Efgartigimod as rescue treatment in acute phase of neuromyelitis optica spectrum disorder: A Case Report.

Introduction: Neuromyelitis optica spectrum disorder (NMOSD) is a central nervous system demyelinating disease. Current therapy methods, however, have limited effect on acute attacks except for intravenous methylprednisolone (IVMP). Efgartigimod is a first-in-class novel human immunoglobulin G1 (IgG1) Fc fragment approved for the treatment of generalized myasthenia gravis. Its capacity to rapidly decrease serum IgG levels, including pathogenic autoantibodies, positions it as a potentially effective option for managing the acute phase of NMOSD. Case presentation: We report the case of a 59-year-old female patient with acute NMOSD, presenting with vision loss and numbness in all four limbs. Despite an initial inadequate response to intravenous methylprednisolone (IVMP), the addition of Efgartigimod to her treatment regimen led to rapid improvement, notably including a significant reduction in serum aquaporin-4 antibody titers, total IgG levels, and inflammation cytokine levels. Furthermore, no adverse events were reported during a four-month follow-up period. Conclusion: As an adjunct to glucocorticoid therapy, Efgartigimod has proven effective and safe for this patient. However, to ascertain its potential as a novel therapeutic option for acute NMOSD, larger-scale prospective clinical trials are required.

Nomograms based on multiparametric MRI radiomics integrated with clinical-radiological features for predicting the response to induction chemotherapy in nasopharyngeal carcinoma.

OBJECTIVE: To establish nomograms integrating multiparametric MRI radiomics with clinical-radiological features to identify the responders and non-responders to induction chemotherapy (ICT) in nasopharyngeal carcinoma (NPC). METHODS: We retrospectively analyzed the clinical and MRI data of 168 NPC patients between December 2015 and April 2022. We used 3D-Slicer to segment the regions of interest (ROIs) and the "Pyradiomic" package to extract radiomics features. We applied the least absolute shrinkage and selection operator regression to select radiomics features. We developed clinical-only, radiomics-only, and the combined clinical-radiomics nomograms using logistic regression analysis. The receiver operating characteristic curves, DeLong test, calibration, and decision curves were used to assess the discriminative performance of the models. The model was internally validated using 10-fold cross-validation. RESULTS: A total of 14 optimal features were finally selected to develop a radiomic signature, with an AUC of 0.891 (95 % CI, 0.825-0.946) in the training cohort and 0.837 (95 % CI, 0.723-0.932) in the testing cohort. The nomogram based on the Rad-Score and clinical-radiological factors for evaluating tumor response to ICT yielded an AUC of 0.926 (95 % CI, 0.875-0.965) and 0.901 (95 % CI, 0.815-0.979) in the two cohorts, respectively. Decision curves demonstrated that the combined clinical-radiomics nomograms were clinically useful. CONCLUSION: Nomograms integrating multiparametric MRI-based radiomics and clinical-radiological features could non-invasively discriminate ICT responders from non-responders in NPC patients.

Identification of Y‒linked biomarkers and exploration of immune infiltration of normal-appearing gray matter in multiple sclerosis by bioinformatic analysis.

