ICU Nurses' Perception of Sensitive Indicators of Quality of Care for ECMO Patients in Guizhou Province, China: A Cross-Sectional Study.

Purpose: This study aimed to investigate the cognitive evaluation level of ICU nurses in Guizhou Province, China, on the sensitivity indicators of nursing quality for ECMO patients. Patients and Methods: This was a cross-sectional observational study conducted in Guizhou Province, China, from May to July 2023, 259 ICU nurses were surveyed. Objective sampling method was used to select the participants from 10 hospitals in Guizhou Province that carried out ECMO. Data were collected through questionnaire survey. Two researchers checked and recorded Epidata 3.1. SPSS 25.0 was used for statistical analysis of the data, and frequency, mean and component ratio were used for descriptive statistical analysis. The importance rating was used to reflect the degree of nurses' agreement with the indicators. Results: The results of this study showed that 79.1% of the 253 ICU nurses in Guizhou Province, China, had not participated in training and courses related to indicators of quality of care evaluation for ECMO patients. The main way for ICU nurses to acquire knowledge related to indicators of quality of care sensitivity for ECMO patients was departmental training, which accounted for 87.4%. And the other ways, in descending order, were public, the matic lectures or academic conferences, journals and magazines; their evaluation scores of the importance of most of the quality of care sensitivity indicators for ECMO patients was moderate, with the scores ranging from 73 to 150. Among them, the range of importance evaluation scores for each indicator was 4.01 ~ 4.48. Conclusion: The overall cognitive evaluation of ICU nurses in Guizhou Province, China, on most sensitivity indicators of quality of care for ECMO patients was moderate, and there is a general lack of systematic courses and training on the knowledge related to ECMO care quality sensitive indicators.

Characterization, hazard identification, and risk assessment of volatile organic compounds in Poly(butylene adipate-co-terephthalate)-based food contact articles.

The chemical safety of poly (butylene adipate-co-terephthalate) (PBAT) based food contact articles (FCAs) has aroused increasing toxicological concerns in recent years, but the chemical characterization and associated risk assessment still remain inadequate as it fails to elucidate the distribution pattern and discern the potential genotoxic and carcinogenic hazards of the identified substances. Herein, the volatile organic compounds (VOCs) in 50 batches of PBAT-based FCAs of representative categories and 10 batches of PLA and PBAT pellets were characterized, by which 237 VOCs of 10 chemical categories were identified and exhibited characteristic distribution patterns in the chemical spaces derived from their molecular descriptors. Chemical hazards associated with the identified VOCs were discerned by a hazard-driven classification scheme integrating hazard-related knowledge from multiple publicly available sources, and 34 VOCs were found to bear genotoxic or carcinogenic hazards and to feature higher average molecular weight than the other VOCs. Finally, the Risk and hazard quotient (HQ) calculated as the metrics of risk suggested that all identified VOCs posed acceptable risks (Risk<10-4 or HQ < 1), whereas oxolane, butyrolactone, N,N-dimethylacetamide, 2-butoxyethanol, benzyl alcohol, and 1,2,3-trichloropropane posed non-negligible (Risk>10-6) genotoxic or carcinogenic risk and thus should be of prioritized concern to promote the chemical safety of PBAT-based FCAs.

Spatiotemporal observations of host-pathogen interactions in mucosa during SARS-CoV-2 infection indicate a protective role of ILC2s.

IMPORTANCE: Our study revealed the spatial interaction between humanized ACE2 and pseudovirus expressing Spike, emphasizing the role of type 2 innate lymphoid cells during the initial phase of viral infection. These findings provide a foundation for the development of mucosal vaccines and other treatment approaches for both pre- and post-infection management of coronavirus disease 2019.

CircularRNA Hsa_circ_0093335 promotes hepatocellular carcinoma progression via sponging miR-338-5p.

