Association of hemoglobin-to-red cell distribution width ratio with the three-month outcomes in patients with acute ischemic stroke.

Aim: To explore the association of Hemoglobin-to-Red Cell Distribution Width Ratio (HRR) with the risk of three-month unfavorable outcomes in acute ischemic stroke (AIS). Methods: A secondary analysis was conducted based on a prospective cohort study. A total of 1,889 patients with AIS treated in South Korea from January 2010 to December 2016 were enrolled. Multivariable logistic regression was conducted to investigated the independent relationship between HRR and risk of three-month unfavorable outcomes in AIS. Fitted smoothing curves were used to determine non-linear correlations. The recursive method was employed to explore the turning point and build a two-piece linear regression model. In addition, a set of subgroup analyses were carried out to evaluate the relationship between HRR and risk of three-month unfavorable outcomes. Results: Multivariate analysis in which potential confounders were adjusted for indicated that the risk of unfavorable outcomes was reduced by 10% for each unit increased of HRR [OR = 0.90, 95% CI: 0.84-0.96, p = 0.0024]. In addition, a non-linear relationship was observed between HRR and risk of three-month unfavorable outcomes, which had an inflection point of HRR was 10.57. The effect sizes and the confidence intervals on the left side of the inflection point were 0.83 (0.75, 0.91), p = 0.0001. On the right side of the inflection point, no association was found between HRR and the risk of three-month unfavorable outcomes. Conclusion: This study demonstrates a negative association between HRR and risk of three-month unfavorable outcomes. The relationship between HRR and risk of three-month unfavorable outcomes is non-linear. The correlation is negative for HRR values less than 10.57. For, HRR higher than 10.57, HRR is not associated with the risk of three-month unfavorable outcomes.

Red Cell Distribution Width-to-Platelet Count Ratio: A Promising Predictor of In-Hospital All-Cause Mortality in Critically Ill Patients with Acute Ischemic Stroke.

INTRODUCTION: The red blood cell distribution width-to-platelet ratio (RPR), a novel inflammatory index, has already been proven as a prognostic factor in some other diseases, but its prognostic effect on critically ill patients with acute ischemic stroke (AIS) has been rarely investigated. This study aimed to investigate the association between RPR and in-hospital mortality in these patients. METHODS: We extracted clinical data from the Medical Information Mart for Intensive Care IV 1.0 database. The primary outcome was in-hospital all-cause mortality of patients with critical AIS. The main independent variable was RPR. To investigate the association between RPR and in-hospital all-cause mortality in patients with critical AIS, multivariable logistic analyses, smooth curve fitting, and stratified analyses were conducted. RESULTS: In total, 2,673 patients with AIS who were admitted to the intensive care unit were included in the study. In the multivariable analysis, in-hospital mortality was positively related to RPR (odds ratio [OR] 1.28, 95% confidence interval [CI] 1.02-1.59). According to the two-piecewise logistic regression model, we found that the inflection point of RPR was 1.89%. To the left of the inflection point (RPR ≤1.89%), we did not detect any relationship between RPR and in-hospital all-cause mortality (OR [95% CI]: 0.73 [0.41, 1.31], p = 0.2884). In contrast, to the right of the inflection point (RPR >1.89%), RPR was positively related to in-hospital all-cause mortality (OR [95% CI]: 1.61 [1.18, 2.19], p = 0.0027). CONCLUSIONS: RPR showed a nonlinear relationship with in-hospital all-cause mortality in patients with critical AIS.

Differential microRNA expression profiles determined by next-generation sequencing in three fulvestrant-resistant human breast cancer cell lines.

