosiglitazone reversed the metastatic properties of FABP4-deficient GC cells in vitro and demonstrated viable therapeutic potential in multiple mouse models. For GC patients with diabetes, low FABP4 portends better prognosis than high FABP4 after receipt of rosiglitazone treatment. Additionally, chromatin inaccessibility induced by HDAC1 reduced FABP4 expression at the epigenetic level.

Conclusions: Our findings suggest that chromatin inaccessibility orchestrates a reduction in FABP4 expression, which inhibits CADM3 transcription via PPAR-γ, thereby resulting in GC metastasis. The antidiabetic drug rosiglitazone restores PPAR-γ/CADM3 activation in FABP4-deficient GC and thus has promising therapeutic potential.

Cascade Ring-Opening Dual Halogenation of Cyclopropenones with Saturated Oxygen Heterocycles

Represented is a CuX₂- or I₂-promoted ring-opening dual halogenation of cyclopropenones with saturated oxygen heterocycles, providing an efficient method for the synthesis of 3-haloacrylates. The ring-opening reaction enables the construction of two C-X (X = Cl, Br, or I) bonds and a C-O bond as well as the cleavage of two C-O bonds and a C-C bond in a single step. This protocol is highly atom economical, has an excellent substrate scope, and exhibits the ability for gram-scale reaction.

Effects of maternal and progeny dietary selenium supplementation on growth performance and antioxidant capacity in ducklings

This study evaluated the effects of selenium (Se) supplementation in maternal and offspring diets on performance and antioxidant capacity of ducklings aged from 0 to 2 wk. A total of 144 female Longyan duck breeders aged 22-wk were allotted into 2 treatments and fed a control diet or a 0.16 mg Se/kg supplemented diet. At 40-wk, 120 offspring from each treatment were divided into 2 groups, with 6 replicates of 10 birds. Using a 2 × 2 factorial design, ducklings from each maternal dietary treatment were assigned to a control diet or a 0.16 mg Se/kg supplemented diet from hatch to 2-wk. Compared with Se-deficient diet, maternal diet supplemented with 0.16 mg Se/kg increased the BW of hatchlings (P < 0.01). There were interactions between maternal and progeny diet with 0.16 mg Se/kg in BW of ducklings aged 2 wk and BW gain (BWG) as ducklings from maternal Se/progeny none treatment had the lightest BW and BWG (P < 0.01). Maternal diet with 0.16 mg Se/kg decreased plasma concentration of uric acid and insulin-like growth factor 1 (P < 0.01), and progeny diet supplemented with 0.16 mg Se/kg increased the activities of glutathione peroxidase 3 (GPx3) in plasma and glutathione peroxidase 1 in erythrocyte (P < 0.01). Maternal diet with 0.16 mg Se/kg increased (P < 0.05) the hepatic activity of total superoxide dismutase (T-SOD). Progeny diet supplemented with 0.16 mg Se/kg increased (P < 0.01) hepatic activity of GPx3 and decreased (P < 0.01) the hepatic concentration of malondialdehyde. Interactions were detected between maternal and progeny diet with 0.16 mg Se/kg in hepatic activity of T-SOD and maternal and progeny diet supplemented with Se displayed the highest hepatic activity of T-SOD (P < 0.05). Overall, Se supplementation in the diet of duck breeders and offspring increased the antioxidant capacity of ducklings. Maternal Se supplementation increased the BW of hatchlings, whereas maternal and progeny dietary Se supplementation did not affect the BWG of ducklings aged from 0 to 2 wk. Se supplementation with additional 0.16 mg/kg in the diet of duck breeders and offspring displayed beneficial effects particularly on the antioxidant capacity in ducklings.

Retrospective Study of Critically Ill COVID-19 Patients With and Without Extracorporeal Membrane Oxygenation Support in Wuhan, China

Background: Extracorporeal membrane oxygenation (ECMO) might benefit critically ill COVID-19 patients. But the considerations besides indications guiding ECMO initiation under extreme pressure during the COVID-19 epidemic was not clear. We aimed to analyze the clinical characteristics and in-hospital mortality of severe critically ill COVID-19 patients supported with ECMO and without ECMO, exploring potential parameters for guiding the initiation during the COVID-19 epidemic.