Circular RNAs play an important role in the development of various malignancies, including hepatocellular carcinoma (HCC). Nevertheless, the role of Hsa_circ_0093335 (circ0093335) in HCC has not yet been explored. To investigate the biological effects and molecular mechanisms of circ0093335 on HCC. Circ0093335 expression was detected in HCC cells and clinical specimens using qRT-PCR. The association between circ0093335 expression and HCC patients' clinical characteristics was determined using SPSS. The role of circ0093335 in HCC was estimated by overexpression and knockdown experiments in vitro and in vivo. qRT-PCR, nucleoplasma separation assay, FISH assay, RIP, dual luciferase reporter assay and rescue assay were used to validate the regulatory effect of circ0093335 on miR-338-5p. The study findings showed that circ0093335 was upregulated in HCC. High circ0093335 expression was linked with the tumour-node-metastasis stage and microvascular tumour invasion. circ0093335 is greatly involved in HCC cell proliferation, aggressive ability and mouse tumour growth, according to many in vitro and in vivo tests. Mechanistically, circ0093335 downregulated miR-338-5p expression by sponging, consequently promoting HCC progression. Our research indicated that circ0093335 might be a target for HCC therapy since it promotes tumour progression by acting as a miR-338-5p 'sponge'.

[Spherical amino-functionalized covalent organic frameworks: Synthesis and adsorption performance toward perfluorinated compounds].

Perfluorinated compounds (PFCs) are widely used in textiles, fire protection, metal electroplating, and semiconductor production owing to their hydrophobic and oil-repellent characteristics. However, they are also persistent organic pollutants. The uncontrolled discharge of PFCs into the environment has led to serious global pollution. PFCs pose severe reproductive, neural, immune, and other threats to human health by accumulating through the food chain. Thus, the development and application of high-performance extraction materials has become a research hotspot in efforts to achieve the accurate detection of trace PFCs in environmental waters. Most traditional PFC adsorbents present a number of disadvantages, such as low adsorption selectivity, slow diffusion, and poor reusability. Covalent organic frameworks (COFs) are crystalline polymers with ordered porous structures, large specific surface areas, and high chemical and thermal stability. These frameworks can easily be functionalized for the desired purpose. In this paper, spherical amino-functionalized COFs (denoted COF-NH2) were fabricated via a two-step method to effectively enrich/remove PFCs from water. First, vinyl covalent organic framework (Vinyl COF) was synthesized at room temperature using 1,4-diradical-2,5-divinylbenzene (Dva) and 1,3,5-tris(4-aminophenyl)benzene (Tab) as building blocks. Then, thioether-bridged aromatic amine-functionalized spherical COF-NH2 was synthesized through a thiol-alkenyl click reaction using 4-aminothiophenol as the functional monomer. COF-NH2 showed good dispersion in water owing to its abundant amino groups, forming multiple hydrogen bonds with the F atoms of PFCs. The synergistic hydrophobic interactions between the organic skeleton of the COF and alkyl carbon chains of the PFCs led to enhanced adsorption efficiency. The produced Vinyl COF and COF-NH2 were characterized by Fourier transform infrared spectroscopy (FT-IR), field-emission scanning electron microscopy (SEM), powder X-ray diffraction (PXRD), thermogravimetric analysis (TGA), and Brunner-Emmet-Teller (BET) measurements. The results confirmed that spherical COF-NH2 materials with a homogeneous size distribution were successfully fabricated. The obtained COF-NH2 microspheres had a diameter of approximately 500 nm and exhibited high thermal stability as well as a large specific surface area and pore volume. The adsorption kinetics, isotherm adsorption models, pH effects, and regeneration properties of COF-NH2 were also investigated, and the results indicated that the adsorption of PFCs by COF-NH2 conformed to the pseudo-second-order kinetic and Langmuir isotherm adsorption models. The obtained COF-NH2 microspheres can be applied over a wide pH range, and the best adsorption effect was achieved in neutral and alkaline environments. After five cycles of regeneration and reuse, the COF-NH2 microspheres retained their good adsorption efficiency for PFCs. The adsorption mechanism was mainly attributed to the synergistic effect of hydrogen bonding and hydrophobic interactions between COF-NH2 and the PFCs. The extraction efficiencies of the microspheres toward five PFCs (perfluorobutyric acid, perfluorovaleric acid, perfluorohexanoic acid, perfluorooctanoic acid, and perfluorononanoic acid) in tap and Pearl River water samples were between 91.76% and 98.59%, with relative standard deviations (RSDs) (n=3) varying from 0.82% to 3.8%; these findings indicate that the obtained COF-NH2 is promising for the extraction of PFCs from complex water samples. Given their uniform size distribution, high thermal stability, good adsorption performance, and reusability, the novel spherical COF-NH2 materials developed in this study may be used as solid-phase extraction materials or filled into liquid chromatographic columns for the enrichment, separation, and detection of PFCs in complex samples.