Background: The knowledge of normal‒appearing cortical gray matter (NAGM) in multiple sclerosis (MS) remains unclear. In this study, we aimed to identify diagnostic biomarkers and explore the immune infiltration characteristics of NAGM in MS through bioinformatic analysis and validation in vivo. Methods: Differentially expressed genes (DEGs) were analyzed. Subsequently, the functional pathways of the DEGs were determined. After screening the overlapping DEGs of MS with two machine learning methods, the biomarkers' efficacy and the expression levels of overlapping DEGs were calculated. Quantitative reverse transcription polymerase chain reaction (qRT‒PCR) identified the robust diagnostic biomarkers. Additionally, infiltrating immune cell populations were estimated and correlated with the biomarkers. Finally, the characteristics of immune infiltration of NAGM from MS were evaluated. Results: A total of 98 DEGs were identified. They participated in sensory transduction of the olfactory system, synaptic signaling, and immune responses. Nine overlapping genes were screened by machine learning methods. After verified by ROC curve, four genes, namely HLA‒DRB1, RPS4Y1, EIF1AY and USP9Y, were screened as candidate biomarkers. The mRNA expression of RPS4Y1 and USP9Y was significantly lower in MS patients than that in the controls. They were selected as the robust diagnostic biomarkers for male MS patients. RPS4Y1 and USP9Y were both positively correlated with memory B cells. Moreover, naive CD4+ T cells and monocytes were increased in the NAGM of MS patients compared with those in controls. Conclusions: Low expressed Y‒linked genes, RPS4Y1 and USP9Y, were identified as diagnostic biomarkers for MS in male patients. The inhomogeneity of immune cells in NAGM might exacerbate intricate interplay between the CNS and the immune system in the MS.

Knockdown of RGMA improves ischemic stroke via Reprogramming of Neuronal Metabolism.

Neuronal energy metabolism dysregulation is involved in various pathologies of Ischemia-reperfusion (I/R), yet the role of RGMA in neuronal metabolic reprogramming has not been reported. In this study, we found that RGMA expression significantly increased after I/R, and compared to control mice, mice with MCAO/R showed an increase in glycolytic metabolic products and the expression of glycolytic pathway proteins. Furthermore, RGMA levels are closely related to neuronal energy metabolism. We discovered that knockdown of RGMA can shift neuronal energy metabolism towards oxidative phosphorylation and the pentose phosphate pathway, thereby protecting mice from ischemic reperfusion injury. Mechanistically, knockdown of RGMA can downregulate PGK1 expression, reducing the increase in glycolytic flux following ischemia reperfusion. Moreover, we found that knockdown of RGMA can reduce the interaction between USP10 and PGK1, thus affecting the ubiquitination degradation of PGK1. In summary, our data suggest that RGMA may regulate neuronal energy metabolism by inhibiting the USP10-mediated deubiquitination of PGK1, thus protecting it from I/R injury. This study provides new ideas for clarifying the intrinsic mechanism of neuronal damage after I/R.

Grape seed proanthocyanidin extract alleviates inflammation in experimental colitis mice by inhibiting NF-κB signaling pathway.

Ulcerative colitis (UC) is a complex inflammatory disease of colorectum that induces abnormal immune responses and severely affects the quality of life of the patients. Grape seed proanthocyanidin extract (GSPE) exerts anti-inflammatory and antioxidant functions in many inflammatory diseases. The objective of this study was to investigate the potential therapeutic effects and underlying mechanisms of GSPE in UC using a dextran sodium sulfate (DSS)-induced mouse UC model and a lipopolysaccharide (LPS)-stimulated RAW264.7 macrophage model. In this study, we found that the GSPE markedly prevented DSS-induced weight loss and colon length shortening in UC mice. Further investigations showed that GSPE significantly attenuated the expression of pro-inflammatory cytokines TNF-α, IL-6, and IL-1ß, and elevated the expression of anti-inflammatory cytokine IL-10 in the colon tissues and serum of DSS-induced colitis mice by suppressing NF-κB signaling pathway. Furthermore, LPS-induced inflammation in RAW264.7 cells was also reversed by GSPE. Taken together, our results confirm that GSPE can ameliorate inflammatory response in experimental colitis via inhibiting NF-κB signaling pathway. This study advances the research progress on a potentially effective therapeutic strategy for inflammatory bowel diseases.

Plaque enhancement predicts recurrence in acute ischemic stroke patients with large artery intracranial atherosclerosis.

