Molecular generation strategy and optimization based on A2C reinforcement learning in de novo drug design.

MOTIVATION: In the field of pharmacochemistry, it is a time-consuming and expensive process for the new drug development. The existing drug design methods face a significant challenge in terms of generation efficiency and quality. RESULTS: In this paper, we proposed a novel molecular generation strategy and optimization based on A2C reinforcement learning. In molecular generation strategy, we adopted transformer-DNN to retain the scaffolds advantages, while accounting for the generated molecules' similarity and internal diversity by dynamic parameter adjustment, further improving the overall quality of molecule generation. In molecular optimization, we introduced heterogeneous parallel supercomputing for large-scale molecular docking based on message passing interface communication technology to rapidly obtain bioactive information, thereby enhancing the efficiency of drug design. Experiments show that our model can generate high-quality molecules with multi-objective properties at a high generation efficiency, with effectiveness and novelty close to 100%. Moreover, we used our method to assist shandong university school of pharmacy to find several candidate drugs molecules of anti-PEDV. AVAILABILITY AND IMPLEMENTATION: The datasets involved in this method and the source code are freely available to academic users at https://github.com/wq-sunshine/MomdTDSRL.git.

T-type voltage-gated channels, Na+/Ca2+-exchanger, and calpain-2 promote photoreceptor cell death in inherited retinal degeneration.

Inherited retinal degenerations (IRDs) are a group of untreatable and commonly blinding diseases characterized by progressive photoreceptor loss. IRD pathology has been linked to an excessive activation of cyclic nucleotide-gated channels (CNGC) leading to Na+- and Ca2+-influx, subsequent activation of voltage-gated Ca2+-channels (VGCC), and further Ca2+ influx. However, a connection between excessive Ca2+ influx and photoreceptor loss has yet to be proven.Here, we used whole-retina and single-cell RNA-sequencing to compare gene expression between the rd1 mouse model for IRD and wild-type (wt) mice. Differentially expressed genes indicated links to several Ca2+-signalling related pathways. To explore these, rd1 and wt organotypic retinal explant cultures were treated with the intracellular Ca2+-chelator BAPTA-AM or inhibitors of different Ca2+-permeable channels, including CNGC, L-type VGCC, T-type VGCC, Ca2+-release-activated channel (CRAC), and Na+/Ca2+ exchanger (NCX). Moreover, we employed the novel compound NA-184 to selectively inhibit the Ca2+-dependent protease calpain-2. Effects on the retinal activity of poly(ADP-ribose) polymerase (PARP), sirtuin-type histone-deacetylase, calpains, as well as on activation of calpain-1, and - 2 were monitored, cell death was assessed via the TUNEL assay.While rd1 photoreceptor cell death was reduced by BAPTA-AM, Ca2+-channel blockers had divergent effects: While inhibition of T-type VGCC and NCX promoted survival, blocking CNGCs and CRACs did not. The treatment-related activity patterns of calpains and PARPs corresponded to the extent of cell death. Remarkably, sirtuin activity and calpain-1 activation were linked to photoreceptor protection, while calpain-2 activity was related to degeneration. In support of this finding, the calpain-2 inhibitor NA-184 protected rd1 photoreceptors.These results suggest that Ca2+ overload in rd1 photoreceptors may be triggered by T-type VGCCs and NCX. High Ca2+-levels likely suppress protective activity of calpain-1 and promote retinal degeneration via activation of calpain-2. Overall, our study details the complexity of Ca2+-signalling in photoreceptors and emphasizes the importance of targeting degenerative processes specifically to achieve a therapeutic benefit for IRDs. Video Abstract.

Large-Scale Molecular Dynamics Simulation Based on Heterogeneous Many-Core Architecture.