"Two-in-one" dual-function luminescent MOF hydrogel for onsite ultra-sensitive detection and efficient enrichment of radioactive uranium in water.

In consideration of the severe hazards of radioactive uranium pollution and the growing demand of uranium resources, the novel sensor/adsorbent composite was creatively developed to integrate the dual functions for on-site detection of uranium contamination and efficient recovery of uranium resources. By hybridizing the luminescent 3D terbium (III) metal-organic framework (Tb-MOF) with sodium alginate (SA) gel using terbium (III) as cross-linker, the Tb-MOF/Tb-AG was fabricated with multi-luminescence centers and sufficient binding sites for uranium. Notably, the ultra-high sensitivity with detection limit as low as 1.2 ppt was achieved, which was 4 orders of magnitude lower than the uranium contamination standard in drinking water (USEPA) and even comparable to the sensitivity of the ICP-MS. Furthermore, the very wide quantification range (1.0 ×10-9-5.0 ×10-4 mol/L), remarkable adsorption capacity (549.0 mg/g) and outstanding anti-interference ability have been achieved without sophisticated sample preparation procedures. Applied in complex natural water samples from Uranium Tailings and the Pearl River, this method has shown good detection accuracy. The ultra high sensitivity and great adsorption capacity for uranium could be ascribed to the synergistic coordination, hydrogen bonding and ion exchange between uranium and Tb-MOF/Tb-AG. The mechanisms were explored by infrared spectroscopy, batch experiments, X-ray photoelectron studies and energy dispersive spectroscopic studies. In addition, the Tb-MOF/Tb-AG can be reused for uranium adsorption.

Novel biocompatible and sensitive visual sensor based on aggregation-induced emission for on-site detection of radioactive uranium in water and live cell imaging.

In consideration of the severe hazards of radioactive uranium pollution, the rapid assessment of uranium in field and in vivo are urgently needed. In this work a novel biocompatible and sensitive visual fluorescent sensor based on aggregation-induced emission (AIE) was designed for onsite detection of UO22+ in complex environmental samples, including wastewater from Uranium Plant, river water and living cell. The AIE-active sensor (named as TPA-SP) was prepared with a "bottom-up" strategy by introducing a trianiline group (TPA) with a single-bond rotatable helix structure into the salicylaldehyde Schiff-base molecule. The photophysical properties, cytotoxicity test, recognition mechanism and the analytical performance for the detection of UO22+ in actual water samples and cell imaging were systematically investigated. TPA-SP exhibited high sensitivity and selectivity toward UO22+ as well as outstanding anti-interference ability against large equivalent of different ions in a wide effective pH range. A good linear relationship in the UO22+ concentration range of 0.05-1 µM was obtained with a low limit of detection (LOD) of 39.4 nM (9.38 ppb) for uranium detection. The prepared visual sensor showed great potential for fast risk assessment of uranium pollution in environmental systems. In addition, our results also indicated that the TPA-SP exhibited very low cytotoxicity in cells and demonstrated great potential for uranium detection in vivo.

