Decoding the genomic enigma: Approaches to studying extrachromosomal circular DNA.

Extrachromosomal circular DNA (eccDNA), a pervasive yet enigmatic component of the eukaryotic genome, exists autonomously from its chromosomal counterparts. Ubiquitous in eukaryotes, eccDNA plays a critical role in the orchestration of cellular processes and the etiology of diseases, particularly cancers. However, the full scope of its influence on health and disease remains elusive, presenting a rich vein of research yet to be mined. Unraveling the complexities of eccDNA necessitates a distillation of methodologies - from biogenesis to functional analysis - a landscape we overview in this study with precision and clarity. Here, we systematically outline cutting-edge methodologies from high-throughput sequencing and bioinformatics to experimental validations, showcasing the intricate world of eccDNAs. We combed through a treasure trove of auxiliary research resources and analytical tools. Moreover, we chart a course for future inquiry, illuminating the horizon with potential groundbreaking strategies for designing eccDNA research projects and pioneering new methodological frontiers.

Fetal movement during delivery can lead to damage to the umbilical vessels and endanger the life of the fetus.

INTRODUCTION: Fetal umbilical cord hematoma has a low incidence but high mortality, and its cause during delivery is often unclear. We report an autopsy case in which it was concluded that umbilical cord hematoma resulted from fetal movements during childbirth. CASE PRESENTATION AND AUTOPSY FINDINGS: A 27-year-old primigravida at 39 + 2 weeks gestation with normal antenatal visits suffered a fetal heart rate decrease during active labor. Bedside ultrasound revealed fetal death in utero 22 min later. Forensic pathologists found that the umbilical vessels were torn and bleeding on almost the same plane, and the hematoma compressed both umbilical arteries, which is the cause of fetal stillness in utero. A total of 32 cases were reported, including 6 umbilical cord ruptures and 26 umbilical cord hematomas. The cause of hematoma was unknown in 77 % of cases, while dysplasia was present in 56.25 % of umbilical cords. DISCUSSION: This case indicates that fetal movements may cause umbilical cord vessel injury, particularly when oxytocin is used to induce labor. When fetal heart sounds decrease for no apparent reason, the possibility of cord injury should be considered, and cesarean delivery should be performed as soon as possible. Therefore, rigorous fetal heart tracing during active delivery is necessary.

Comparative effects of different types of physical activity on health-related quality of life in breast cancer survivors: A systematic review, network meta-analysis, and meta-regression.

Background: Physical activity is associated with improved health-related quality of life (HRQoL) in breast cancer survivors (BCS); however, no studies have assessed optimal physical activity. Objective: We aimed to investigate the optimal types of physical activity for improving HRQoL in patients with BCS during and after cancer treatment. Methods: A comprehensive search was conducted in Medline, Embase, Web of Science, and Cochrane Library from inception to November 2023. We included randomized controlled trials (RCTs) reporting the effects of different physical activities on HRQoL in BCS. Two independent reviewers assessed the risk of bias using the Cochrane risk of bias tool for randomized trials (version 2.0). A network meta-analysis approach based on a frequentist framework was used to rank the effectiveness of different physical activities. Results: A total of 66 RCTs with 6464 participants were included. For all BCS, aerobic combined with resistance exercise (CE) (standardized mean difference [SMD] = 0.71; 95 % confidence interval [CI]: 0.40 to 1.10; P-score = 0.75; Grade: moderate) was the most effective physical activity to improve HRQoL. For participants in treatment, resistance exercise (RE) (SMD = 0.68; 95 % CI: 0.35 to 1.10; P-score = 0.84; Grade: moderate) was the most effective. However, after treatment, CE (SMD = 0.77; 95 % CI: 0.28 to 1.26; P-score = 0.74; Grade: very low) remained the most effective way to improve HRQoL in BCS. In addition, the regression analysis did not find any sources of heterogeneity. Conclusions: The findings of this study suggest that all physical activities improved HRQoL in BCS compared to the control group. CE may have the best effect on all survivors and post-treatment survivors, whereas RE has the best effect during treatment. In addition, the quality of the included studies was low, and there was some risk of bias, which may affect the interpretation of the findings.

Regulating the catalytic behaviour of iron oxyhydroxide by introducing Ni sites for facilitating polysulfide anchoring and conversion.