Methods: Observational cohort study of all the critically ill patients indicated for ECMO support from January 1 to May 1, 2020, in all 62 authorized hospitals in Wuhan, China.

Results: Among the 168 patients enrolled, 74 patients actually received ECMO support and 94 not were analyzed. The in-hospital mortality of the ECMO supported patients was significantly lower than non-ECMO ones (71.6 vs. 85.1%, P = 0.033), but the role of ECMO was affected by patients' age (Logistic regression OR 0.62, P = 0.24). As for the ECMO patients, the median age was 58 (47–66) years old and 62.2% (46/74) were male. The 28-day, 60-day, and 90-day mortality of these ECMO supported patients were 32.4, 68.9, and 74.3% respectively. Patients survived to discharge were younger (49 vs. 62 years, P = 0.042), demonstrated higher lymphocyte count (886 vs. 638 cells/uL, P = 0.022), and better CO₂ removal (PaCO2 immediately after ECMO initiation 39.7 vs. 46.9 mmHg, P = 0.041). Age was an independent risk factor for in-hospital mortality of the ECMO supported patients, and a cutoff age of 51 years enabled prediction of in-hospital mortality with a sensitivity of 84.3% and specificity of 55%. The surviving ECMO supported patients had longer ICU and hospital stays (26 vs. 18 days, P = 0.018; 49 vs. 29 days, P = 0.001 respectively), and ECMO procedure was widely carried out after the supplement of medical resources after February 15 (67.6%, 50/74).

Conclusions: ECMO might be a benefit for severe critically ill COVID-19 patients at the early stage of epidemic, although the in-hospital mortality was still high. To initiate ECMO therapy under tremendous pressure, patients' age, lymphocyte count, and adequacy of medical resources should be fully considered.

Comparison of submucosal and subserosal approaches toward optimized indocyanine green tracer-guided laparoscopic lymphadenectomy for patients with gastric cancer (FUGES-019): a randomized controlled trial

BACKGROUND

Application of indocyanine green (ICG) fluorescence imaging is effective in guiding laparoscopic radical lymphadenectomy for gastric cancer. However, the optimal approach for indocyanine green injection is controversial. Therefore, the objective of this study was aimed to compare the efficacy and ICG injection between the preoperative submucosal and intraoperative subserosal approaches for lymph node (LN) tracing during laparoscopic gastrectomy.

METHOD

This randomized controlled trial (ClinicalTrials.gov, NCT04219332) included 266 patients with potentially resectable gastric cancer (cT1-T4a, N0/+, M0) enrolled from a tertiary teaching center between December 2019 and October 2020. The primary endpoint was total number of retrieved LNs.

RESULTS

In total, 259 patients (n = 130 and n = 129 in the submucosal and subserosal groups, respectively) were included in the per-protocol analysis. There are no significant differences in total number of retrieved LNs between the two groups (49.8 vs. 49.2, P = 0.713). The rate of LN noncompliance in the submucosal group was comparable to that in the subserosal group (32.3% vs. 33.3%, P = 0.860). No significant difference was found between the submucosal and subserosal groups in terms of the incidence (17.7% vs. 16.3%; P = 0.762) or severity of postoperative complications. The mean fluorescence cost in the submucosal group was higher than that in the subserosal group ($335.3 vs. $182.4; P < 0.001). The overall treatment satisfaction score was lower in the submucosal group than in the subserosal group (70.5 vs. 76.1%, P = 0.048).

CONCLUSION

ICG administered by subserosal injection was comparable to that administered by submucosal injection for lymph node tracing in gastric cancer. However, the former approach imposed a lower economic and mental burden on patients undergoing laparoscopic D2 lymphadenectomy.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT04219332 .