Cellular basis of enhanced humoral immunity to SARS-CoV-2 upon homologous or heterologous booster vaccination analyzed by single-cell immune profiling.

SARS-CoV-2 vaccine booster dose can induce a robust humoral immune response, however, its cellular mechanisms remain elusive. Here, we investigated the durability of antibody responses and single-cell immune profiles following booster dose immunization, longitudinally over 6 months, in recipients of a homologous BBIBP-CorV/BBIBP-CorV or a heterologous BBIBP-CorV/ZF2001 regimen. The production of neutralizing antibodies was dramatically enhanced by both booster regimens, and the antibodies could last at least six months. The heterologous booster induced a faster and more robust plasmablast response, characterized by activation of plasma cells than the homologous booster. The response was attributed to recall of memory B cells and the de novo activation of B cells. Expanded B cell clones upon booster dose vaccination could persist for months, and their B cell receptors displayed accumulated mutations. The production of antibody was positively correlated with antigen presentation by conventional dendritic cells (cDCs), which provides support for B cell maturation through activation and development of follicular helper T (Tfh) cells. The proper activation of cDC/Tfh/B cells was likely fueled by active energy metabolism, and glutaminolysis might also play a general role in promoting humoral immunity. Our study unveils the cellular mechanisms of booster-induced memory/adaptive humoral immunity and suggests potential strategies to optimize vaccine efficacy and durability in future iterations.

Clinical risk score for early prediction of recurring SARS-CoV-2 positivity in non-critical patients.

Introduction: Recurrent positive results in quantitative reverse transcriptase-PCR (qRT-PCR) tests have been commonly observed in COVID-19 patients. We aimed to construct and validate a reliable risk stratification tool for early predictions of non-critical COVID-19 survivors' risk of getting tested re-positive within 30 days. Methods: We enrolled and retrospectively analyzed the demographic data and clinical characters of 23,145 laboratory-confirmed cases with non-critical COVID-19. Participants were followed for 30 days and randomly allocated to either a training (60%) or a validation (40%) cohort. Multivariate logistic regression models were employed to identify possible risk factors with the SARS-CoV-2 recurrent positivity and then incorporated into the nomogram. Results: The study showed that the overall proportion of re-positive cases within 30 days of the last negative test was 24.1%. In the training cohort, significantly contributing variables associated with the 30-day re-positivity were clinical type, COVID-19 vaccination status, myalgia, headache, admission time, and first negative conversion, which were integrated to build a nomogram and subsequently translate these scores into an online publicly available risk calculator (https://anananan1.shinyapps.io/DynNomapp2/). The AUC in the training cohort was 0.719 [95% confidence interval (CI), 0.712-0.727] with a sensitivity of 66.52% (95% CI, 65.73-67.30) and a specificity of 67.74% (95% CI, 66.97-68.52). A significant AUC of 0.716 (95% CI, 0.706-0.725) was obtained for the validation cohort with a sensitivity of 62.29% (95% CI, 61.30-63.28) and a specificity of 71.26% (95% CI, 70.34-72.18). The calibration curve exhibited a good coherence between the actual observation and predicted outcomes. Conclusion: The risk model can help identify and take proper management in high-risk individuals toward the containment of the pandemic in the community.

Paternal exposure to microcystin-LR induces fetal growth restriction partially through inhibiting cell proliferation and vascular development in placental labyrinth.

