TGFβ-induced EN1 promotes tumor budding of adenoid cystic carcinoma in patient-derived organoid model

Adenoid cystic carcinoma (ACC) and basal cell adenoma (BCA) share many histological characteristics and often need a differential diagnosis in clinical pathology. Recently, we found homeobox protein engrailed-1 (EN1) was a potential diagnostic marker for ACC in an organoids library of salivary gland tumors (SGTs). Here we aim to confirm EN1 as a differential diagnostic marker for ACC, and further investigate the regulatory mechanism and biological function of EN1 in tumor progression. The transcriptional analysis, quantitative polymerase chain reaction, Western blot and immunohistochemistry staining were performed and revealed that EN1 was specifically and highly expressed in ACC, and accurately differentiated ACC from BCA. Furthermore, TGFβ signaling pathway was found associated with ACC, and the regulation of EN1 through TGFβ was detected in the human ACC cell lines and patient-derived organoids (PDOs). TGFβ-induced EN1 was important in promoting tumor budding in the PDOs model. Interestingly, a high level of EN1 and TGFβ1 in the budding tips was observed in ACC clinical samples, and the expression of EN1 and TGFβ1 in ACC was significantly associated with the clinical stage. In summary, our study verified EN1 is a good diagnostic marker to differentiate ACC from BCA. TGFβ-induced EN1 facilitates the tumor budding of ACC, which might be an important mechanism related to the malignant phenotype of ACC.

Occupational stress, respect, and the need for psychological counselling in Chinese nurses: a nationwide cross-sectional study

OBJECTIVES

This study aimed to explore occupational stress, perceived respect, and the need for psychological counselling among nurses in China.

STUDY DESIGN

This was a nationwide cross-sectional study.

METHODS

Chinese nurses from 311 cities were randomly selected through a simple random sampling method. Occupational stress, perceived respect, and psychological counselling need were assessed using an online questionnaire validated by experts. The underlying associated factors were analysed using multiple logistic regression analyses.

RESULTS

We collected and analysed 51,406 valid online questionnaires. Family factors and low income were the most commonly cited sources of occupational stress, and 91.9% and 80.0% of nurses, respectively, perceived that individuals in society and patients did not give adequate respect. Furthermore, 75.5% and 79.7%, respectively, believed they were not respected by clinical managers and doctors. As a result, 64.7% nurses believed they had a moderate or high need for psychological counselling. However, 80.7% indicated that receiving adequate respect could decrease the need for stress-related psychological counselling. Indeed, multiple logistic regression analyses showed that lower respect perceived by nurses was associated with higher need for psychological counselling, particularly regarding criticism that nurses perceived from nursing managers (a little: odds ratio [OR], 1.597; 95% confidence interval [CI], 1.176-2.170; P = 0.003; moderately: OR, 1.433; 95% CI, 1.180-1.741; P < 0.001) and the difficulty of receiving respect from patients and their families (a little: OR, 1.389; 95% CI, 1.044-1.850; P = 0.024).

CONCLUSIONS

Nurses in China perceive high levels of occupational stress and low levels of respect and often seek psychological counselling.

Role of LncMALAT1-miR-141-3p/200a-3p-NRXN1 Axis in the Impairment of Learning and Memory Capacity in ADHD

As a prevalent neurodevelopmental disease, attention-deficit hyperactivity disorder (ADHD) impairs the learning and memory capacity, and so far, there has been no available treatment option for long-term efficacy. Alterations in gene regulation and synapse-related proteins influence learning and memory capacity; nevertheless, the regulatory mechanism of synapse-related protein synthesis is still unclear in ADHD. LncRNAs have been found participating in regulating genes in multiple disorders. For instance, lncRNA Metastasis Associated Lung Adenocarcinoma Transcript 1 (MALAT1) has an essential regulatory function in numerous psychiatric diseases. However, how MALAT1 influences synapse-related protein synthesis in ADHD remains largely unknown. Here, our study found that MALAT1 decreased in the hippocampus tissue of spontaneously hypertensive rats (SHRs) compared to the standard controls, Wistar Kyoto (WKY) rats. Subsequent experiments revealed that MALAT1 enhanced the expression of neurexin 1 (NRXN1), which promoted the synapse-related genes (SYN1, PSD95, and GAP43) expression. Then, the bioinformatic analyses predicted that miR-141-3p and miR-200a-3p, microRNAs belonging to miR-200 family and sharing same seed sequence, could interact with MALAT1 and NRXN1 mRNA, which were further confirmed by luciferase report assays. Finally, rescue experiments indicated that MALAT1 influenced the expression of NRXN1 by sponging miR-141-3p/200a-3p. All data verified our hypothesis that MALAT1 regulated synapse-related proteins (SYN1, PSD95, and GAP43) through the MALAT1-miR-141-3p/200a-3p-NRXN1 axis in ADHD. Our research underscored a novel role of MALAT1 in the pathogenesis of impaired learning and memory capacity in ADHD and may shed more light on developing diagnostic biomarkers and more effective therapeutic interventions for individuals with ADHD.

An organoid library of salivary gland tumors reveals subtype-specific characteristics and biomarkers

BACKGROUND

Salivary gland tumors (SGTs) include a large group of rare neoplasms in the head and neck region, and the heterogeneous and overlapping features among the subtypes frequently make diagnostic difficulties. There is an urgent need to understand the cellular mechanisms underlying the heterogeneity and overlap among the subtypes, and explore the subtype-specific diagnostic biomarkers.