Clinical implications of Indocyanine Green Fluorescence Imaging-Guided laparoscopic lymphadenectomy for patients with gastric cancer: A cohort study from two randomized, controlled trials using individual patient data

BACKGROUND

The value of indocyanine green (ICG) fluorescence imaging in tracing metastatic lymph nodes (LNs) has rarely been reported. We aimed to evaluate the clinical implications of fluorescence imaging-guided lymphadenectomy and the sensitivity of fluorescent lymphography to detect metastatic LN stations in gastric cancer (GC).

MATERIALS AND METHODS

This analysis pooled data from two randomized controlled trials (FUGES-012 and FUGES-019 studies) on laparoscopic ICG tracer-guided lymphadenectomy for GC between November 2018 and October 2020. Patients who received ICG injection using either the intraoperative subserosal or preoperative submucosal approaches 1 day before surgery and underwent fluorescence imaging-guided lymphadenectomy were defined as the ICG group. Patients who underwent conventional lymphadenectomy without ICG injection and intraoperative imaging were defined as the non-ICG group.

RESULTS

Among 514 enrolled patients, the ICG and non-ICG groups included 385 and 129, respectively. A significantly higher mean number of LNs was retrieved in the ICG group than in the non-ICG group (49.9 vs. 42.0, P < 0.001). The ICG group showed a lower LN noncompliance rate than that in the non-ICG group (31.9% vs. 57.4%, P < 0.001). The sensitivity of fluorescence imaging for detecting all metastatic LN stations was 86.8%. The negative predictive value was 92.2% for nonfluorescent stations. For detecting all metastatic stations, subgroup analysis revealed 97.7%, 91.7%, 86.2%, and 84.3% sensitivities for pT1, pT2, pT3, and pT4a tumors, respectively. Regardless of gastrectomy type, the diagnostic accuracy for detecting all metastatic stations in the D1+ and D2 stations for cT1-cT2 disease reached 100%.

CONCLUSION

ICG fluorescence imaging, using either the subserosal or submucosal approaches, assisted in the thorough dissection of potentially metastatic LNs, as recommended for individualized laparoscopic lymphadenectomy for GC.

Prevalence and related factors of dyslipidemia among urban adults aged 35 to 79 years in Southwestern China

This study aimed to investigate the prevalence of dyslipidemia and its related factors among urban adults aged 35 to 79 years in Southwestern China. From September 2013 to March 2014, a multi-stage sampling was conducted, and a total of 10,221 people aged 35-79 years living in Chengdu and Chongqing were included. More than 30 investigators were trained in data collection, including questionnaire, anthropometric measurements and blood biomarkers testing. The prevalence of high triglycerides (≥ 2.3 mmol/L), high total cholesterol (≥ 6.2 mmol/L), high low-density lipoprotein cholesterol (≥ 4.1 mmol/L), low high-density lipoprotein cholesterol (< 1.0 mmol/L), and dyslipidemia were 15.7% (95% confidence interval, 15.0-16.4%), 5.4% (4.9-5.8%), 2.5% (2.2-2.8%), 5.7% (5.3-6.2%), and 27.4% (26.5-28.2%), respectively. The prevalence of dyslipidemia was positively correlated with higher education level, monthly income over 2000 CNY, smoking, hypertension, diabetes, overweight and obesity, and central obesity, and negatively correlated with daily physical exercise. The prevalence of dyslipidemia in Southwestern China is lower than the national average level, with high triglycerides being the most common form of dyslipidemia.

Estimation of dietary tryptophan requirement for laying duck breeders: effects on productive and reproductive performance, egg quality, reproductive organ and ovarian follicle development and serum biochemical indices