Microcystin-leucine arginine (MC-LR) has reproductive and developmental toxicities. Previous studies indicated that gestational exposure to MC-LR induced fetal growth restriction in mice. The aim of this study was to further evaluate the effect of paternal MC-LR exposure before mating on fetal development. Male mice were intraperitoneally injected with either normal saline or MC-LR (10 µg/kg) daily for 35 days. Male mouse was then mated with female mice with 1:1 ratio. There was no significant difference on the rates of mating and pregnancy between MC-LR-exposed male mice and controls. Body weight and crown-rump length were reduced in fetuses whose fathers were exposed to MC-LR. Despite no difference on relative thickness of labyrinthine layer, cell proliferation, as measured by Ki67 immunostaining, was reduced in labyrinth layer of MC-LR-exposed mice. Moreover, blood sinusoid area in labyrinth layer was decreased in the fetus whose father was exposed to MC-LR before mating. Correspondingly, cross-sectional area of CD34-positive blood vessel in labyrinth layer was lower in fetuses whose fathers were exposed to MC-LR than in controls. These results provide evidence that paternal MC-LR exposure before mating induces fetal growth restriction partially through inhibiting cell proliferation and vascular development in labyrinth layer.

A Critical Role of Peptidylprolyl Isomerase A Pseudogene 22/microRNA-197-3p/Peptidylprolyl Isomerase A Axis in Hepatocellular Carcinoma.

The burden of hepatocellular carcinoma (HCC) worldwide is increasing over time, while the underlying molecular mechanism of HCC development is still under exploration. Pseudogenes are classified as a special type of long non-coding RNAs (lncRNAs), and they played a vital role in regulating tumor-associated gene expression. Here, we report that a pseudogene peptidylprolyl isomerase A pseudogene 22 (PPIAP22) and its parental gene peptidylprolyl isomerase A (PPIA) were upregulated in HCC and were associated with the clinical outcomes of HCC. Further investigation revealed that PPIAP22 might upregulate the expression of PPIA through sponging microRNA (miR)-197-3p, behaving as competing endogenous RNA (ceRNA). PPIA could participate in the development of HCC by regulating mRNA metabolic process and tumor immunity based on the functional enrichment analysis. We also found a strong correlation between the expression levels of PPIA and the immune cell infiltration or the expression of chemokines, especially macrophage, C-C motif chemokine ligand 15 (CCL15), and C-X-C motif chemokine ligand 12 (CXCL12). Our findings demonstrate that the PPIAP22/miR-197-3p/PPIA axis plays a vital role in the progression of HCC by increasing the malignancy of tumor cells and regulating the immune cell infiltration, especially macrophage, through CCL15-CCR1 or CXCL12-CXCR4/CXCR7 pathways.

Microcystin-LR inhibits testosterone synthesis via reactive oxygen species-mediated GCN2/eIF2α pathway in mouse testes.

Previous studies demonstrated that microcystin-leucine-arginine (MC-LR) disrupted testosterone (T) synthesis, but the underlying mechanisms are not entirely elucidated. This study aims to explore the role of reactive oxygen species (ROS)-mediated GCN2/eIF2α activation on MC-LR-induced disruption of testicular T synthesis. Male mice were intraperitoneally injected with MC-LR (0 or 20 µg/kg) daily for 5 weeks. Serum T was decreased in MC-LR-exposed mice (0.626 ± 0.122 vs 24.565 ± 8.486 ng/ml, P < 0.01), so did testicular T (0.667 ± 0.15 vs 8.317 ± 1.387 ng/mg protein, P < 0.01). Steroidogenic proteins including StAR, CYP11A1 and CYP17A1 were downregulated in MC-LR-exposed mouse testes and TM3 cells. Mechanistically, p-GCN2 and p-eIF2α were elevated in MC-LR-exposed TM3 cells. GCN2iB attenuated MC-LR-induced GCN2 and eIF2α phosphorylation in TM3 cells. Moreover, GCN2iB attenuated MC-LR-induced downregulation of steroidogenic proteins in TM3 cells. Further analysis found that cellular ROS were elevated and HO-1 was upregulated in MC-LR-exposed TM3 cells. PBN rescued MC-LR-induced activation of GCN2/eIF2α signaling in TM3 cells. Additionally, pretreatment with PBN attenuated MC-LR induced downregulation of steroidogenic proteins and synthases in TM3 cells. These results suggest that ROS-mediated GCN2/eIF2α activation contributes partially to MC-LR-caused downregulation of steroidogenic proteins and synthases. The present study provides a new clue for understanding the mechanism of MC-LR-induced endocrine disruption.