METHODS

The tumor tissue and the adjacent normal tissue from the 6 most common types of SGTs were processed for organoid culture which only maintained tumor epithelial cells. Organoids were histologically evaluated based on phenotype markers, followed by transcriptional profiling using RNA-sequencing. The transcriptomic similarities and differences among the subtypes were analyzed by subtype consensus clustering and hierarchical clustering. Furthermore, by comparative transcriptional analysis for these 6 types of SGTs and the matched organoids, the potential diagnostic biomarkers from tumor epithelium were identified, in which two selected biomarkers were evaluated by qPCR and confirmed by immunohistochemistry staining using a tissue microarray.

RESULTS

We generated a biobank of patient-derived organoids (PDOs) with 6 subtypes of SGTs, including 21 benign and 24 malignant SGTs. The PDOs recapitulated the morphological and transcriptional characteristics of the parental tumors. The overlap in the cell types and the heterogenous growth patterns were observed in the different subtypes of organoids. Comparing the bulk tissues, the cluster analysis of the PDOs remarkably revealed the epithelial characteristics, and visualized the intrinsic relationship among these subtypes. Finally, the exclusive biomarkers for the 6 most common types of SGTs were uncovered by comparative analysis, and PTP4A1 was demonstrated as a useful diagnostic biomarker for mucoepidermoid carcinoma.

CONCLUSIONS

We established the first organoid biobank with multiple subtypes of SGTs. PDOs of SGTs recapitulate the morphological and transcriptional characteristics of the original tumors, which uncovers subtype-specific biomarkers and reveals the molecular distance among the subtype of SGTs.

[Differential diagnosis model of benign and malignant breast BI-RADS category 4 nodules based on serum SP70 and conventional laboratory indicators]

Objective: To develop a nomogram model for the differential diagnosis of benign and malignant breast BI-RADS (Breast Imaging Reporting and Data System) category 4 nodules based on serum tumor specific protein 70 (SP70) and conventional laboratory indicators and validate its predictive efficacy. Methods: A case-control study design was used to retrospectively analyze the data of 429 female patients diagnosed with BI-RADS category 4 breast nodules by breast color doppler flow imaging at the First Affiliated Hospital of Nanjing Medical University from January 2021 to April 2022 with an age range of 16 to 91 years and a median age of 50 years, and the patients were divided into a training cohort (314 patients) and a validation cohort (115 patients) according to the inclusion time successively. Using postoperative pathological findings as the"gold standard", univariate and multivariate logistic regression analyses were used to identify the predictor variables used for the model. The nomogram, receiver operating characteristic (ROC) curves and calibration curves were drawn for the prediction model, and the discrimination and calibration of the model were evaluated using the consistency index (C-index) and calibration plots. Results: The postoperative pathological results showed that 286 (66.7%) were malignant nodules and 143 (33.3%) were benign nodules of 429 breast BI-RADS category 4 nodules. The serum SP70 (OR=1.227,95%CI: 1.033-1.458,P=0.020), NLR (OR=1.545,95%CI: 1.047-2.280,P=0.028), LDL-C (OR=2.215, 95%CI: 1.354-3.622, P=0.002), GLU (OR=2.050,95%CI:1.222-3.438,P=0.007), PT (OR=1.383,95%CI: 1.046-1.828,P=0.023), nodule diameter (OR=1.042, 95%CI: 1.008-1.076, P=0.015) and age (OR=1.062,95%CI: 1.011-1.116,P=0.016) were independent risk factors which could be used to distinguish benign and malignant breast BI-RADS category 4 nodules (P<0.05). The nomogram was plotted by the above seven independent variables, and the concordance index (C-index) for the training cohort and validation cohort were 0.842 (95%CI:0.786-0.898) and 0.787 (95%CI:0.687-0.886), respectively. The sensitivity and specificity of using this model to identify benign and malignant breast BI-RADS category 4 nodules in the training and validation cohort were 83.5%, 72.5% and 79.2%, 73.6%, respectively. The calibration curves showed good agreement between the predicted and actual values in the nomogram. Conclusions: This study combined serum SP70, conventional laboratory indicators and breast color doppler flow imaging to develop a nomogram model for the differential diagnosis of benign and malignant breast BI-RADS category 4 nodules. The model may have good predictive efficacy and may provide a basis for clinical treatment options, which is beneficial for guiding breast cancer screening and prevention.

[Effect of placenta previa attached to cesarean scar for adverse pregnant outcomes in patients with placenta accreta spectrum disorders]

Objective: To investigate the effect of placenta previa attached to cesarean scar for adverse pregnant outcomes in patients with or without placenta accreta spectrum disorders (PAS). Methods: The clinical information of patients with cesarean section history and placenta previa during the perioperative period at Peking University First Hospital from January 1st, 2015 to December 31st, 2020 were collected retrospectively. There were 53 cases without PAS and 172 cases with PAS, 153 cases with abnormally invasive placenta (containing placenta increta and placenta percreta) and 72 cases without PAS or with placenta accreta. The pregnant outcomes including rate of postpartum hemorrhage, transfusion, hysterectomy between the above groups were compared. Multivariate analysis was performed to study the factors significantly associated with PAS. Results: Pregnant women with PAS were at higher risk of adverse pregnant outcomes than those without PAS. Patients with PAS had higher incidences of hysterectomy [12.2% (21/172) vs 0(0/53); P=0.005], postpartum hemorrhage [60.5% (104/172) vs 5.7% (3/53); P<0.01] and blood transfusion [66.9% (115/172) vs 7.5% (4/53); P<0.01]. In the subgroup analysis stratified by the type of PAS, patients with abnormally invasive placenta were at higher risk of hysterectomy [13.7% (21/153) vs 0 (0/72); P<0.01], postpartum hemorrhage [66.7% (102/153) vs 6.9% (5/72); χ²=70.873, P<0.01] and blood transfusion [74.5% (114/153) vs 6.9% (5/72); χ²=90.869, P<0.01]. After multiple logistic regression, the type of creta had the positive relation with postpartum hemorrhage (OR=27.622, 95%CI:9.873~77.280; P<0.01) and blood transfusion (OR=36.912, 95%CI:13.239~102.922; P<0.01). There were no significant correlations between adverse pregnant outcomes and the type of placenta previa or the times of cesarean section (all P>0.01). Conclusions: Placenta previa attached to cesarean scar without PAS or with placenta accreta could not act as the factor of predicting adverse pregnant outcomes in clinic. Placenta previa attached to cesarean scar with placenta increta or placenta percreta could increase the risk of adverse pregnant outcomes.

