MRI-based bone marrow radiomics for predicting cytogenetic abnormalities in multiple myeloma

AIM

To develop a radiomics signature applied to magnetic resonance imaging (MRI)-images to predict cytogenetic abnormalities in multiple myeloma (MM).

MATERIALS AND METHODS

Patients with newly diagnosed MM were enrolled retrospectively from March 2019 to September 2022. They were categorised into the high-risk cytogenetics (HRC) group and standard-risk cytogenetics (SRC) group. The patients were allocated randomly at a ratio of 7:3 into training and validation cohorts. Volumes of interest (VOI) was drawn manually on fat suppression T2-weighted imaging (FS-T2WI) and copied to the same location of the T1-weighted imaging (T1WI) sequence. Radiomics features were extracted from two sequences and selected by reproducibility and redundant analysis. The least absolute shrinkage selection operation (LASSO) algorithm was applied to build the radiomics signatures. The performance of the radiomics signatures to distinguish HRC with SRC was evaluated by ROC curves. The area under the curve (AUC), specificity, and sensitivity were also calculated.

RESULTS

A total of 105 MM patients were enrolled in this study. The four and 11 most significant and relevant features were selected separately from T1WI and FS-T2WI sequences to build the radiomics signatures based on the training cohort. Compared to the T1WI sequence, the radiomics signature based on the FS-T2WI sequence achieved better performance with AUCs of 0.896 and 0.729 in the training and validation cohorts respectively. A sensitivity of 0.833, specificity of 0.667, and Youden index of 0.500 were achieved for the FS-T2WI radiomics signature in the validation cohort.

CONCLUSIONS

The radiomics signature based on MRI provides a non-invasive and convenient tool to predict cytogenetic abnormalities in MM patients.

[Pathogenic characteristics and influence factors of bloodstream infection-induced severe sepsis in pediatric intensive care unit]

Objective: To summarize the pathogenic characteristics of bloodstream infection (BSI)-induced severe sepsis and analyze the influence factors in pediatric intensive care unit (PICU). Methods: Pediatric patients who were diagnosed with severe sepsis caused by BSI in the PICU of Children's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2016 to December 2021 were retrospectively selected and divided into survival group and death group according to their discharge outcomes. Clinical characteristics, laboratory parameters, pathogenic characteristics and drug resistance of the patients were collected. The characteristics of pathogens, clinical and laboratory indicators were summarized, and the influencing factors of death in children with severe sepsis caused by BSI were analyzed based on binary multivariate logistic regression. Results: A total of 132 patients, aged [M (Q1, Q3)] 36 (10, 119) months, with BSI-induced severe sepsis were enrolled in this study, including 81 males and 51 females. There were 38 cases aged 36 (15, 120) months in the death group, including 23 males and 15 females. There were 94 cases, aged 36 (8, 108) months, in the survival group, including 58 males and 36 females. A total of 132 strains of pathogens were isolated, including 87 strains (65.9%) of Gram-negative bacteria. The top 5 pathogens were Klebsiella pneumoniae (24 cases, 18.2%), Escherichia coli (17 cases, 12.9%), Acinetobacter baumannii (13 cases, 9.8%), Pseudomonas aeruginosa (10 cases, 7.6%) and Staphylococcus aureus (10 cases, 7.6%). The proportion of multi-drug resistant bacteria in hospital-acquired BSI was higher than that in community-acquired BSI [52.9% (36/68) vs 15.6% (10/64), P=0.001]. The proportions of community-acquired infection were 58.5% (55/94) and 23.7% (9/38) in the survival and death groups, respectively, the difference was statistically significant (P<0.001). The proportion of central venous catheter insertion before bloodstream infection in the death group was higher than that in the survival group [63.2% (24/38) vs 42.6% (40/94), P=0.034]. According to the binary multivariate logistic regression analysis, hospital-acquired infection (OR=4.80, 95%CI: 1.825-12.621, P=0.001), absolute neutrophil count (ANC) (OR=0.93, 95%CI: 0.863-0.993, P=0.030) and decreased albumin (OR=0.89, 95%CI: 0.817-0.977, P=0.014) were risk factors for death. Conclusions: The common pathogen of BSI-induced severe sepsis in PICU is Gram-negative bacteria. The proportion of multi-drug resistant organisms of BSI obtained in hospitals is high. Children with severe sepsis due to BSI with nosocomial acquired infection, ANC and decreased albumin have a high risk of death.

Intraperitoneal PD-1 monoclonal antibody for the treatment of advanced primary liver cancer with malignant ascites: a single-arm, single-center, phase Ib trial

BACKGROUND

Advanced primary liver cancer patients with malignant ascites have a poor prognosis and lack effective treatment plans. This phase Ib study aims to explore the safety and clinical efficacy of intraperitoneal anti-programmed cell death protein 1 (PD-1) antibody in these patients.

PATIENTS AND METHODS

Patients received sintilimab 100 mg intraperitoneally plus best supportive care on days 1, 8, and 15 in three cycles of 4 weeks. The course was repeated every 28 days until intolerable toxicity had developed or disease progression. The primary endpoint was safety, while the secondary endpoints were objective response rate (ORR), ascites control rate (ACR), and overall survival (OS).

