Effectiveness of the frailty index in predicting short-term and long-term mortality risk in patients with chronic heart failure.

OBJECTIVE: This study explored the effectiveness of a newly constructed frailty index (FI) for predicting short-term and long-term mortality in patients with chronic heart failure (HF). MATERIALS AND METHODS: This retrospective study included inpatients aged ≥60 years diagnosed with chronic HF at a teaching hospital in western China. General data on the patients were collected from the electronic medical record system between January 1, 2017, and July 7, 2022, and death information was obtained from follow-up calls made from July 31, 2022, to August 1, 2022. Receiver operating characteristic (ROC) curves were used to analyze the accuracy of the FI in predicting death in patients with chronic HF. Logistic regression (during hospitalization and within 30 days after discharge) and Cox regression (within 180 days after discharge and one year after discharge) analyses were used to assess associations between frailty and mortality risk in elderly patients with chronic HF. RESULTS: A total of 432 patients with chronic HF were included in the study. The non-frail group had FI values <0.3, while the FI values in the frail group were ≥0.3. Overall, 130 patients (30.09 %) were diagnosed with frailty, 66 (15.28 %) died during hospitalization or within 30 days after discharge, 55 (12.73 %) died within 180 days after discharge, and 68 (15.74 %) died within one year after discharge. The in-hospital and 30-day mortality rates, the 180-day mortality rates, and the 1-year mortality rates were higher in frail patients than in non-frail patients (in-hospital and 30-day mortality rates, 37.69 % vs. 5.63 %, P < 0.001; within 180 days, 30.61 % vs. 8.45 %, P < 0.001; within 1 year, 34.69 % vs. 11.49 %, P < 0.001). The area under the curve (AUC) values of FI for predicting in-hospital and 30-day mortality after discharge were 0.804, with values of 0.721 for 180-day mortality after discharge and 0.720 for 1-year mortality after discharge. Logistic regression analysis with adjustment for potential confounders indicated that frail HF patients had a higher risk of death during hospitalization and within 30 days than non-frail patients (odds ratio [OR] = 4.98, 95 % confidence interval [CI]: 2.46-10.09). Cox regression analysis with adjustment for potential confounders showed that frail HF patients had a higher risk of death within 180 days (hazard ratio [HR] = 2.63, 95 %CI: 1.47-4.72) and within 1 year (HR = 2.01, 95 %CI: 1.19-3.38). CONCLUSION: The results of this study showed that the new FI constructed according to the established construction rules could predict the in-hospital mortality and the risk of death within 30 days after discharge, 180 days after discharge, and 1 year after discharge in patients with chronic HF.

Effectiveness of sarcopenia screening markers in predicting out-of-hospital death in the oldest (≥80 years) older.

OBJECTIVE: The goal of this investigation was to elucidate the correlation between sarcopenia screening indicators (aspartate transaminase/alanine transaminase (AST/ALT) and creatinine/cystatin C*100 (Cr/CysC*100)) and the risk of out-of-hospital (OFH) death among the very advanced age (≥80 years) population. METHODS: We conducted a retrospective cohort investigation, involving internal medicine inpatients aged ≥80 years of age, who sought treatment at a teaching hospital in western China. We obtained OFH mortality information from telephonic interviews. Subsequently, we employed Cox proportional hazards models to analyze the links between AST/ALT and Cr/CysC*100 and OFH all-cause mortality among the very advanced age (≥80 years old) population. RESULTS: In all, we recruited 398 subjects, among which 51.51% were male. The median age of OFH deceased male patients was 85 years, and the same for female patients was 87 years. The total quantity of OFH deaths was 164 (41.21%). Among the oldest male population, those who died OFH exhibited enhanced AST/ALT, relative to those who survived (death vs. survival: 1.5 vs 1.3, P=0.008). However, among the oldest female, there was no difference in AST/ALT between patients who expired OFH, and those who survived. Among the oldest elders (male and female), Cr/CysC*100 did not significantly differ between surviving and OFH deceased patients. Additional analysis involving the Cox proportional hazards model revealed that among the oldest male population, an enhanced AST/ALT denoted an augmented risk of OFH death (hazard ratios (HRs) =1.797, 95%CI: 1.2-2.691). However, Cr/CysC*100 was not correlated with OFH mortality risk. Among the oldest female population, neither AST/ALT nor Cr/CysC*100 was correlated with OFH mortality risk. CONCLUSIONS: Enhanced AST/ALT was correlated with an augmented OFH mortality risk among the oldest male, but not female population. Alternately, Cr/CysC*100 was not linked to OFH mortality risk among any population.