BACKGROUND: The association between the degree of plaque enhancement and ischemic brain stroke recurrence remains unclear. We aimed to establish models to predict plaque enhancement and stroke recurrence. METHODS: Seventy-eight participants with acute ischemic brain stroke due to intracranial arterial stenosis were recruited and divided into high enhancement (HE) and non-HE groups. The relationship between imaging characteristics (degree of stenosis, minimal lumen area, intraplaque hemorrhage, and plaque burden) and the degree of plaque contrast enhancement was analyzed. Inflammatory cytokine expression was examined by flow cytometry. Independent predictors of stroke recurrence were investigated via multivariate Cox proportional hazards regression analysis. Nomogram was used to construct a prediction model. Harrell's concordance indices (c-indices) and calibration curves were used to assess the discrimination of the nomogram. A risk prediction nomogram for prognosis was constructed. RESULTS: Thirty-three participants were assigned to the HE group and 45 to the non-HE group. The degree of stenosis and plaque burden in the HE group was higher than that in the non-HE group (P<0.05). Multiple linear regression analysis showed the degree of stenosis was associated with HE (ß=0.513; P=0.000). After adjusting for confounding factors, age (HR=1.115; 95%CI=1.034-1.203, P=0.005) and HE plaques (HR=10.457; 95%CI=1.176-93.018; P=0.035) were independent risk factors of stroke recurrence, whereas cytokine levels were not statistically significant between two group. CONCLUSIONS: HE of intracranial atherosclerosis plaques is an independent factor for ischemic brain stroke recurrence.

Integrated Analysis of Immune Infiltration and Hub Pyroptosis-Related Genes for Multiple Sclerosis.

Purpose: Studies on overall immune infiltration and pyroptosis in patients with multiple sclerosis (MS) are limited. This study explored immune cell infiltration and pyroptosis in MS using bioinformatics and experimental validation. Methods: The GSE131282 and GSE135511 microarray datasets including brain autopsy tissues from controls and MS patients were downloaded for bioinformatic analysis. The gene expression-based deconvolution method, CIBERSORT, was used to determine immune infiltration. Differentially expressed genes (DEGs) and functional enrichments were analyzed. We then extracted pyroptosis-related genes (PRGs) from the DEGs by using machine learning strategies. Their diagnostic ability for MS was evaluated in both the training set (GSE131282 dataset) and validation set (GSE135511 dataset). In addition, messenger RNA (mRNA) expression of PRGs was validated using quantitative real-time polymerase chain reaction (qRT-PCR) in cortical tissue from an experimental autoimmune encephalomyelitis (EAE) model of MS. Moreover, the functional enrichment pathways of each hub PRG were estimated. Finally, co-expressed competitive endogenous RNA (ceRNA) networks of PRGs in MS were constructed. Results: Among the infiltrating cells, naive CD4+ T cells (P=0.006), resting NK cells (P=0.002), activated mast cells (P=0.022), and neutrophils (P=0.002) were significantly higher in patients with MS than in controls. The DEGs of MS were screened. Analysis of enrichment pathways showed that the pathways of transcriptional regulatory mechanisms and ion channels associating with pyroptosis. Four PRGs genes CASP4, PLCG1, CASP9 and NLRC4 were identified. They were validated in both the GSE135511 dataset and the EAE model by using qRT-PCR. CASP4 and NLRC4 were ultimately identified as stable hub PRGs for MS. Single-gene Gene Set Enrichment Analysis showed that they mainly participated in biosynthesis, metabolism, and organism resistance. ceRNA networks containing CASP4 and NLRC4 were constructed. Conclusion: MS was associated with immune infiltration. CASP4 and NLRC4 were key biomarkers of pyroptosis in MS.

Clinical features and power spectral entropy of electroencephalography in Wilson's disease with dystonia.