RESULTS

From February 2021 through November 2022, a total of 21 patients (14 hepatocellular carcinoma and 7 cholangiocarcinoma) were enrolled to receive intraperitoneal sintilimab. Twelve patients had adverse events (AEs). The most common grade 3 AEs were fatigue, rash, and abdominal pain. No grade ≥4 AEs occurred in any patients. ORR was only evaluated in 13 patients, including partial response in 4, stable disease in 7, and progressive disease in 2. A reduction in the median maximum diameter of the tumor after treatment was observed; however, there was no statistical significance among patients. The objective remission rate of ascites was 43.75%, and the median OS for all 21 patients was 17.6 weeks.

CONCLUSIONS

This exploratory study represents the first trial to demonstrate the safety and clinical efficacy of intraperitoneal anti-PD-1 antibody administration. No unexpected safety concerns were identified. A large, multicenter, prospective study is needed to confirm the promising clinical efficacy.

Discriminating minimal residual disease status in multiple myeloma based on MRI: utility of radiomics and comparison of machine-learning methods

AIM

To explore the possibility of discriminating minimal residual disease (MRD) status in multiple myeloma (MM) based on magnetic resonance imaging (MRI) and identify optimal machine-learning methods to optimise the clinical treatment regimen.

MATERIALS AND METHODS

A total of 83 patients were analysed retrospectively. They were divided randomly into training and validation cohorts. The regions of interest were segmented and radiomics features were extracted and analysed on two sequences, including T1-weighted imaging (WI) and fat saturated (FS)-T2WI, and then radiomics models were built in the training cohort and evaluated in the validation cohort. Clinical characteristics were calculated to build a traditional model. A combined model was also built using the clinical characteristics and radiomics features. Classification accuracy was assessed using area under the curve (AUC) and F1 score.

RESULTS

In the training cohort, only the bone marrow (BM) infiltrate ratio (p=0.005) was retained after univariate and multivariable logistic regression analysis. In T1WI, the linear support vector machine (SVM) achieved the best performance compared to other classifiers, with AUCs of 0.811 and 0.708 and F1 scores of 0.792 and 0.696 in the training and validation cohorts, respectively. Similarly, in FS-T2WI sequence, linear SVM achieved the best performance with AUCs of 0.833 and 0.800 and F1 score of 0.833 and 0.800. The combined model constructed by the FS-T2WI-linear SVM and BM infiltrate ratio outperformed the traditional model (p=0.050 and 0.012, Delong test), but showed no significant difference compared with the radiomics model (p=0.798 and 0.855).

CONCLUSION

The linear SVM-based machine-learning method can offer a non-invasive tool for discriminating MRD status in MM.

Mechanism exploration of 6-Gingerol in the treatment of atherosclerosis based on network pharmacology, molecular docking and experimental validation

BACKGROUND

The 6-Gingerol has significant anti-inflammatory, anti-oxidative and hypolipidemic activities and is widely used for treating cardiac-cerebral vascular diseases. However, the multi-target mechanism of 6-Gingerol in the treatment of atherosclerosis remains to be elucidated.

METHODS

Firstly, the therapeutic actions of 6-Gingerol anti-atherosclerosis were researched based on an atherosclerotic ApoE-deficient mice model induced by high-fat feed. Then, network pharmacology and molecular docking were employed to reveal the anti-atherogenic mechanism of 6-Gingerol. Finally, the target for these predictions was validated by target protein expression assay in vitro and in vivo experiments and further correlation analysis.

RESULTS

Firstly, 6-Gingerol possessed obvious anti-atherogenic activity, which was manifested by a significant reduction in the plaque area, decrease in the atherosclerosis index and vulnerability index. Secondly, based on network pharmacology, 14 predicted intersection target genes between the targets of 6-Gingerol and atherogenic-related targets were identified. The key core targets of 6-Gingerol anti-atherosclerosis were found to be TP53, RELA, BAX, BCL2, and CASP3. Lipid and atherosclerosis pathways might play a critical role in 6-Gingerol anti-atherosclerosis. Molecular docking results also further revealed that the 6-Gingerol bound well and stable to key core targets from network pharmacological predictions. Then, the experimental results in vivo and in vitro verified that the up-regulation of TP53, RELA, BAX, CASP3, and down-regulation of BCL2 from atherosclerotic ApoE-deficient mice model can be improved by 6-Gingerol intervention. Meanwhile, the correlation analysis further confirmed that 6-Gingerol anti-atherosclerosis was closely related to these targets.

CONCLUSION

The 6-Gingerol can markedly improve atherosclerosis by modulating key multi-targets TP53, RELA, BAX, CASP3, and BCL2 in lipid and atherosclerosis pathways. These novel findings shed light on the anti-atherosclerosis mechanism of 6-Gingerol from the perspective of multiple targets and pathways.