The relationship between asymmetrical grip strength criteria and fall incidence among middle-aged and older Chinese adults.

PURPOSE: Current handgrip strength (HGS) protocols employ a variety of criteria, affecting the assessment of asymmetric HGS. The impact of these different criteria on fall prediction is understudied. This study was devised to compare the relative performance of average and maximum HGS asymmetry criteria as tools to predict fall incidence among middle-aged or older adults in China. METHODS: 9627 Chinese adults 50 + years of age who were participants in the China Health and Retirement Longitudinal Study (2013-2015 waves) were evaluated. The measurement of HGS was achieved based on either the maximum recorded value (HGSmax) or the average (HGSave), and these values were employed for the calculation of HGS asymmetry. Fall incidence over a 2-year period was evaluated based on self-reported data. Logistic regression analyses were utilized to determine the predictive performance of HGSmax asymmetry or HGSave asymmetry when gaging 2-year fall risk. RESULTS: Significant differences in overall rates of HGS asymmetry and the rates of subdivisions thereof were observed when comparing the HGSmax and HGSave criteria, with moderate consistency (kappa = 0.599, p < 0.001). Over the 2-year follow-up period, 1743 fall incidents were recorded. Adjusted logistic regression models indicated that only HGSmax asymmetry > 30.0% was significantly related to fall risk (p = 0.034, odds ratio = 1.36, 95% confidence interval: 1.02-1.81). CONCLUSION: These findings highlight the importance of HGS criteria in detecting HGS asymmetry, and suggest that HGSmax is a more robust criterion for predicting fall risk among Chinese adults 50 + years of age.

Suitable ultrasound screening method for older adults with disability to identify low muscle mass.

Objective: This study aimed to investigate the accuracy and consistency of different ultrasound protocols for the measurement of gastrocnemius muscle (GM) thickness and to identify a suitable ultrasound scheme that can be used to detect the low muscle mass in older with disability. Materials and methods: In this cross-sectional study, each participant underwent three different ultrasound protocols for the measurement of the GM thickness, and each measurement was repeated three times. The three measurement schemes were as follows: method A, lying on the examination bed in a prone position with legs stretched and relaxed and feet hanging outside the examination bed; method B, lateral right side lying position with legs separated (left leg flexed and right leg in a relaxed state); and method C, right side lying position with legs together and lower limb muscles in a relaxed state. The low muscle mass was determined by averaging two or three measurements of the GM thickness determined using different sonographic protocols. Results: The study included 489 participants. The difference in the prevalence of low muscle mass identified between two and three replicates of the same measurement protocol ranged from 0 to 1.3%. Considering the three repeated measurements of the method A as the reference, the area under the curve (AUC) in different measurement schemes were 0.977-1 and 0.973-1 in males and females, respectively. Furthermore, male and female Kappa values from low to high were 0.773, 0.801, 0.829, 0.839, and 0.967 and 0.786, 0.794, 0.804, 0.819, and 0.984, respectively. Conclusion: Different ultrasound measurement protocols showed high accuracy and consistency in identifying low muscle mass. Repeating the measurements two or three times was found to be feasible.

Functional and morphological evaluation of the meibomian glands and ocular surface assessment at high altitude.

Purpose: To compare the function and morphology of the meibomian glands and the ocular surface of individuals from highland and lowland. Methods: This was a randomized controlled trial. The study was performed with 104 individuals (51 individuals from the highland and 53 individuals from the lowland). Detailed eye examinations comprising tear meniscus height, lipid layer grading, non-invasive Keratograph tear breakup time (NIKBUT), and scoring of the meibomian glands from the upper and lower eyelids of the individuals were performed by Keratograph 5M (OCULUS, Wetzlar, Germany). Symptoms related to dry eye disease were assessed using the Ocular Surface Disease Index (OSDI). Results: In the highland group, tear meniscus height was lower (P = 0.024), lipid layer grade, as well as all the meiboscores were higher (P < 0.05) than that in the lowland group. The OSDI (P = 0.018) and the percentage of dry eye disease were also higher as compared to that of the lowland group (P = 0.032). The first NIKBUT and average NIKBUT did not differ significantly between groups. The frequency of plugged meibomian gland orifices was greater in the lowland group compared to the highland group (P = 0.036). Conclusion: It was observed that dry eye disease was more common in the highland group. The morphological changes of meibomian gland dropout were significant in highlanders as demonstrated objectively with Keratograph 5M. Our study may raise a concern for environmental influences on ocular surface changes.