Fulvestrant resistance is a major clinical issue in the treatment of endocrine-based breast cancer. MicroRNAs (miRNAs) are known to serve an important role in tumor chemoresistance. In the present study, the association between miRNA expression profiles and fulvestrant resistance was investigated in human breast cancer cell lines. Three fulvestrant-resistant breast cancer cell lines, namely MCF-7-CC, MCF-7-TT and MCF-7-21, were established using the human breast cancer cell line MCF-7 as the parental cell line and fulvestrant as the screening drug in vitro. Next-generation sequencing was used to determine the miRNA expression profiles in these cell lines. Subsequently, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed to determine the biological functions of differentially expressed miRNAs. In total, 1,536 miRNAs were detected in all the samples, including 1,240 known miRNAs and 296 predicted miRNAs. It was observed that the differential miRNA expression profiles varied among the three fulvestrant-resistant cell lines (MCF-7-CC, MCF-7-TT and MCF-7-21), and certain differentially expressed miRNAs were only detected in one or two of the cell lines. A total of 257 miRNAs that were differentially expressed between MCF-7-CC and MCF-7 cells were detected, among which 69 miRNAs were upregulated and 188 miRNAs were downregulated. In addition, 270 miRNAs with significantly different expression between MCF-7-TT and MCF-7 cells were observed, including 180 upregulated and 90 downregulated miRNAs. Between MCF-7-21 and MCF-7 cells, a total of 227 miRNAs were differentially expressed, among which 52 miRNAs were upregulated and 175 miRNAs were downregulated. The miRNAs that were differentially expressed in the three fulvestrant-resistant cell lines as compared with the parental MCF-7 cell line were primarily involved in the following biological processes: Biological regulation, extracellular matrix-receptor interaction, the Notch signaling pathway and focal adhesion. Taken together, the results suggested that miR-143, miR-145, miR-137, miR-424 and miR-21 may serve important roles in fulvestrant resistance in breast cancer. The study findings may provide a basis for further research on the treatment of fulvestrant-resistant breast cancer.

The intensified constructed wetlands are promising for treatment of ammonia stripped effluent: Nitrogen transformations and removal pathways.

This study investigated the treatment performance and nitrogen removal mechanism of highly alkaline ammonia-stripped digestate effluent in horizontal subsurface flow constructed wetlands (CWs). A promising nitrogen removal performance (up to 91%) was observed in CWs coupled with intensified configurations, i.e., aeration and effluent recirculation. The results clearly supported that the higher aeration ratio and presence of effluent recirculation are important to improve the alkalinity and pollutant removal in CWs. The influent pH (>10) was significantly decreased to 8.2-8.8 under the volumetric hydraulic loading rates of 0.105 and 0.21 d-1 in the CWs. Simultaneously, up to 91% of NH4+-N removal was achieved under the operation of a higher aeration ratio and effluent recirculation. Biological nitrogen transformations accounted for 94% of the consumption of alkalinity in the CWs. The significant enrichment of δ15N-NH4+ in the effluent (47-58‰) strongly supports the occurrence of microbial transformations for NH4+-N removal. However, relatively lower enrichment factors of δ15N-NH4+ (-1.8‰ to -11.6‰) compared to the values reported in previous studies reflected the inhibition effect of the high pH alkaline environment on nitrifiers in these CWs.

Differential microRNA expression profiles in tamoxifen-resistant human breast cancer cell lines induced by two methods.