[Observation on the clinical outcomes of continued pregnancy following cesarean scar pregnancy in 55 women]

Objective: To observe the clinical outcomes of continued pregnancy in pregnant women with cesarean scar pregnancy (CSP). Methods: A retrospective analysis was performed on the pregnancy outcomes of 55 pregnant women who were diagnosed with CSP at the Second Affiliated Hospital of Army Medical University during the first trimester of pregnancy from August 1st, 2018 to October 31st, 2021 and strongly requested to continue the pregnancy. Results: Of the 55 pregnant women, 15 terminated the pregnancy in the first trimester, 1 underwent hysterotomy at 23 weeks of gestation due to cervical dilation, and 39 (71%, 39/55) continued pregnancy to the third trimester achieving live births via cesarean section. The gestational age of the 39 pregnant women delivered by cesarean section was 35⁺⁶ weeks (range: 28⁺⁵-39⁺² weeks), of whom 7 cases at 28⁺⁵-33⁺⁶ weeks, 20 cases at 34-36⁺⁶ weeks, and 12 cases at 37-39⁺² weeks. The results of pathological examination were normal placenta in 3 cases (8%, 3/39), placenta creta in 4 cases (10%, 4/39), placenta increta in 9 cases (23%, 9/39) and placenta percreta in 23 cases (59%, 23/39). Among the 36 pregnant women who were pathologically confirmed as placenta accreta spectrum disorders (PAS) after surgery, the last prenatal ultrasonography showed placenta previa in 27 cases (75%, 27/36) and not observed placenta previa in 9 cases. The median intraoperative blood loss, autologous blood transfusion, and allogeneic suspended red blood cell infusion of 39 pregnant women during cesarean section were 1 000 ml (300-3 500 ml), 300 ml (0-2 000 ml) and 400 ml (0-2 400 ml), respectively. The uterine preservation rate was 100% (39/39), and only 1 case received cystostomy due to intracystic hemorrhage. The birth weight of the newborn was 2 580 g (1 350-3 800 g), and 1 case of mild asphyxia. Conclusions: Pregnant women with CSP who continue pregnancy under close monitoring after adequate ultrasound evaluation and doctor-patient communication could achieve better maternal and infant outcomes, but pregnant women with CSP are highly likely to continue pregnancy and develop into PAS. Effective hemostasis means and multidisciplinary team cooperation are needed in perinatal period for ensuring maternal and fetal safety.

A Canine Surgical Model of Stroke by Minimally Invasive Occlusion of the Proximal Middle Cerebral Artery

In this study, a model of ischemic stroke by surgical proximal middle cerebral artery (MCA) occlusion was developed on 10 beagle dogs. The advantages of this model are the transtemporal approach and a minimally invasive surgical procedure. Dogs were randomly assigned to two groups: sham-operated (proximal MCA exposure without occlusion) and experimental (permanent proximal MCA occlusion) groups. Different evaluation methods were used to assess the consequences of MCA occlusion in dogs, including neurobehavioral tests, MRI, and immunohistochemical staining. Clear signs of cerebral infarction associated with the region supplied by MCA were confirmed and the model showed good repeatability and consistency. The model can serve as an appropriate large animal model to improve the translation of stroke therapeutics research from the laboratory to the clinical practice.

Association of aldehyde exposure with bone mineral density in the national health and nutrition examination survey (NHANES 2013-2014)

PURPOSE

The association between aldehyde exposure and bone health in humans remains unclear. This study was to evaluate the association of serum aldehydes with bone mineral density (BMD) and osteopenia/osteoporosis.

METHODS

We analyzed the US National Health and Nutrition Examination Survey cross-sectional data from 2013 to 2014. Weighted multivariate-adjusted linear regression and logistic regression models were used to assess the association between specific aldehydes and osteopenia/osteoporosis. Associations between aldehyde combinations and BMD were also evaluated using the restricted cubic spline (RCS) method.

RESULTS

Compared with men in the first tertile, those in the third tertile of propanaldehyde concentration were negatively associated with proximal femur and lumbar spine BMD. Significant inverse associations were observed between benzaldehyde exposure and trochanter BMD in women. Benzaldehyde increased the risk of osteopenia/osteoporosis 2.75-fold [95% confidence interval (CI) = 1.06, 7.11] in the highest tertile in women compared to the lowest tertile concentration. In males, the prevalence of total femur, femur neck, and trochanter osteopenia/osteoporosis was significantly higher in the highest versus the lowest tertile of propanaldehyde exposure, with odds ratios (ORs) of 6.84 (95% CI = 2.33, 20.04), 2.72 (95% CI = 1.18, 6.27), and 3.26 (95% CI = 1.25, 8.56), respectively. RCS regression also showed decreased BMD continuously with increasing serum mixed aldehyde levels.

CONCLUSIONS

Serum aldehyde concentrations were associated with low BMD and high osteopenia/osteoporosis risk in adults, with propanaldehyde and benzaldehyde being the most critical. Co-exposure to aldehyde combinations was negatively correlated with BMD.

Malignant acanthosis nigricans and diseases with extensive oral papillary hyperplasia

Oral papillary lesions represent a variety of developmental and neoplastic conditions. Early diagnoses of different papillary lesions are challenging for oral medicine specialists. Malignant acanthosis nigricans (MAN) is a rare cutaneous disorder and a potential marker of underlying hidden tumours. It is characterized by papillary lesions that always involve the oral mucosa. In oral medicine specialities, MAN is not well understood. When the early signs of MAN are extensive oral lesions and slight cutaneous pigmentation without obvious florid cutaneous papillomatosis, the diagnosis can be incorrect or delayed. Oral medicine specialists should ask affected patients to provide details of their medical history and conduct a timely systemic examination.