Myopia progression and associated factors of refractive status in children and adolescents in Tibet and Chongqing during the COVID-19 pandemic.

Objectives: To investigate myopia progression and associated factors of refractive status among children and adolescents in Tibet and Chongqing in China during the COVID-19 pandemic. Methods: A population-based cross-sectional study was conducted to compare rates of myopia and high myopia, axial length (AL), spherical equivalent (SE), outdoor activity time, digital device use, and frequency of visual examinations for children and adolescents affected by myopia in Chongqing and Tibet in 2021. Results: A total of 2,303 students from Chongqing and 1,687 students from Tibet were examined. The overall prevalence of myopia and high myopia in these two groups were 53.80 and 7.04% vs. 43.86 and 1.30%, respectively in each case. The Chongqing students had a longer AL than the group from Tibet (23.95 vs. 23.40 mm, respectively; p < 0.001). The mean SE of the students with myopic parents in Tibet was lower than that of the students in Chongqing with myopic parents (-2.57 ± 2.38 diopters (D) vs. -2.30 ± 2.34 D, respectively) (p < 0.001). Conversely, the mean SE of the students from urban areas in Chongqing was lower than that of the students in Tibet (-2.26 ± 2.25 D vs. -1.75 ± 1.96 D, respectively; p < 0.001). The Chongqing students exhibited lower SE (-2.44 ± 2.22 D) than their Tibetan counterparts (mean SE: -1.78 ± 1.65 D (p = 0.0001) when spending more than 2.5 h outdoors. For example, 61.35% of the students in Tibet spent more than 2.5 h outdoors daily, compared with 43.04% of the students in Chongqing. Correspondingly, the proportion of students using digital devices in Tibet (64.43%) was lower than that in Chongqing (100%). For the latter, 38.62% of the students in Chongqing spent more than 2.5 h online using digital devices compared to 10.49% of the students in Tibet. Greater monitoring of visual status was observed for the Chongqing students (mean SE: -1.90 ± 1.98 D) compared with students in Tibet (mean SE: -2.68 ± 1.85 D) (p = 0.0448), with the frequency of optimal examinations being every 6 months. Outdoor activity time was identified as a common risk factor for myopia in both of the populations examined, with odds ratios (ORs) of 1.84 (95% CI: 1.79-1.90) in Chongqing and 0.84 (95% CI: 0.73-0.96) in Tibet. Digital screen time was associated with myopia and high myopia in Chongqing, with ORs of 1.15 (95% CI: 1.08-1.22) and 1.06 (95% CI: 0.94-1.77), respectively. Digital screen time was also found to be a risk factor for high myopia in Tibet (OR: 1.21, 95% CI: 0.77-1.61). The type of digital devices used was also associated with myopia and high myopia in Tibet (OR: 1.33, 95% CI: 1.06-1.68 and OR: 1.49, 95% CI: 0.84-2.58, respectively). Finally, examination frequency was found to correlate with high myopia in the Tibet group (OR: 1.79, 95% CI: 0.66-2.71). Conclusion: Based on our data, we observed that the prevalence of refractive errors in children and adolescents was significantly lower in Tibet than in Chongqing. These results are potentially due to prolonged outdoor activity time, and the type and time of use for digital devices that characterize the group of children and adolescents from Tibet. It is recommended that parents and children in Chongqing would benefit from increased awareness regarding myopia progression and its prevention.

The Effectiveness and Rotational Stability of Vertical Implantation of the Implantable Collamer Lens for the Treatment of Myopia.