OBJECTIVE: To study the clinical features and power spectral entropy (PSE) of electroencephalography signals in Wilson's disease (WD) patients with dystonia. METHODS: Several scale evaluations were performed to assess the clinical features of WD patients. Demographic information and electroencephalography signals were obtained in all subjects. RESULTS: 34 WD patients with dystonia were recruited in the case group and 24 patients without dystonia were recruited in the control group. 20 healthy individuals were included in the healthy control group. The mean body mass index (BMI) in the case group was significantly lower than that in the controls (p < .05). The case group had significantly higher SAS, SDS, and Bucco-Facial-Apraxia Assessment scores (p < .05). Total BADS scores in the case group were lower than those in the control group (p < .01). Note that 94.11% of the case group presented with dysarthria and 70.59% of them suffered from dysphagia. Dysphagia was mainly related to the oral preparatory stage and oral stage. Mean power spectral entropy (PSE) values in the case group were significantly different (p < .05) from those in the control group and the healthy group across the different tasks. CONCLUSIONS: The patients with dystonia were usually accompanied with low BMI, anxiety, depression, apraxia, executive dysfunction, dysarthria and dysphagia. The cortical activities of the WD patients with dystonia seemed to be more chaotic during the eyes-closed and reading tasks but lower during the swallowing stages than those in the control group.

Chronic exposure to microcystin-leucine-arginine induces epithelial hyperplasia and inflammation in the mouse bladder.

Microcystin-leucine-arginine (MC-LR) is a cyclic heptapeptide compound produced by cyanobacteria with strong cytotoxicity. Previous studies have confirmed that MC-LR could exert toxic effects on the genitourinary system, but there are few reports about its toxicity to the bladder. In this study, we investigated the effects of MC-LR on mouse bladder and human bladder epithelial cells (SV-HUC-1 cells). We observed that the bladder weight and the number of bladder epithelial cells were markedly increased in mice following chronic low-dose exposure to MC-LR. Further investigation showed that MC-LR activates AKT/NF-kB signaling pathway to induce the production of proinflammatory cytokines TNF-α and IL-6. In addition, the expression of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) in bladder tissue was increased and the relative migration and invasion capacities of SV-HUC-1 cells were enhanced upon exposure to MC-LR. In conclusion, these results suggest that chronic exposure to MC-LR induced epithelial hyperplasia and inflammation, upregulated the expression of matrix metalloproteinases (MMPs) and promoted the migration and invasion of bladder epithelial cells, which provides a basis for further exploring the potential mechanism by which environmental factors increasing the risk of bladder cancer.

Distribution of bacteriologically positive and bacteriologically negative pulmonary tuberculosis in Northwest China: spatiotemporal analysis.

Pulmonary tuberculosis (PTB) is a major health issue in Northwest China. Most previous studies on the spatiotemporal patterns of PTB considered all PTB cases as a whole; they did not distinguish notified bacteriologically positive PTB (BP-PTB) and notified bacteriologically negative PTB (BN-PTB). Thus, the spatiotemporal characteristics of notified BP-PTB and BN-PTB are still unclear. A retrospective county-level spatial epidemiological study (2011-2018) was conducted in Shaanxi, Northwest China. In total, 44,894 BP-PTB cases were notified, with an average annual incidence rate of 14.80 per 100,000 persons between 2011 and 2018. Global Moran's I values for notified BP-PTB ranged from 0.19 to 0.49 (P < 0.001). Anselin's local Moran's I analysis showed that the high-high (HH) cluster for notified BP-PTB incidence was mainly located in the southernmost region. The primary spatiotemporal cluster for notified BP-PTB (LLR = 612.52, RR = 1.77, P < 0.001) occurred in the central region of the Guanzhong Plain in 2011. In total, 116,447 BN-PTB cases were notified, with an average annual incidence rate of 38.38 per 100,000 persons between 2011 and 2018. Global Moran's I values for notified BN-PTB ranged from 0.39 to 0.69 (P < 0.001). The HH clusters of notified BN-PTB were mainly located in the north between 2011 and 2014 and in the south after 2015. The primary spatiotemporal cluster for notified BN-PTB (LLR = 1084.59, RR = 1.85, P < 0.001) occurred in the mountainous areas of the southernmost region from 2014 to 2017. Spatiotemporal clustering of BP-PTB and BN-PTB was detected in the poverty-stricken mountainous areas of Shaanxi, Northwest China. Our study provides evidence for intensifying PTB control activities in these geographical clusters.

