Real-world tobacco cessation practice in China: findings from the prospective, nationwide multicenter China National Tobacco Cessation Cohort Study (CNTCCS).

Background: Tobacco cessation is proven to be the most effective and cost-effective strategy for smokers to reduce their risk of smoking-related disease and premature death. Providing effective, efficient, safe, and patient-centred tobacco cessation treatment to reach those who need them is a significant challenge. To date, only a few nationwide studies in China have assessed the overall clinical care practice and treatment outcome of tobacco cessation. Methods: This a prospective, nationwide, multicenter, cohort study covering all Eastern China, Northwest China, Central China, North China, Southwest China, Northeast China, and South China. Participants who were current smokers aged 18-85 years attending clinic for smoking cessation were included. All the participants were treated with 3-month cessation treatment and followed up for 3 months. Data were collected prospectively using online system. The primary outcome was 7-day point abstinence rate at 24 weeks, validated biochemically by an expired carbon monoxide level of less than 10 ppm. The participants lost to follow-up or not providing validation were included as non-abstainers. Findings: A representative sample of 3557 participants were recruited and 2943 participants were included into this analysis. These participants had mean age of 53.05 years, and 94.8% were males, with 75.8% showing symptoms of tobacco dependence. A total of 965 (32.8%) participants were treated with Bupropion + behavioural counselling, followed by 935 (31.8%) with behavioural counselling, 778 (26.4%) with Varenicline + behavioural counselling, 135 (4.6%) with alternative treatments + behavioural counselling, and 130 (4.4%) with nicotine replacement therapy (NRT) + behavioural counselling. After 3-month treatment and 3-month follow-up, 21.74% of the participants quit smoking at 24 weeks. In the multivariable-adjusted analyses, quitting smoking was significantly associated with female, higher socioeconomic status, poor health condition, different treatment received, and less smoking intensity. The tobacco cessation treatment varied widely across different areas of China. In particular, the areas with higher usage of cessation medication were associated with better cessation treatment outcome. Interpretation: The CNTCCS is the first large-scale nationwide cohort study of smoking cessation in China. Rich data collected from this prospective cohort study provided the opportunity to evaluate the clinical practice of tobacco cessation treatment in China. Funding: Chinese Academy of Medical Sciences (CAMS) Initiative for Innovative Medicine (CAMS 2021-I2M-1-010), Heilongjiang Provincial Science and Technology Key Program (2022ZXJ03C02), and National Key R&D Program of China (grant no. 2017YFC1309400).

XGBoost-based multiparameters from dual-energy computed tomography for the differentiation of multiple myeloma of the spine from vertebral osteolytic metastases.

OBJECTIVES: To evaluate the performance of extreme gradient boosting (XGBoost) combined with multiparameters from dual-energy computed tomography (mpDECT) to differentiate between multiple myeloma (MM) of the spine and vertebral osteolytic metastases (VOM). METHODS: For this retrospective study, 28 patients (83 lesions) with MM of the spine and 23 patients (54 lesions) with VOM who underwent DECT were included. The mpDECT for each lesion, including normalized effective atomic number, slope of the spectral Hounsfield unit curve, CT attenuation, and virtual noncalcium (VNCa), was obtained. Boruta was used to select the key parameters, and then subsequently merged with XGBoost to yield a prediction model. The lesions were divided into the training and testing group in a 3:1 ratio. The highest performance of the univariate analysis was compared with XGBoost using the Delong test. RESULTS: The mpDECT of MM was significantly lower than that of VOM (all p < 0.05). In univariate analysis, VNCa had the highest area under the receiver operating characteristic curve (AUC) in the training group (0.81) and testing group (0.87). Based on Boruta, 6 parameters of DECT were selected for XGBoost model construction. The XGBoost model achieved an excellent and stable diagnostic performance, as shown in the training group (AUC of 1.0) and testing group (AUC of 0.97), with a sensitivity of 80%, a specificity of 95%, and an accuracy of 88%, which was superior to VNCa (p < 0.05). CONCLUSIONS: XGBoost combined with mpDECT yielded promising performance in differentiating between MM of the spine and VOM. KEY POINTS: • The multiparameters obtained from dual-energy CT of multiple myeloma differed significantly from those of vertebral osteolytic metastases. • The virtual noncalcium offered the highest AUC in the univariate analysis to distinguish multiple myeloma from vertebral osteolytic metastases. • Extreme gradient boosting combined with multiparameters from dual-energy CT had a promising performance to distinguish multiple myeloma from vertebral osteolytic metastases.