Association of coagulation dysfunction with cardiac injury among hospitalized patients with COVID-19.

Cardiac injury is a common complication of the coronavirus disease 2019 (COVID-19), and is associated with adverse clinical outcomes. In this study, we aimed to reveal the association of cardiac injury with coagulation dysfunction. We enrolled 181 consecutive patients who were hospitalized with COVID-19, and studied the clinical characteristics and outcome of these patients. Cardiac biomarkers high-sensitivity troponin I (hs-cTnI), myohemoglobin and creatine kinase-myocardial band (CK-MB) were assessed in all patients. The clinical outcomes were defined as hospital discharge or death. The median age of the study cohort was 55 (IQR, 46-65) years, and 102 (56.4%) were males. Forty-two of the 181 patients (23.2%) had cardiac injury. Old age, high leukocyte count, and high levels of aspartate transaminase (AST), D-dimer and serum ferritin were significantly associated with cardiac injury. Multivariate regression analysis revealed old age and elevated D-dimer levels as being strong risk predictors of in-hospital mortality. Interleukin 6 (IL6) levels were comparable in patients with or without cardiac injury. Serial observations of coagulation parameters demonstrated highly synchronous alterations of D-dimer along with progression to cardiac injury. Cardiac injury is a common complication of COVID-19 and is an independent risk factor for in-hospital mortality. Old age, high leukocyte count, and high levels of AST, D-dimer and serum ferritin are significantly associated with cardiac injury, whereas IL6 are not. Therefore, the pathogenesis of cardiac injury in COVID-19 may be primarily due to coagulation dysfunction along with microvascular injury.

Reactive oxygen species-evoked genotoxic stress mediates arsenic-induced suppression of male germ cell proliferation and decline in sperm quality.

This study aimed to investigate whether genotoxic stress mediates arsenic (As)-induced decline in sperm quality. Mice drank ultrapure water containing NaAsO2 (15 mg/L) for 70 days. The mature seminiferous tubules and epididymal sperm count were reduced in As-exposed mice. Cell proliferation, determined by immunostaining with Ki67, was suppressed in As-exposed seminiferous tubules and GC-1 cells. PCNA, a proliferation marker, was reduced in As-exposed mouse testes. Cell growth index was decreased in As-exposed GC-1 cells. Flow analysis showed that As-exposed GC-1 cells were retarded at G2/M phase. CDK1 and cyclin B1 were reduced in As-exposed GC-1 cells and mouse testes. Additional experiment revealed that p-ATR, a marker of genotoxic stress, was elevated in As-exposed mouse testes and GC-1 cells. Accordingly, p-p53 and p21, two downstream molecules of ATR, were increased in As-exposed GC-1 cells. Excess reactive oxygen species (ROS), measured by immunofluorescence, and DNA-strand break, determined by Comet assay, were observed in As-exposed GC-1 cells. γH2AX, a marker of DNA-strand break, was elevated in As-exposed seminiferous tubules and GC-1 cells. NAC alleviated As-evoked DNA damage, genotoxic stress, cell proliferation inhibition and sperm count reduction. In conclusion, ROS-evoked genotoxic stress mediates As-induced germ cell proliferation inhibition and decline in sperm quality.