Transcriptome analysis of oviduct in laying ducks under different stocking densities

1. High stocking densities can lead to animal stress responses and lead to changes in bird behaviour, egg production and the fertility of laying birds. The oviduct plays a crucial role during the process of laying eggs. Therefore, it is essential to know how high stocking density affects oviduct function.2. In this study, a total of 2,115 differentially expressed genes (DEGs) were identified in duck oviduct tissues between different stocking density groups. These genes are mainly enriched in membrane components, calcium ion binding, cytokine-cytokine receptor interaction and focal adhesion. These pathways were closely related to the formation of eggs. This indicated that secretion and material transport functions of the oviduct are affected under high-density stocking. Further analysis showed that a total of 408 genes related to the transportation process were expressed in the oviduct, of which 96 genes were differentially expressed (LogFC≥1, P < 0.05). Forty-two of these DEGs belonged to the solute carrier family. The data showed that the expression of 31 transcripts was different between the two density groups. Expression of KCNJ15, SLC26A8, and TRPM5 was only seen in the high-density group (8/m²), while ATP13A3 and KCNIP2 were only expressed in the low-density group (4/m²).3. Consequently, high stocking density may affect the expression and splicing of genes related to molecular transport in the oviduct.

[Establishment of naive Bayes classifier-based risk prediction model for chemotherapyinduced nausea and vomiting]

OBJECTIVE

To establish a risk prediction model of chemotherapy-induced nausea and vomiting based on naive Bayes classifier.

OBJECTIVE

We collected the basic information, treatment protocols and follow-up data from 300 patients receiving chemotherapy in the Oncology Department of Second Xiangya Hospital from July to September, 2020. Correlation analysis was carried out between the potential factors related to nausea and vomiting in the treatment plan and the individual characteristics of the patients. For the two characteristics with a correlation coefficient greater than 0.8, their contribution to the area under curve (AUC) was calculated, and the characteristic with a smaller contribution was removed. The naive Bayes classifier in the machine learning library scikit-learn was used as the prediction model of chemotherapy-induced nausea and vomiting, and 10-fold stratified-shuffled-split cross-validation was used to obtain the final result of the model. The machine learning model was trained using 70% of the samples, and 30% of the samples were used as the test set to assess the performance of the model.

OBJECTIVE

The sensitivity of the model for predicting the risk of nausea and vomiting due to acute chemotherapy was 0.83±0.04 (95%CI: 0.80-0.86) with a specificity of 0.45±0.03 (95%CI: 0.42-0.47) and an AUC of 0.72±0.04 (95% CI: 0.69-0.75). The sensitivity of the model for predicting the risk of delayed chemotherapy-induced nausea and vomiting was 0.84±0.01 (95%CI: 0.83-0.86) with a specificity of 0.48±0.03 (95%CI: 0.45-0.52) and an AUC of 0.74±0.02 (95%CI: 0.72-0.77).

OBJECTIVE

The naive Bayes classifier model has a good performance in predicting the risk of chemotherapy-induced nausea and vomiting in Chinese cancer patients.

Small RNA sequencing reveals miRNAs important for hypoxic adaptation in the Tibetan chicken

1. The Tibetan chicken, which is an indigenous breed living on the Tibetan Plateau, exhibits hypoxic adaptations to its high-altitude environment. However, the molecular mechanism behind this hypoxic adaptation is still unclear. This study aimed to investigate differentially expressed miRNAs involved in hypoxic adaptation through high-throughput RNA sequencing. 2. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to verify the differentially expressed miRNAs and their target genes in chicken embryonic heart tissues and fibroblasts. Luciferase reporter assays were performed to confirm the relationship between miRNAs and target genes. 3. The study identified 37 differentially expressed miRNAs in Tibetan chicken embryonic heart tissues, including 20 up- and 17 down-regulated miRNAs, compared to those found in lowland chickens. Differentially expressed miRNAs were mainly involved in biological processes, such as cell cycle arrest, toll-like receptor signalling pathways, and I-kappa B kinase/NF-kappa B signalling. The data showed that gga-miR-34 c-5p was significantly upregulated in Tibetan chicken tissues and hypoxic fibroblasts, while EHHADH, a target gene of gga-miR-34 c-5p, was downregulated. Moreover, gga-miR-34 c-5p dramatically decreased the luciferase activity of the wild EHHADH, whereas no effect on the mutational EHHADH was found. 4. This study identified miRNA expression profiles in the Tibetan chicken and suggested that miR-34 c-5p acts as a novel miRNA associated with hypoxic adaptation. This facilitates the understanding of molecular mechanisms that underlie long-term exposure to hypoxia.

[Effect of pedicled thoracodorsal artery perforator flap on the repair of moderate to severe axillary scar contracture deformity]