The sluggish conversion kinetics and notorious shuttle effect of polysulfides are critical hindrances to practical implementation of lithium-sulfur batteries. Herein, bimetallic oxyhydroxide (FeNiOOH) as a functional sulfur host is proposed to overcome these obstacles. The introduction of Ni sites can modulate the electronic structure of the active sites to implement strong soluble polysulfide species immobilization and accelerate the conversion reaction kinetics of polysulfides, resulting in improved sulfur utilization and reduced polarization during the electrochemical reaction process. Benefiting from these advantages, FeNiOOH enables the sulfur cathode to deliver superior rate capability and cycling stability.

Death from Pulmonary Embolism Caused by Vaginal Injection of Hyaluronic Acid: a Case Report and a Literature Review.

A 40-year-old woman underwent vaginoplasty with intramural injection of fillers from an illegal medical practitioner. Approximately 2 h after the injection, she developed lower abdominal pain. The patient was taken to the hospital approximately 5 h later due to worsening pain. When the patient was admitted for physical examination, she suddenly experienced cardiac and respiratory arrest. She was resuscitated but remained in a coma. Unfortunately, the patient died approximately 12 h after being admitted to the hospital. The forensic autopsy revealed extensive amorphous basophilic emboli in the small interstitial vascular lumen of both lungs, and a large amount of the same type of substances were also found in the vaginal wall. Hyaluronidase digestion and Alcian blue staining confirmed that most components of the injection were hyaluronic acid (HA). HA is widely used as a cosmetic filler in the field of plastic surgery and is generally considered to have few adverse effects. This paper reports the first anatomical case of fatal pulmonary embolism caused by vaginal injection of HA. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Eosinophilic granulomatosis with polyangiitis in allergic asthma: Efforts to make early diagnosis possible.

Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare autoimmune disease that can affect multiple organ systems in the body. A majority of patients with EGPA present with asthma-like symptoms and may be misdiagnosed with refractory asthma. It is necessary to distinguish EGPA from asthma and provide a theoretical basis for effective future prevention and treatment. Objective: This study aimed to compare the clinical features of EGPA and the clinical features of allergic asthma in an effort to make an early diagnosis possible. Methods: We reviewed the basic information, test results, pre-onset conditions, and prognosis of 44 adult patients with EGPA who were admitted to our hospital between January 2013 and June 2021, and conducted a 1:1 matched case-control study to compare patients with EGPA and patients with allergic asthma. Results: The 44 patients with EGPA were older than those with allergic asthma, but more than half of the patients with EGPA had been diagnosed with bronchial asthma, with a history of 10 months to 40 years, and had previously used inhalers or systemic steroids. The proportion of male-to-female cases was ∼1:1, with seven antineutrophil cytoplasmic antibodies (ANCA) positive cases (15.9%), 20 limited EGPA cases (45.45%), and 24 systemic EGPA cases (54.55%). Although the peripheral blood eosinophil count and percentage were lower in the male patients than in the female patients, male patients with higher five-factor scores might indicate worse prognosis. The fractional exhaled nitric oxide (FeNO) level, eosinophil percentage and count, and total immunoglobulin E (IgE) level were higher in the EGPA group than in the allergic asthma group. Unlike in allergic asthma, the FeNO level is not correlated with the blood eosinophil count or percentage in EGPA. Seven patients received cardiac emission computed tomography (ECT) tests, with abnormalities suggested in six patients. Results of an electrocardiogram, color-Doppler echocardiography, myocardial enzyme level, and troponin level suggested no obvious abnormality. Conclusion: The proportion of patients with EGPA who tested positive for ANCA is not high, and patients with high eosinophil counts should be alert to the possibility of having EGPA. For patients with infiltration of eosinophils into the airway, a diagnosis should not be based on peripheral blood eosinophil counts. It is recommended that the FeNO level and pulmonary function should also be monitored for patients who present with symptoms in other body systems. The sensitivity of cardiac ECT tests is higher than routine tests, so timely screening by cardiac ECT is recommended for all patients with EGPA.

The interaction between long non-coding RNA LINC01564 and POU2F1 promotes the proliferation and metastasis of gastric cancer.

