The effect of airborne particulate matter 2.5 (PM2.5) on meibomian gland.

Exposure to particulate matters in air pollution of 2.5 µm or less (PM2.5) was associated with loss of meibomian glands. The aim of this study was to verify that PM2.5 could directly impact meibomian gland epithelial cells and damage their function. To investigate the impact of PM2.5 on meibomian gland, immortalized human meibomian gland epithelial cells were treated with various concentrations of PM2.5in vitro. Meibomian gland cell microstructure, cell viability, expression of proliferating cell nuclear antigen and IL-1ß, and intracellular accumulation of acidic vesicles were measured by transmission electron microscopy, cell counting, Western blot and LysoTracker staining, respectively. To further study the effect of PM2.5in vivo, male C57BL/6J mice were treated with 5 mg/ml PM2.5 or vehicle for 3 months. Corneal fluorescein staining and ocular examinations were done before and after the treatment. Eyelids tissues were processed for morphological studies, immunostaining and Oil Red O staining. Our data suggest that exposure to PM2.5 caused significant meibomian gland dropout, clogged gland orifice and increased corneal fluorescein staining that were consistent with the clinical presentations of meibomian gland dysfunction. Prominent changes in the morphology and ultrastructure of meibomian glands was observed with PM2.5 treatment. PM2.5 promoted ductal keratinization, inhibited cell proliferation, induced cell apoptosis and increased Interleukin-1ß production in meibomian gland epithelial cells. This study may explain the association between PM2.5 exposure and meibomian gland dropout observed in clinic. PM2.5 resuspension instillation could be used to induce a meibomian gland dysfunction animal model.

Eyes on the Lid: The Impact of Fibroblast Growth Factor Receptor Targeting Drug on Human Meibomian Gland.

OBJECTIVE: To determine whether fibroblast growth factor receptor (FGFR)-targeting drug could impact human meibomian gland. METHODS: We followed up with three patients who were using pemigatinib for 4 to 10 weeks. The patients were evaluated for their ocular surface disease index, best-corrected visual acuity, Schirmer test, cornea staining, meibum expressibility score, tear meniscus height, noninvasive tear film breakup time, and meibomian gland area. The distribution of the FGFR family, FGF7, and FGF10 were evaluated by immunofluorescence staining and Western blot in fresh tarsal tissues from deidentified patients who underwent lid plastic surgeries. RESULTS: All patients developed apparent meibomian gland atrophy, shortening and narrowing of ducts, and significantly increased meibum expressibility and decreased noninvasive tear film breakup time within 5 to 8 weeks. Laboratory evaluations confirmed that human meibomian gland expresses abundant fibroblast growth factor receptors. CONCLUSIONS: These findings indicate that meibomian gland is a target tissue of FGFR inhibitors, and patients who use these drugs may develop meibomian gland dysfunction.

[Therapeutic effects of alkaloids in Tibetan medicine Bangna (Aconiti Penduli et Aconiti Flavi Radix) on osteoarthritis rats and mechanisms].