This study aimed to determine the dietary tryptophan (Trp) requirement for laying duck breeders. A total of 504 Longyan duck breeders (body weight: 1.20 ± 0.02 kg) aged 22 wk were randomly allocated to 6 treatments, each with 6 replicates of 14 ducks. During the next 16 wk, birds were fed the basal diet with total Trp contents of 1.00, 2.00, 3.00, 4.00, 5.00 and 6.00 g/kg, respectively. Dietary Trp levels increased egg production, egg mass and feed intake of duck breeders from 22 to 37 wk (P < 0.05), and there were linear and quadratic effects of Trp level (P < 0.05). The feed conversion ratio (FCR) quadratically decreased with dietary Trp levels (P < 0.05). Dietary Trp levels decreased (P < 0.05) egg albumen height and Haugh unit at wk 8 or 12, and the responses were linear and quadratic (P < 0.05). The body weight of breeders, absolute and relative weight of oviduct, number and total weight of preovulatory follicles (POF), and its proportion relative to ovarian weight were increased (P < 0.05), and the responses were linear (P < 0.01) and quadratic (P < 0.001). Ovarian weight increased quadratically (P < 0.05), and the mean weight of POF increased (P < 0.05), linearly and quadratically. The proportion of small yellow follicles relative to ovary weight decreased (P < 0.01) linearly and quadratically. At wk 16 of the trial period, the serum albumin content and alanine aminotransferase activity decreased (P < 0.05) and the creatinine content increased (P < 0.01) linearly and quadratically. The Trp requirements were estimated to be 3.14 g/kg for optimizing egg production, 2.93 g/kg for egg mass, and 2.92 g/kg for FCR. Overall, dietary Trp levels (1 to 6 g/kg) affected productive performance, egg quality, reproductive organ and ovarian follicle development, and serum biochemical indices of layer duck breeders, and a diet containing 2.9 to 3.1 g Trp per kg feed was adequate during the laying period (22 to 37 wk of age).

Prevalence and risk factors of diabetic retinopathy in patients with type 2 diabetes in Shanghai

AIM

To investigate the prevalence of diabetic retinopathy (DR) in residents of Shanghai and analyze the risk factors of DR.

METHODS

This study involved 7233 patients with diabetes in 2016. The demographic data of the participants were collected using a questionnaire survey. Physical examination, laboratory tests, and ophthalmological examinations were conducted. Two professional ophthalmologists diagnosed and graded DR by fundus examination and then combined the results with fundus images. The unconditional multivariate Logistic regression analysis was used to determine the risk factors.

RESULTS

In total, 6978 patients with type 2 diabetes in Shanghai with a mean age of 68.33±8.40y were recruited, including 2975 males (42.6%) and 4003 females (57.4%). Overall, 1184 patients were diagnosed with DR, with a prevalence rate of 16.97%. Regression analysis showed that duration of diabetes (OR 1.061, 95%CI 1.049-1.073), high systolic blood pressure (SBP; OR 1.071, 95%CI 1.037-1.106), increased glycosylated hemoglobin level (OR 1.234, 95%CI 1.162-1.311), high blood glucose level (OR 1.061, 95%CI 1.023-1.099), increased neutrophil-to-lymphocyte ratio (NLR; OR 1.132, 95%CI 1.053-1.217) and mean platelet volume (MPV; OR 1.077, 95%CI 1.016-1.142) were risk factors of DR. Conversely, hematocrit (HCT; OR 0.971, 95%CI 0.954-0.988) and mean corpuscular volume (MCV; OR 0.980, 95%CI 0.965-0.994) were protective factors.

CONCLUSION

The prevalence rate of DR in Shanghai is 16.97%. The duration of diabetes, high SBP, increased glycosylated hemoglobin, NLR, and MPV were determined as risk factors of DR.

A novel nomogram for predicting locoregional recurrence risk in breast cancer patients treated with neoadjuvant chemotherapy and mastectomy

BACKGROUND

This study aimed to establish a nomogram for predicting locoregional recurrence (LRR) in breast cancer patients treated with neoadjuvant chemotherapy (NAC) and mastectomy.

METHODS

A total of 2368 patients who received NAC and mastectomy between 2000 and 2014 from 12 grade A tertiary hospitals in China were analyzed retrospectively. The nomogram was developed based on the patients treated in three cancer hospitals (training set, n = 1629) and validated based on patients from the other nine general hospitals (validation set, n = 739). Factors identified from Fine and Gray's competing risk analysis were used to establish the nomogram. The predictive performance of the nomogram model was compared with the cTNM stage, ypTNM stage, and the Neo-Bioscore model by using the area under the time dependent receiver operating characteristic curves (tAUC), calibration curve, and decision curve analysis (DCA).