Objective: To investigate the effect of pedicled thoracodorsal artery perforator (TDAP) flap on the repair of axillary moderate to severe scar contracture deformity. Methods: From January 2012 to January 2017, 29 patients with axillary moderate to severe scar contracture deformity were admitted to the the Second Xiangya Hospital of Central South University, including 18 females and 11 males, aged 14-42 years. There were 3 patients with cicatricial contracture deformity of bilateral axillas and 26 patients with cicatricial contracture deformity of unilateral axilla. After relevant preoperative examinations were completed and basic diseases were controlled, axillary scar was removed or released under the anesthesia of endotracheal intubation. The areas of wounds ranged from 7.5 cm×5.0 cm to 21.0 cm×8.5 cm after the operation. The pedicled TDAP flaps were used to repair the defects, which were thinned based on demand of the recipient sites before being transferred. The areas of flaps ranged from 9.0 cm×6.0 cm to 22.0 cm×10.0 cm. The donor sites were sutured directly. The status of thinned flaps, the survival of flaps after the operation and during follow-up, and the shoulder joint function during follow-up were observed. Results: Thirty-two pedicled TDAP flaps were harvested for repairing the defects. Among them, 14 flaps were transferred directly without thinning and the thickness of the flaps ranged from 9.0 mm to 15.0 mm, with average thickness of 13.6 mm.While the other 18 flaps were thinned, and the thickness of the thinned flaps ranged from 5.0 mm to 8.0 mm, with average thickness of 7.5 mm. The distal parts of 3 flaps in 3 patients showed small size of blackening or necrosis within 72 hours after the operation, and 2 of them were thinned and the other one was not. Finally, the 3 flaps were healed after hyperbaric oxygen therapy, dressing change, or other treatments. One flap occurred vein congestion 8 hours after the operation caused by pressure on the pedicle, and the color of the flap turned back to normal after the pressure was relieved. The rest of the flaps survived well. All the patients were followed up for 9 to 36 months, with an average of 18 months. All the flaps survived well, the color of the flaps was nearly the same as the recipient sites, and none of the flaps developed obvious contraction. The shoulder joint function of all patients was significantly improved compared with that before operation, with abduction angles of shoulder joints ranged from 90.0-145.0°, with an average of 130.0°. Conclusions: Pedicled TDAP flap is an relatively ideal choice for the repair of moderate to severe axillary scar contracture deformity, and better results will be achieved if the flaps are thinned to a appropriate thickness according to the condition of axillary defects.

[The value of analysis of quantitative radiomics based on DTI in predicting astrocytoma IDH1 mutation]

Objective: Non-invasive prediction of IDH1 mutations by establishing a quantitative radiographic model based on DTI-based whole-tumor texture analysis. Methods: Preoperative MRI images of patients with surgically confirmed astrocytoma were collected in the First Affiliated Hospital of Soochow University from February 2016 to June 2019, including T(1)WI, T(2)WI, DTI, and T(1)-contrast enhancement images.A total of 38 patients were included, consisting of 12 mutants and 26 wilds, 20 males and 18 females, the average age was (49±15) years old.The ROIs were drawn on each level of the T(2)WI image using MaZda software and copied to the ADC and FA maps to extract texture feature parameters. The LASSO regression was used to determine the best radiomics features, radiological scores were calculated, and binary Logistic regression was used to construct a prediction model, then the ROC curve was used to analyze the diagnostic efficiency and the calibration curve was used to evaluate model prediction performance. Results: The four most valuable radiomics features were determined by LASSO regression, and then the radiomics scores and Logistic regression models of each patient were established. The radiomics scores of the wild and mutant groups were 2.3±0.3 and 1.8±0.4. There were significant differences between the groups (P<0.05). The ROC curve analysis showed an AUC of 0.837 with sensitivity and specificity of 91.7% and 61.5%, respectively. The Logistic regression model had good predictive performance with AUC of 0.907, sensitivity and specificity of 91.7% and 84.6%. Conclusions: DTI-based whole tumor radiomics model is benefit for predicting astrocytoma IDH1 mutations.

Current updates on the role of reactive oxygen species in bladder cancer pathogenesis and therapeutics

Bladder cancer (BCa) is the fourth most common urological malignancy in the world, it has become the costliest cancer to manage due to its high rate of recurrence and lack of effective treatment modalities. As a natural byproduct of cellular metabolism, reactive oxygen species (ROS) have an important role in cell signaling and homeostasis. Although up-regulation of ROS is known to induce tumorigenesis, growing evidence suggests a number of agents that can selectively kill cancer cells through ROS induction. In particular, accumulation of ROS results in oxidative stress-induced apoptosis in cancer cells. So, ROS is a double-edged sword. A modest level of ROS is required for cancer cells to survive, whereas excessive levels kill them. This review summarizes the up-to-date findings of oxidative stress-regulated signaling pathways and transcription factors involved in the etiology and progression of BCa and explores the possible therapeutic implications of ROS regulators as therapeutic agents for BCa.

MicroRNAs in the Intestine: Role in Renewal, Homeostasis, and Inflammation

The mammalian intestine is not only an organ for food digestion and nutrient absorption but also an integral part of the immune and endocrine systems. The intestinal epithelium under stressful environments requires epithelial cells to rapidly elicit changes in gene expression patterns to regulate their survival, adapt to stress, and maintain epithelial homeostasis. Recently, miRNAs have emerged as a novel class of posttranscriptional gene regulators that are fundamentally involved in many aspects of intestinal epithelial differentiation, architecture, and barrier function. In this review, we highlight the critical roles of miRNAs in both the crypt-villus axis of cellular self-renewal and inflammation in the mammalian intestinal mucosa and their impact on the microbiota. We also discuss the functions of specific miRNAs within the intestine to better understand the cellular mechanisms that promote intestinal homeostasis, and the influence of dietary components in the regulation of endogenous miRNA in the study of nutrition and gene regulation in intestinal health.

Forensic Pathology Analysis of 363 Sudden Death Cases in Yunnan Province

OBJECTIVES

To study the epidemiological and pathological features of sudden death （SD） in Yunnan Province and to provide scientific evidence for prevention and forensic identification of sudden death.

METHODS

Totally 363 SD cases were collected from the autopsies between 2009 and 2017 in the Forensic Centre of Kunming Medical University. The related factors such as etiology, age, inducing factor, time interval between the onset of disease and death, morbidity season and pathological change were retrospectively analysed.