PURPOSE: To explore the effectiveness and rotational stability of vertical implantation of the Implantable Collamer Lens (ICL) (STAAR Surgical) to treat myopia. METHODS: This was a prospective, randomized, controlled study, including 78 eyes from 46 patients with myopia who underwent ICL implantation. The patients were randomly divided into vertical and horizontal implantation groups. At 1 day, 1 week, 1 month, and 3 months after surgery, rotational stability was evaluated using the postoperative axis deviation from the intended axis by the digital anterior segment photograph. The vault, crystalline lens rise, anterior chamber depth, manifest refraction spherical equivalent, intraocular pressure, and visual acuity values were obtained before and after surgery. RESULTS: A 3-month follow-up period showed significant differences between the efficacy indexes in the horizontal (1.11 ± 0.02) and vertical (1.13 ± 0.02) groups (P = .455). No significant difference was observed in the postoperative manifest refraction spherical equivalent between the horizontal (-0.27 ± 0.18 diopters) and vertical (0.01 ± 0.08 diopters) groups (P = .151). Also, no statistically significant difference was observed in the corneal endothelial cells and intraocular pressure between groups (P = .555, P = .464). The rotation angle of the horizontal group was greater at 1 week, 1 month, and 3 months (3.14° ± 2.13°, 2.97° ± 2.01°, 3.27° ± 2.12°, respectively) compared to that of the vertical group (1.30° ± 1.29°, 1.85° ± 1.60°, 1.74° ± 1.33°, respectively) (P < .001 for all). From 1 week to 3 months, the changing angle of horizontal (0.31° ± 1.86°) and vertical (0.49° ± 1.33°) ICL rotation displayed a positive correlation with the changing vault of horizontal (48.41 ± 86.02 mm) and vertical (39.64 ± 78.43 mm) ICL rotation (r = 0.242, 0.335, P = .033, .037). CONCLUSIONS: The study supports great efficacy and safety in both vertical and horizontal implantation, with the vertical implantation group displaying better stability. [J Refract Surg. 2022;38(10):641-647.].

Optimizing the IPSA Conditions to Improve the Treatment Plan Quality in Brachytherapy for Cervical Cancer.

Recent prevalent use of three-dimensional image-guided brachytherapy (3D brachytherapy) has dramatically improved the treatment outcomes of cervical cancer. Inverse planning simulated annealing (IPSA) is one of the commonly used algorithms in 3D brachytherapy, but different conditions may affect the treatment plan quality. In this study, we compared HRCTV (high-risk clinical target volume) D90 (dose prescription) and HRCTV D95 D2cc (dose received by 2.0cc) of the rectum, bladder, and sigmoid in 30 patients with cervical cancer under four IPSA conditions. The HRCTV D90 (mean ± SD cGy) was 607.32 ± 37.86, 599.01 ± 23.62, 598.67 ± 13.07, and 596.45 ± 10.94 in four groups, respectively. The HRCTV D95 was 558.19 ± 38.51, 558.17 ± 25.72, 557.03 ± 16.12, and 555.26 ± 12.78, respectively. The sigmoid D2cc was 282.96 ± 44.84, 273.14 ± 60.69, 268.94 ± 62.32, and 292.69 ± 52.44. HRCTV D90, HRCTV D95, and sigmoid D2cc were not statistically different among the four groups (p > 0.05). However, the target fitness in group one, especially at the cervix, was poor. The rectum D2cc was 351.49 ± 32.90, 361.49 ± 28.09, 370.82 ± 24.44, and 375.33 ± 30.90. The rectum D2cc in group one was the lower than that in group three and group four (p < 0.05). The bladder D2cc was 423.59 ± 31.39, 380.75 ± 37.25, 383.27 ± 32.55, and 385.22 ± 25.79. The bladder D2cc in group one was higher than the other groups (p < 0.05). The maximum rectum limit dose (400cGy) is lower than the bladder (500cGy), and HRCTV is a whole in the IPSA algorithm; these result in the insufficiency or even absence of cervix dose that first need to meet in clinics. In conclusion, IPSA condition optimization can improve the quality of treatment plan in 3D brachytherapy and make it closer to clinical practice.

Ocular microbial diversity, community structure, and function at high altitude.