BACKGROUND: An increasing number of studies have demonstrated that long non-coding RNAs (lncRNAs) serve as key regulators in tumor development and progression. However, only a few lncRNAs have been functionally characterized in gastric cancer (GC). METHODS: Bioinformatics analysis was conducted to find lncRNAs that are associated with GC metastasis. RNA FISH, RIP, and RNA pull down assays were used to study the complementary binding of LINC01564 complementary to the 3'UTR of transcription factor POU2F1. The transcription activation of LINC01564 by POU2F1 as a transcription factor was examined by ChIP assay. In vitro assays such as MTT, cell invasion assay, and clonogenic assay were conducted to examined the impacts of LINC01564 and POU2F1 on GC cell proliferation and invasion. Experiments in vivo were performed to access the impacts of LINC01564 and POU2F1 on GC metastasis. RESULTS: The results showed that LINC01564 complementary bound to the 3'UTR of POU2F1 to form an RNA duplex, whereby stabilizing POU2F1 mRNA and increasing the enrichment in cells. The level of LINC01564 was also increased by POU2F1 through transcription activation. In vitro assays showed that LINC01564 promoted the proliferation, invasion and migration of GC cells through increasing POU2F1. In vivo experiments indicate the promotion of GC proliferation and metastasis by the interaction between LINC01564 and POU2F1. CONCLUSION: Taken together, our results indicate that the interaction between LINC01564 and POU2F1 promotes the proliferation, migration and invasion of GC cells.

Downregulation by CNNM2 of ATP5MD expression in the 10q24.32 schizophrenia-associated locus involved in impaired ATP production and neurodevelopment.

Genome-wide association studies (GWAS) have accelerated the discovery of numerous genetic variants associated with schizophrenia. However, most risk variants show a small effect size (odds ratio (OR) <1.2), suggesting that more functional risk variants remain to be identified. Here, we employed region-based multi-marker analysis of genomic annotation (MAGMA) to identify additional risk loci containing variants with large OR value from Psychiatry Genomics Consortium (PGC2) schizophrenia GWAS data and then employed summary-data-based mendelian randomization (SMR) to prioritize schizophrenia susceptibility genes. The top-ranked susceptibility gene ATP5MD, encoding an ATP synthase membrane subunit, is observed to be downregulated in schizophrenia by the risk allele of CNNM2-rs1926032 in the schizophrenia-associated 10q24.32 locus. The Atp5md knockout (KO) in mice was associated with abnormal startle reflex and gait, and ATP5MD knockdown (KD) in human induced pluripotent stem cell-derived neurons disrupted the neural development and mitochondrial respiration and ATP production. Moreover, CNNM2-rs1926032 KO could induce downregulation of ATP5MD expression and disruptions of mitochondrial respiration and ATP production. This study constitutes an important mechanistic component that links schizophrenia-associated CNNM2 regions to disruption in energy adenosine system modulation and neuronal function by long-distance chromatin domain downregulation of ATP5MD. This pathogenic mechanism provides therapeutic implications for schizophrenia.

Association of cystatin C levels with metabolic syndrome incidence: a nested case-control study with propensity score matching.

OBJECTIVE: Metabolic syndrome (MetS) involves multiple metabolic disorders and seriously affects human health. Identification of key biological factors associated with MetS incidence is therefore important. We explored the association between MetS and the biochemical profiles of Chinese adults in Shenyang City in a nested case-control study. METHODS: We included adult participants who underwent physical examination at our hospital for 2 consecutive years. Participants' biochemical profiles and other MetS components were tested and monitored continuously. Propensity score matching was used to adjust confounding factors between participants with and without MetS. We analyzed the association between incidence of MetS and the biochemical profiles of participants. RESULTS: Of 5702 participants who underwent physical examination between 1 January 2017 and 1 December 2018, 538 had confirmed newly developed MetS. After successfully matching 436 pairs of participants, mean cystatin C (Cys-C) level was significantly higher in the MetS group than in the non-MetS group. Logistic regression analysis indicated that age (years) and γ-glutamate transpeptidase, creatinine, uric acid, and Cys-C levels were significantly associated with MetS incidence; among these, the odds ratio of Cys-C was highest (3.03; 95% confidence interval, 1.02-9.00). CONCLUSIONS: Cys-C levels were significantly associated with the incidence of MetS among Chinese adults.

Evaluation of the Association between Obesity Markers and Type 2 Diabetes: A Cohort Study Based on a Physical Examination Population.