RESULTS

The incidence of SD in males was significantly higher than that of females. The peak age was ≥35-55 years. The mortality rate was relatively high within 6 h after the onset of disease. The season order with descending number of deaths was spring, summer, winter and autumn. The top ten causes of SD were coronary heart disease, sudden unexplained death （SUD）, cerebral hemorrhage, acute hemorrhagic necrotic pancreatitis, aortic dissection rupture, cardiomyopathy, pneumonia, pulmonary thromboembolism, amniotic fluid embolism and allergy. Exercise, infusion, surgery, medication and minor injury were the most common predisposing factors of sudden coronary death. Consciousness disorder or coma, chest pain or chest tightness, and abdominal pain were the most common premortem symptoms of sudden coronary death.

CONCLUSIONS

The SD is more common in middle-aged males, which is the key population for the prevention of SD. For the forensic identification and prevention of SD, the attention on SUD should be paid.

The inflammasome as a target for pain therapy

The interleukin-1 family of cytokines are potent inducers of inflammation and pain. Proteolytic activation of this family of cytokines is under the control of several innate immune receptors that coordinate to form large multiprotein signalling platforms, termed inflammasomes. Recent evidence suggests that a wide range of inflammatory diseases, cancers, and metabolic and autoimmune disorders, in which pain is a common complaint, may be coordinated by inflammasomes. Activation of inflammasomes results in cleavage of caspase-1, which subsequently induces downstream initiation of several potent pro-inflammatory cascades. Therefore, it has been proposed that targeting inflammasome activity may be a novel and effective therapeutic strategy for these pain-related diseases. The purpose of this narrative review article is to provide the reader with an overview of the activation and regulation of inflammasomes and to investigate the potential therapeutic role of inflammasome inhibition in the treatment of diseases characterized by pain, including the following: complex regional pain syndrome, gout, rheumatoid arthritis, inflammatory pain, neuropathic pain, chronic prostatitis, chronic pelvic pain syndrome, and fibromyalgia. We conclude that the role of the inflammasome in pain-associated diseases is likely to be inflammasome subtype and disease specific. The currently available evidence suggests that disease-specific targeting of the assembly and activity of the inflammasome complex may be a novel therapeutic opportunity for the treatment of refractory pain in many settings.

[Association between ribavirin plasma concentration and sustained virologic response in treatment of patients with genotype 1b chronic hepatitis C with pegylated interferon-α-2b and ribavirin]

OBJECTIVE

To investigate the association between the dose and plasma concentration of ribavirin (RBV) and sustained virologic response (SVR) during the anti-hepatitis C virus (HCV) treatment with pegylated interferon-α-2b (PEG-IFN-α-2b) and RBV.

METHODS

A total of 40 patients with chronic hepatitis C (CHC) who were treated with PEG-IFN-α-2b and RBV as the antiviral treatment were enrolled, and according to the therapeutic effect (SVR was defined as HCV RNA maintained below the lower limit of detection at 24 weeks after drug discontinuation in patients who achieved virologic response at the end of treatment, and recurrence was defined as HCV RNA turning positive), these patients were divided into SVR group (20 patients aged 19-55 years, including 10 male patients) and recurrence group (20 patients aged 21-76 years, including 12 male patients). The HPLC-MS/MS was used to measure the RBV plasma concentration at weeks 4, 12, 24, and 48 of treatment. The t-test and receiver operating characteristic (ROC) curve were used for statistical analysis.

RESULTS

During the antiviral treatment, the dose of RBV showed a significant difference between the two groups (15.01 ± 1.21 mg/kg vs 10.28 ± 2.81 mg/kg,t= 6.908,P= 0.000). The area under the ROC curve reached 0.96 (95%CI0.00-1.00,P= 0.000), suggesting that the dose of RBV had a high value in predicting SVR. When the dose of RBV was higher than 13.05 mg/kg (sensitivity 100%; specificity 85%), the possibility of achieving SVR was also increased. The RBV plasma concentrations in the SVR group at weeks 4,12, 24, and 48 of treatment were 1 894.8 ± 740.7 ng/ml, 2 029.9 ± 547.7 ng/ml, 2 011.8 ± 354.2 ng/ml, and2 093.5 ± 540.3 ng/ml, respectively, and those in the recurrence group were 1 223.1 ± 722.7 ng/ml, 1 286.9±685.4 ng/ml, 1304.7 ± 692.0 ng/ml, and 1 221.3 ± 655.3 ng/ml, respectively. The RBV plasma concentration at each time point showed significant differences between the two groups (t= 2.903,P= 0.006;t= 3.787,P= 0.001;t= 4.068,P= 0.000;t= 4.593,P= 0.000). The results of ROC analysis showed that the areas under the ROC curve at weeks 4, 12, 24, and 48 of treatment were 0.76 (95%CI0.61-0.92,P= 0.005), 0.83 (95%CI0.68-0.97,P= 0.000), 0.83 (95%CI0.69-0.98,P= 0.000), and 0.86 (95%CI0.72-1.00,P= 0.000), respectively, suggesting that the RBV plasma concentration had a high value in predicting SVR. When the cut-off values of RBV plasma concentration at weeks 4, 12, 24, and 48 of treatment were higher than 1262.5 ng/ml (sensitivity 90%; specificity 60%), 1432 ng/ml (sensitivity 100%; specificity 65%), 1427 ng/ml (sensitivity 100%; specificity 65%), and 1610 ng/ml (sensitivity 95%; specificity 80%), respectively, there was a greater possibility of achieving SVR.