This study aims to investigate the therapeutic effects of alkaloids in Tibetan medicine Bangna(Aconiti Penduli et Aconiti Flavi Radix) on osteoarthritis(OA) rats in vitro and in vivo and the underlying mechanisms. Chondrocytes were isolated from 2-3 week-old male SD rats and lipopolysaccharide(LPS) was used to induce OA in chondrocytes in vitro. Methyl thiazolyl tetrazolium(MTT) assay was used to investigate the toxicity of seven alkaloids(12-epi-napelline, songorine, benzoylaconine, aconitine, 3-acetylaconitine, mesaconitine, and benzoylmesaconine) to chondrocytes. Chondrocytes were classified into the control group, model group(induced by LPS 5 µg·mL~(-1) for 12 h), and administration groups(induced by LPS 5 µg·mL~(-1) for 12 h and incubated for 24 h). The protein expression of inflammatory factors cyclooxygenase-2(COX-2), inducible nitric oxide synthetase(iNOS), tumor necrosis factor-α(TNF-α), and interleukin-1ß(IL-1ß) in each group were detected by Western blot, and the protein expression of matrix metalloprotease-13(MMP-13), aggrecan, collagen Ⅱ, fibroblast growth factor 2(FGF2) by immunofluorescence staining. For the in vivo experiment, sodium iodoacetate was used to induce OA in rats, and the expression of MMP-13, TNF-α, and FGF2 in cartilage tissues of rats in each group was detected by immunohistochemistry. The results showed that the viability of chondrocytes could reach more than 90% under the treatment of the seven alkaloids in a certain dose range. Aconitine, 12-epi-napelline, songorine, 3-acetylaconitine, and mesaconitine could decrease the protein expression of inflammatory factors COX-2, iNOS, TNF-α and IL-1ß compared with the model group. Moreover, 12-epi-napelline, aconitine, and mesaconitine could down-regulate the expression of MMP-13 and up-regulate the expression of aggrecan and collagen Ⅱ. In addition, compared with the model group and other Bangna alkaloids, 12-epi-napelline significantly up-regulated the expression of FGF2. Therefore, 12-epi-napelline was selected for the animal experiment in vivo. Immunohistochemistry results showed that 12-epi-napelline could significantly reduce the expression of MMP-13 and TNF-α in cartilage tissues, and up-regulate the expression of FGF2 compared with the model group. In conclusion, among the seven Bangna alkaloids, 12-epi-napelline can promote the repair of OA in rats by down-regulating the expression of MMP-13 and TNF-α and up-regulating the expression of FGF2.

DGUOK-AS1 promotes cell proliferation in cervical cancer via acting as a ceRNA of miR-653-5p.

Cervical cancer (CC) holds the second highest incidence and is the fourth dominating cause of cancer-induced death in women. It has been widely accepted that long noncoding RNAs (lncRNAs) are implicated in pathological and physiological activities of CC. However, the research of lncRNAs is still in the initial stage. The biological function of lncRNA deoxyguanosine kinase antisense RNA 1 (DGUOK-AS1) in human cancers has not been reported yet. We found that DGUOK-AS1 was aberrantly upregulated in cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) tissues through TCGA database. Real-time quantitative polymerase chain reaction (RT-qPCR) also verified the high expression of DGUOK-AS1 in CC cell lines. Loss-of-function assays indicated that DGUOK-AS1 silence repressed CC cell growth. In addition, dual-luciferase reporter and RNA immunoprecipitation (RIP) experiments validated the binding relation between miR-653-5p and DGUOK-AS1 or EMSY. Results of the rescue assays elucidated that EMSY overexpression or miR-653-5p downregulation reversed the suppressive function of DGUOK-AS1 knockdown on cell growth and DNA repair in CC. To sum up, this research highlighted that DGUOK-AS1 could promote CC cell proliferation via serving as a ceRNA of miR-653-5p to release EMSY, which might inspire us to discover novel strategies for CC treatment. SIGNIFICANCE OF THE STUDY: DGUOK-AS1 knockdown hinders proliferation of CC cells. DGUOK-AS1 sequesters miR-653-5p to elevate EMSY in CC. EMSY is required for DGUOK-AS1 to induce cell proliferation and repress DNA damage in CC.

The genomic alterations of lung adenocarcinoma and lung squamous cell carcinoma can explain the differences of their overall survival rates.

In the US, lung carcinoma accounted for over 150,000 deaths in 2018 and the advances in increasing survival rates are still limited. In this study, we investigated the cohorts with lung adenocarcinoma (LUAD) or lung squamous cell carcinoma (LUSC) from The Cancer Genome Atlas to figure out the risk factors and genomic alterations that affected their prognosis. The histoclinical factors that differed between LUAD and LUSC were identified and the risk factors affecting the overall survival were figured out for both LUAD and LUSC. Next, the patterns of nucleotides substitutions and the mutational signatures were extracted to illustrate whether different mutational processes performed for them. Finally, the genes that had different frequencies of mutation were identified. LUAD and LUSC presented differences in histoclinical factors including age at the time of diagnosis, sex, smoking history, pathological T classification, and overall survival. This was caused by the distinct genomic alterations including the transition-to-transversion ratios, mutational signatures, and the frequently mutated genes. We proposed that the mutational signature associated with aging could be used to predict the prognosis of patients with LUAD. On the other hand, the AID/APOBEC family was associated with the prognosis of LUSC. Finally, SNTG1 and LRRK2 might be important in LUAD and LUSC, respectively.