Practice and prospect of radiotherapy and immunotherapy for lung cancer / 中华放射肿瘤学杂志

In recent years, immunotherapy has become the hottest topic in the field of oncology. Both the Keynote189 study and the Keynote407 study have confirmed that progression-free survival is significantly prolonged in patients who have been benefited from immune checkpoint blockades in lung cancer. In an article published in The New England Journal of Medicine in 2012, a case report of radiation abscopal effects caused by immunization combined with conventional radiotherapy has attracted great attention in the field of oncology. The Pacific study, published in 2017, expanded the indications for immunotherapy from advanced to locally-advanced non-small cell lung cancer. The second analysis of Keynote001, published in the Lancet Oncology in the same year, suggested that radiation therapy may mediate the immune memory effects, whereas the mechanism and time window are still unclear. With the publication of PEMBRO-RT study and several pieces of work by our team in recent years, various details of radiotherapy combined with immunotherapy (iRT) have become more mature. In clinical practice, iRT is involved in the full treatment of lung cancer. However, iRT is not a hodgepodge or stew that needs further refinement and sorting. In this article, the principles, efficacy in clinical practice, and exploration of the details of iRT were discussed.

Hepatitis B Virus-Induced Imbalance of Inflammatory and Antiviral Signaling by Differential Phosphorylation of STAT1 in Human Monocytes.

It is not clear how hepatitis B virus (HBV) modulates host immunity during chronic infection. In addition to the key mediators of inflammatory response in viral infection, monocytes also express a high-level IFN-stimulated gene, CH25H, upon response to IFN-α exerting an antiviral effect. In this study, the mechanism by which HBV manipulates IFN signaling in human monocytes was investigated. We observed that monocytes from chronic hepatitis B patients express lower levels of IFN signaling/stimulated genes and higher levels of inflammatory cytokines compared with healthy donors. HBV induces monocyte production of inflammatory cytokines via TLR2/MyD88/NF-κB signaling and STAT1-Ser727 phosphorylation and inhibits IFN-α-induced stat1, stat2, and ch25h expression through the inhibition of STAT1-Tyr701 phosphorylation and in an IL-10-dependent, partially autocrine manner. Further, we found that enhancement of STAT1 activity with a small molecule (2-NP) rescued HBV-mediated inhibition of IFN signaling and counteracted the induction of inflammatory cytokines. In conclusion, HBV contributes to the monocyte inflammatory response but inhibits their IFN-α/ß responsiveness to impair antiviral innate immunity. These effects are mediated via differential phosphorylation of Tyr701 and Ser727 of STAT1.

Activated NK cells kill hepatic stellate cells via p38/PI3K signaling in a TRAIL-involved degranulation manner.

NK cells are important in regulating hepatic fibrosis via their cytotoxic killing of hepatic stellate cells (HSCs). NK cells are activated by both cytokines such as IL-12 and IL-18, and innate immune stimuli such as ligation of TLRs. The secretion of IL-18 depends upon activation of the inflammasome, whereas TLRs are stimulated by microbial products. In the case of NK cells, IL-18 acts synergistically with stimulation of TLR3 to cause cell activation and cytotoxic function. In the present study, we activated NK cells to kill HSCs via IL-18 and TLR3 ligand stimulation, and dissected the signaling pathways or molecules critical for such activation or killing. We find that such activation depends on signaling via the p38/PI3K/AKT pathway, and that the activated NK cells mediate HSC death in a TRAIL-involved mechanism. As liver fibrosis is a major global health problem with no good solution, these results emphasize that the p38/PI3K/AKT pathway in NK cells may be a novel drug target to promote fibrosis regression.

Development of a Genetic and Clinical Data-Based (GC) Risk Score for Predicting Survival of Hepatocellular Carcinoma Patients After Tumor Resection.