Epidemiological Evidence Between Variants in Matrix Metalloproteinases-2, -7, and -9 and Cancer Risk.

Background: Matrix metalloproteinases (MMPs), a kind of proteases, have a critical function in cancer occurrence, invasion, and migration. MMP gene variants (e.g., MMP-2, MMP-7, and MMP-9) can affect the biological functions of these enzymes and lead to the occurrence and progression of cancer, which has become a hot topic in recent years, but the corresponding results are still controversial. In this context, here, the meta-analysis was conducted for assessing the relations of variants in MMP-2, MMP-7, and MMP-9 with the risk of various cancers. Methods: PubMed, Web of Science, and Medline were systemically searched, and data were extracted from all eligible studies so as to investigate the susceptibility of MMP-2, MMP-7, and MMP-9 to different types of cancers. The association between a variant in MMP and cancer susceptibility was analyzed through odds ratios (ORs) as well as 95% CIs. The Venice criteria and false-positive report probability (FPRP) were adopted to evaluate epidemiological evidence of significant associations discovered. Results: The associations between the variants of MMPs and cancer risk in 36,530 cases and 41,258 controls were found, with 12 associations (MMP-2 rs243865 with esophageal cancer and lung cancer, MMP-7 rs11568818 with bladder and cervical cancer, and MMP-9 rs3918242 with breast cancer) rated as strong associations for cancer risk and 7 and 15 as moderate and weak associations, respectively. These significant associations were mostly found in Asians. Conclusions: These findings support the relations between variants of MMP-2, MMP-7, and MMP-9 and various cancers risk, demonstrating the credibility of these relations.

Piperlongumine synergistically enhances the antitumour activity of sorafenib by mediating ROS-AMPK activation and targeting CPSF7 in liver cancer.

Sorafenib, a multikinase inhibitor, is the first-line agent for advanced liver cancer. Sorafenib strongly inhibits both cell proliferation and tumour angiogenesis. However, the development of drug resistance hampers its anticancer efficacy. To improve the antitumour activity of sorafenib, we demonstrate that piperlongumine (PL), an alkaloid isolated from the fruits and roots of Piper longum L., enhances the cytotoxicity of sorafenib in HCCLM3 and SMMC7721 cells using the cell counting kit-8 test. Flow cytometry analysis indicated that PL and sorafenib cotreatment induced robust reactive oxygen species (ROS) generation and mitochondrial dysfunction, thereby increasing the number of apoptotic cells and the ratio of G2/M phase cells in both HCCLM3 and SMMC7721 cells. Furthermore, AMP-protein kinase (AMPK) signalling was activated by excess ROS accumulation and mediated growth inhibition in response to PL and sorafenib cotreatment. RNA-sequencing analysis indicated that PL treatment disrupted RNA processing in HCCLM3 cells. In particular, PL treatment decreased the expression of cleavage and polyadenylation specificity factor 7 (CPSF7), a subunit of cleavage factor I, in a time- and concentration-dependent manner in HCCLM3 and SMMC7721 cells. CPSF7 knockdown using a gene interference strategy promoted growth inhibition of PL or sorafenib monotherapy, whereas CPSF7 overexpression alleviated the cytotoxicity of sorafenib in cultured liver cancer cells. Finally, PL and sorafenib coadministration significantly reduced the weight and volume of HCCLM3 cell xenografts in vivo. Taken together, our data indicate that PL displays potential synergistic antitumour activity in combination with sorafenib in liver cancer.

Predictive Models for HCC Prognosis, Recurrence Risk, and Immune Infiltration Based on Two Exosomal Genes: MYL6B and THOC2.