PURPOSE: To evaluate the predictive effect of different obesity markers on the risk of developing type 2 diabetes in a population of healthy individuals who underwent physical examination and to provide a reference for the early detection of individuals at risk of diabetes. METHODS: This retrospective cohort study included 15206 healthy subjects who underwent a physical examination (8307 men and 6899 women). Information on the study population was obtained from the Dryad Digital Repository. Cox proportional risk models were used to calculate the hazard ratio (HR) and 95% confidence interval (CI) of different obesity markers, including the lipid accumulation index (LAP), body mass index (BMI), waist-to-height ratio (WHtR), visceral adiposity index (VAI), and body roundness index (BRI) on the development of type 2 diabetes. The effectiveness of each obesity marker in predicting the risk of developing type 2 diabetes was analyzed using the receiver operating characteristic curve (ROC curve) and the area under the curve (AUC). RESULTS: After a mean follow-up of 5.4 years, there were 372 new cases of type 2 diabetes. After correcting for confounding factors such as age, sex, smoking, alcohol consumption, exercise, and blood pressure, Cox proportional risk model analysis showed that elevations in BMI, LAP, WHtR, VAI, and BRI increased the risk of developing type 2 diabetes. The ROC curve results showed that LAP was the best predictor of the risk of developing diabetes, with an AUC (95% CI) of 0.759 (0.752-0.766), an optimal cutoff value of 16.04, a sensitivity of 0.72, and a specificity of 0.69. CONCLUSION: An increase in the BMI, LAP, WHtR, VAI, and BRI can increase the risk of developing type 2 diabetes, with LAP being the best predictor of this risk.

Oxymatrine Inhibits the Proliferation and Invasion of Breast Cancer Cells via the PI3K Pathway.

PURPOSE: Oxymatrine has been reported to possess anti-cancer activity, but its role in breast cancer (BC) is weakly defined. We investigated the anti-cancer effects of oxymatrine in human BC cells, and the underlying molecular mechanisms of these effects. METHODS: BC lines were treated with oxymatrine. The MTT assay was conducted to evaluate cell viability. The cell cycle and apoptosis of BC cells were analyzed using flow cytometry and Hoechst 33258 staining. Transwell™ assays were undertaken to measure the migratory and invasive abilities of MCF-7 or MDA-MB-231 cells. Expression of phosphatidylinositol 3-kinase (PI3K), Akt, cyclin D1, cluster of differentiation (CD)K2, PARP, Gsk3ß, caspase-3, matrix metalloproteinase (MMP)2 and Bax at protein and RNA levels was measured by Western blotting and quantitative real-time polymerase chain reaction. RESULTS: Oxymatrine inhibited the proliferation of BC cells in a time-dependent manner. It induced apoptosis in a dose- and time-dependent way according to Annexin V and Hoechst 33258 staining. Oxymatrine could inhibit the invasion of BC cells as shown by the Transwell assay. Oxymatrine inhibited expression of B-cell lymphoma-2 while increasing that of Bax as well as increasing expression of caspase-3 and caspase-9. Addition of oxymatrine to BC cells attenuated the PI3K/Akt signaling pathway cascade, as evidenced by dephosphorylation of P13K and Akt. CONCLUSION: Oxymatrine exerts its anti-tumor effects in BC cells by abolishing the PI3K pathway. Oxymatrine may be a new compound for BC treatment.

Hepatocellular carcinoma grading and recurrence prediction using T1 mapping on gadolinium-ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging.