Mediating effects of social support between antenatal depression and fear of childbirth among nulliparous woman.

BACKGROUND: Although gestation and childbirth are progressive physical processes for most pregnant women, there are both physical and great psychosocial challenges throughout the process, which increase the sensitivity and vulnerability of women. Even for women with low-risk pregnancies, it is common to experience degrees of fear, especially for primipara women when faced with childbirth. During their first pregnancy, women may have no relevant health knowledge or experience with delivery and have difficulty identifying prenatal depression and other existing mental health factors; a fear of childbirth (FOC) may engender adverse outcomes for mothers and babies. Social support is a very important influential factor for prenatal depression. METHODS: This study adopted a descriptive cross-sectional design. The participant cohort involved 609 primipara women (≥18 years old) who had received routine prenatal care and visited a tertiary care hospital in Xi'an. The participants completed structured questionnaires, including the 10-item Edinburgh Postnatal Depression Scale (EPDS), 12-item Multidimensional Scale of Perceived Social Support (MSPSS), and 33-item Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), alongside contribution of information regarding their demographic characteristics. Descriptive and correlation analyses were adopted to verify the correlations among these variables. Multiple regression models were examined by the SPSS PROCESS procedure with bootstrapping to confirm the significance of the mediation effect. RESULTS: The widespread prevalence of FOC in healthy pregnant women was 22.3% (WDEQ score ≥85). The mean scores of depression, social support, as well as FOC scores of participants were 9.50 (5.19), 70.91 (9.25), and 70.43 (20.88), respectively. Remarkable correlations were identified between pregnancy depressive symptoms, social support, and FOC. Results presented an indirect effect, indicating that the impacts of antenatal depression on FOC were mediated by social support. CONCLUSIONS: Perceived social support played a mediating role between antenatal depression and FOC among healthy primipara women. Techniques and suggestions for boosting social support may be expected to have a positive impact on the depressive symptoms of pregnant women with FOC.

Fear of Childbirth and Associated Risk Factors in Healthy Pregnant Women in Northwest of China: A Cross-Sectional Study.

AIM: Fear of childbirth (FOC) is an extreme state of anxiety, distress and worry about childbirth. Despite its common occurrence, the prevalence and risk factors for FOC are inadequately understood in the northwestern region of China. PURPOSE: This study aimed to examine the prevalence and risk factors for fear of childbirth (FOC) in a cohort of pregnant women in northwest of China. PATIENTS AND METHODS: A total of 922 healthy pregnant women were included in this cross-sectional study. Participants filled out a questionnaire on socio-demographic characteristics, as well as the Childbirth Attitudes Questionnaire (CAQ), the Multidimensional Scale of Perceived Social Support (MSPSS), the Edinburgh Postnatal Depression Scale (EPDS), and the Pregnancy Pressure Scale (PPS). Psychosocial factors were analyzed to determine their association with fear of childbirth. Optimal scale regression analysis was used to determine the risk factors associated with FOC. RESULTS: The mean score on the CAQ was 33.92 ± 10.17. A total of 72% of participants reported low to mild FOC. Six percent (n=51/922) and 22% (n=199/922) of pregnant women reported severe and moderate FOC, respectively. Based on optimal scaling regression analysis, the factors most strongly associated with FOC were residence, marital status, parity, gestational age, relationship with partner, pregnancy stress, social support and depressive symptoms. CONCLUSION: This study indicates the high prevalence of FOC (70.3%, ranging from mild to severe) in healthy pregnant women in northwest of China. FOC showed a positive correlation with pregnancy-related stress and depressive symptoms and a negative correlation with social support. Screening for FOC and helping pregnant women identify a support system early in pregnancy could reduce a woman's stress level and severity of depression.