As the application of molecular dynamics (MD) simulations continues to evolve, the demand for accelerating large-scale simulation systems and handling of enormous simulation tasks is steadily increasing. We propose a parallel acceleration method for large-scale MD simulations based on Sunway heterogeneous many-core processors. This method integrates task scheduling, simulation calculations, and data storage, effectively tackling issues related to large-scale simulations and numerous simulation tasks. The task scheduling strategy flexibly handles tasks on various scales and enables parallel execution of multiple tasks. During the simulation calculations, we ported GROMACS to the Sunway architecture and accelerated the calculation of short-range forces through a heterogeneous processor. Our method achieves approximately 10-fold acceleration and 90% scalability when executing a single simulation task. When handling numerous simulation tasks, our method achieves parallel execution of all of the tasks with 90% scalability. By employing our method, we carried out 50 ns simulations on over 3000 distinct conotoxin structures individually within just 5 h. Additionally, we evaluated more than 200 protein-ligand complexes, and the simulation efficiency significantly exceeded that of midsized to small GPU clusters.

Engaging and (the Illusion of) Learning? Examining the Relationship Between Different Social Media Activities and Reproductive Health Knowledge.

Social media have become fundamental platforms for learning about health, including reproductive health knowledge. However, little is known about what specific user activity is conducive to learning about reproductive health and by what means. Drawing upon the cognitive mediation model, this study examines how different social media activities function in terms of elaboration and knowledge gain. Our hypothesized model was largely supported by a nationwide online survey with 1,000 Chinese women residing in both rural and urban areas. The results revealed the crucial role of information elaboration in bridging different social media activities with both subjective and factual reproductive health knowledge. Interestingly, public reposting of reproductive health information was found to be positively related to subjective knowledge but negatively related to factual knowledge, suggesting the emergence of an illusion of knowing among our participants. Multigroup SEM analyses revealed that the positive roles of scanning and private sharing in encouraging elaboration were more pronounced among users with lower levels of need for cognition. The findings are expected to contribute to a more nuanced understanding of health learning based on users' social media activities and intrinsic motivations for learning.

IncRNA MIAT Accelerates Keloid Formation by miR-411-5p/JAG1 Axis.

The long non-coding RNA (lncRNA) myocardial infarction-associated transcript (MIAT) regulates the biological functions of many kinds of cells. The aim of this study is to explore the mechanism of MIAT and how it affects keloid progression. The expressions of MIAT, JAG1, and miR-411-5p in keloid tissues and keloid fibroblasts (KEL FIBs) were quantified by conducting Western blot and quantitative reverse transcription polymerase chain reaction analyses. The influences of MIAT, JAG1, and miR-411-5p on the abilities of KEL FIBs to proliferate, migrate, and invade were assessed by means of the CCK-8, wound healing, and Transwell experiments. To determine the binding relationship among MIAT, JAG1, and miR-411-5p, we performed luciferase reporter and RIP experiments. In keloid tissues and KEL FIBs, MIAT and JAG1 were upregulated while miR-411-5p was downregulated. Knocking-down MIAT or JAG1 significantly inhibited proliferation, migration and invasion. On the contrary, suppressing miR-411-5p expression produced an opposite effect. With regard to mechanisms, MIAT sponged miR-411-5p, which targeted JAG1. MIAT accelerates keloid formation by modulating the miR-411-5p/JAG1 axis.

"Premature" Girls with "Illegitimate" Diseases: A Qualitative Exploration of the Stigma of Gynecological Diseases for Unmarried Young Women in China.

Stigma has been a prominent barrier in women's pursuit of better sexual and reproductive health (SRH). Specifically, evidence supports the stigmatization of gynecological diseases (GDs) for unmarried young women. Drawing upon the model of social identity threats, this study explored the GD stigma and social identity threats faced by unmarried young women in China with 26 in-depth interview data. The interpersonal, socio-cultural, and intrapersonal layers of GD stigma were identified. First, participants' disclosure and concealment of GDs concerning different significant others were contrasted as an interpersonal layer and voluntary response to social identity threats. In participants' GD experiences, peers stood out for providing emotional, tangible, and informational support, while parents were most often avoided for anticipated stigma. Second, collective representations of GDs and the cultural rationale in the socio-cultural layer were probed. The traditional and modernized sexual norms centering on the legitimacy of premarital sex and SRH knowledge were unveiled. At last, the interpersonal layer was identified. Unmarried young patients suffered social identity threats regarding their independence, sexual agency, and bodily awareness. This is one of the first studies that investigated the underappreciated GD stigma in China. Theoretical and practical implications are discussed.