RESULTS

The nomogram incorporated six risk factors derived from multivariable analysis of the training set including age, ypT stage, ypN stage, lymph node ratio, postmastectomy radiotherapy, and endocrine therapy. In the training set, the AUC of the nomogram was 0.792, which was higher than the values of the cTNM stage (0.582), ypTNM stage (0.737), and the Neo-Bioscore prognosis model (0.658). In the validation set, the AUC of the cTNM (0.619); ypTNM (0.636); and Neo-Bioscore staging system (0.584) were also significantly lower than the AUC of the nomogram (0.705). Both in the training and validation sets, the calibration curve showed good agreement between the nomogram-based predictions and the actual observations.

CONCLUSION

The novel nomogram provides a more accurate evaluation of LRR for breast cancer patients treated with NAC and mastectomy.

Molecular and functional characterization of HtrA protein in Actinobacillus pleuropneumoniae

Actinobacillus pleuropneumoniae (A.pleuropneumoniae) causes serious economic loss for the swine industry. A high-temperature requirements A (HtrA)-like protease and its homologs have been reported to be involved in protein quality control and expression of important immunoprotective antigens in many pathogens. In this study, we showed that HtrA of A.pleuropneumoniae exhibited both chaperone and proteolytic activities. Moreover, Outer membrane protein P5 (OmpP5) in A.pleuropneumoniae and Heat shock protein 90 (Hsp90) in porcine lung tissues were first discovered and identified as specific proteolytic substrates for rHtrA. The maximum cleavage activity occurs at 50 ℃ in a time-dependent manner. In addition, rHtrA mainly induced IgG 2a subtype of IgG and Th1 (IFN-γ, IL-2) response in a mice model, and promoted a significant proliferation of spleen lymphocytes compare with negative control (P < 0.05). The survival rates of 37.5 % were observed against A.pleuropneumoniae strain. Together, these data demonstrate that rHtrA plays a multi-functional role in A.pleuropneumoniae.

Systemic Characterization of Novel Immune Cell Phenotypes in Recurrent Pregnancy Loss

Recurrent pregnancy loss (RPL) is a disturbing disease in women, and 50% of RPL is reported to be associated with immune dysfunction. Most previous studies of RPL focused mainly on the relationship between RPL and either T cells or natural killer (NK) cells in peripheral blood and the decidua; few studies presented the systemic profiles of the peripheral immune cell subsets in RPL women. Herein, we simultaneously detected 63 immune cell phenotypes in the peripheral blood from nonpregnant women (NPW), women with a history of normal pregnancy (NP) and women with a history of RPL (RPL) by multi-parameter flow cytometry. The results demonstrated that the percentages of naïve CD4⁺ T cells, central memory CD4⁺ T cells, naïve CD8⁺ T cells, mature NK cells, Vδ1⁺ T cells and the ratio of Vδ1⁺ T cells/Vδ2⁺ T cells were significantly higher in the RPL group than those in the NPW and NP groups, whereas the percentages of terminal differentiated CD4⁺ T cells, effective memory CD4⁺ T cells, immature NK cells and Vδ2⁺ T cells were significantly lower in the RPL group than those in the NPW and NP groups. Interestingly, we found that peripheral T helper (T_PH) cells were more abundant in the NPW group than in the NP and RPL groups. In addition, we also determined the 5^th percentile lower limit and 95^th percentile upper limit of the significantly changed immunological parameters based on the files of the NPW group. Taken together, this is the first study to simultaneously characterize the multiple immune cell subsets in the peripheral blood at a relatively large scale in RPL, which might provide a global readout of the immune status for clinicians to identify clinically-relevant immune disorders and guide them to make clear and individualized advice and treatment plans.

