[Comparison of clinical efficacy of two noninvasive respiratory support therapies for respiratory distress syndrome in very low birth weight preterm infants].

OBJECTIVE: To compare the clinical efficacy of nasal intermittent positive pressure ventilation (NIPPV) and heated humidified high flow nasal cannula (HHHFNC) in the treatment of respiratory distress syndrome (RDS) among very low birth weight (VLBW) preterm infants. METHODS: A total of 89 very low birth weight premature infants with respiratory distress syndrome (RDS) who were randomly administered with NIPPV (n=46) and HHHFNC (n=43) as an initial respiratory support. The incidence of initial treatment failure, the usage of pulmonary surfactant (PS), the parameters of respiratory support treatment and the incidence of complications were compared between the two groups. RESULTS: There were no significant differences between the NIPPV and HHHFNC groups in the following items: the rate of intubation within 72 hours, rate of PS use, duration of invasive or non-invasive mechanical ventilation, duration of oxygen therapy, and incidence rates of severe apnea and pneumonia (P>0.05). There were also no significant differences in the incidence rates of bronchopulmonary dysplasia, necrotizing enterocolitis, retinopathy of prematurity, patent ductus arteriosus, intracranial hemorrhage, and air leak between the two group (P>0.05). The incidence rate of nose injury in the NIPPV group was higher than that in the HHHFNC group (P<0.05). CONCLUSIONS: As an initial respiratory support for very low birth weight preterm infants with RDS, HHHFNC has a similar clinical effect as NIPPV, suggesting that HHHFNC is a safe and effective clinical option as a non-invasive ventilation treatment.

PIK3R1 targeting by miR-21 suppresses tumor cell migration and invasion by reducing PI3K/AKT signaling and reversing EMT, and predicts clinical outcome of breast cancer.

We have previously shown that dysregulation of miR-21 functioned as an oncomiR in breast cancer. The aim of the present study was to elucidate the mechanisms by which miR-21 regulate breast tumor migration and invasion. We applied pathway analysis on genome microarray data and target-predicting algorithms for miR-21 target screening, and used luciferase reporting assay to confirm the direct target. Thereafter, we investigated the function of the target gene phosphoinositide-3-kinase, regulatory subunit 1 (α) (PIK3R1), and detected PIK3R1 coding protein (p85α) by immunohistochemistry and miR-21 by RT-qPCR on 320 archival paraffin-embedded tissues of breast cancer to evaluate the correlation of their expression with prognosis. First, we found that PIK3R1 suppressed growth, invasiveness, and metastatic properties of breast cancer cells. Next, we identified the PIK3R1 as a direct target of miR-21 and showed that it was negatively regulated by miR-21. Furthermore, we demonstrated that p85α overexpression phenocopied the suppression effects of antimiR-21 on breast cancer cell growth, migration and invasion, indicating its tumor suppressor role in breast cancer. On the contrary, PIK3R1 knockdown abrogated antimiR­21-induced effect on breast cancer cells. Notably, antimiR-21 induction increased p85α, accompanied by decreased p-AKT level. Besides, antimiR-21/PIK3R1-induced suppression of invasiveness in breast cancer cells was mediated by reversing epithelial-mesenchymal transition (EMT). p85α downregulation was found in 25 (7.8%) of the 320 breast cancer patients, and was associated with inferior 5-year disease-free survival (DFS) and overall survival (OS). Taken together, we provide novel evidence that miR-21 knockdown suppresses cell growth, migration and invasion partly by inhibiting PI3K/AKT activation via direct targeting PIK3R1 and reversing EMT in breast cancer. p85α downregulation defined a specific subgroup of breast cancer with shorter 5-year DFS and OS, which may require more aggressive treatment.