PURPOSE: To investigate the composition and function of ocular surface microbiome in healthy people from different altitudes. METHODS: Thirty-two healthy people living in a high altitude region and 30 sex- and age-matched individuals living in a low altitude region were enrolled. Samples were collected from the lower conjunctival sac of one randomly chosen eye for each participant. 16S rRNA sequencing was conducted to study the bacterial community composition and predict gene function using PICRUSt software. RESULTS: Microbial diversity and richness was significantly decreased in samples from highlanders as calculated by Abundance-based Coverage Estimator (ACE) index, Chao1 index, and observed-species index (all p < 0.01). Principle coordinate analysis (PCoA) suggested significantly distinct clustering of the conjunctival sac bacterial communities between two groups (p = 0.03), especially the dominant genera. The relative abundances of Corynebacterium, Staphylococcus, and Anaerococcus were significantly enriched in highlanders, while those of Pseudomonas and Massilia were significantly decreased as compared with lowlanders (p < 0.01). In the functional annotation analysis, we found that 74 gene pathways, mainly in metabolism, differed in abundance. Pathways related to immune system diseases and infectious diseases were also enriched in highlanders. CONCLUSION: The composition and function of ocular surface microbiome in highlanders were distinct from those of lowlanders and our study may provide a reference catalog of the healthy conjunctival microbiome in highlanders.

An Adversarial Deep-Learning-Based Model for Cervical Cancer CTV Segmentation With Multicenter Blinded Randomized Controlled Validation.

PURPOSE: To propose a novel deep-learning-based auto-segmentation model for CTV delineation in cervical cancer and to evaluate whether it can perform comparably well to manual delineation by a three-stage multicenter evaluation framework. METHODS: An adversarial deep-learning-based auto-segmentation model was trained and configured for cervical cancer CTV contouring using CT data from 237 patients. Then CT scans of additional 20 consecutive patients with locally advanced cervical cancer were collected to perform a three-stage multicenter randomized controlled evaluation involving nine oncologists from six medical centers. This evaluation system is a combination of objective performance metrics, radiation oncologist assessment, and finally the head-to-head Turing imitation test. Accuracy and effectiveness were evaluated step by step. The intra-observer consistency of each oncologist was also tested. RESULTS: In stage-1 evaluation, the mean DSC and the 95HD value of the proposed model were 0.88 and 3.46 mm, respectively. In stage-2, the oncologist grading evaluation showed the majority of AI contours were comparable to the GT contours. The average CTV scores for AI and GT were 2.68 vs. 2.71 in week 0 (P = .206), and 2.62 vs. 2.63 in week 2 (P = .552), with no significant statistical differences. In stage-3, the Turing imitation test showed that the percentage of AI contours, which were judged to be better than GT contours by ≥5 oncologists, was 60.0% in week 0 and 42.5% in week 2. Most oncologists demonstrated good consistency between the 2 weeks (P > 0.05). CONCLUSIONS: The tested AI model was demonstrated to be accurate and comparable to the manual CTV segmentation in cervical cancer patients when assessed by our three-stage evaluation framework.

Hsa_circ_0102171 aggravates the progression of cervical cancer through targeting miR-4465/CREBRF axis.

Cervical cancer (CC) has caused numerous cancer-related deaths in women. Recent years, circular RNAs have been reported as vital factors in CC tumorigenesis. Our current study focused on the role of hsa_circ_0102171 (called circ_0102171 subsequently) in CC. At first, we applied reverse transcription polymerase chain reaction to detect the expression of circ_0102171 in CC tissues and cells. Subsequently, we silenced circ_0102171 to conduct loss-of-function assays, including cell counting kit-8 assay, 5-ethynyl-2'-deoxyuridine staining, Transwell assay, and flow cytometry analysis. Interestingly, we discovered that circ_0102171 expressed at a high level in CC tissues and cells. Functionally, silencing circ_0102171 prohibited cell proliferation, migration and invasion, and strengthened cell apoptosis in CC in vitro. Mechanistic investigations revealed that circ_0102171 could act as a sponge for miR-4465. Gain-of-function assays demonstrated that miR-4465 hindered the growth and migration of CC cells. Moreover, circ_0102171 enhanced the level of CREB3 regulatory factor (CREBRF) which was the downstream target of miR-4465. Rescue assays suggested that CREBRF and miR-4465 could involve in circ_0102171-mediated CC progression. Finally, in vivo data supported that silencing circ_0102171 hindered CC cell growth. In conclusion, circ_0102171 aggravates CC progression via targeting miR-4465/CREBRF axis.