Blocking VRK2 suppresses pulmonary adenocarcinoma progression via ERK1/2/AKT signal pathway by targeting miR-145-5p

OBJECTIVE

The incidence of pulmonary adenocarcinoma locates first in all the malignant tumors in the world. At present, there are many diagnostic methods for pulmonary adenocarcinoma, but there are a few methods that are mature or have ideal application prospects. We aim to explore the role of VRK2 in the occurrence and development of pulmonary adenocarcinoma and its possible regulatory mechanism.

PATIENTS AND METHODS

Western blot and qRT-PCR were performed to assess the expression of VRK2. Flow cytometry, Western blot, and Caspase-3 colorimetric assay Kit were used to evaluate the apoptosis level. The proliferation, migration, and invasion ability were measured via cell cycle assay, wound healing, and transwell invasion assay. Luciferase assay verified the relationship between VRK2 and miR-145-5p. The effect of FGD5-AS1 on tumorigenesis of glioma was detected by the xenograft nude mice model.

RESULTS

VRK2 was significantly increased in tumor tissues and cell lines. Loss of VRK2 promoted apoptosis level and inhibited the proliferation, migration, and invasion in A549 cells via regulating the ERK1/2/AKT signal pathway. Luciferase assay reported that VRK2 could bind with miR-145-5p. The level of miR-145-5p was negatively correlated with the expression of VRK2 and involved in VRK2 regulating tumor progression. The tumor growth assay showed that the silencing of VRK2 inhibited tumorigenesis with the inactivating ERK1/2/AKT pathway.

CONCLUSIONS

Knockdown of VRK2 inhibited the development of pulmonary adenocarcinoma via regulating the ERK1/2/AKT signal pathway by targeting miR-145-5p, which providing some novel experimental basis for clinical treatment of pulmonary adenocarcinoma.

[Evaluation of demand of resources for laboratory testing and prevention and control of COVID-19 in the context of global pandemic]

Objective: To rapidly evaluate the level of healthcare resource demand for laboratory testing and prevention and control of corona virus disease 2019 (COVID-19) in different epidemic situation, and prepare for the capacity planning, stockpile distribution, and funding raising for infectious disease epidemic response. Methods: An susceptible, exposed, infectious, removed infectious disease dynamics model with confirmed asymptomatic infection cases and symptomatic hospitalized patients was introduced to simulate different COVID-19 epidemic situation and predict the numbers of hospitalized or isolated patients, and based on the current COVID-19 prevention and control measures in China, the demands of resources for laboratory testing and prevention and control of COVID-19 were evaluated. Results: When community or local transmission or outbreaks occur and total population nucleic acid testing is implemented, the need for human resources is 3.3-89.1 times higher than the reserved, and the current resources of medical personal protective equipment and instruments can meet the need. The surge in asymptomatic infections can also increase the human resource demand for laboratory testing and pose challenge to the prevention and control of the disease. When vaccine protection coverage reach ≥50%, appropriate adjustment of the prevention and control measures can reduce the need for laboratory and human resources. Conclusions: There is a great need in our country to reserve the human resources for laboratory testing and disease prevention and control for the response of the possible epidemic of COVID-19. Challenges to human resources resulted from total population nucleic acid testing and its necessity need to be considered. Conducting non-pharmaceutical interventions and encouraging more people to be vaccinated can mitigate the shock on healthcare resource demand in COVID-19 prevention and control.

[Long-term prognosis of drug eluting stents implantation in elderly patients with unprotected left main coronary artery disease]

Objective: To analyze the clinical characteristics and long-term prognosis of implantation of drug-eluting stents (DES) for elderly patients with unprotected left main artery (ULM) disease. Methods: A total of 414 patients (327 males and 87 females) who underwent DES implantation were enrolled in the Department of Cardiology, Beijing Anzhen Hospital from January 2005 to March 2010, with a mean age of (61.5±10.7) years old. The patients were divided into two groups according to age: 300 cases in the group of age <70 years old, and 114 cases in the group of age ≥70 years old. The clinical characteristics and long-term prognosis of two groups were compared. Results: In the group of age ≥ 70 years old, the proportion of female was higher (31.6% vs 17.0%, P=0.001) and the incidence of chronic total occlusion (CTO) (P=0.020), hypertension (P=0.018) and cerebrovascular disease (P=0.013) were higher than those in the group of <70 years old. All-cause mortality and cardiac mortality were also higher than those in the group of <70 years old (P=0.025, P=0.013). The follow-up period was (21.4±9.6) months. After adjusting for multiple clinical factors, there were no statistical differences of incidence of the total major adverse cardiac and cerebral events (MACCE), myocardial infarction, cerebrovascular events, and revascularization recurrence between the two groups. But all-cause mortality (HR=3.790, 95%CI: 1.271-11.298, P=0.017) and cardiac mortality (HR=17.424, 95%CI: 2.440-124.410, P=0.004) in the group of age ≥70 years old were still remarkably higher than those in the group of <70 years old. Conclusions: Age is an independent risk factor for increased mortality after DES stent implantation in ULM disease. DES stent implantation in age ≥70 years old patients with ULM disease is considered feasible, but it needs to be treated with caution.