The aim of the present study was to explore the value of T1 mapping on gadolinium-ethoxybenzyl diethylenetriamine pentaacetic (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) for grading hepatocellular carcinoma (HCC) and predicting its recurrence rate. A retrospective study was performed that included 75 patients (66 men and 9 women; mean age, 52.89 years; age range, 23-79 years) with HCC who had undergone Gd-EOB-DTPA-enhanced MRI with T1 mapping before surgery. The T1 relaxation time of the 81 lesions and non-tumorous liver parenchyma in 75 patients with HCC were measured before Gd-EOB-DTPA was injected and then at 5, 10 and 20 min after administration, respectively. T1[lesion (L)-hepatic parenchyma (H)]/H (%) was calculated as the increment rate of the T1 value in the lesions relative to the non-tumorous liver parenchyma. One-way analysis of variance and Spearman's correlation analysis was used to compare the differences and relationship of T1 mapping values among the three grades of HCC. A total of 81 lesions were divided into well-differentiated HCC (grades I; n=21), moderately differentiated HCC (grades II; n=40) and poorly differentiated HCC (grades III; n=20) according to the histopathology. The T1(L-H)/H (%) value among grades I, II and III HCC on pre-contrast results and on post-contrast results at the 5-, 10- and 20-min hepatobiliary phase (HBP) were significantly different (P<0.05), and T1(L-H)/H (%) was correlated with the histological grade of HCC at each time point (r=0.637, r=0.554, r=0.499 and r=0.560, respectively, P<0.001). A total of 41 recurrence cases [grade I (n=5), grade II (n=23) and grade III (n=13)] were verified by imaging (CT, MRI or ultrasound) or reoperation. Patients with grade III and grade II HCC had higher recurrence rates compared with that in patients with grade I HCC (P<0.05; median recurrence times were 258 days, 605 days and undefined, respectively). According to the optimal cut-off point for the T1(L-H)/H (%) of the three grades of HCC, patients with HCC in the low T1(L-H)/H (%) value group (≤155.15%) had lower cumulative recurrence rates compared with that in the medium (T1(L-H)/H (%) >155.15% and T1(L-H)/H (%) ≤241.20%) and high (T1(L-H)/H (%) >241.20%) value groups at the 20-min HBP (P<0.05; median recurrence times were undefined, 530 days and 447 days, respectively). These results indicate that the parameters of T1 mapping would be beneficial for predicting the grading and recurrence of HCC.

Clinical outcomes following an initial experience with a novel powered vascular stapler in video-assisted thoracoscopic lobectomies: results of a Chinese multi-center study.

BACKGROUND: The development of minimally invasive surgical approaches has revolutionized surgical care and greatly improved surgical outcomes. This study aimed to evaluate the clinical effectiveness of a powered vascular stapler (PVS) during video-assisted thoracoscopic surgery (VATS) lobectomy. METHODS: This prospective, multi-center, post-market clinical study in China enrolled 50 patients with either a suspected or formal diagnosis of clinical stage IA to IIB non-small cell lung cancer (NSCLC) scheduled for VATS lobectomy. The clinical effectiveness of the PVS for successful pulmonary artery (PA)/pulmonary vein (PV) transection was evaluated. In addition, the surgeon's stress, device usability, and surgeon satisfaction were measured using multiple questionnaires. RESULTS: A total of 167 PAs/PVs were transected with 3 (1.8%) requiring intra-operative intervention. Fourteen of the 50 patients (28.0%) experienced at least one adverse event (AE), among whom 5 (10.0%) suffered from serious AEs. There were no postoperative hemorrhagic complications related to transection of the PA/PV with PVS. Surgeon satisfaction was surveyed by questionnaire after each of the 50 procedures resulting in a 96% reported satisfaction with device usability, specifically related to a low stress load and an increase in work efficiency. CONCLUSIONS: For VATS lobectomy, the PVS demonstrated a positive surgical effectiveness and value in cognitive and physical distress reduction. Complications following VATS lobectomy to treat NSCLC were generally low and as expected. Intraoperative complications were few and there were no postoperative complications related to the transection of the PA and PV during VATS lobectomy. Favorable results were reported on the surgeon satisfaction questionnaire regarding usability and surgeon stress.

Radiation tolerance of La-doped nanocrystalline steel under heavy-ion irradiation at different temperatures.

Nanostructured materials have great potential for use as structural materials in advanced nuclear reactors due to the high density of grain boundaries that can serve as sinks to absorb irradiation-induced defects. In the present study, the irradiation tolerance of a La-doped nanocrystalline 304 austenitic stainless steel (NC-La) with a grain size of about 40 nm was investigated under an irradiation of 6 MeV Au ions to 1.5 × 1016 ions cm-2 at 600 °C and room temperature. Compared to its coarse-grained counterpart, in La-doped nanocrystalline steel no visible voids were observed at high-temperature irradiation, and no significant difference in extended defects, such as irradiation-induced dislocation loops or clusters, were found between irradiated and unirradiated areas at room temperature irradiation. Furthermore, the nano grain remains stable under irradiation, and no significant grain growth occurs at both irradiation temperatures. The excellent irradiation tolerance of the La-doped nanocrystalline alloys is attributed to the abundant grain boundaries and enhanced stability of nano grains induced by the Zener pinning effect and La segregation on grain boundaries. This study therefore demonstrates the superior irradiation tolerance of the La-doped nanocrystalline steel.