Tamoxifen (TAM) resistance has become a severe problem for endocrine therapy of breast cancer. The present study investigated the association between microRNA (miRNA) expression and TAM resistance in breast cancer. The TAM-resistant breast cancer MCF-7C and MCF-7T cell lines were established using the human breast cancer cell line MCF-7 as the parental cell line and 4-hydroxytamoxifen (OHT) as the screening drug in vitro. The MCF-7C cell line was established by dose stepwise induction beginning with a low concentration of OHT; the MCF-7T cell line was established by temporal stepwise induction beginning with a high concentration of OHT. Differential miRNA expression profiles between TAM-sensitive (MCF-7) and TAM-resistant (MCF-7C and MCF-7T) breast cancer cell lines were detected and analyzed using RNA sequencing technology. The results of western blot analysis indicated that the level of ERα protein expression in drug-resistant cells was significantly increased. A total of 1,646 miRNAs were detected in all samples, including 1,376 known miRNAs and 270 predicted miRNAs. There were 118 miRNAs expressed at significantly different levels between MCF-7C and MCF-7 cells (P<0.05); among them, 67 miRNAs were upregulated (P<0.05) and 51 miRNA were downregulated (P<0.05). There were 42 miRNAs expressed at significantly different levels between MCF-7T and MCF-7 (P<0.05); among them, 23 miRNAs were upregulated (P<0.05) and 19 miRNAs were downregulated (P<0.05). There were 126 miRNAs with significant differences between MCF-7C and MCF-7T (P<0.05); among them, 76 miRNAs were upregulated (P<0.05) and 50 miRNAs were downregulated. On the basis of the results of the present study, we hypothesize that miR-21, miR-146a, miR-148a, miR-34a and miR-27a may serve important roles in mediating TAM resistance in breast cancer, and have potential as therapeutic targets for TAM-resistant breast cancer.

Removal of organic matter, nitrogen and faecal indicators from diluted anaerobically digested slurry using tidal flow constructed wetlands.

The rapid implementation of anaerobic digestion for renewable energy production has resulted in increased generation of anaerobically digested slurry, which contains a variety of pollutants and therefore has the potential to cause serious environmental problems. Tidal flow constructed wetlands, which could generate beneficial oxygen conditions, were investigated for their success in removing nitrogen, organic matter and pathogens in anaerobically digested slurry. The results indicated that tidal operation had a positive effect on promoting NH4+-N and organic matter (chemical oxygen demand (COD)) removal. With an average influent NH4+-N concentration of 288 mg/L and COD concentration of 839 mg/L, the average removal efficiency reached up to 93% (325 g/m2 day) for NH4+-N and 53% (603 g/m2 day) for COD, with total inorganic nitrogen (TIN) removal efficiency of 51% (226 g/m2 day). The nitrogen removal in the tidal-operated CWs is highly dependent on the flooded and drained (F/D) time ratio. Changing flooded time from 3 to 5 h enhanced denitrification (nitrite reductase-K (nirK) abundance) and further resulted in improved TIN removal efficiency of 62% (237 g/m2 day). The removal of faecal indicators was also examined, with reduction rate of approximately 0.9 log10 CFU/100 mL for both Escherichia coli and total coliforms, which was independent of the influent loadings and differing flooded/drained time ratio. Tidal flow CWs were demonstrated to have the high potential to treat diluted anaerobically digested slurry.

Clinicopathological significance of forkhead box protein A1 in breast cancer: A meta-analysis.

The aim of the present study was to investigate the associations between the expression of forkhead box protein A1 (FOXA1) and differential clinicopathological characteristics in breast cancer using a meta-analysis method. Eligible studies that investigated the correlation between FOXA1 expression and the clinical characteristics of breast cancer were collected through searching numerous databases, including PubMed, EMBASE, the Chinese National Knowledge Infrastructure and the VIP database. In total, eight studies were included in the meta-analysis. Following a systematic analysis, the expression of FOXA1 was found to be significantly associated with the estrogen receptor α status, the progesterone receptor status, lymph node metastasis and the histological grade in breast cancer. However, no statistically significant association was observed between FOXA1 expression and the human epidermal growth factor receptor-2 status in breast cancer patients.

Optimization of high-rate TN removal in a novel constructed wetland integrated with microelectrolysis system treating high-strength digestate supernatant.