Dose fusion and efficacy evaluation of different radical radiotherapy doses for cervical cancer.

BACKGROUND: The recommended external beam radiotherapy (EBRT) dose for cervical cancer is 40-50 Gy, but there is no consensus. In this study, 45-Gy and 50.4-Gy treatment groups were compared for fused doses to target tumor areas and organs at risk (OARs), clinical efficacy, and quality of life. METHODS: Seventy-nine cases receiving radical radiotherapy within the past 3 years were retrospectively analyzed. EBRT and three-dimensional brachytherapy dose fusion values were calculated for target areas and OARs using Elastix V5.0. Clinical efficacy was assessed using Response Evaluation Criteria in Solid Tumors (RECIST), adverse events using Common Terminology Criteria for Adverse Events v4.03 (CTCAE4.03), and quality of life using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). RESULTS: Minimum fused dose delivered to 90% of the high-risk clinical target volume (HRCTV D90) did not differ significantly between 45-Gy and 50.4-Gy groups, whereas D2cc values of rectum and bladder (OARs) were significantly lower in the 45-Gy group (both p < 0.05). Further analysis showed that these D2cc differences resulted primarily from EBRT. No grade III-IV adverse events were observed in either group during follow up. Short-term clinical efficacy, adverse events, and EORTC QLQ-C30 functional and symptom scales also did not differ significantly between groups (all p > 0.05). However, quality of life was markedly higher in the 45-Gy group (p < 0.05). CONCLUSION: Appropriate EBRT dose reduction can reduce OAR irradiation without compromising total target area dose or clinical efficacy. Dose fusion can facilitate the judicious choice of EBRT to limit OAR exposure, reduce adverse events, and enhance the quality of life.

Effect of hypothermic perfusion on phacoemulsification in cataract patients complicated with uveitis: a randomised trial.

BACKGROUND: To evaluate the effectiveness and safety of hypothermic perfusion in the phacoemulsification of cataract caused by uveitis. METHODS: This was a prospective, single-masked, randomised, controlled clinical trial. One hundred and six patients with uveitis-associated cataract underwent phacoemulsification with perfusion fluid temperature at 4 °C (treatment group) or 24 °C (control group). Anterior chamber inflammation grade, corneal endothelial cell count, corneal thickness, macular fovea thickness, and intraocular pressure (IOP) were observed on the 1st day and 7th day after operation. RESULTS: The aqueous flare score was 0.83 ± 0.76 in the 4 °C group, which was lower than that in the 24 °C group (1.51 ± 1.02, p = 0.006) on the first day after operation. The aqueous cells score was lower in the 4 °C group (0.17 ± 0.38) than that in the 24 °C group (0.62 ± 0.94, p = 0.025). The mean corneal thickness of incision in the 4 °C group (907.66 ± 85.37 µm) was thinner than that in the 24 °C group (963.75 ± 103.81 µm, p = 0.005). Corneal endothelial cells density, macular fovea thickness, or percentage of transiently increased IOP showed no difference between the two groups (p > 0.05). There was no significant difference in all the main outcome parameters between the two groups on the 7th day after operation (p > 0.05). CONCLUSIONS: Hypothermic perfusion in the phacoemulsification of uveitis-associated cataract is safe, and it can effectively inhibit anterior chamber inflammation and reduce the incisional corneal edema in the early postoperative stage. TRIAL REGISTRATION: The study was registered with the Chinese Clinical Trial Registry. (http://www.chictr.org.cn/, Registration Number: ChiCTR1800016145).

LINC02535 co-functions with PCBP2 to regulate DNA damage repair in cervical cancer by stabilizing RRM1 mRNA.