INTRODUCTION: Hepatocellular carcinoma (HCC) is a heterogeneous molecular disease with complex molecular pathogenesis that influences the efficacy of therapies. Exosomes play a crucial role in tumorigenesis and poor disease outcomes in HCC. OBJECTIVE: The aim of this study was to identify the optimal gene set derived from exosomes in HCC with substantial predictive value to construct models for determining prognosis, recurrence risk and diagnosis and to identify candidates suitable for immunotherapy and chemotherapy, thereby providing new ideas for the individualized treatment of patients and for improving prognosis. METHODS: Weighted correlation network analysis (WGCNA) and univariate and multivariate Cox PH regression analyses were applied to identify exosome-related signatures in the TCGA and exoRbase databases associated with clinical relevance, immunogenic features and tumor progression in HCC. Cell experiments were performed to further confirm the oncogenic effect of MYL6B and THOC2. RESULTS: The models for prognosis and recurrence risk prediction were built based on two exosomal genes (MYL6B and THOC2) and were confirmed to be independent predictive factors with superior predictive performance. Patients with high prognostic risk had poorer prognosis than patients with low prognostic risk in all HCC datasets, namely, the TCGA cohort (HR=2.5, P<0.001), the ICGC cohort (HR=3.15, P<0.001) and the GSE14520 cohort (HR=1.85, P=0.004). A higher recurrence probability was found in HCC patients with high recurrence risk than in HCC patients with low recurrence risk in the TCGA cohort (HR=2.44, P<0.001) and the GSE14520 cohort (HR=1.54, P=0.025). High prognostic risk patients had higher expression of immune checkpoint genes, such as PD1, B7H3, B7H5, CTLA4 and TIM3 (P<0.05). Diagnostic models based on the same two genes were able to accurately distinguish HCC patients from normal individuals and HCC from dysplastic nodules. CONCLUSION: Our findings lay the foundation for identifying molecular markers to increase the early detection rate of HCC, improve disease outcomes, and determine more effective individualized treatment options for patients.

A Model Using Support Vector Machines Recursive Feature Elimination (SVM-RFE) Algorithm to Classify Whether COPD Patients Have Been Continuously Managed According to GOLD Guidelines.

Purpose: Patients with chronic obstructive pulmonary disease (COPD) would have a poor prognosis if they were not continuously managed according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. We aim to develop a model to classify whether COPD patients have been continuously managed according to GOLD in the previous year. Methods: The Managed group were COPD patients from a prospective cohort from November 2017 to November 2019, who have been continuously managed according to GOLD for 1 year. The Control group were COPD patients who were not continuously managed according to GOLD. They were from a retrospective cohort from October 2016 to October 2017 in the same hospitals as the Managed group. A synthetic minority over-sampling technique (SMOTE) algorithm was used to up-sample the Managed group in a training dataset. Features for classification were selected using a support vector machine recursive feature elimination (SVM-RFE) algorithm. The classification model was developed using LibSVM, and its performance was assessed on the testing dataset. Results: The final analysis included 15 subjects in the Managed group and 191 in the Control group. SVM-RFE selects nine features including smoking history, post-bronchodilator (post-)FVC before management, and those after 1-year follow-up (BMI, moderate and severe AECOPD frequency in previous 12 months, mMRC score, post-FEV1, post-FEV1%pred, post-FVC, and post-FEV1/FVC). For our model, positive predictive value is 66.7%, F1 score is 0.978, and AUC is 0.987. Conclusion: SVM classifier combined with SVM-REF feature selection algorithm could achieve good classification between COPD patients who are or are not continuously managed. This model could be applied in clinical practice to help doctors make decisions and enhance COPD patients' compliance with standard treatment.

Remnant Cystic Duct Disease After Cholecystectomy: A Case Series.

BACKGROUND: Remnant cystic duct (RCD) may be responsible for postcholecystectomy syndrome. We present our experience with the management of remnant cystic duct disease (RCDD) after cholecystectomy. METHODS: Over a period of 5 years, 10 patients underwent reoperation for RCDD in our hospital. Cystic duct was identified by intraoperative exploration. RESULTS: There were 4 men and 6 women ranging in age from 37 to 76 years (median, 60.40 y). All 10 had biliary pain, 5 had jaundice, and 2 had pancreatitis. The time from initial cholecystectomy to reoperation ranged from 4 to 28 years (median, 12.22 y). Eight patients had an abnormal liver function. Six of these 8 patients (75%) were diagnosed by magnetic resonance cholangiopancreatography. In 7 patients treated by completed cholecystectomy (6 by laparoscopy and 1 by laparotomy), pathology proved the presence of an RCD and chronic cholecystitis. The other 3 patients were treated by removing stones. All patients had 6- to 14-day hospital stays after reoperation, except for 1 patient with a 3-day stay. CONCLUSIONS: RCDD may be a more reasonable explanation for a source of postcholecystectomy syndrome. Magnetic resonance cholangiopancreatography has a role in the diagnosis of RCDD. We believe that excision of diseased RCD is necessary and that laparoscopic surgery is feasible.

By downregulating Ku80, hsa-miR-526b suppresses non-small cell lung cancer.