Spatial bacterial subpopulations of a human lung lobe and their potential impact on the progression of pulmonary tuberculosis.

Better understanding the spatial variation in resident pulmonary bacteria can help to link the disease severity of pulmonary tuberculosis (TB) with lung bacteriomes. This study aimed to investigate bacterial compositions in subniches of a lung lobe from pulmonary TB patient with two separate visible lesions. There were no significant differences between the bacterial compositions in normal tissue and TB lesions, but the bacterial compositions of the two TB lesions differed significantly (P = 0.009). Interestingly, 52 OTUs (relative abundance >1%) that specifically inhabiting certain lung niches were observed and they were affiliated with five phyla. Specific OTUs affiliated with Firmicutes mainly inhabited normal tissues. The dominant phylum in the lung subniches was Proteobacteria, with a relative abundance between 67.03% and 99.99%. Ralstonia, Achromobacter, and Pseudomonas were the most abundant genera, collectively accounting for 34.02% of total bacterial species. A total of 667 of the 700 bacterial connections in a co-correlation network of 145 OTUs (Operational Taxonomic Unit) were positive, indicating a cooperative relationship between bacterial members. Using PICRUSt tool, we do predict bacterial MetaCyc functions responsible for lipid synthesis and heme biosynthesis across the lung lobe that are essential for generation of caseous necrosis and TB disease pathology. MetaCyc pathways responsible for the degradation of aromatic biogenic amines, sulfur oxidation, and denitrification were all related to M.tb growth status, and they were significantly enriched in the lesion with necrosis than that with inflammation. These results open a new insight for us to comprehend the spatial profile of bacteriomes in a pulmonary TB human lung lobe, and shed light on the design of future diagnosis and treatment for pulmonary TB disease.

Circ-Sirt1 inhibits vascular smooth muscle cells proliferation via the c-Myc/cyclin B1 axis.

Vascular smooth muscle cells (VSMCs) are an important cellular component of the vascular wall. Restenosis is mainly due to VSMC excessive proliferation. However, little is known about the role of circRNAs in VSMC proliferation and phenotypic switching. Herein, using fluorescence in situ hybridization assay and quantitative real-time polymerase chain reaction, we found that circ-Sirt1 was markedly downregulated in neointimal formation after injury and in VSMCs treated with platelet-derived growth factor BB (PDGF-BB). Bromodeoxyuridine and MTT assays confirmed the inhibitory role of circ-Sirt1 on cell proliferation. Mechanistically, circ-Sirt1 was mainly expressed in the cytoplasm of VSMCs. Through RNA immunoprecipitation and RNA pull-down assays, we found that circ-Sirt1 bound with c-Myc, which protein associated with proliferation of VSMCs. Chromatin immunoprecipitation assay also provided evidence that the overexpression of circ-Sirt1 almost ceased PDGF-BB-induced binding of c-Myc to the promoter of cyclin B1 in VSMCs. These results indicated that circ-Sirt1 had an inhibitory effect on c-Myc activity, providing a mechanism for suppressing PDGF-BB-induced VSMC proliferation by direct interactions with c-Myc and its sequestration in the cytoplasm. Overall, our study demonstrated that a previously unrecognized circ-Sirt1/c-Myc/cyclin B1 axis in VSMCs mediates neointimal formation following injury.

Inhibition of the MAPK/c-Jun-EGR1 Pathway Decreases Photoreceptor Cell Death in the rd1 Mouse Model for Inherited Retinal Degeneration.