Pseudogene DUXAP10 can be used as a diagnostic and prognostic biomarker in human cancers.

The pseudogene DUXAP10 is overexpressed in numerous types of human cancers. However, the diagnostic and prognostic value of DUXAP10 in cancers has yet to be characterized. PubMed, EMBASE, Web of Science, the Cancer Genome Atlas (TCGA), and Gene Expression Omnibus databases were comprehensively searched in this study. A total of 50 studies comprising 11,292 patients were collected in this integrated analysis. DUXAP10 was confirmed to be significantly overexpressed in various human cancers (p < .05). Summary receiver operating characteristic (SROC) curve analysis was implemented, which indicated that DUXAP10 was a potential diagnostic biomarker for human cancers (area under the curve [AUC] of SROC curve = 0.81 [0.77-0.84]; pooled sensitivity = 0.69 [0.62-0.75]; pooled specificity = 0.81 [0.73-0.87]). In addition, hazard ratios (HRs) with 95% confidence intervals (CIs) were obtained to evaluate the association of DUXAP10 expression with overall survival (OS) time of cancer patients. Outcomes of meta-analysis suggested that upregulation of DUXAP10 was closely associated with poor OS (pooled HR = 1.11 [1.03-1.18]). Our study revealed that the pseudogene DUXAP10 was upregulated in multiple types of cancers and could be a potential biomarker with good diagnostic and prognostic value for human cancers.

[ITS2 sequence analysis and identification of medicinal Artemisia plants].

Artemisia hedinii occupies an important position in the Tibetan medicine. Plants in Artemisia vary a lot and are widely distributed in the Qinghai-Tibet Plateau, many plants in Artemisia look similar, making traditional identification methods laborious. In this article, ITS2 sequences were used as DNA barcoding to identify four kinds of confusable Tibetan medicine plants in Artemisia, aiming to establish a rapid and accurate identification methods. Twenty-one samples in Artemisia were collected from the Qinghai-Tibet Plateau, ITS2 sequence PCR amplification and sequencing were conducted after the extraction of DNA. Another 11 sequence downloaded from Genbank were added to the analysis. Genetic distance calculation and analysis, building Neighbor Joining (NJ) phylogenetic tree were conducted by MEGA 6.0, also comparison of secondary structures of ITS2 sequences among samples. A. hedinii, A. annua, A. dubia and A. argyi shared close genetic distance, but the maximum distance between the four species was much greater than the minimum distance within each species, NJ tree showed that the four species went to four separate branches, differences among secondary structures of ITS2 sequences also made it clear to identify these medical plants. It could be an accurate and rapid method for identification and recognition, as well as the evolutionary relationships between the species by using ITS2 sequence as DNA barcode for plants of Tibetan Artemisia. The study provides theoretical basis for quality control, medication safety and rational exploitation.

Therapeutic efficacy of classic Tibetan formulas combined at different hours in resisting cerebral ischemia.

The study focused on the therapeutic efficacy of Tibetan medicines on cerebral ischemia. The combined medication methods and administration habits in clinic for more than 10 years were simulated. Three typical Tibetan medicines, i.e., 25-Herb Shanhu pill, Wishful-Treasure pill and 20-Herb Chenxiang pill, were administered to the animal model of permanent middle cerebral artery occlusion in the morning, noon and evening, respectively. On the second day after the final administration, the activity of serum oxidative stress marker SOD and the content of MDA were evaluated. Infarct volumes were quantified through TTC staining. Inflammatory reaction maker NF-kappaB p65 gene and apoptosis. makers Bax and Cyct were selected to study the molecular mechanism of combined herbs with the immunohistochemistry technique. According to the result, the respective combination of 25-Herb Shanhu pill, Wishful-Treasure pill and 20-Herb Chenxiang pill in the morning, noon and evening showed unique advantages in reducing the damage of oxidative stress, infarct volumes, encephaledema caused by ischemia, inflammatory factor aggregation and inhibiting apoptosis, with consistent therapeutic efficacies in clinic.