The application of reduced dietary crude protein levels supplemented with additional amino acids in laying ducks

This study was aimed at studying use of reduced dietary crude protein (CP) level supplemented with additional amino acids in laying ducks. A total of 720 Jingjiang ducks (50 wk) were randomly assigned to 5 treatments and fed 5 basal diets with CP levels at 17.5, 16.5, 15.5, 14.5, or 13.5%, with additional amino acids added to each diet for 12 wk. Each treatment had 6 replicates of 24 ducks each. Dietary CP levels affected (P < 0.05) egg production and mass of laying ducks, and there was a linear and quadratic decrease with decreasing CP levels (P < 0.05). Dietary CP levels did not affect egg weight and feed conversion ratio (FCR), but egg weight decreased linearly (P < 0.05); FCR increased linearly and quadratically (P < 0.05) with decreasing CP levels. There were no significant differences in egg quality among the different CP levels (P > 0.05). Ovarian weight, total and mean weight of preovulatory follicles, and total weight of small yellow follicles (SYF) were decreased by dietary CP levels (linear, P < 0.01 and quadratic, P < 0.05). The oviductal weight decreased linearly (P < 0.05), and the number of SYF decreased linearly and quadratically with decreasing CP levels (P < 0.05). The serum estradiol content decreased linearly with dietary CP levels (P < 0.05). The serum contents of luteinizing hormone, prolactin, and progesterone decreased (P < 0.05), linearly and quadratically (both P < 0.01) with decreasing CP levels. The serum contents of creatinine (CRE), triglycerides (TG), total cholesterol (TC), and alanine aminotransferase (ALT) activity were affected (P < 0.05) by different dietary CP levels. The total protein content increased linearly (P < 0.05), TC content increased quadratically (P < 0.05), and contents of albumin, CRE, TG, and phosphorus, and activities of aspartate aminotransferase and ALT increased linearly and quadratically (both P < 0.05) with decreasing CP levels. Overall, reduced dietary CP levels with addition of amino acids affected the laying performance, the development of reproductive organs and ovarian follicles, serum hormones, and biochemical indices of laying ducks. Dietary CP levels can be reduced to 14.5% with additional amino acid supplementation for 12 wk in laying ducks without negative effect on laying performance and egg quality.

Cobalt-catalyzed selective hydroacylation of alkynes

An efficient protocol for alkyne hydroacylation using a catalytic system incorporating Co(acac)3, dppp and AlMe3 is disclosed.

Effects of capsaicin on laying performance, follicle development, and ovarian antioxidant capacity in aged laying ducks

The present study was conducted to evaluate the effects of dietary addition of capsaicin (CAP) on egg production performance, follicular development, and ovarian antioxidant capacity in laying ducks. Three hundred seventy eight 58-wk-old laying ducks were randomly divided into 3 treatments, each treatment consisted 6 replicates, with 12 individually caged laying ducks per replicate. Ducks fed a basal diet served as control, the other 2 groups of ducks were fed the same diet containing 150 mg/kg CAP but in the manner of feed restriction (pair-fed) or ad libitum fed. The experiment lasted for 8 wk. The results showed that the dietary supplementation with CAP under conditions of ad libitum feeding increased feed intake (P < 0.001) and tended (P < 0.1) to increase egg production and egg weight in laying ducks but had no effects on daily egg mass and feed conversion ratio. The relative weight of large yellow follicles from the 2 CAP-supplemented groups at 64 wk of age were significantly higher than that of the controls (P = 0.01). The relative weight of the small yellow follicles in the CAP free-fed group was significantly higher than that of the other 2 groups (P < 0.01). Capsaicin supplementation under ad libitum feding conditions tended to increase the number of dominant follicles in laying ducks (P = 0.06). The ovarian mRNA expression of genes related to calcium signaling (TRPV4, ATP2A2, ITPR1, and CaM) in the CAP ad libitum fed groups were significantly higher than those of the other 2 groups (P < 0.05). The ovarian mRNA expression of CDK1 in CAP free-fed ducks was significantly higher than that of the other 2 groups (P = 0.01). Capsaicin supplementation significantly increased the plasma glutathione peroxidase activity (P < 0.01) in comparison with the control group but reduced the malondialdehyde content in the ovaries of laying ducks (P < 0.01). The results of this study indicates that dietary supplementation of CAP increased feed intake and improved egg production performance probably by activating calcium signaling pathway and improving redox status.