Retinitis pigmentosa (RP) is a group of inherited retinal dystrophies that typically results in photoreceptor cell death and vision loss. Here, we explored the effect of early growth response-1 (EGR1) expression on photoreceptor cell death in Pde6brd1 (rd1) mice and its mechanism of action. To this end, single-cell RNA-seq (scRNA-seq) was used to identify differentially expressed genes in rd1 and congenic wild-type (WT) mice. Chromatin immunoprecipitation (ChIP), the dual-luciferase reporter gene assay, and western blotting were used to verify the relationship between EGR1 and poly (ADP-ribose) polymerase-1 (PARP1). Immunofluorescence staining was used to assess PARP1 expression after silencing or overexpression of EGR1. Photoreceptor cell death was assessed using the TUNEL assay following silencing/overexpression of EGR1 or administration of MAPK/c-Jun pathway inhibitors tanzisertib and PD98059. Our results showed differential expression of ERG1 in rd1 and WT mice via scRNA-seq analysis. The ChIP assay demonstrated EGR1 binding to the PARP1 promoter region. The dual-luciferase reporter gene assay and western blotting results revealed that EGR1 upregulated PARP1 expression. Additionally, the TUNEL assay showed that silencing EGR1 effectively reduced photoreceptor cell death. Similarly, the addition of tanzisertib and PD98059 reduced the expression of c-Jun and EGR1 and decreased photoreceptor cell death. Our study revealed that inhibition of the MAPK/c-Jun pathway reduced the expression of EGR1 and PARP1 and prevented photoreceptor cell death. These results highlight the importance of EGR1 for photoreceptor cell death and identify a new avenue for therapeutic interventions in RP.

Single-Cell Transcriptomic Profiling in Inherited Retinal Degeneration Reveals Distinct Metabolic Pathways in Rod and Cone Photoreceptors.

The cellular mechanisms underlying hereditary photoreceptor degeneration are still poorly understood. The aim of this study was to systematically map the transcriptional changes that occur in the degenerating mouse retina at the single cell level. To this end, we employed single-cell RNA-sequencing (scRNA-seq) and retinal degeneration-1 (rd1) mice to profile the impact of the disease mutation on the diverse retinal cell types during early post-natal development. The transcriptome data allowed to annotate 43,979 individual cells grouped into 20 distinct clusters. We further characterized cluster-specific metabolic and biological changes in individual cell types. Our results highlight Ca2+-signaling as relevant to hereditary photoreceptor degeneration. Although metabolic reprogramming in retina, known as the 'Warburg effect', has been documented, further metabolic changes were noticed in rd1 mice. Such metabolic changes in rd1 mutation was likely regulated through mitogen-activated protein kinase (MAPK) pathway. By combining single-cell transcriptomes and immunofluorescence staining, our study revealed cell type-specific changes in gene expression, as well as interplay between Ca2+-induced cell death and metabolic pathways.

Integrative RNA-seq and ATAC-seq analyses of phosphodiesterase 6 mutation-induced retinitis pigmentosa.

PURPOSE: Inhibition of poly-ADP-ribose polymerase 1 (PARP1) could relieve phosphodiesterase 6 mutation-induced retinitis pigmentosa (RP). However, the mechanism related to PARP1 overexpression in the RP has not been clarified. We attempted to explore the potential mechanism related to PARP1 regulating RP. METHODS: ATAC-seq and RNA-seq were performed for retina tissues of C3H and rd1 mice. The differentially expressed genes (DEGs) were identified, followed by the construction of PARP1-DEG co-expression and protein-protein interaction (PPI) networks. Gene ontology-biological process and pathway enrichment of DEGs were performed by clusterProfiler software. The overlapped genes that might play regulatory roles in PARP1 expression were mined by integrated analysis of RNA-seq and ATAC-seq data. RESULTS: A total of 1061 DEGs were identified between C3H and rd1 group. Co-expression network was constructed with 313 PARP1-gene co-expression pairs. The down-regulated DEGs were closely related to visual perception and light stimulus-related biological process, while the up-regulated DEGs were significantly enriched in phototransduction and PPAR signaling pathway. PPI network was constructed with 202 nodes and 375 edges, which was clustered into 3 modules. Module 1 genes were closely related to detection of light stimulus, visual perception related biological process and phototransduction pathway (involved with Gnat1/Guca1b/Gnat2/Sag/Pde6g). By integrated analysis of the RNA-seq and ATAC-seq, the overlapped up-regulated genes were Asxl3 and Nyap2, while the down-regulated genes were Tmem136 and Susd3. CONCLUSION: Gnat1 may play a key role in RP development by interacting with PARP1. Susd3 may play a regulatory role in PARP1 expression and affect RP formation.