[Identification and analysis of Corydalis boweri, Meconopsis horridula and their close related species of the same genus by using ITS2 DNA barcode].

The study is aimed to ensure the quality and safety of medicinal plants by using ITS2 DNA barcode technology to identify Corydalis boweri, Meconopsis horridula and their close related species. The DNA of 13 herb samples including C. boweri and M. horridula from Lhasa of Tibet was extracted, ITS PCR were amplified and sequenced. Both assembled and web downloaded 71 ITS2 sequences were removed of 5. 8S and 28S. Multiple sequence alignment was completed and the intraspecific and interspecific genetic distances were calculated by MEGA 5.0, while the neighbor-joining phylogenetic trees were constructed. We also predicted the ITS2 secondary structure of C. boweri, M. horridula and their close related species. The results showed that ITS2 as DNA barcode was able to identify C. boweri, M. horridula as well as well as their close related species effectively. The established based on ITS2 barcode method provides the regular and safe detection technology for identification of C. boweri, M. horridula and their close related species, adulterants and counterfeits, in order to ensure their quality control, safe medication, reasonable development and utilization.

Overexpression of SAMD9 suppresses tumorigenesis and progression during non small cell lung cancer.

The Sterile Alpha Motif Domain-containing 9 (SAMD9) gene has been recently emphasized during the discovery that it is expressed at a lower level in aggressive fibromatosis and some cases of breast and colon cancer, however, the underlying mechanisms are poorly understood. Here, we found that SAMD9 is down-regulated in human non-small cell lung cancer (NSCLC). Furthermore, knockdown of SAMD9 expression is increased the invasion, migration and proliferation in H1299 cells in vitro and overexpression of SAMD9 suppressed proliferation and invasion in A549 cells. Finally, depletion of SAMD9 increases tumor formation in vivo. Our results may provide a strategy for blocking NSCLC tumorigenesis and progression.

Engineering the activity and thermostability of a carboxylic acid reductase in the conversion of vanillic acid to vanillin.

Vanillin is a valuable natural product that can be used as a fragrance and additive. Recent research in the biosynthesis of vanillin has brought attention to a key enzyme, carboxylic acid reductase (CAR), which catalyzes the reduction of vanillic acid to vanillin. Nevertheless, the biosynthesis of vanillin is hampered by the low activity and stability of CAR. As such, a rational design campaign was conducted on a well-documented carboxylic acid reductase from Segniliparus rugosus (SrCAR), using vanillic acid as the model substrate. After combined active site saturation and iterative site-specific mutagenesis, the best quadruple mutant N292H/K524S/A627L/E1121W (M3) was successfully obtained. In comparison to the wildtype SrCAR, M3 demonstrated a 4.2-fold increase in catalytic efficiency (kcat/Km), and its half-life (t1/2) was enhanced by 3.8 times up to 385.08 minutes at 40 °C. In silico docking and molecular dynamics simulation provided insights into the improved activity and stability. In the subsequent preparative-scale reaction with 100 mM (16.8 g L-1) vanillic acid, the whole cell catalysis utilizing M3 produced 10.15 g·L-1 of vanillin and 1.11 g·L-1 of vanillyl alcohol, respectively. This work demonstrates a dual improvement in the activity and thermal stability of SrCAR, thereby potentially facilitating the application of carboxylic acid reductase in the biosynthesis of vanillin.

Constituent isoflavones of Puerariae radix as a potential neuroprotector in cognitive impairment: Evidence from preclinical studies.