Cervical cancer (CC) is one of the commonest malignant cancers among women with high morbidity and mortality. Despite encouraging advances had been found in diagnostic and therapeutic strategies, effective therapeutic strategy and further exploration of the mechanism underlying in CC is still needed. We searched The Cancer Genome Atlas database and found that long noncoding RNA LINC02535 was highly expressed in CC. LINC02535 has not been studied in CC, and its molecular regulation mechanism remains unknown. Based on starBase database, LINC02535 could potentially bind poly (rC) binding protein 2 (PCBP2). In the present study, we discovered a significant increase of the LINC02535 and PCBP2 expression in CC tissues and cells as compared with the adjacent normal tissues and normal cervical epithelial cells. LINC02535 and PCBP2 can bind with each other and were colocated in cytoplasm. LINC02535 and PCBP2 promoted cell proliferation, migration, invasion, and suppressed apoptosis in CC. LINC02535 and PCBP2 facilitated the repair of DNA damage to promote CC progression. LINC02535 cooperated with PCBP2 to enhance the stability of RRM1 messenger RNA (mRNA). RRM1 promoted the repair of DNA damage and epithelial-to-mesenchymal transition (EMT) process in CC cells. LINC02535 regulated tumorigenesis in vivo. In conclusion, LINC02535 cooperated with PCBP2, regulated stability of RRM1 mRNA to promote cell proliferation and EMT process in CC cells by facilitating the repair of DNA damage, providing a potential biomarker for CC.

Effect of hypothermic perfusion on phacoemulsification in eyes with hard nuclear cataract: randomized trial.

PURPOSE: To evaluate the effectiveness and safety of hypothermic perfusion in the phacoemulsification of hard nuclear cataract. SETTING: Tertiary opthalmology center, China. DESIGN: Laboratory study and prospective randomized clinical trial. METHODS: Rabbits and patients with hard nuclear cataract underwent phacoemulsification with perfusion temperatures at 4°C or 24°C. Anterior segment optical coherence tomography (AS-OCT), corneal endothelial cell count (ECC), and cornea sections were observed before the rabbits' operation and 1 day and 7 days postoperatively. AS-OCT, corneal ECC, and anterior chamber (AC) inflammation were observed before the patients' operation and 1 day, 7 days, and 30 days postoperatively. RESULTS: The study comprised 40 rabbits and 80 patients. In the animal models, the mean central corneal thickness (CCT) in the 4°C group (370.4 µm ± 45.5 [SD]) was thinner than in the 24°C group (496.7 ± 121.5 µm) 1 day postoperatively (P < .001). The mean AC inflammation reaction grade in the 4°C group (1.1 ± 0.9) was lower than in the 24°C group (2.2 ± 0.8) (P = .0333). In clinical trials, the mean CCT and incisional corneal thicknesses in the 4°C group (600.7 ± 51.8 µm and 859.2 ± 177.8 µm, respectively) were thinner than in the 24°C group (655.3 ± 85.0 µm and 955.9 ± 196.7 µm, respectively) (P < .001). The endothelial cell density (P = .036) and hexagonality (P = .001) were higher in the 4°C group. The mean AC inflammation reaction grade in the 4°C group (0.6 ± 0.6) was lower than in the 24°C group (1.3 ± 1.0) 1 day postoperatively (P = .004). CONCLUSIONS: Hypothermic perfusion in phacoemulsification of hard nuclear cataract is safe and it can effectively protect corneal endothelium, decrease corneal edema, and reduce AC inflammation in the early postoperative stage.

Pseudogene RACGAP1P activates RACGAP1/Rho/ERK signalling axis as a competing endogenous RNA to promote hepatocellular carcinoma early recurrence.

Accumulating evidence has indicated crucial roles for pseudogenes in human cancers. However, the roles played by pseudogenes in the pathogenesis of HCC, particularly HCC early recurrence, still incompletely elucidated. Herein, we identify a novel early recurrence related pseudogene RACGAP1P which was significantly upregulated in HCC and was associated with larger tumour size, advanced clinical stage, abnormal AFP level and shorter survival time. In vitro and in vivo experiments have shown that RACGAP1P is a prerequisite for the development of malignant characteristics of HCC cells, including cell growth and migration. Mechanistic investigations indicated that RACGAP1P elicits its oncogenic activity as a ceRNA to sequestrate miR-15-5p from its endogenous target RACGAP1, thereby leading to the upregulation of RACGAP1 and the activation of RhoA/ERK signalling. These results may provide new insights into the functional crosstalk of the pseudogene/miRNA/parent-gene genetic network during HCC early relapse and may contribute to improving the clinical intervention for this subset of HCC patients.

p68 prompts the epithelial-mesenchymal transition in cervical cancer cells by transcriptionally activating the TGF-ß1 signaling pathway.