Heterogeneous components of lung adenocarcinomas confer distinct EGFR mutation and PD-L1 expression.

BACKGROUND: Lung adenocarcinoma (LAC) is composed of lepidic, papillary, mucinous, micropapillary and solid components in its parenchyma. Complex responses to therapeutics result from intratumoral heterogeneity. However, it remains confused that what components in a mixed LAC tumor are responsible to the heterogeneous EGFR mutation and PD-L1 expression. METHODS: We investigated EGFR status via laser microdissection to capture spatially separated cancer cell subpopulations and digital droplet PCR to determine the abundance of EGFR sensitizing mutation and naïve T790M. Whilst, PD-L1 expression level via tumor proportion score (TPS) was evaluated by Ventana immunohistochemistry using SP263 antibody. PD-L1 expression levels were tiered in < 1, 1-49% and > =50% groups. RESULTS: EGFR mutation harbored in 154 (59%) of 261 LAC patients and more frequently occurred in papillary, lepidic and micropapillary constituents. Higher levels of PD-L1 were found in LACs at stage III and IV (68.3%) versus those at stage I and II (31.7%) (P = 0.04). Solid predominant LACs (41.3%) expressed PD-L1 with TPS > =50%, versus mucinous and lepidic LACs (P < 0.01). LACs with solid constituents also had more positive proportion of PD-L1 protein. Cut-offs < 1, 1-49% or > =50% were associated with patients' progression-free survival and longer in the < 1% group (22.9 month, 95% CI 17.6-28.2) (P < 0.05). LACs consisting of two constituents with PD-L1 TPS < 1% had a better prognosis than the groups with single component and more than two components (P < 0.05). Eighteen LACs (6.9%) had concomitantly deletion in exon 19 or L858R and naïve T790M mutation. The abundance of T790M varied diversely with sensitizing mutation. PD-L1 expression was not concordant in same components and usually negative in the EGFR-mutated constituents. Heterogeneous PD-L1 expression occurred in the vicinity of stromal tissues. 58.8, 29.4 and 11.8% in ALK positive LACs (N = 17) were found PD-L1 expression via cutoffs of < 1, 1-49% and > =50%, respectively (P > 0.05). CONCLUSION: Intratumoral genetic heterogeneity of LACs was demonstrated associated with histological patterns. Heterogeneous PD-L1 expression in higher level usually occurred in solid component both in EGFR mutated and EGFR wild-typed LACs. EGFR mutated LACs heterogeneously had sensitizing and resistant mutation and was accompanied with PD-L1 expression, but discordant among histological constituents. Immune checkpoint inhibitor combined with third generation EGFR tyrosine kinase inhibitor should be more effective to these LACs.

MUC5AC enhances tumor heterogeneity in lung adenocarcinoma with mucin production and is associated with poor prognosis.