With the increasing aging population worldwide, the incidence of senile cognitive impairment (CI) is increasing, posing a serious threat to the health of elderly persons. Despite developing new drugs aimed at improving CI, progress in this regard has been insufficient. Natural preparations derived from plants have become an unparalleled resource for developing new drugs. Puerariae radix (PR) has a long history as Chinese herbal medicine. PR is rich in various chemical components such as isoflavones, triterpenes, and saponins. The isoflavones (puerarin, daidzein, formononetin, and genistein) exhibit potential therapeutic effects on CI through multiple mechanisms. Relevant literature was organized from major scientific databases such as PubMed, Elsevier, SpringerLink, ScienceDirect, and Web of Science. Using "Puerariae radix," "Pueraria lobata," "isoflavones," "puerarin," "antioxidant," "daidzein," "formononetin," "genistein," "Alzheimer"s disease," and "vascular cognitive impairment" as keywords, the relevant literature was extracted from the databases mentioned above. We found that isoflavones from PR have neuroprotective effects on multiple models of CI via multiple targets and mechanisms. These isoflavones prevent Aß aggregation, inhibit tau hyperphosphorylation, increase cholinergic neurotransmitter levels, reduce neuroinflammation and oxidative stress, improve synaptic plasticity, promote nerve regeneration, and prevent apoptosis. PR has been used as traditional Chinese herbal medicine for a long time, and its constituent isoflavones exert significant therapeutic effects on CI through various neuroprotective mechanisms. This review will contribute to the future development of isoflavones present in PR as novel drug candidates for the clinical treatment of CI.

Two-layer accumulated quantized compression for communication-efficient federated learning: TLAQC.

Federated learning enables multiple nodes to perform local computations and collaborate to complete machine learning tasks without centralizing private data of nodes. However, the frequent model gradients upload/download operations required by the framework result in high communication costs, which have become the main bottleneck for federated learning as deep models scale up, hindering its performance. In this paper, we propose a two-layer accumulated quantized compression algorithm (TLAQC) that effectively reduces the communication cost of federated learning. TLAQC achieves this by reducing both the cost of individual communication and the number of global communication rounds. TLAQC introduces a revised quantization method called RQSGD, which employs zero-value correction to mitigate ineffective quantization phenomena and minimize average quantization errors. Additionally, TLAQC reduces the frequency of gradient information uploads through an adaptive threshold and parameter self-inspection mechanism, further reducing communication costs. It also accumulates quantization errors and retained weight deltas to compensate for gradient knowledge loss. Through quantization correction and two-layer accumulation, TLAQC significantly reduces precision loss caused by communication compression. Experimental results demonstrate that RQSGD achieves an incidence of ineffective quantization as low as 0.003% and reduces the average quantization error to 1.6 × [Formula: see text]. Compared to full-precision FedAVG, TLAQC compresses uploaded traffic to only 6.73% while increasing accuracy by 1.25%.

Small amounts of main group metal atoms matter: ultrathin Pd-based alloy nanowires enabling high activity and stability towards efficient oxygen reduction reaction and ethanol oxidation.

Proton-exchange membrane fuel cells are considered as promising energy-conversion devices. Alloying 3d transition metals with noble metals not only highly improves the performance of noble metal-based catalysts towards electrocatalytic reactions in fuel cells due to d-d hybridization interaction but also decreases the total cost. However, the rapid leaching of transition metal atoms leads to a fast decay of the activity, which seriously affects the performance of the fuel cell. Herein, alloyed Pd-main group metal (e.g. Pb, Bi, Sn) ultrathin nanowires were realized by a facile one-step wet-chemical strategy. The content of the main group metal could be tuned in a certain range while maintaining the same one-dimensional ultrathin nanowire morphology, which provided a large surface area and many more active sites. These Pd-based alloys showed a significant improvement in electrocatalytic activity and durability towards the oxygen reaction reaction as well as ethanol oxidation reaction. Optimal activity occurred when a small amount of main group metal existed, which could be explained through calculations by a strong p-d hybridization interaction between the main group metal and Pd to optimize the surface electronic structure collaboratively. Besides, high stability was achieved, which could be ascribed to the increased antioxidant activity of Pd by the main group metal. Furthermore, the low amount of the main group metal atoms also prevented them from leaching out of the crystal lattice.

[Constructing duplication hasABC of chromosome recombinant in Streptococcus equi subsp. Zooepidemicu].