A multi-center evaluation of a powered surgical stapler in video-assisted thoracoscopic lung resection procedures in China.

BACKGROUND: Lung cancer is one of the most prevalent malignancies worldwide. The number of anatomic lung cancer resections performed via video-assisted thoracoscopic surgery (VATS) is growing rapidly. Staplers are widely used in VATS procedures, but there is limited clinical data regarding how they might affect performance and postoperative outcomes, including air leak. This clinical trial assessed the use of a powered stapler in VATS lung resection, with a primary study endpoint being occurrence and duration of air leak and prolonged air leak (PAL). METHODS: Data was collected from a single arm, multi-center study in Chinese patients receiving VATS wedge resection or lobectomy. Intra-operative data included surgery duration; cartridge selection for ligation/transection of bronchus, major vessels, and lung parenchyma; staple line interventions; blood loss; and device usage. Post-operative data included air leak assessments, chest tube duration, length of hospital stay, and adverse events (AEs). RESULTS: A total of 94 procedures across four institutions in China were included in the final analysis: 15 wedge resections, 74 lobectomies, and five wedge resections followed by lobectomies. Post-operative air leak occurred in five (5.3%) patients who had lobectomy procedures, with PAL in one (1.1%) patient. Sites were generally consistent relative to cartridge use by tissue type. The incidence of stapler firings requiring surgical interventions was seven out of 550 (1.3%). Surgeons participating in the study were satisfied with the articulation and overall usability of the stapler. CONCLUSIONS: The powered staplers make the VATS procedure easier for the surgeons and have achieved intra- and post-operative patient outcomes comparable to those previously reported.

Role of EZH2 protein expression in gastric carcinogenesis among Asians: a meta-analysis.

The present meta-analysis aggregated the results of relevant studies to identify the role of zeste homolog 2 (EZH2) expression in gastric carcinogenesis among Asians. Related articles were found by searching the following electronic databases without language restrictions: PubMed, SpringerLink, Karger Medical and Scientific Publishers, Chinese Biomedical Database (CBM), Chinese National Knowledge Infrastructure (CNKI), and Google Scholar. Meta-analysis was performed using STATA statistical software. Crude odds ratios (ORs) or hazard ratios (HRs) with their corresponding 95 % confidence interval (95 % CI) were calculated. Ten relevant studies, which enrolled a total of 872 gastric cancer patients, were selected for statistical analysis. The most important findings of our meta-analysis was that cancer tissues exhibited higher expression levels of EZH2 protein than normal, adjacent and benign tissues (cancer tissues vs normal tissues: OR = 32.15, 95 % CI 22.58 ~ 45.79, P < 0.001; cancer tissues vs adjacent tissues: OR = 16.10, 95 % CI 11.35 ~ 22.84, P < 0.001; cancer tissues vs benign tissues: OR = 2.66, 95 % CI 1.89 ~ 3.75, P < 0.001; respectively). Furthermore, we observed positive correlations between EZH2 expression and the TNM stage (OR = 2.86, 95 % CI 1.72 ~ 4.75, P < 0.001) as well as lymph node metastasis (OR = 3.02, 95 % CI 2.01 ~ 4.53, P < 0.001) of patients with gastric carcinoma. The correlation between EZH2 expression and gastric cancer prognosis was also evaluated in the meta-analysis. Statistical analysis demonstrated that the overall survival (OS) of EZH2-negative patients was shorter than that of patients with positive expressions of EZH2 (HR = 0.54, 95 % CI = 0.05 ~ 1.03, P = 0.032). Our meta-analysis confirmed the view that EZH2 expression might participate in the development of gastric carcinogenesis. Thus, EZH2 protein may be a valuable biomarker for the diagnosis and prognosis of gastric cancer.

Meta-analysis of associations between four polymorphisms in the matrix metalloproteinases gene and gastric cancer risk.