BACKGROUND/AIMS: Carnitine palmitoyltransferase 1A (CPT1A) is a rate-limiting enzyme in the transport of long-chain fatty acids for ß-oxidation. Increasing evidence has indicated that CPT1A plays an important role in carcinogenesis. However, the expression and prognostic value of CPT1A in hepatocellular carcinoma (HCC) have not been extensively studied. METHODS: Here, we collected 66 post-operative liver cancer tissue samples. Gene profile expression was tested by RT-PCR. Receiver operating characteristic (ROC) analysis was performed and multivariate analysis with Cox's Proportional Hazard Model was used for confirming the selected markers' predictive efficiency for HCC patients' survival. A simple risk scoring system was created based on Cox's regression modeling and bootstrap internal validation. RESULTS: Cox multivariate regression analysis demonstrated that CPT1A, tumor size, intrahepatic metastasis, TNM stage and histological grade were independent risk factors for the prognosis of HCC patients after surgery. Our genetic and clinical data-based (GC) risk scoring system revealed that HCC patients whose total score≥3 are more likely to relapse and die than patients whose total score < 3. Finally, the good discriminatory power of our risk scoring model was validated by bootstrap internal validation. CONCLUSIONS: The genetic and clinical data-based risk scoring model can be a promising predictive tool for liver cancer patients' prognosis after operation.

Regulatory NK cells mediated between immunosuppressive monocytes and dysfunctional T cells in chronic HBV infection.

BACKGROUND AND AIMS: HBV infection represents a major health problem worldwide, but the immunological mechanisms by which HBV causes chronic persistent infection remain only partly understood. Recently, cell subsets with suppressive features have been recognised among monocytes and natural killer (NK) cells. Here we examine the effects of HBV on monocytes and NK cells. METHODS: Monocytes and NK cells derived from chronic HBV-infected patients and healthy controls were purified and characterised for phenotype, gene expression and cytokines secretion by flow cytometry, quantitative real-time (qRT)-PCR, ELISA and western blotting. Culture and coculture of monocytes and NK cells were used to determine NK cell activation, using intracellular cytokines staining. RESULTS: In chronic HBV infection, monocytes express higher levels of PD-L1, HLA-E, interleukin (IL)-10 and TGF-ß, and NK cells express higher levels of PD-1, CD94 and IL-10, compared with healthy individuals. HBV employs hepatitis B surface antigen (HBsAg) to induce suppressive monocytes with HLA-E, PD-L1, IL-10 and TGF-ß expression via the MyD88/NFκB signalling pathway. HBV-treated monocytes induce NK cells to produce IL-10, via PD-L1 and HLA-E signals. Such NK cells inhibit autologous T cell activation. CONCLUSIONS: Our findings reveal an immunosuppressive cascade, in which HBV generates suppressive monocytes, which initiate regulatory NK cells differentiation resulting in T cell inhibition.

Risk Factors Associated with Meningitis after Neurosurgery: A Retrospective Cohort Study in a Chinese Hospital.

BACKGROUND: Meningitis is a serious complication occurring after neurosurgical operations, which can result in severe morbidity and high mortality. This retrospective cohort study aimed to determine the risk factors of postoperative meningitis in a large clinical center of neurosurgery in China. METHODS: Patients who underwent a neurosurgical procedure between January 2014 and December 2015 were selected, and 1016 cases were included our final analysis. On the basis of propensity scores, 84 patients with postoperative meningitis were successfully matched to 84 patients without postoperative meningitis. RESULTS: After propensity score matching, age, hospitalization duration, intraoperative use of corticoids, intraoperative use of antibiotics, external ventricular drainage, lumbar drainage, enteral nutrition, duration of surgery, major craniotomy, and transsphenoidal surgery were associated with postoperative meningitis. Furthermore, preoperative use of corticoids, intraoperative use of corticoids, intraoperative use of antibiotics, external ventricular drainage, lumbar drainage, and major craniotomy were independent predictors of postoperative meningitis in propensity score-matched cohort. A prediction model including these 6 independent predictors was established. Finally, receiver operating characteristic curve and discriminant analysis confirmed that this model has strong predictive power for evaluating postoperative meningitis. CONCLUSIONS: The prediction model built in our study can be an excellent tool for predicting meningitis after neurosurgical procedures.