OBJECTIVE: To investigate the possibility of increasing the yield of hyaluronic acid by constructing duplication hasABC of chromosome recombinant in Streptococcus equi subsp. Zooepidemicus with a thermosensitive delivery vector system pJR700. METHODS: We amplified a 4147 bp DNA fragment of hyaluronic acid synthase operon hasABC genes from chromatosome of S. zooepidemicus using PCR. This DNA fragment was subcloned into the pJR700 at ClaI sites to result in recombinant plasmid pXL32. The recombinant plasmid was transformed into S. Zooepidemicus by electroperation. The homologous recombination was induced by growing the bacteria at 37 degrees C, and transformants were selected according to kanamycin resistance for 3 rounds. Then the culture was shifted to grow at 30 degrees C without antibiotics for 4 rounds to induce excision of the pJR700 indicated fragment. Colonies with kanamycin sensitivity were selected by plating on THY agar at 37 degrees C. The hasABC recombinant of S. Zooepidemicus was identified through RT-PCR with primers homologous to the flanking regions. HA titers were measured by the modified carbazole assay. RESULTS: We constructed successfully the duplication hasABC of chromosome recombinant of S. Zooepidemicus and the HA titer production by recombinants harboring duplication hasABC was 34% higher than that of the wild type at 24 h in shake flask culture. CONCLUSION: The thermosensitive delivery vector of pJR700 could be used to construct the streptococcal hasABC recombinant strain for increasing the yield of HA in S. Zooepidemicus.

[Immune Checkpoint Inhibitors Related Diabetes Mellitus: 
A Report of 2 Cases and Literature Review].

Immune checkpoint inhibitors (ICIs) are widely used in clinic, and the incidence of rare adverse events are increasing. The aim of this paper is to better define the rare adverse effect of diabetes mellitus associated with ICIs. We report 2 cases of diabetes mellitus associated with ICIs. Literature review was conducted and we discussed the clinical presentation, potential mechanisms and suggestions for optimal management. Two patients were both elderly women, case 1 had increased blood glucose after 7 months of using Durvalumab, and cases 2 had diabetic ketoacidosis after 6 weeks of using Pembrolizumab. Both patients were administered exogenous insulin to control blood glucose. Case 1 has been treated with Durvalumab until now and case 2 discontinued using of Pembrolizumab. HLA genotypes and other factors may explain the risk factors of diabetes associated with ICIs in some individuals. Diabetes mellitus associated with ICIs is an uncommon but potentially life-threatening endocrine system adverse event, which requires doctors to be vigilant. The patients who use ICIs need to monitor blood glucose. If they have hyperglycemia, endocrinologists should be asked to assist in diagnosis and treatment.
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Engineering the degree of concavity of one-dimensional Au-Cu alloy nanorods with partial intermetallic compounds by facile wet chemical synthesis.

Finely modulating the morphology of bimetallic nanomaterials plays a vital role in enhancing their catalytic activities. Among the various morphologies, concave structures have received considerable attention due to the three advantageous features of high-index facets, high surface areas, and high curvatures, which contribute greatly to enhancing the catalytic performance. However, concave morphologies are not the products generated from thermodynamically controlled growth with minimized surface energy. Additionally, most nanocrystals with concave shapes are currently in the state of mono-metals or alloys with disordered arrangements of atoms. The synthesis of alloy structures with ordered atom arrangements, intermetallic compounds, which tend to display superior catalytic performance on account of their optimal geometric and electronic effects, has rarely been reported as high-temperature annealing is usually needed, which constrains the modulation of morphology and surface structure. In this work, concave one-dimensional Au-Cu nanorods with a partially ordered intermetallic structure were synthesized via a facile wet chemical method. By simply adjusting the reaction kinetics via the concentrations of the corresponding metal precursors, the degree of concavity of the one-dimensional Au-Cu nanorods could be regulated. In both the p-nitrophenol reduction and CO2 electro-reduction reactions, the concave-shaped Au-Cu nanorods demonstrated superior catalytic activity compared to corresponding non-concave samples with the same structure due to the morphological advantages provided by the concave structure.

The inhibitory mechanism of methyl jasmonate on Aspergillus flavus growth and aflatoxin biosynthesis and two novel transcription factors are involved in this action.