CONCLUSION

During the antiviral treatment with PEG-IFN-α-2b and RBV, the dose and plasma concentration of RBV have a high value in predicting the recurrence of CHC and the possibility of SVR.

Transfer and expression of the rabbit defensin NP-1 gene in lettuce (Lactuca sativa)

Lettuce (Lactuca sativa L.) is an annual plant of the daisy family, Asteraceae, with high food and medicinal value. However, the crop is susceptible to several viruses that are transmitted by aphids and is highly vulnerable to post-harvest diseases, as well as insect and mammal pests and fungal and bacterial diseases. Here, the rabbit defensin gene NP-1 was transferred into lettuce by Agrobacterium-mediated transformation to obtain a broad-spectrum disease-resistant lettuce. Transgenic lettuce plants were selected and regenerated on selective media. The presence of the NP-1 gene in these plants was confirmed by western blot analyses. Resistance tests revealed native defensin NP-1 expression conferred partial resistance to Bacillus subtilis and Pseudomonas aeruginosa, which suggests new possibilities for lettuce disease resistance.

Insights into the Mechanisms Involved in the Expression and Regulation of Extracellular Matrix Proteins in Diabetic Nephropathy

Diabetic Nephropathy (DN) is believed to be a major microvascular complication of diabetes. The hallmark of DN includes deposition of Extracellular Matrix (ECM) proteins, such as, collagen, laminin and fibronectin in the mesangium and renal tubulo-interstitium of the glomerulus and basement membranes. Such an increased expression of ECM leads to glomerular and tubular basement membranes thickening and increase of mesangial matrix, ultimately resulting in glomerulosclerosis and tubulointerstitial fibrosis. The characteristic morphologic glomerular mesangial lesion has been described as Kimmelstiel-Wilson nodule, and the process at times is referred to as diabetic nodular glomerulosclerosis. Thus, the accumulation of ECM proteins plays a critical role in the development of DN. The relevant mechanism(s) involved in the increased ECM expression and their regulation in the kidney in diabetic state has been extensively investigated and documented in the literature. Nevertheless, there are certain other mechanisms that may yet be conclusively defined. Recent studies demonstrated that some of the new signaling pathways or molecules including, Notch, Wnt, mTOR, TLRs and small GTPase may play a pivotal role in the modulation of ECM regulation and expression in DN. Such modulation could be operational for instance Notch through Notch1/Jagged1 signaling, Wnt by Wnt/β- catenin pathway and mTOR via PI3-K/Akt/mTOR signaling pathways. All these pathways may be critical in the modulation of ECM expression and tubulo-interstitial fibrosis. In addition, TLRs, mainly the TLR2 and TLR4, by TLR2- dependent and TGF-β-dependent conduits, may modulate ECM expression and generate a fibrogenic response. Small GTPase like Rho, Ras and Rab family by targeting relevant genes may also influence the accumulation of ECM proteins and renal fibrosis in hyperglycemic states. This review summarizes the recent information about the role and mechanisms by which these molecules and signaling pathways regulate ECM synthesis and its expression in high glucose ambience in vitro and in vivo states. The understanding of such signaling pathways and the molecules that influence expression, secretion and amassing of ECM may aid in developing strategies for the amelioration of diabetic nephropathy.

Oral administration of putrescine and proline during the suckling period improves epithelial restitution after early weaning in piglets

Polyamines are necessary for normal integrity and the restitution after injury of the gastrointestinal epithelium. The objective of this study was to investigate the effects of oral administration of putrescine and proline during the suckling period on epithelial restitution after early weaning in piglets. Eighteen neonatal piglets (Duroc × Landrace × Large Yorkshire) from 3 litters (6 piglets per litter) were assigned to 3 groups, representing oral administration with an equal volume of saline (control), putrescine (5 mg/kg BW), and proline (25 mg/kg BW) twice daily from d 1 to weaning at 14 d of age. Plasma and intestinal samples were obtained 3 d after weaning. The results showed that oral administration of putrescine or proline increased the final BW and ADG of piglets compared with the control (P < 0.05). Proline treatment decreased plasma D-lactate concentration but increased the villus height in the jejunum and ileum, as well as the percentage of proliferating cell nuclear antigen (PCNA) positive cells and alkaline phosphatase (AKP) activity in the jejunal mucosa (P < 0.05). The protein expressions for zonula occludens (ZO-1), occludin, and claudin-3 (P < 0.05) but not mRNA were increased in the jejunum of putrescine- and proline-treated piglets compared with those of control piglets. The voltage-gated K+ channel (Kv) 1.1 protein expression in the jejunum of piglets administrated with putrescine and the Kv1.5 mRNA and Kv1.1 protein levels in the ileum of piglets administrated with proline were greater than those in control piglets (P < 0.05). These findings indicate that polyamine or its precursor could improve mucosal proliferation, intestinal morphology, as well as tight junction and potassium channel protein expressions in early-weaned piglets, with implications for epithelial restitution and barrier function after stress injury.