MUC 15 Promotes Osteosarcoma Cell Proliferation, Migration and Invasion through Livin, MMP-2/MMP-9 and Wnt/ß-Catenin Signal Pathway.

Objective: To investigate the high expression of MUC15 in promoting proliferation, migration and invasion in osteosarcoma (OS) cell and its potential mechanism. Methods: The expressions of MUC15 in OS patients were analyzed from GEO Datasets, tumor cell lines and clinical samples. The roles of MUC15 in OS were explored by CCK-8, flow cytometry, transwell and western blot assay, respectively. Results: MUC15 was highly expressed in osteosarcoma, and there was a significant negative correlation between MUC15 and the prognosis. Knockdown of MUC15 in HOS and U-2OS could promote tumor cell apoptosis, down-regulate the expression of MMP2/9, reduce the epithelial interstitial transition and silence the Wnt/b-Catenin signal pathway. Conclusion: The high-expression of MUC15 promotes the proliferation, migration and invasion of osteosarcoma through anti-apoptosis, increasing the invasive ability by epithelial interstitial transition, and activating the Wnt/b-Catenin signal pathway.

Developing and Validating an Adjustment Scale: The Adaptation Status Assessment of Drug-Resistant Tuberculosis Patients.

PURPOSE: Drug-resistant tuberculosis (DR-TB) remains a major global public health issue. For DR-TB patients, effective adaptation is crucial to prevent disease progression, improve health outcomes and decrease mortality. To date, there is no appropriate tool for evaluating the adaptation status of DR-TB patients. In this work, we aim to develop an adjustment scale for DR-TB patients (AS-DRTBP) and to evaluate its psychometric properties. PATIENTS AND METHODS: The development of the AS-DRTBP was based on the theory of the Roy adaptation model (RAM). The scale was designed through a literature review, in-depth individual interviews, a Delphi survey, and pilot testing. In total, 433 patients with DR-TB were recruited to validate the instrument. The split-half reliability coefficient, Cronbach's alpha coefficient, and test-retest reliability coefficient were calculated to assess the reliability of the instrument. Content validity, construct validity and concurrent validity tests were applied to calculate the validity of the instrument. RESULTS: The final AS-DRTBP consisted of four dimensions and 26 items. The Cronbach's alpha coefficient, split-half reliability coefficient and test-retest reliability coefficient were 0.893, 0.954, and 0.853, respectively. The content validity index was 0.92. Four factors that explained 64.605% of the total variance were also further determined by confirmatory factor analysis (CFA). The CFA results showed that the fitting effect of the model was appropriate (CMIN/DF = 1.681, GFI = 0.832, AGFI = 0.799, RMSEA = 0.055, SRMR = 0.0684). The AS-DRTBP and adjustment scale had correlation in the total score, and the correlation coefficient was 0.355 (p<0.05). CONCLUSION: The findings of this study demonstrate that the AS-DRTBP is a reliable and valid instrument for measuring the adaptation status of patients with DR-TB, allowing health providers to comprehend the adaptive level of DR-TB patients and thus laying the foundation for interventions to help these patients achieve a physiologically, psychologically and socially optimal outcome.

Development And Preliminary Evaluation Of Psychometric Properties Of A Tuberculosis Self-Efficacy Scale (TBSES).

PURPOSE: No instrument exists for measuring TB patients' self-efficacy which is vital for choosing and insisting in benefit TB-management behaviors. Our study aimed to develop and test a new tuberculosis self-efficacy scale (TBSES). PATIENTS AND METHODS: The TBSES was designed through literature review, individual interviews, Delphi surveys, and pilot testing. After that, 460 TB patients were recruited to validate TBSES. Exploratory and confirmatory factor analysis and correlation analysis were used to evaluate the scale reliability and validity. The cut-off point for TBSES was identified using receiver operating characteristic (ROC) analysis. RESULTS: The final TBSES includes 21 items scored on a 5-point Likert scale, and these items are loaded in four distinct factors that explain 67.322% of the variance, both exploratory and confirmatory factor analysis proved that the scale had good construct validity. The scale had adequate internal consistency, split-half reliability, test-retest reliability, as well as demonstrated content, concurrent validity. The ROC analysis results showed the cut-off point was 86.5. CONCLUSION: This 21-item TBSES demonstrated favorable psychometric properties. It provides an instrument for not only measuring specific self-efficacy in TB, but also identifying patients with low self-efficacy and determining the specific area toward designing interventions for enhance self-efficacy.