Gender and age differences in the association between sleep characteristics and fasting glucose levels in Chinese adults

AIM

The present study examined the associations between night-time sleep duration, midday napping duration and bedtime, and fasting glucose levels, and whether or not such associations are dependent on gender and age.

METHODS

This study was a cross-sectional analysis of 172,901 adults aged≥40 years living in mainland China. Sleep duration was obtained by self-reports of bedtime at night, waking-up time the next morning and average napping duration at midday. Fasting plasma glucose (FPG)≥7.0mmol/L was defined as hyperglycaemia. Independent associations between night-time sleep duration, midday naptime duration and bedtime with hyperglycaemia were evaluated using regression models.

RESULTS

Compared with night-time sleep durations of 6-7.9h, both short (<6h) and long (≥8h) night-time sleep durations were significantly associated with an increased risk of hyperglycaemia in women [odds ratio (OR): 1.12, 95% confidence interval (CI): 1.01-1.29 and OR: 1.14, 95% CI: 1.08-1.21, respectively], and revealed a U-shaped distribution of risk in women and no significant association in men. Long midday nap durations (≥1h) were significantly but weakly associated with hyperglycaemia (OR: 1.04, 95% CI: 1.01-1.09) compared with no napping without interactions from gender or age, whereas the association between bedtime and fasting glucose levels did vary according to gender and age.

CONCLUSION

Night-time sleep duration, midday napping duration and bedtime were all independently associated with the risk of hyperglycaemia, and some of the associations between these sleep characteristics and hyperglycaemia were gender- and age-dependent.

Bacillus coagulans and its applications in medicine

Bacillus coagulans is a probiotic bacterium that produces spores. Due to its excellent stability, it has been widely used in medicine, food and chemical industry. Recent studies have shown that B. coagulans has therapeutic effects on intestinal diseases, such as acute diarrhoea, irritable bowel syndrome, antibiotic-related diarrhoea, constipation and colitis via modulation of the microbiota composition, host immunity and metabolism. Additionally, toxicological experiments and a large number of clinical observations have showed that B. coagulans is safe and has no effect of mutagenicity, teratogenicity or genotoxicity. This review summarises the latest advances associated with B. coagulans, from its biological features, probable action mechanisms, toxicity, and medical applications.

Bacillus coagulans and its applications in medicine

Bacillus coagulans is a probiotic bacterium that produces spores. Due to its excellent stability, it has been widely used in medicine, food and chemical industry. Recent studies have shown that B. coagulans has therapeutic effects on intestinal diseases, such as acute diarrhoea, irritable bowel syndrome, antibiotic-related diarrhoea, constipation and colitis via modulation of the microbiota composition, host immunity and metabolism. Additionally, toxicological experiments and a large number of clinical observations have showed that B. coagulans is safe and has no effect of mutagenicity, teratogenicity or genotoxicity. This review summarises the latest advances associated with B. coagulans, from its biological features, probable action mechanisms, toxicity, and medical applications.

Effect of the acrosome reaction on the efficiency of sperm-mediated DNA transfer

Sperm-mediated gene transfer (SMGT) is based on the ability of spermatozoa to bind exoge- nous DNA and transfer it into oocytes by fertilization. However, SMGT is still undergoing opti- mization to improve its efficiency to produce transgenic animals. The acrosome reaction is neces- sary for spermatozoa to carry the exogenous DNA into oocytes. In this study, the effect of the acrosome reaction on the efficiency of spermatozoa carrying exogenous DNA was evalua- ted. The results showed that the efficiency of the acrosome reaction was significantly higher (p⟨0.05) after incubation with 50 μmol/L progesterone compared to incubation without proges- terone. It was significantly higher (p⟨0.05) in the 20, 40, and 60 min of progesterone treatment groups than in the 0 min treatment group. The spermatozoa were further incubated with cyanine dye Cy5 labeled DNA (Cy5-DNA) for 30 min at 37°C, and positive fluorescence signals were detected after the acrosome reaction was induced by progesterone at concentrations of 0 and 50 μmol/L for 40 min. The percentage of positive Cy5-DNA signals in spermatozoa was 96.61±2.06% and 97.51±2.03% following exposure to 0 and 50 μmol/L progesterone, respective- ly. The percentage of partial spermatozoa heads observed following combination with Cy5-DNA was 39.73±3.03% and 56.88±3.12% following exposure to 0 and 50 μmol/L progesterone, respec- tively. The ratio of positively stained spermatozoa combined with exogenous DNA showed no reduction after the acrosome reaction. These results suggest that the acrosome reaction might not be the key factor affecting the efficiency of SMGT.

Mechanism of vasoactive peptide intermedin in vascular collagen remodeling during angiotensin II-induced hypertention

OBJECTIVE

Renin-angiotensin axis plays a pivotal role in the cardiovascular system, and Angiotensin II (Ang II) is of great importance in the progression of hypertension. Vasoactive peptide intermedin (IMD) belongs to calcitonin gene-related peptide (CGRP) family, which is involved in the regulation of the cardiovascular function. This study aims to determine the effect of vasoactive peptide intermedin on vascular collagen remodeling caused by angiotensin II-induced hypertension.

MATERIALS AND METHODS

12-week old rats were randomly assigned into three groups, and each group consisted of 12 rats. Rats were administered with Ang II or Ang II+IMD, respectively. Control group received saline administration. Blood pressure of caudal artery was examined two weeks after administration. Serum procollagen I and III were detected by enzyme-linked immunosorbent assay (ELISA). The vascular microstructure was examined via hematoxylin-eosin (HE) staining to evaluate vascular collagen remodeling. Expressions of protein kinase B (Akt) and mitogen-activated protein kinase (MAPK) were tested by using Western-blot and RT-PCR.