Ku80 is involved in DNA double-strand breaks (DSBs) repair. Ku80 is overexpressed in lung cancer tissues, yet, molecular mechanisms have not been examined. We identified that miRNA, hsa-miR-526b, is bound to the 3'-UTR of Ku80 mRNA, thus decreasing Ku80 expression in NSCLC cells. Hsa-miR-526b was downregulated in NSCLC tissues compared with corresponding non-tumorous tissues, and its expression was inversely correlated with Ku80 upregulation. Overexpression of Ku80 and downregulation of hsa-miR-526b were associated with poor clinical outcomes of NSCLC patients. Hsa-miR-526b suppressed NSCLC cell proliferation, clonogenicity, and induced cell cycle arrest and apoptosis. Hsa-miR-526b inhibited xenografts and orthotopic lung tumor growth. Further, Ku80 knockdown in NSCLC cells suppressed tumor properties in vitro and in vivo similar to hsa-miR-526b overexpression. In agreement, Ku80 restoration partially reversed cell cycle arrest and apoptosis induced by hsa-miR-526b in NSCLC cells in vitro and in vivo. In addition, hsa-miR-526b overexpression or Ku80 knockdown increased p53 and p21CIP1/WAF1 expression. These findings reveal that hsa-miR-526b is a potential target in cancer therapy.

Determination of L-tyrosine by beta-cyclodextrin sensitized fluorescence quenching method.

A novel beta-cyclodextrin (beta-CD) sensitized fluorescence quenching method for the determination of l-tyrosine (l-Tyr) with Mo(VI)-phenyl-fluorone (PF) as a fluorescence probe has been developed. The fluorescence intensity of Mo(VI)-PF-beta-CD was diminished as the l-tyrosine was added, the fluorescence quenching value DeltaF=F(beta-CD-Mo-PF)-F(beta-CD-Mo-PF-l-Tyr) was enhanced in beta-CD and there was a linear relationship between the DeltaF and the concentration of l-Tyr. Under the optimal conditions, the linear range of calibration curve for the determination of l-tyrosine was 0.3-20.0microgmL(-1); the detection limit was 0.094microgmL(-1). NaOH (10%, w/v) is the best reagent of hydrolysis in sample preparation. The sensitized mechanism of beta-cyclodextrin was discussed. The method has been applied to the determination of l-tyrosine in spirulina and food samples with satisfactory results.

Study on the interaction between methyl violet and bovine serum albumin by spectral analyses.

In this article the interaction between methyl violet (MV) and bovine serum albumin (BSA) was studied with spectroscopy. The results indicated that the fluorescence intensity of BSA was quenched strongly by MV through a static quenching procedure. The association constants, the number of binding sites and basic thermodynamic parameters were obtained based on fluorescence quenching data. The effect of MV on the conformation of BSA had been investigated with synchronous fluorescence spectroscopy and circular dichroism (CD) spectrum.

[Effects of Maidang Rutong granule on l-dopa-induced galactozemia in rats].

OBJECTIVE: To study galactagogue effect of Maidang Rutong granule on the lactation rats. METHOD: The experiments were designed to observe the efficiency of Maidang Rutong granule on lactescence, serum prolactin, and morphology of mammary gland with rat galactozemia model established by injecting l-dopa. RESULT: Maidang Rutong granule showed significant enhancement for lactescence and the offspring's body weight. It could antagonize the decrease of serum prolactin and the atrophy of mammary gland induced by l-dopa. CONCLUSION: Maidang Rutong granule exhibited significant galactagogue effect on the l-dopa-induced galactozemia in rats.

Investigation on liver function among population in high background of rare earth area in South China.

The health effects of long-term ingestion of rare earth elements (REEs) on the villagers living in high-REE-background areas in South Jangxi Province, China were studied. Major health complaints from the REE area population included indigestion, diarrhea, abdominal distension, anorexia, weakness, and fatigue, especially after high-fat or high-protein intake. Liver function tests were conducted for adult villagers. Among them, 45 live in a heavy rare earth (HREE) area, 62 in a light rare earth (LREE) area, and 49 in the control area. Test results showed that serum total protein and globulin from both HREE and LREE areas, as well as albumin from the LREE area, were significantly lower (p < 0.01 - 0.01) compared to the results from the control area, whereas albumin from the HREE area showed no significant variance (p > 0.05). The chi-square test showed that Serum-glutamic pyruvic transaminase (SGPT) in both areas were not significant (p > 0.05), whereas the IgM in the HREE area was significantly elevated. It is our conclusion that long-term ingestion of REE affected activities of some digestive enzymes, causing malabsorption and indigestion, and might further lead to a low-protein effect for the villagers in the LREE area. However, the damage to the liver was rather mild. The elevation of IgM was probably the result of stimulation induced by the formation of a large amount of granules as a result of direct binding of REEs to globulin or albumin (combination of REEs with globulin or albumin).