OBJECTIVE: The clinicopathological significance of Mucin5AC (MUC5AC) in lung adenocarcinoma with mucin production is still unclear. This study aimed to explore MUC5AC expression in lung adenocarcinoma with mucin production and its correlation with histological subtypes, common driver mutations and its impact on prognosis. METHODS: MUC5AC and thyroid transcription factor 1 immunohistochemistry was performed on surgical samples from 90 patients with lung adenocarcinoma with mucin production. Common driver mutations including EGFR and KRAS mutations and ALK rearrangement were detected by established methods. RESULTS: MUC5AC was significantly associated with lymphovascular invasion (P = 0.023) and tumors with intra-cytoplasmic mucin (P < 0.001). Moreover, MUC5AC was more significant in invasive mucinous adenocarcinoma (P < 0.001), as well as in tumors with KRAS mutations (P = 0.005) and a lack of thyroid transcription factor 1 expression (P < 0.001). Conversely, MUC5AC was less significantly detected in acinar predominant adenocarcinoma (P = 0.036) and tumors with EGFR mutations (P = 0.001). Notably, MUC5AC in non-pure mucinous subtype of lung adenocarcinoma with mucin production showed more aggressive behavior, distinct expression pattern and a lack of significant correlation with thyroid transcription factor 1 (P = 0.113) when compared with pure mucinous subtype. MUC5AC-positive tumors were significantly associated with a worse prognosis compared to MUC5AC-negative tumors (P < 0.001). A multivariate survival analysis showed that MUC5AC was an independent prognosis factor for poor prognosis (P = 0.006). CONCLUSIONS: The clinicopathological features of non-pure mucinous subtype of lung adenocarcinoma with mucin production were distinct and should be distinguished from pure mucinous subtype. MUC5AC was associated with poor prognosis and could be a potential therapeutic target for this distinct type of lung adenocarcinoma that has few effective treatments.

Photo-irradiated E/Z isomerization reaction of star-shaped isomers containing two cyanostilbene arms with charge transfer excited states.

The E/Z isomerization reaction of the multi-cyanostilbene molecule is still not clear. Herein, we have designed and synthesized three star-shaped molecular isomers with a triphenylamine core linked to two cyanostilbene groups with E/Z isomerization, Z,Z-TPDCF, Z,E-TPDCF and E,E-TPDCF, possessing three different isomeric molecular configurations, to investigate the specific E/Z isomerization reaction of the cyanostilbene groups in the two molecular arms. The in situ UV, 1H NMR and HPLC spectra under UV-irradiation clearly showed that the E/Z isomerization reactions of both E,E-TPDCF and Z,Z-TPDCF firstly turned them into Z,E-TPDCF, and the Z,E-TPDCF was almost simultaneously turned into more E,E-TPDCF and less Z,Z-TPDCF due to the calculated lowest unoccupied molecular orbitals of Z,E-TPDCF on the cyanostilbene arm with the Z-configuration. In general, Z,E-TPDCF exhibited a relatively better configurational stability than Z,Z-TPDCF or E,E-TPDCF under the photo-irradiation conditions. Further research demonstrated that all three isomers exhibited excellent aggregation-induced emission (AIE) properties.

Multi-color electrochromism containing green color based on electrochemically polymerized star-shaped phenyl bithiophene.

A star-shaped thiophene derivative, namely PHBT, consisting of one central core of phenyl and three arms of bithiophene, was newly synthesized and characterized, in order to further investigate the relationship between the star-shaped monomer structure (central core and peripheral arm) and the polymeric electrochromic properties. Then it was further successfully prepared into the corresponding cross-linked polymer pPHBT via electrochemical polymerization. After applying positive voltage, pPHBT exhibited excellent electrochromic properties with surprising multi-color changes between three colors, orange-yellow, green and blue, and a fast color switching speed. Furthermore, electronic structure, cyclic voltammetry and electrochromic results of pPHBT can contribute much to explain the electrochromic behavior of pTPABT with the triphenylamine core and the quadruple thiophene arm. The electrochromism of pTPABT might consist of two parts derived from the oxidative states of triphenylamine and quadruple thiophene groups, respectively. This offers a new insight into the electrochromism mechanics of conjugated polymers.

ERPs and oscillations during encoding predict retrieval of digit memory in superior mnemonists.