Cavity modes with optical orbital angular momentum in a metamaterial ring based on transformation optics

In this work, we theoretically study the cavity modes with transverse orbital angular momentum in metamaterial ring based on transformation optics. The metamaterial ring is designed to transform the straight trajectory of light into the circulating one by enlarging the azimuthal angle, effectively presenting the modes with transverse orbital angular momentum. The simulation results confirm the theoretical predictions, which state that the transverse orbital angular momentum of the mode not only depends on the frequency of the incident light, but also depends on the transformation scale of the azimuthal angle. Because energy dissipation inevitably reduces the field amplitude of the modes, the confined electromagnetic energy and the quality factor of the modes inside the ring are also studied in order to evaluate the stability of those cavity modes. The results show that the metamaterial ring can effectively confine light with a high quality factor and maintain steady modes with the orbital angular momentum, even if the dimension of the ring is much smaller than the wavelength of the incident light. This technique for exploiting the modes with optical transverse orbital angular momentum may provides a unique platform for applications related to micromanipulation.

RNF126 promotes homologous recombination via regulation of E2F1-mediated BRCA1 expression

RNF126 is an E3 ubiquitin ligase. The deletion of RNF126 gene was observed in a wide range of human cancers and is correlated with improved disease-free and overall survival. These data highlights the clinical relevance of RNF126 in tumorigenesis and cancer therapy. However, the specific functions of RNF126 remain largely unknown. Homologous recombination (HR)-mediated DNA double-strand break repair is important for tumor suppression and cancer therapy resistance. Here, we demonstrate that RNF126 facilitates HR by promoting the expression of BRCA1, in a manner independent of its E3 ligase activity but depending on E2F1, a well-known transcription factor of BRCA1 promoter. In support of this result, RNF126 promotes transactivation of BRCA1 promoter by directly binding to E2F1. Most importantly, an RNF126 mutant lacking 11 amino acids that is responsible for the interaction with E2F1 has a dominant-negative effect on BRCA1 expression and HR by suppressing E2F1-mediated transactivation of BRCA1 promoter and blocking the enrichment of E2F1 on BRCA1 promoter. Lastly, RNF126 depletion leads to the increased sensitivity to ionizing radiation (IR) and poly (ADP-ribose) polymerase (PARP) inhibition. Collectively, our results suggest a novel role of RNF126 in promoting HR-mediated repair through positive regulation on BRCA1 expression by direct interaction with E2F1. This study not only offers novel insights into our current understanding of the biological functions of RNF126 but also provides a potential therapeutic target for cancer treatment.

Quantitative structure-activity relationship study on BTK inhibitors by modified multivariate adaptive regression spline and CoMSIA methods

Bruton's tyrosine kinase (BTK) plays a crucial role in B-cell activation and development, and has emerged as a new molecular target for the treatment of autoimmune diseases and B-cell malignancies. In this study, two- and three-dimensional quantitative structure-activity relationship (2D and 3D-QSAR) analyses were performed on a series of pyridine and pyrimidine-based BTK inhibitors by means of genetic algorithm optimized multivariate adaptive regression spline (GA-MARS) and comparative molecular similarity index analysis (CoMSIA) methods. Here, we propose a modified MARS algorithm to develop 2D-QSAR models. The top ranked models showed satisfactory statistical results (2D-QSAR: Q(2) = 0.884, r(2) = 0.929, r(2)pred = 0.878; 3D-QSAR: q(2) = 0.616, r(2) = 0.987, r(2)pred = 0.905). Key descriptors selected by 2D-QSAR were in good agreement with the conclusions of 3D-QSAR, and the 3D-CoMSIA contour maps facilitated interpretation of the structure-activity relationship. A new molecular database was generated by molecular fragment replacement (MFR) and further evaluated with GA-MARS and CoMSIA prediction. Twenty-five pyridine and pyrimidine derivatives as novel potential BTK inhibitors were finally selected for further study. These results also demonstrated that our method can be a very efficient tool for the discovery of novel potent BTK inhibitors.

Targeting type Iγ phosphatidylinositol phosphate kinase inhibits breast cancer metastasis

Most deaths from breast cancer are caused by metastasis, a complex behavior of cancer cells involving migration, invasion, survival, and microenvironment manipulation. Type Iγ phosphatidylinositol phosphate kinase (PIPKIγ) regulates focal adhesion assembly, and its phosphorylation at Y639 is critical for cell migration induced by EGF. However, the role of this lipid kinase in tumor metastasis remains unclear. Here we report that PIPKIγ is vital for breast cancer metastasis. Y639 of PIPKIγ can be phosphorylated by stimulation of EGF and hepatocyte growth factor (HGF), two promoting factors for breast cancer progression. Histological analysis revealed elevated Y639-phosphorylation of PIPKIγ in invasive ductal carcinoma lesions and suggested a positive correlation with tumor grade. Orthotopically transplanted, PIPKIγ-depleted breast cancer cells showed substantially reduced growth and metastasis, as well as suppressed expression of multiple genes related to cell migration and microenvironment manipulation. Re-expression of wild-type PIPKIγ in PIPKIγ-depleted cells restored tumor growth and metastasis, reinforcing the importance of PIPKIγ in breast cancer progression. Y639-to-F or a kinase-dead mutant of PIPKIγ could not recover the diminished metastasis in PIPKIγ-depleted cancer cells, suggesting that Y639 phosphorylation and lipid kinase activity are both required for development of metastasis. Further analysis with in vitro assays indicated that depleting PIPKIγ inhibited cell proliferation, MMP9 secretion, and cell migration and invasion, lending molecular mechanisms for the eliminated cancer progression. These results suggest that PIPKIγ, downstream of EGF and/or HGF receptor, participates in breast cancer progression from multiple aspects and deserves further studies to explore its potential as a therapeutic target.