As the most toxic and carcinogenic mycotoxin, aflatoxin B1 (AFB1) biosynthesis depends on a series of enzymatic reactions and a complicated regulatory system. Methyl jasmonate (MeJA) is one of stress associated phytohormones. In this study, MeJA could inhibit A. flavus growth and AFB1 production with a dose-dependent manner. SEM and TEM analysis indicated that morphological ultrastructure deteriorations were observed in A. flavus treated with MeJA. RNA-Seq indicated that the initial-steps aflatoxins (AFs) genes were no drastic difference, but the middle- and later- steps genes were significantly down-regulated, which might be due to the decreases of global regulators, especially AtfB. More importantly, two novel regulators (AFLA_085880 and AFLA_015850) were involved in the inhibition, and were recognized as the critically positive regulators for AFs productions. The two genes mutants also showed significantly decrease expressions of AFs cluster genes and AFs associated regulators, and subsequent AFB1 biosynthesis. This research partly clarified inhibitory mechanism of MeJA and made some contributions to the elimination of AFs contamination.

The role of brain metastases in patients with pulmonary adenocarcinoma: a retrospective study.

BACKGROUND: Brain metastasis is common in patients with lung cancer and has a negative impact on overall survival (OS). The aim of this study was to investigate therapeutic effects and prognosis-related factors for survival of patients with pulmonary adenocarcinoma and brain metastasis. METHODS: This was a retrospective study involving the data of patients with pulmonary adenocarcinoma and brain metastasis who were treated at the Department of Oncology, Tianjin Medical University General Hospital. Participants were divided into 2 groups: the initial-metastasis group (brain metastases at first visit), and the late-metastasis group (developed metastasis during treatment). The quantitative index was described as mean ± standard deviation (SD), independent sample t-test was used to calculate the P value. All data were processed using the software SPSS 20.0 software package. RESULTS: There were a total of 43 patients in the initial-metastasis group and 49 in the late-metastasis group. First-line treatment efficacy (P=0.004), OS (P<0.001), and progression-free survival (PFS) (P=0.006) were higher in the late-metastasis group. Kaplan-Meier curves revealed that the late-metastasis group had longer OS, intracranial progression-free survival (IPFS), and PFS (all P<0.001). Multivariate analysis showed that gender, Karnofsky performance status (KPS), efficacy of first-line treatment, radiotherapy, and brain metastasis at initial visit were significantly related to OS. CONCLUSIONS: Participants with pulmonary adenocarcinoma and brain metastasis at their initial visit had shorter OS and PFS than those who developed brain metastasis later. The efficacy of first-line treatment was related to OS while female gender and high KPS score were protective factors.

Validation of manufacturers' laryngeal mask airway size selection standard: a large retrospective study.

BACKGROUND: Laryngeal mask airway (LMA) is a prominent supraglottic airway device, widely used especially in difficult airway management. However, the LMA sizes recommended by the manufacturers are not always well matched in clinical practice, which leads to complications. To date, there are rare models to validate whether the manufacturers' standard is suitable for use in clinical practice. METHODS: A total of 58,956 patients undergoing general anesthesia using LMA device were included in the study between January 1, 2011 and December 31, 2018, to validate the adherence rate of LMA sizes according to the manufacturers' recommendations. A logistic regression analysis was performed based on the actual LMA size used in clinical practice to establish separately size selection guidelines with gender, weight, and age as variables in adults, adolescents, and children. RESULTS: LMA insertions were analyzed in 50,776 (86.1%) adults, 3,548 (6%) adolescents, and 4,632 (7.9%) children. Suitability of manufacturers' recommendations was higher in children [male: 86.02%; female: 85.09%] than adults [male: 72.75%; female: 78.13%] or adolescents [male: 73.4%; female: 70.79%]. For adults and adolescents, LMA size was better predicted using the regression model rather than the manufacturers' recommendations [male adults: 82.4% (81.16-83.57%) vs. 73.21% (71.79-74.59%), P<0.05; female adults: 87.82% (86.65-88.9%) vs. 77.07% (75.6-78.48%), P<0.05; male adolescents: 79.45% (74.86-83.4%) vs. 72.05% (67.09-76.53%), P<0.05; female adolescents: 78.4% (71.11-84.31%) vs. 72.22% (64.54-78.82%), P<0.05]. For children, there was equal performance suitability using the regression model and the manufacturers' recommendations. CONCLUSIONS: The model-based guidelines may provide more accurate directions for LMA size selection for adolescents and adults than the manufacturers' weight-based recommendations, whereas the manufacturers' recommendation in children is consistent with clinical practice.