Previous studies have consistently demonstrated that superior mnemonists (SMs) outperform normal individuals in domain-specific memory tasks. However, the neural correlates of memory-related processes remain unclear. In the current EEG study, SMs and control participants performed a digit memory task during which their brain activity was recorded. Chinese SMs used a digit-image mnemonic for encoding digits, in which they associated 2-digit groups with images immediately after the presentation of each even-position digit in sequences. Behaviorally, SMs' memory of digit sequences was better than the controls'. During encoding in the study phase, SMs showed an increased right central P2 (150-250ms post onset) and a larger right posterior high-alpha (10-14Hz, 500-1720ms) oscillation on digits at even-positions compared with digits at odd-positions. Both P2 and high-alpha oscillations in the study phase co-varied with performance in the recall phase, but only in SMs, indicating that neural dynamics during encoding could predict successful retrieval of digit memory in SMs. Our findings suggest that representation of a digit sequence in SMs using mnemonics may recruit both the early-stage attention allocation process and the sustained information preservation process. This study provides evidence for the role of dynamic and efficient neural encoding processes in mnemonists.

[Clinicopathological features of lung adenocarcinoma harboring anaplastic lymphoma kinase rearrangements].

OBJECTIVE: To analyze the clinicopathological characteristics of patients with anaplastic lymphoma kinase (ALK) rearrangements in lung adenocarcinoma, and the clinical therapy and prognosis of the patients. METHODS: Clinicopathological data of 34 cases of ALK-positive patients treated in the Beijing Chest Hospital from 2005 to 2014 were reviewed. The expression of ALK proteins in the resected tumors was detected by immunohistochemistry, and EGFR mutations were examined by polymerase chain reaction and a direct DNA sequencing method. RESULTS: Among the 34 patients, 20 were male and 14 were female, the median age was 49, and 11 were smokers and 23 were never smokers. The clinical stages of the patients were stage IA in 5 patients, IB in one patient, IIA in two patients, IIIA in 16 patients, IIIB in 5 patients, IV in 4 patients, and one patient of unknown stage. ALK-positive tumors showed strong granular staining in cell cytoplasm by immunohistochemistry. Forteen patients were solid predominant subtype with mucin production, 10 of acinar predominant subtype, 6 of papillary predominant subtype, 3 of micropapillary predominant subtype, and one was of colloid variant. There were 18 cases with mucin production, 6 cases had signet-ring cell morphology, and 10 cases showed cribriform pattern. Only one patient had coexistence of ALK rearrangement and EGFR mutation (L858R at exon 21). Of the 34 patients, 24 patients were followed up. The median follow up of the 24 patients was 11.0 months (1.7-48.7 months). CONCLUSIONS: ALK-positive tumors as a molecular subtype of lung adenocarcinoma have distinct clinicopathological features. The histological findings of ALK-positive tumors are characterized by solid predominant subtype with mucin production, acinar predominant subtype, signet-ring cells and cribriform structures. They were rarely co-mutated with EGFR mutation.

[Relationship between expression of anaplastic lymphoma kinase in pleural effusion and clinicopathological features of patients with lung adenocarcinoma and the response to crizotinib].

OBJECTIVE: To explore the expression of anaplastic lymphoma kinase (ALK) protein in pleural effusion cells from patients with lung adenocarcinoma and to investigate the relationship between ALK status and the clinicopathological features, and the response to crizotinib. METHODS: Eighty-five cases were reviewed from Sept. 2013-Nov. 2014 at Beijing Chest Hospital. There were 42 males and 43 females, with a median age of 58 (30-87). ALK rearrangements were screened by using immunohistochemistry on Benchmark XT auto-stainer. RESULTS: The frequency of ALK positive reactivity was 15.3% among the 85 patients. The incidence of ALK expression was more frequent in patients <60 years as compared with patients ≥ 60 years of age (26.1%, 2.6%, χ² =9.015, P=0.002). Among the ALK-positive patients, 8 were males and 5 were females (19.1%, 11.6%, χ² =0.903, P=0.259). There were 8 never-smokers and 5 smokers harboring ALK rearrangement (17.0%, 13.5%, χ²=0.379, P=0.827). Among patients with ALK rearrangement, 6 received EGFR detection, and 5 showed no EGFR mutation, and 1 showed 19del EGFR mutation. Among the 13 ALK-positive patients, 4 received crizotinib therapy, and all showed partial response. CONCLUSION: Patients with lung adenocarcinoma with ALK rearrangement were significantly younger than those with ALK wild-type, and ALK rearrangement was rarely concur with EGFR mutation. Screening ALK fusion protein expression in patients with lung adenocarcinoma by paraffin-embedded sediments of pleural effusion was useful in guide of crizotinib therapy.