RESULTS

Compared with the control group (92.2±9.1 mmHg), blood pressure of group Ang II was increased by 88% (173.1±11.2 mmHg) (p<0.01). Moreover, blood pressure level in group Ang II+IMD (131.0±10.9 mmHg) was reduced compared to that in group Ang II (p<0.05). Compared with that in control group, higher level of serum procollagen, with significantly increasing vascular W/C ratio and collagen area percentage, was found in group Ang II, while all testing indexes above in group Ang II+IMD were lower than that in group Ang II. No differences were detected in the levels of Akt and MAPK mRNA among all three groups. However, highest expressions of phosphorylation Akt and MAPK protein were shown in group Ang II, and the levels were gradually lower in groups of Ang II+IMD and control.

CONCLUSIONS

IMD could attenuate the vascular collagen remodeling caused by angiotensin II-induced hypertension via inhibiting phosphorylation of Akt and MAPK.

A method for tracing exogenous DNA uptake in live spermatozoa and embryos

Sperm-mediated gene transfer(SMGT) is a simple method for producing transgenic animals. Due to the lack of repeatability in spermatozoa binding and internalization of exogenous DNA, the efficiency of SMGT is still low. Considering this point, the present work aims to develop a method for evaluating the spermatozoa capacity of binding exogenous DNA after co-incubation with DNA. The main approach is using a Cy5-labelled DNA to trace the exogenous DNA and assess the ability of spermatozoa to take up exogenous DNA. Using this technique, we found that the percentage of spermatozoa that are binding and uptaking DNA is higher at concentration of 10 μg/mL and 100 μg/mL than 5 μg/mL, 1 μg/mL and 0 μg/mL after incubation with Cy5-DNA for 30min at 37oC. After fertilization, the DNA fluorescence signal was also detected in zygotes in groups where spermatozoa were incubated with 10 μg/mL and 100 μg/mL of Cy5-DNA. These results showed a simple and convenient method to trace the exogenous DNA in spermatozoa and zygote when compared to conventional methods of labeling DNA during fertilization, resulting in a real-time observation of the exogenous DNA in spermatozoa and zygote.

Multicentre randomized controlled trial with sensor-augmented pump vs multiple daily injections in hospitalized patients with type 2 diabetes in China: Time to reach target glucose

AIM

Sensor-augmented pump (SAP) technology, which combines continuous subcutaneous insulin infusion (CSII) and real-time continuous glucose monitoring (RT-CGM), has been available for several years in China. In this study, the time required to reach predefined glycaemic targets with SAP vs multiple daily injection (MDI) therapy was compared in hospitalized patients with type 2 diabetes mellitus (T2DM).

METHODS

Adults (aged 18-65 years) with T2DM treated with insulin and admitted to hospital for glucose management were randomized to either SAP (Medtronic MiniMed™ Paradigm™ 722 system) or MDI with blinded CGM (Medtronic MiniMed CGMS System Gold™) for a 2-week period. Glycaemic targets were defined as three preprandial measurements between 80 and 130mg/dL (4.4 and 7.2mmol/L) and three 2-h postprandial measurements between 80 and 180mg/dL (4.4 and 10.0mmol/L) within the same day.

RESULTS

When data from 81 patients (40 SAP, 41 MDI) were analysed, 21 patients using SAP therapy, compared with six using MDI therapy, achieved their glycaemic targets within 3 days, and their time to reach their glucose targets was significantly shorter (3.7±1.1 vs 6.3±3.1 days for MDI; P<0.001), while three MDI patients failed to reach glycaemic targets within 14 days. SAP vs MDI patients experienced significantly less hypoglycaemia [sensor glucose<50mg/dL (2.8mmol/L): 0.04% vs 0.32%, respectively; P<0.05] and significantly less hyperglycaemia [sensor glucose>180mg/dL (10mmol/L): 21.56% vs 35.03%, respectively; P<0.05].

CONCLUSION

SAP vs MDI therapy in hospitalized patients with T2DM significantly reduced the time required to achieve glycaemic targets, and such systems may be a cost-effective way to improve glucose control and reduce hospital stays in T2DM patients.

APPL proteins promote TGFβ-induced nuclear transport of the TGFβ type I receptor intracellular domain

The multifunctional cytokine transforming growth factor-β (TGFβ) is produced by several types of cancers, including prostate cancer, and promote tumour progression in autocrine and paracrine manners. In response to ligand binding, the TGFβ type I receptor (TβRI) activates Smad and non-Smad signalling pathways. The ubiquitin-ligase tumour necrosis factor receptor-associated factor 6 (TRAF6) was recently linked to regulate intramembrane proteolytic cleavage of the TβRI in cancer cells. Subsequently, the intracellular domain (ICD) of TβRI enters in an unknown manner into the nucleus, where it promotes the transcription of pro-invasive genes, such as MMP2 and MMP9. Here we show that the endocytic adaptor molecules APPL1 and APPL2 are required for TGFβ-induced nuclear translocation of TβRI-ICD and for cancer cell invasiveness of human prostate and breast cancer cell lines. Moreover, APPL proteins were found to be expressed at high levels in aggressive prostate cancer tissues, and to be associated with TβRI in a TRAF6-dependent manner. Our results suggest that the APPL–TβRI complex promotes prostate tumour progression, and may serve as a prognostic marker.