Well-designed retrospective study versus small-sample prospective study in research based on laparoscopic and open radical distal gastrectomy for advanced gastric cancer

BACKGROUND

Well-designed retrospective studies (RSs) and small-sample prospective studies (PSs) evaluating the efficacy of interventions have received much attention. This study was designed to evaluate the differences between well-designed RSs and small-sample randomized controlled trials based on the efficacy of laparoscopic distal gastrectomy (LDG) and open distal gastrectomy (ODG) for advanced gastric cancer (GC).

METHODS

The clinicopathological data of 1360 patients with GC who underwent DG were analysed. After propensity score matching (1:1), 380 cases (ODG = 190, LDG = 190) were finally selected in a RS. Meanwhile, data from 120 patients (ODG = 60, LDG = 60) who enrolled in a PS were analysed.

RESULTS

In the PS, the LDG group had less intraoperative blood loss, shorter time to first flatus, and shorter time to fluid diet than the ODG group. In the RS, the LDG group had less intraoperative blood loss, and a shorter postoperative hospital stay than the ODG group. In the PS, the 3-year overall survival (OS) rate was 83.3% in the LDG group and 83.2% in the ODG group (p = 0.877). In the RS, the 3-year OS rate was 68.7% in the LDG group and 66.6% in the ODG group (p = 0.752). No significant interactions were observed between the two groups and any of the variables examined, either in the PS or RS. The recurrence patterns were similar in the two groups. Furthermore, Cox regression analysis showed that surgical method (LDG/ODG) was not a prognostic factor affecting OS or DFS, either prospectively or retrospectively.

CONCLUSIONS

The oncologic efficacy of laparoscopic and open distal gastrectomy for advanced GC is comparable. Well-designed RSs can be similar to small sample of PSs in assessing long-term oncologic outcomes of surgical interventions, but the short-term outcomes obtained should be treated with caution.

Prevalence and associated factors of hyperuricemia among urban adults aged 35-79 years in southwestern China: a community-based cross-sectional study

Hyperuricemia is prevalent throughout the world. However, a well-designed large-scale epidemiological investigation of hyperuricemia in southwestern China is lacking. A regional representative sample of 10,141 participants were included using multistage, stratified sampling in Chengdu and Chongqing from September 2013 to March 2014. Hyperuricemia was defined as the self-reported of the doctor's diagnosis of hyperuricemia, or serum uric acid > 420 μmol/L in men or serum uric acid > 360 μmol/L in women. The overall age- and sex-standardized prevalence of hyperuricemia among adults aged 35-79 years was 13.5%. Compared with women, the prevalence of hyperuricemia in men was higher (17.3% versus 10.0%). Hypertension, hyperlipidemia, overweight or obesity, central obesity were associated with an increased risk for hyperuricemia both in men and in women. Married men and women were not susceptible to hyperuricemia. Current cigarette smoking was an associated risk factor of hyperuricemia only in women. Hyperuricemia has become a major health problem among urban adults aged 35-79 years in southwestern China, and special attention should be paid to men. Comorbidities associated with hyperuricemia and causality worth further investigation.

Lycium barbarum Polysaccharide Inhibited Hypoxia-Inducible Factor 1 in COPD Patients

Background

Chronic obstructive pulmonary disease (COPD) is a chronic airway inflammatory disease characterized by irreversible airflow obstruction. Pathogenic mechanisms underlying COPD remain largely unknown.

Objective

The current study was designed to explore serum concentration of hypoxia-inducible factor 1α (HIF-1α) in stable COPD patients and the potential effect of Lycium barbarum polysaccharides (LBP) on HIF-1α protein expression.

Methods

Serum HIF-1α was quantified by ELISA in 102 stable COPD patients before and after 2-week orally taken LBP (100 mL/time, twice daily, 5–15 mg/mL). Correlation of serum LBP and lung function (FEV1%) or blood gas (PO₂ and PCO₂) was also analyzed. As a control, 105 healthy subjects were also enrolled into this study.