Counteracting sexual and reproductive health misperceptions: Investigating the roles of stigma, misinformation exposure, and information overload.

OBJECTIVE: Sexual and reproductive health (SRH) misperceptions constitute a critical precursor to undesired health outcomes for women. Drawing on the model of stigma management communication and exposure effects, we aimed to investigate the underlying processes of SRH misperceptions. METHODS: A nationwide survey was conducted via quota sampling with Chinese women (N = 1000). Structural equation modeling with maximum likelihood estimation and 5000 bootstrapping resamples were used to test the hypotheses. RESULTS: Stigma perceptions positively predicted information avoidance (ß = 0.207, p < 0.001), which, in turn, was positively associated with misperceptions (ß = 0.195, p < 0.001). Misinformation exposure significantly predicted misperceptions (ß = 0.607, p < 0.001), and this relationship was mediated by information avoidance (ß = 0.020, 95% CI [0.007, 0.040]). Moreover, information overload strengthened the relationship between misinformation exposure and information avoidance (ß = 0.153, p < 0.001) as well as the relationship between misinformation exposure and misperceptions (ß = 0.077, p = 0.006). CONCLUSION: Stigma and misinformation exposure play prominent roles in the formation of SRH misperceptions. Information overload facilitates the misinformation-misperception transformation. PRACTICE IMPLICATIONS: To counteract SRH misperceptions, health education should alleviate SRH stigma perceptions and strategically design messages to avoid information avoidance and overload.

Alterations of functional brain activity and connectivity in female nurses working on long-term shift.

AIM: To investigate the alterations of functional brain activity and connectivity in female nurses working on long-term shifts and explore their correlations with work-related psychological traits. DESIGN: An exploratory cross-sectional study. METHODS: Thirty-five female nurses working on long-term shifts (shift nurses) and 35 female nurses working on fixed days (fixed nurses) were enrolled. After assessing the work-related psychological traits, including burnout, perceived stress, anxiety, and depression of nurses, the fractional amplitude of low-frequency fluctuations (fALFF) and region of interest (ROI)-based functional connectivity (FC) analyses were performed to investigate the differences of brain spontaneous activity and functional connectivity between these two groups of nurses. Thereafter, correlations between the functional brain parameters (fALFF and FC) and clinical metrics were investigated among the shift nurses. RESULTS: Compared to fixed nurses, shift nurses had higher burnout, perceived stress and depression scores, lower fALFF in the right dorsolateral prefrontal cortex (dlPFC), left and right superior parietal lobule (SPL), bilateral anterior cingulate cortex (ACC), and higher fALFF in the right superior/middle temporal gyrus, as well as decreased FC between the right dlPFC (the selected ROI) and bilateral ACC, left and right inferior frontal/orbitofrontal gyrus (IFG/IOFG), right SPL, and left middle occipital gyrus (voxel-level p < 0.001, cluster level p < 0.05, GRF correction). Correlation analyses demonstrated that the fALFF value of the right dlPFC was significantly correlated with the burnout and anxiety scores, the FC value of the right dlPFC-right SPL was correlated with the perceived stress and burnout scores, the FC value of the right dlPFC-right IFG/IOFG was correlated with the burnout score in shift nurses (p < 0.05). CONCLUSION: Shift nurses had work-related altered functional activity and connectivity in the right frontoparietal network, which provided objective and visualised evidence to clarify the hazards of long-term shift work on female nurses. PATIENT OR PUBLIC CONTRIBUTION: Seventy nurses participated deeply as subjects in this study. These findings are expected to draw managers' attention to the harmful influences of shift work on nurses.