Gastrointestinal tract development in fattening lambs fed diets with different amylose to amylopectin ratios

Thirty-six, 7-d-old male lambs of similar weights were used in the current study to examine the effects of dietary amylose to amylopectin ratios (amylose/amylopectin) on gastrointestinal development in fattening lambs fed concentrates with different sources of starch (tapioca, wheat, maize, and pea) and amylose/amylopectin (0.12, 0.23, 0.24, and 0.48, respectively). The maize starch (MS) and wheat starch (WS) diets improved weight and volume of gastrointestinal. The pea starch diet significantly increased papillar height (P < 0.001), papillar surface area (P = 0.019), and density of papillae (P = 0.001) in the rumen. Additionally, the pea starch diet significantly enhanced villus height, crypt depth, and villus surface area and villus/crypt ratio (P < 0.05) in small intestine. Expressions of insulin-like growth factors I (IGF-1) and insulin-like growth factors’ receptors (IGF-1R) significantly increased in the duodenum mucosa (P = 0.021, P = 0.006, respectively), jejunum mucosa (P = 0.002, P = 0.005, respectively), and ileum mucosa (P = 0.003, P < 0.01, respectively) in the pea starch diet group. The results of the present study show that MS and WS accelerated physical development of rumen and intestine compartments, whereas pea starch increased development of their some morphological parameters, possibly through enhanced expression of genes such as IGF-1 and IGF-1R in fattening lambs.

Genetic correlations between female fertility and postweaning growth and feed efficiency traits in multibreed beef cattle

With selection in beef cattle now incorporating feed efficiency, knowing the relationship with other traits is needed. Genetic relationships were estimated with an animal model in ASReml with a three-generation pedigree inclusive of 2882 animals. Multibreed data from two Ontario beef research farms with fertility traits were available on 1366 females and postweaning traits, including feed efficiency on 1297 individuals. Estimates of heritability for fertility traits were low to moderate ranging from 0.03 ± 0.01 for pregnancy rate to 0.21 ± 0.02 for gestation length, and postweaning traits were moderate to high with feed conversion ratio at 0.22 ± 0.06 to mid-metabolic weight at 0.89 ± 0.01. Both dry matter intake and mid-metabolic weight were genetically correlated with most fertility traits from −0.52 to 0.34. The genetic correlation between average daily gain and days to calving was moderately negative (–0.33 ± 0.16) as was residual feed intake with days to calving (–0.34 ± 0.17). Bigger cows with more feed intake and faster growth were more fertile, and residual feed intake had an unfavorable genetic correlation with days to calving, indicating that programs to select for feed efficiency should include fertility simultaneously in a selection index.

Efficacy and safety of liraglutide versus sitagliptin, both in combination with metformin, in Chinese patients with type 2 diabetes: a 26-week, open-label, randomized, active comparator clinical trial

AIMS

To compare the efficacy and safety of liraglutide versus sitagliptin as add-on to metformin after 26 weeks of treatment in Chinese patients with type 2 diabetes mellitus (T2DM).

METHODS

This 26-week open-label, active comparator trial (NCT02008682) randomized patients (aged 18-80 years) with T2DM inadequately controlled with metformin [glycated haemoglobin (HbA1c) 7.0-10.0% (53-86 mmol/mol)] 1 : 1 to once-daily subcutaneously administered liraglutide 1.8 mg (n = 184) or once-daily oral sitagliptin 100 mg (n = 184), both as add-on to metformin. The primary endpoint was change in HbA1c from baseline to week 26.

RESULTS

Liraglutide was superior to sitagliptin in reducing HbA1c from baseline [8.1% (65 mmol/mol)] to 26 weeks, as evidenced by estimated mean HbA1c change of -1.65% (-18.07 mmol/mol) versus -0.98% (-10.72 mmol/mol), respectively [estimated treatment difference for liraglutide vs sitagliptin of -0.67% (95% CI -0.86, -0.48) or -7.35 mmol/mol (95% CI -9.43; -5.26); p < 0.0001]. More patients receiving liraglutide (76.5%) than sitagliptin (52.6%) achieved the HbA1c target of <7.0% (53 mmol/mol) at week 26 [odds ratio 3.65 (95% CI 2.18, 6.12); p < 0.0001]. Reductions in fasting plasma glucose, 7-point self-measured plasma glucose and body weight were greater with liraglutide than with sitagliptin (p < 0.0001 for all). More patients experienced nausea (14.8% vs 0.5%), diarrhoea (8.2% vs 2.2%) and decreased appetite (10.9% vs 0.5%) with liraglutide than sitagliptin. Two hypoglycaemic episodes were confirmed for liraglutide and one for sitagliptin; none were severe or nocturnal.

CONCLUSIONS

Liraglutide provided better glycaemic control and greater body weight reduction than sitagliptin when administered as add-on to metformin. More patients had nausea, diarrhoea and decreased appetite with liraglutide versus sitagliptin.

From fighting depression to conquering tumors: a novel tricyclic thiazepine compound as a tubulin polymerization inhibitor

A novel tricyclic thiazepine derivative, 6-(p-tolyl)benzo[f] pyrido[2,3-b][1,4] thiazepine 11,11-dioxide (TBPT), exhibits potent inhibitory effects in two non-small-cell lung cancer cell lines, H460 and its drug-resistant variant, H460_TaxR, while exhibiting much less toxic effects on normal human fibroblasts. After five injections of TBPT at a dose of 60 mg/kg, it inhibits H460_TaxR tumor growth in xenografted mouse models by 66.7% without causing observable toxicity to normal tissues. Based on gene perturbation data and a series of investigations, we reveal that TBPT is not a P-glycoprotein substrate and it inhibits microtubule formation by targeting tubulin, thereby causing cell cycle arrest at the G2/M stage and eventually inducing apoptosis. This redeployment of anti-depressant compound scaffold for anticancer applications provides a promising future for conquering drug-resistant tumors with fewer side effects.

G protein-coupled estrogen receptor is involved in modulating colonic motor function via nitric oxide release in C57BL/6 female mice

BACKGROUND

Estrogen may regulate gastrointestinal motor functions, but the mechanism(s) is not totally understood. Here, we investigated whether G protein-coupled estrogen receptor (GPER/GPR30) was involved in regulating colonic motor functions and explored the underlying physiological mechanisms.