BACKGROUND: Matrix metalloproteinases (MMPs) play important roles in pathogenesis and development of cancer. Recently, many studies have show associations between polymorphisms in the promoter regions of MMPs and risk of gastric cancer. The present meta-analysis was conducted in order to investigate the potential association between four polymorphisms in the MMP gene and gastric cancer risk. METHODS: A computerized literature search was conducted in databases of Med-line, Embase, Science Citation Index and PubMed till June 2013 for any MMP genetic association study of gastric cancer. Odds ratios (ORs) and 95 % confidence intervals (CIs) were estimated for each gene under dominant and recessive models, and heterogeneity between studies was assessed using the Q test and I2 value. Overall and subgroup analyses according to ethnicity were carried out with Stata 12.0. RESULTS: 14 reports covering 8,146 patients (2,980 in the case group and 5,166 in the control group) were included in the present meta-analysis. We found that the MMP-7 (-181A>G) polymorphism increased the gastric cancer risk in therecessive model (GG vs. AA/AG, OR=1.768, 95% CI =1.153-2.712). For MMP2 ?1306 C>T, MMP1-1607 1G/2G, and MMP9?1 562 C>T, there were no associations between these polymorphisms and the risk of gastric cancer under dominant or recessive models. CONCLUSION: This meta-analysis suggested that the MMP7-181 A>G polymorphism may contribute to gastric cancer susceptibility. More studies are needed, especially in Europeans, in the future.

[Analysis of the causes of 117 infants with persistent hoarseness].

OBJECTIVE: To explore the causes of persistent hoarseness in infants. METHODS: One hundred and seventeen infants with persistent hoarseness treated in the department of otorhinolaryngology in Children's Hospital of Fudan University between June 2008 and July 2010 were retrospectively analyzed (all patients received antibiotic therapy for 2 weeks and the symptoms were not relieved after that). The patients were divided into three groups according to the age at first visit: 22 newborns, < 6 months old in 60 cases, < 12 months old in 35 cases. All patients had video laryngoscope examinations. Some of them received CT scan, cardiac ultrasonography and pathological examination in additional. The diagnosis was established by clinical history and imaging modalities, and the causes were analyzed subsequently. RESULTS: Among the 117 patients, 45 cases were vocal hypertrophy and hyperplasia (37.81%), 39 cases were vocal cord paralyses (32.78%), 7 cases were laryngeal hemangiomas (5.89%), 4 cases were laryngeal webs and cyst (3.36%), 2 cases were vocal cord polyps (1.68%), 2 cases were glottic incompetence (1.68%), 1 case was laryngeal papillomas(0.84%), 1 case was vocal code granulomas (0.84%), 1 case was glottis restricted by neck lymphangioma (0.84%); 4 cases were undetermined and 13 cases were no abnormalities. The percentage of patients with congenital heart diseases (19 cases) in vocal cord paralysis was 48.72%. The proportion of vocal cord paralysis in younger group was higher than that in elder one, their percentage were 50.00%, 36.67% and 17.14% respectively (χ(2) = 7.18, P < 0.05). CONCLUSIONS: A variety of causes can lead to persistent hoarseness in infants. The majority of them are vocal hypertrophy and hyperplasia, followed by vocal cord paralyze. Vocal cord paralysis is more common in younger infants than in elder ones, and the main causes are post-cardiac surgery and congenital heart disease.

[Expression and significance of VEGF-C and VEGF-D in differentiated thyroid carcinoma].

OBJECTIVE: VEGF-C,D are known to be capable of inducing proliferation of lymphatic endothelia cell and development of lymphatic vessels, so we investigated the expression of VEGF-C,D in the differentiated thyroid carcinoma tissues microarray in order to understand the significance mechanism of cervix lymphatic metastasis of thyroid cancer. METHOD: A tissue microarray containing 71 specimens was constructed, including normal thyroid tissues, thyroid adenoma, papillary thyroid carcinoma with and without lymphatic metastasis, follicular thyroid carcinoma. VEGF-C, D protein expression was detected with immunohistochemistry. RESULT: The expression of VEGF-C,D were not observed in normal thyroid tissues and adenoma tissues. The expression of VEGF-C,D in papillary thyroid carcinoma was significantly higher than those in follicular thyroid carcinoma (P < 0.05) and adeno ma tissues (P < 0.01). The expression of VEGF-C,D in papillary thyroid carcinoma with lymphatic metastasis was significantly higher than those in papillary thyroid carcinoma without lymphatic metastasis (P < 0.05). CONCLUSION: By inducing proliferation of lymphatic endothelia cell and development of lymphatic vessels, VEGF-C,D contributed to lymphatic metastasis of papillary thyroid carcinoma.