Overexpression of p68 has been reported in various types of cancer. However, little study has been conducted on the expression and role of p68 in cervical cancer. Therefore, the present study focuses on the role of p68 in cervical cancer cells, which may elucidate its potential mechanism of cervical cancer progression and shed light on the precision medical treatment of cervical cancer. Firstly, the expression of p68 was analyzed using reverse transcription-quantitative polymerase chain reaction and western blot analysis. The changes to cell morphology were observed using an inverted microscope (XDS-500D; Shanghai Caikon Optical Instrument Co., Ltd., Shanghai, China). Cell migration was determined using an in vitro scratch assay. The present study demonstrated that the mRNA and protein levels of p68 were significantly enhanced in cervical cancer CaSki, HeLa [human papillomavirus (HPV)-18-positive], SiHa (HPV-16-positive) and C-33A (HPV-negative) cell lines compared with the human keratinocyte HaCaT cell line. Overexpression of p68 induced an elongated and spindle-shaped morphology in CaSki cells. Upregulation of p68 increased the expression of α-smooth muscle actin, vimentin and fibronectin however, epithelial marker E-cadherin was significantly decreased. Furthermore, the in vitro scratch assay demonstrated that overexpression of p68 markedly enhanced CaSki cell migration capacity at 24 and 48 h. Knockdown of p68 partially reversed transforming growth factor-ß1 (TGF-ß1)-induced changes in epithelial-mesenchymal transition (EMT) markers and cell morphological changes. In summary, the present study demonstrated that p68 transcriptionally activated the expression of TGF-ß1, thereby prompting EMT in cervical cancer cells.

Radiotherapy induces cell cycle arrest and cell apoptosis in nasopharyngeal carcinoma via the ATM and Smad pathways.

Nasopharyngeal carcinoma (NPC) is a common malignant neoplasm of the head and neck which is harmful to human's health. Radiotherapy is commonly used in the treatment of NPC and it induces immediate cell cycle arrest and cell apoptosis. However, the mechanism remains unknown. Evidences suggested the activation of Ataxia telangiectasia mutated (ATM) pathway and Smad pathway are 2 of the important crucial mediators in the function of radiotherapy. In this study, we performed in vitro assays with human nasopharyngeal carcinoma CNE-2 cells and in vivo assays with nude mice to investigate the role of the ATM and Smad pathways in the treatment of nasopharyngeal carcinoma with radiotherapy. The results suggested that radiation induced activation of ATM pathway by inducing expression of p-ATM, p-CHK1, p-CHK2, p15 and inhibiting expression of p-Smad3. In addition, Caspase3 expression was increased while CDC25A was decreased, leading to cell cycle arrest and cell apoptosis. On the other hand, activation of Smad3 can inhibited the ATM pathway and attenuated the efficacy of radiation. In summary, we suggest that both ATM and Smad pathways contribute to the cell cycle arrest and cell apoptosis during nasopharyngeal carcinoma cells treated with radiation.

Laparoscopic resection of primary adrenal ganglioneuroma: A case report and review of the literature.

Adrenal ganglioneuroma (AGN) is an extremely rare, benign tumor that originates from the neural crest tissue of the sympathetic nervous system. The majority of cases are detected incidentally, since the disease often lacks clear clinical manifestations or is asymptomatic. In addition, AGN is often misdiagnosed as being an adrenal adenoma or adrenal pheochromocytoma. The present study describes a 58-year-old female who visited the outpatient clinic of the Affiliated Hospital of Guangdong Medical College (Zhanjiang, Guangdong, China) with symptoms of face and lower extremity dropsy. Color Doppler ultrasonography revealed a solid tumor in the right kidney, and abdominal computed tomography identified an irregular, solid tumor measuring ~6×4.5×7 cm3 and arising from the right adrenal gland, with a clear boundary. Magnetic resonance imaging was not performed. An initial diagnosis of adrenal adenoma was established. The patient was treated by laparoscopy in order to remove the tumor. However, following surgery, a pathological examination suggested that the tumor was a GN originating from the adrenal medulla. The formation of a correct diagnosis can be extremely challenging, as AGNs do not exhibit any specific clinical manifestations. Therefore, detection often depends entirely upon imaging studies, and the final diagnosis can be only by confirmed following a histopathological evaluation.