METHODS

Adult female C57BL/6 mice were used. The expression and localization of GPER were examined by RT-PCR, western blot, and immuno-labeling. The role of GPER in modulating colonic motor functions was assessed by the bead propulsion test in vivo and organ bath experiments in vitro.

KEY RESULTS

GPER was expressed in colonic myenteric neurons. The colonic transit time (CTT) in proestrus and estrus was significantly longer than that in diestrus. In vivo treatment with the selective GPER blocker G15 significantly shortened CTT in proestrus and estrus. In ovariectomized mice, acute estrogen supplementation increased CTT, which could be abolished by G15 co-administration. The GPER agonist G-1 caused a concentration-dependent inhibition of carbachol -induced circular muscle strips contraction, which was abolished by tetrodotoxin and the neuronal nitric oxide synthase (nNOS) inhibitor N-propyl-l-arginine. G-1 stimulated NO production in isolated longitudinal muscle myenteric plexus and cultured myenteric neurons, which was dependent on nNOS. Immunofluorescence labeling showed co-localization of GPER with nNOS in the myenteric plexus.

CONCLUSIONS & INFERENCES

We suggest that activation of GPER exerts an inhibitory effect on colonic motility by promoting NO release from myenteric nitrergic nerves. These results raise a possibility that GPER may be involved in mediating the inhibitory effect of estrogen on colonic motor functions, via a non-genomic, neurogenic mechanism.

Comparison of efficacy of different embolic agents on uterine leiomyoma

The aim of this study was to explore the efficacies, postoperative side effects, and complications of uterine artery embolization (UAE) treatments for uterine leiomyoma (UL) with different embolic agents. The study included 107 patients with UL that were treated with UAE with polyvinyl alcohol (PVA group) or pingyangmycin lipiodol emulsion and silk-segment (PLES group). Six months later, the improvement rate of anaemia, the menstrual improvement rate, the incidence rate of fever, the disappearance rates of compression symptoms and abdominal symptoms in the PVA group were 93.8%, 94.7%, 22.0%, 60.0%, and 88.9%, respectively, which showed no significant difference from those in the PLES group (90.5%, 92.3%, 84.8%, 53.3%, and 8 1.3%, respectively). The incidence rate of fever after embolization in PVA group was significantly lower than that in PLES group (c² = 41.958, p = 0.000). However, the efficacy, improvement rate of symptoms, and postoperative side effects of two groups showed no significant difference (p > 0.05). PVA and PLES have significant efficacy for UAE treatment on patients with UL.

Sleep duration and snoring associate with hypertension and glycaemic control in patients with diabetes

AIMS

Few studies have analysed the effect of sleep duration and snoring on hypertension and glycaemic control in patients with diabetes. This study aims to investigate the relationship of sleep duration and snoring on prevalent hypertension and glycaemic control in people with diabetes.

METHODS

In the baseline survey of the REACTION study, 56 032 patients with diabetes were categorized into four groups according to self-reported sleep duration: < 6, 6-7.9, 8-8.9 and ≥ 9 h. Snoring frequency was evaluated as 'usually', 'occasionally' or 'never'. Hypertension was assessed by systolic blood pressure, diastolic blood pressure, self-reported previous diagnosis and antihypertensive medications. 'Good' glycaemic control was defined as HbA1c < 53 mmol/mol (7.0%) and 'poor' glycaemic control as HbA1c ≥ 53 mmol/mol (7.0%).

RESULTS

Controlling for potential confounders and intermediates, sleep ≥ 9 h relative to intermediate sleep (6-7.9 h) was significantly associated with prevalent hypertension (OR: 1.25, 95% CI: 1.18-1.32) and poor glycaemic control (OR: 1.11, 95% CI: 1.05-1.18), and a U-shaped association was found between sleep duration and prevalent hypertension (P for quadratic trend = 0.019). Usually snoring was positively associated with prevalent hypertension (OR: 1.30, 95% CI: 1.23-1.37), whereas the association between snoring and poor glycaemic control was only on the borderline of statistical significance.

CONCLUSIONS

Compared with a sleep duration of 6-7.9 h, longer sleep duration was associated with a higher prevalence of hypertension and poor glycaemic control in people with diabetes. Moreover, the relationship between sleep duration and prevalent hypertension was U-shaped. These findings may propose important public health implications for diabetes management.

CIN85 modulates TGFβ signaling by promoting the presentation of TGFβ receptors on the cell surface

Members of the transforming growth factor β (TGFβ) family initiate cellular responses by binding to TGFβ receptor type II (TβRII) and type I (TβRI) serine/threonine kinases, whereby Smad2 and Smad3 are phosphorylated and activated, promoting their association with Smad4. We report here that TβRI interacts with the SH3 domains of the adaptor protein CIN85 in response to TGFβ stimulation in a TRAF6-dependent manner. Small interfering RNA-mediated knockdown of CIN85 resulted in accumulation of TβRI in intracellular compartments and diminished TGFβ-stimulated Smad2 phosphorylation. Overexpression of CIN85 instead increased the amount of TβRI at the cell surface. This effect was inhibited by a dominant-negative mutant of Rab11, suggesting that CIN85 promoted recycling of TGFβ receptors. CIN85 enhanced TGFβ-stimulated Smad2 phosphorylation, transcriptional responses, and cell migration. CIN85 expression correlated with the degree of malignancy of prostate cancers. Collectively, our results reveal that CIN85 promotes recycling of TGFβ receptors and thereby positively regulates TGFβ signaling.