LINC00565 promotes proliferation and inhibits apoptosis of gastric cancer by targeting miR-665/AKT3 axis.

BACKGROUND: Numerous studies have shown that long noncoding RNA (lncRNA) is involved in gastric cancer (GC). A relevant microarray containing gastric cancer-related lncRNAs was downloaded from The Cancer Genome Atlas database. METHODS: qRT-PCR was used to analyze LINC00565 and AKT3 expression in tumor tissues and cell lines. Proliferative, colony formation and apoptotic abilities of GC cells after transfection of sh-LINC00565 were determined by CCK-8, colony formation assay and flow cytometry, respectively. RIP was enrolled to detect the interaction between LINC00565, AKT3 and miR-665. Dual luciferase assay was used to confirm the relation between miR-665 and LINC00565 and AKT3. RESULTS: Expression level of LINC00565 in GC tissue was highly expressed in GC, which was negatively correlated to prognosis of GC patients. The results showed that knockdown of LINC00565 decreased proliferative and colony formation abilities, and induced apoptosis of GC cells. Pearson analysis showed that LINC00565 was positively correlated with AKT3. Besides, AKT3 was significantly up-regulated in GC. In addition, knockdown of LINC00565 down-regulated AKT3. In order to explore the mechanism, we found that miR-665 could bind to LINC00565 by bioinformatics. Dual-luciferase reporter gene assay and RIP assay both verified the binding relationship between miR-665 and AKT3. Finally, rescue experiments were carried out to explore whether AKT3 could reverse the anti-cancer effect of low-level LINC00565 on GC development. CONCLUSION: In summary, the expression of LINC00565 is upregulated in GC. LINC00565 can be used as the sponge of miR-665 to up-regulate the expression of AKT3, thus promoting the progression of GC.

circZNF609 promotes the proliferation and migration of gastric cancer by sponging miR-483-3p and regulating CDK6.

OBJECTIVE: To explore the regulatory effects of circZNF609 on proliferative and migratory capacities of gastric cancer (GC) and its underlying mechanism. METHODS: Expression level of circZNF609, CDK6 and miR-483-3p in GC tissues and cells were detected qRT-PCR verification. CCK-8 and transwell assay were conducted the cell viability and migratory capacities of GC cells. Dual luciferase assay was enrolled to confirm the interaction among circZNF609, CDK6 and miR-483-3p. Western blot was used to detect the protein level of CDK6. RESULTS: Expression levels of circZNF609 were higher in GC patients by qRT-PCR.GC patients with higher expression of circZNF609 were expected to have a higher TNM stage and lower 5-year survival than those with lower expression. ROC curves showed a well diagnostic value of circZNF609 in GC. Treatment of RNase R in GC cells downregulated the expression of ZNF609, whereas circZNF609 expression did not change. Furthermore, cytoplasmic expression of circZNF609 was higher than those of nuclear expression. Besides, biological experiments indicated that overexpression of circZNF609 promoted the proliferative and migratory capacities of GC cells. To demonstrate the underlying mechanism of circZNF609, we found that circZNF609 bound to miR-483-3p, which presented a lower expression in GC tissues than that of paracancerous tissues. Both circZNF609 and miR-483-3p could bind to Ago2, suggesting that circZNF609 may act as a sponge of miR-483-3p. In addition, the effect of overexpressed circZNF609 on cellular behaviors of GC cells were partly reversed by overexpression of miR-483-3p. Bioinformatics suggested that CDK6 has a potential binding site with miR-483-3p. The expression of CDK6 markedly increased in GC tissues and cells, which was negatively correlated with miR-483-3p expression. Dual-luciferase reporter gene results indicated that miR-483-3p could bind to the 3'-UTR of CDK6. Moreover, miR-483-3p downregulated CDK6 at both mRNA and protein levels. Overexpression of miR-483-3p inhibited proliferative and migratory capacities of GC cells, which were reversed by CDK6 overexpression. CONCLUSION: In summary, the expression of circZNF609 is upregulated in GC. CircZNF609 can be used as the sponge of miR-483-3p to regulate the expression level of CDK6, thus participating in the progression of GC by regulating the proliferative and migratory capacities of GC cells.