The potential of high-rate TN removal in three aerated horizontal subsurface-flow constructed wetlands to treat high-strength anaerobic digestate supernatant was evaluated. Different strategies of intermittent aeration and effluent recirculation were applied to compare their effect on nitrogen depuration performance. Additional glucose supply and iron-activated carbon based post-treatment systems were established and examined, respectively, to further remove nitrate that accumulated in the effluents from aerated wetlands. The results showed that intermittent aeration (1 h on:1 h off) significantly improved nitrification with ammonium removal efficiency of 90% (18.1 g/(m(2)·d)), but limited TN removal efficiency (53%). Even though effluent recirculation (a ratio of 1:1) increased TN removal from 53% to 71%, the effluent nitrate concentration was still high. Additional glucose was used as a post-treatment option and further increased the TN removal to 82%; however, this implementation caused additional organic pollution. Furthermore, the iron-activated carbon system stimulated with a microelectrolysis process achieved greater than 85% effluent nitrate removal and resulted in 86% TN removal. Considering the high TN removal rate, aerated constructed wetlands integrated with a microelectrolysis-driven system show great potential for treating high-strength digestate supernatant.

SATB1 is Correlated with Progression and Metastasis of Breast Cancers: A Meta-Analysis.

BACKGROUND/AIMS: Several researches have evaluated the significance of SATB1 (Special AT-rich sequence binding protein 1) expression in breast cancers (BCs), but the results have been disputed, especially in the aspects of clinicopathological features and prognosis. Therefore, our study aimed to use a meta-analysis to summarize the clinical and prognostic relevance of SATB1 gene expression in BCs. METHODS: A literature search of PubMed, EMBASE, Cochrane library, Chinese Wanfang and CNKI was performed to identify eligible studies. Ten studies total, comprising 5,185 patients (1,699 SATB1-positive and 3,486 SATB1-negative), were enrolled in our study, which was performed using Revman5.3 Software and Stata11.0 Software. RESULTS: This meta-analysis showed that the expression of SATB1 was significantly higher in breast cancer than in normal tissues (OR = 12.28; 95%CI = 6.01-25.09), and was statistically related to several clinicopathological parameters, including lymph node metastasis (OR = 1.55, 95%CI = 1.01-2.39) and Tumor Node Metastasis(TNM) stage (OR = 0.35, 95%CI = 0.22-0.56). However, the level of SATB1 was not statistically associated with the age (OR = 1.13, 95%CI = 0.87-1.46), tumour size (OR = 0.72, 95%CI = 0.44-1.19), estrogen receptor (OR = 0.78, 95%CI = 0.55-1.09), progesterone receptor (OR = 0.64, 95%CI = 0.32-1.29), HER2 status (OR=1.98, 95%CI = 0.74-5.30), and histological type (OR = 0.49, 95%CI = 0.22-1.11). CONCLUSION: High expression of SATB1 was significantly correlated with tumourigenesis and metastasis of BCs, indicating poor prognosis for patients. SATB1 could serve as a potential marker for detection and prognosis evaluation of breast cancers.

Quantitative assessment of the association between APC promoter methylation and breast cancer.

Adenomatous polyposis coli (APC) is an important tumor suppressor gene in breast cancer. However, there were inconsistent conclusions in the association between APC promoter methylation and breast cancer. Hence, we conducted a meta-analysis to quantitatively assess the clinicopathological significance and diagnosis role of APC methylation in breast cancer. In total, 3172 samples from 29 studies were performed in this study. The odds ratio (OR) of APC methylation was 5.92 (95% CI = 3.16-11.07) in breast cancer cases compared to controls,. The APC promoter methylation was associated with cancer stage (OR = 0.47, 95% CI = 0.28-0.80, P = 0.006), lymph node metastases (OR = 0.55, 95% CI = 0.36-0.84, P = 0.005) and ER status (OR = 1.34, 95% CI = 1.03-1.73, P = 0.003) in breast cancer. Furthermore, the sensitivity and specificity for all included studies were 0.444 (95% CI: 0.321-0.575, P < 0.0001) and 0.976 (95% CI: 0.916-0.993, P < 0.0001), respectively. These results suggested that APC promoter methylation was associated with breast cancer risk, and it could be a valuable biomarker for diagnosis, treatment and prognosis of breast cancer.