12 cases of primary thyroid lymphoma in China

INTRODUCTION

Primary thyroid lymphoma (PTL) is a rare malignant disease, which can be life threatening because of airway obstruction due to a suddenly and rapidly growing mass. Prompt and accurate detection and diagnosis in the early phase of PTL are crucial for the treatment of this disease. However, due to lack of standardized diagnostic procedures and methods, PTL can be easily missed or misdiagnosed.

MATERIALS AND METHODS

In this study, we retrospectively reviewed 12 thyroid lymphomas cases to determine the typical clinical and sonographic profiles of thyroid lymphomas.

RESULTS

All the patients showed symptoms of rapidly developing neck swelling or mass sensation when they underwent diagnostic procedures. We found that, in sonography, 3 of the 12 patients (25.0 %) showed diffuse heterogeneous hypoechoic parenchyma with intervening echogenic septa-like structures, 8 (66.7 %) showed markedly hypoechoic masses, and 1 (8.3 %) showed a mixed pattern. Histological analysis of the lymphomas using paraffin-embedded sections revealed that all the 12 lymphomas were non-Hodgkin lymphoma with a B cell origin: extranodal marginal zone B cell lymphomas of the mucosa-associated lymphoid tissue lymphoma type in 3 (MALT, 25.0 %), and diffuse large B cell lymphomas in 9 (75.0 %) lymphomas. All the MALT patients had diffuse heterogeneous hypoechoic parenchyma in sonography, but only one of them with diffuse large B cell lymphomas had diffuse heterogeneous hypoechoic parenchyma in sonography. Complete remission was achieved in all patients when they were given CHOP or COP therapy accompanied by local radiotherapy after accurate diagnosis of PTL.

CONCLUSION

We analyzed clinical, sonographic and histological features of twelve cases of malignant lymphoma arising in the thyroid gland and proposed a systematic strategy for prompt and accurate diagnosis of PTL.

Prevalence of restless legs syndrome and sleep quality in carriers of the fragile X premutation

This study examined the relationship between the fragile X premutation and restless legs syndrome (RLS). Demographic, medical history and survey responses related to sleep were collected from 213 participants (127 carriers and 86 age matched controls). Subjects were asked about the presence of the four formal diagnostic criteria for RLS. Individuals with the premutation were 1.9 times as likely to meet criteria for RLS (95% CI 1.1–3.2, p=0.025) as controls. Premutation carriers with RLS also experienced significantly worse symptoms than matched controls with adjusted mean scores of 15.1±8.8 vs 7.9±4.4, respectively on the International Restless Legs Scale (IRLS). As markers for domains of sleep disturbance, all subjects completed the Epworth Sleepiness Scale (ESS), the Insomnia Severity Index (ISA) and the Pittsburgh Sleep Quality Index (PSQI). Premutation carriers demonstrated significantly more pathology on these tests except for the ESS where there was a trend towards increased daytime sleepiness in carriers. RLS joins a host of other conditions that should be carefully screened for in those carrying the fragile X premutation and sleep should be a focus for clinicians providing care to them.

TRAF6 stimulates the tumor-promoting effects of TGFβ type I receptor through polyubiquitination and activation of presenilin 1

Transforming growth factor-β (TGFβ) can be both a tumor promoter and suppressor, although the mechanisms behind the protumorigenic switch remain to be fully elucidated. The TGFβ type I receptor (TβRI) is proteolytically cleaved in the ectodomain region. Cleavage requires the combined activities of tumor necrosis factor (TNF) receptor-associated factor 6 (TRAF6) and TNF-α-converting enzyme (TACE). The cleavage event occurs selectively in cancer cells and generates an intracellular domain (ICD) of TβRI, which enters the nucleus to mediate gene transcription. Presenilin 1 (PS1), a γ-secretase catalytic core component, mediates intramembrane proteolysis of transmembrane receptors, such as Notch. We showed that TGFβ increased both the abundance and activity of PS1. TRAF6 recruited PS1 to the TβRI complex and promoted lysine-63-linked polyubiquitination of PS1, which activated PS1. Furthermore, PS1 cleaved TβRI in the transmembrane domain between valine-129 and isoleucine-130, and ICD generation was inhibited when these residues were mutated to alanine. We also showed that, after entering the nucleus, TβRI-ICD bound to the promoter and increased the transcription of the gene encoding TβRI. The TRAF6- and PS1-induced intramembrane proteolysis of TβRI promoted TGFβ-induced invasion of various cancer cells in vitro. Furthermore, when a mouse xenograft model of prostate cancer was treated with the γ-secretase inhibitor DBZ {(2S)-2-[2-(3,5-difluorophenyl)-acetylamino]-N-(5-methyl-6-oxo-6,7-dihydro-5H-dibenzo[b,d]azepin-7-yl)-propionamide}, generation of TβRI-ICD was prevented, transcription of the gene encoding the proinvasive transcription factor Snail1 was reduced, and tumor growth was inhibited. These results suggest that γ-secretase inhibitors may be useful for treating aggressive prostate cancer.

Two new four-connected zeolite-like magnesium aluminophosphates with intersecting 8-ring channels

JU94 and JU95 are synthesized in the same reaction system, but exhibit different zeolite-like frameworks containing 2D 8-ring channels.

Oxalate degradation in a bioelectrochemical system: reactor performance and microbial community characterization

The aim of this work was to investigate the feasibility of using oxalate at the anode in a continuous reactor. Complete oxalate removal was observed, albeit at a maximum coulombic efficiency of 33.9±0.4%. At the cathode side, there was an increase in pH from 8 to 11 showing production of caustic. Analysis of the microbial community demonstrated a clear shift during reactor start-up, resulting in enrichment of microorganisms belonging to Bacteroidetes, Firmicutes, Mollicutes, and β and γ-Proteobacteria. Methane was produced throughout the experiment; Archaea belonging to the Methanosarcinacea, Methanomicrobiaceae and Methanosaetaceae were identified as key representatives.