Chinese health literacy scale for tuberculosis patients: a study on development and psychometric testing.

BACKGROUND: The role of health literacy on tuberculosis patients has not been evaluated in China, in part because few special health literacy measurements exist. METHODS: A three-step design process was used: (1) Scale construction: Based on the model of revised Bloom's taxonomy, the item-pool was drafted from a literature review, focus group discussion, and in-depth interviews. In addition, a Delphi survey was used in order to select items for inclusion in the scales; (2) Pilot study: Acceptability and clarity were tested with 60 tuberculosis patients; and (3) Psychometric testing: Validity analysis includes content validity, construct validity, and discriminative validity. The Cronbach's alpha coefficient, split-half reliability, and test-retest method were used to assess reliability. Finally, a receiver operating characteristic analysis was conducted to generate a cut-off point. RESULTS: The final scale had 29 items with four domains. The item level Content Validity Index ranged from 0.70 to 1.0, and the scale level Content Validity Index was 0.95. The mean score among the lowest 27% group was significantly lower than that those of the highest 27% group (p < 0.01), which supports adequate discriminant validity. Explanatory factor analysis produced a clear four-factor construct, explaining 47.254% of the total variance. Factor 1 and Factor 2 were consistent with read and memorize TB-related words; Factor 3 was associated with understand the meaning of the health education leaflets and examine if TB patients can apply the correct approach to correct context; Factor 4 was related to the ability of TB patient to calculate and identify what unspecified assumptions are included in known conditions. The confirmatory factory analysis results confirmed that a four-factor model was an acceptable fit to the data, with a goodness-of-fit index = 0.930, adjusted goodness of fit index = 0.970, root mean square error of approximation = 0.069, and χ2/df = 2.153. The scale had good internal consistency and test-retest reliability. Additionally, the receiver operating characteristic analysis indicated that the cut-off point for the instrument was set at 45 and 35. CONCLUSIONS: The Chinese Health Literacy scale for Tuberculosis has good reliability and validity, and it could be used for measuring the health literacy of Chinese patients with tuberculosis.

Perceptions of engagement in health care among patients with tuberculosis: a qualitative study.

PURPOSE: Adherence to treatment is cited as a key challenge in fighting tuberculosis (TB). Treatment of TB requires patients to actively engage in their care. The purpose of this study was to explore the perceptions of patients with TB regarding their engagement in health care. PATIENTS AND METHODS: The study was conducted in three medical wards in one hospital. Purposive sampling was used to recruit participants. Semi-structured, audiotaped interviews were conducted and analyzed using thematic analysis. RESULTS: Twenty-three patients participated in the study. Four major themes emerged: 1) devaluing engagement; 2) interacting with health care providers (HCPs); 3) facing inability; and 4) seeking external support. CONCLUSION: The patients' perceptions of their engagement in health care were generally negative. Paying attention to the preferences and needs of patients and making decisions accordingly are effective strategies for promoting patient engagement. Moreover, HCPs should be aware of their crucial role in helping patients make sense of what engagement is and how to engage. In the process of engagement, providers should establish effective interactions with patients and cooperate with family and peers.