Results

Serum concentration of HIF-1α was significantly higher in the stable COPD patients (37.34 ± 7.20 pg/mL) than that in the healthy subjects (29.55 ± 9.66 pg/mL, P<0.001). Oral administration of LBP (5 mg/mL, 100 mL, twice daily for 2 weeks) not only relieved COPD symptoms but also significantly reduced serum HIF-1α concentration (36.94 ± 9.23 vs 30.49 ± 6.42 pg/mL, P<0.05). In addition, level of serum HIF-1α concentration was significantly correlated with PCO₂ (r = 0.283, P<0.001), but negatively and significantly correlated with PO₂ (r = −0.490, P=0.005) or FEV1%(r = −0.420, P=0.018).

Conclusion

These findings suggested that activation of HIF-1 signaling pathway may be involved in the pathophysiology of COPD and that stabilization of serum HIF-1α concentration by LBP might benefit the stable COPD patients.

Three-Component Reactions of Alkynone o-Methyloximes, Element Selenium, and Boronic Acids Leading to 4-Organoselenylisoxazoles

We report an Ag-catalyzed one-pot three-component reaction of alkynone o-methyloxime, element selenium, and boronic acid, providing a facile route to selenated isoxazole product. This protocol features high efficiency, wide substrate scope, and the use of selenium powder as the selenium source.

Estimation of dietary manganese requirement for laying duck breeders: effects on productive and reproductive performance, egg quality, tibial characteristics, and serum biochemical and antioxidant indices

This study was aimed at estimating the dietary manganese (Mn) requirement for laying duck breeders. A total of 504 Longyan duck breeders (body weight: 1.20 ± 0.02 kg) aged 17 wk were randomly allocated to 6 treatments. The birds were fed with a basal diet (Mn, 17.5 mg/kg) or diets supplemented with 20, 40, 80, 120, or 160 mg/kg of Mn (as MnSO₄·H₂O) for 18 wk. Each treatment had 6 replicates of 14 ducks each. As a result of this study, dietary Mn supplementation did not affect the productive performance of laying duck breeders in the early laying period (17–18 wk), but affected egg production, egg mass, and feed conversion ratio (FCR) from 19 to 34 wk (P < 0.05), and there was a linear and quadratic effect of supplement level (P < 0.05). The proportion of preovulatory ovarian follicles increased (P < 0.01) linearly and quadratically, and atretic follicles (weight and percentage) decreased (P < 0.05) quadratically with dietary Mn supplementation. The density and breaking strength of tibias increased (quadratic; P < 0.05), the calcium content of tibias decreased (linear, quadratic; P < 0.01), and Mn content increased (linear, quadratic; P < 0.001) with increase in Mn. The addition of Mn had a quadratic effect on serum contents of estradiol, prolactin, progesterone, luteinizing hormone, and follicle-stimulating hormone (P < 0.001). Dietary Mn supplementation decreased serum contents of total protein (linear, P < 0.05), glucose (quadratic, P < 0.05), total bilirubin, triglycerides, total cholesterol, low-density lipoprotein cholesterol, and calcium (linear, quadratic; P < 0.05). The serum total antioxidant capacity and total and Mn-containing superoxide dismutase activities increased (linear, quadratic; P < 0.001), and malondialdehyde content decreased (linear, quadratic; P < 0.001) in response to Mn supplemental levels. The dietary Mn requirements, in milligram per kilogram for a basal diet containing 17.5 mg/kg of Mn, for Longyan duck breeders from 19 to 34 wk of age were estimated to be 84.2 for optimizing egg production, 85.8 for egg mass, and 95.0 for FCR. Overall, dietary Mn supplementation, up to 160 mg/kg of feed, affected productive performance, tibial characteristics, and serum biochemical and antioxidant status of layer duck breeders. Supplementing this basal diet (17.5 mg/kg of Mn) with 85 to 95 mg/kg of additional Mn was adequate for laying duck breeders during the laying period.

Ag2O-promoted ring-opening reactions of cyclopropenones with oximes

Ag2O-promoted ring-opening reactions of cyclopropenones with oximes is disclosed in this work, providing a direct route to 1,3-oxazinones. This method highlights a new reactivity of cyclopropenones which undergo 1,4-addition with oximes followed by β-carbon elimination to in situ generate a α-carbonyl ketene intermediate.