SIRT5 functions as a tumor suppressor in renal cell carcinoma by reversing the Warburg effect.

BACKGROUND: The aim of this study was to investigate the biological functions and underlying mechanisms of SIRT5 in clear cell renal cell carcinoma (ccRCC). METHODS: SIRT5 expression data in The Cancer Genome Atlas Kidney Clear Cell Carcinoma (TCGA-KIRC) were selected, and the correlations between SIRT5 expression and various clinicopathological parameters were analysed. SIRT5 expression in ccRCC tissues was examined using immunohistochemistry. Stable cell lines with SIRT5 knockdown were established. In vitro and in vivo experiments were conducted to investigate the functional roles of SIRT5 in the cellular biology of ccRCC, including cell viability assays, wound healing assays, soft agar colony formation assays, Transwell invasion assays, qRT-PCR, and Western blotting. In addition, microarrays, rescue experiments and Western blotting were used to investigate the molecular mechanisms underlying SIRT5 functions. RESULTS: SIRT5 expression was downregulated in ccRCC compared with normal tissues, which correlated with a poor prognosis of ccRCC. SIRT5 knockdown significantly increased cell proliferation, migration and invasion in vitro. In vivo experiments revealed that SIRT5 knockdown promoted ccRCC tumorigenesis and metastasis. Mechanistically, SIRT5 deglycosylated PDHA1 at K351 and increased PDC activity, thereby altering the metabolic crosstalk with the TCA cycle and inhibiting the Warburg effect. SIRT5 overexpression was related to low succinylation of PDHA1. CONCLUSIONS: Downregulated SIRT5 expression in ccRCC accelerated the Warburg effect through PDHA1 hypersuccinylation and induced tumorigenesis and progression, indicating that SIRT5 may become a potential target for ccRCC therapy.

Copper-binding protein modelling by single-cell transcriptome and Bulk transcriptome to predict overall survival in lung adenocarcinoma patients.

Background: Copper and copper-binding proteins are key components of tumour progression as they play an important role in tumour invasion and migration, and abnormal accumulation of copper (Cu) may be intimately linked to with lung adenocarcinoma (LUAD). Methods: Data on lung adenocarcinoma were sourced from the Cancer Genome Atlas (TCGA) database and the National Centre for Biotechnology Information (GEO). 10x scRNA sequencing, which is from Bischoff P et al, was used for down-sequencing clustering and subgroup identification using TSNE. The genes for Copper-binding proteins (CBP) were acquired from the MSigDB database. LASSO-Cox analysis was subsequently used to construct a model for copper-binding proteins (CBPRS), which was then compared to lung adenocarcinoma models developed by others. External validation was carried out in the GSE31210 and GSE50081 cohorts. The effectiveness of immunotherapy was evaluated using the TIDE algorithm and the IMvigor210, GSE78220, and TCIA cohorts. Furthermore, differences in mutational profiles and the immune microenvironment between different risk groups were investigated. The CBPRS's key regulatory genes were screened using ROC diagnostic and KM survival curves. The differential expression of these genes was then verified by RT-qPCR. Results: The six CBP genes were identified as highly predictive of LUAD prognosis and significantly correlated with it. Multivariate analysis showed that patients in the low-risk group had a higher overall survival rate than those in the high-risk group, indicating that the model was an independent predictor of LUAD. The CBPRS demonstrated superior predictive ability compared to 11 previously published models. We constructed a column-line graph that includes CBPRS and clinical characteristics, which exhibits high predictive performance. Additionally, we observed significant differences in biological functions, mutational landscapes, and immune cell infiltration in the tumour microenvironment between the high-risk and low-risk groups. It is noteworthy that immunotherapy was also significant in both the high- and low-risk groups. These results suggest that the model has good predictive efficacy. Conclusions: The CBP model demonstrated good predictive performance, revealing characteristics of the tumour microenvironment. This provides a new method for assessing the efficacy of pre-immunisation and offers a potential strategy for future treatment of lung adenocarcinoma.

Fine-tuning pharmacological properties of mirtazapine antidepressant drug: a theoretical study.

It has become obvious that fluorinated drugs have a significant role in medicinal applications. In this study, the fluorination of mirtazapine antidepressant drug was investigated using density functional theory calculations. We found that the intramolecular hydrogen bonding and charge transfers of the mirtazapine drug were influenced by fluorine substitution. Our results also reveal that the fluorination altered the stability, solubility, and molecular polarity of the mirtazapine antidepressant drug. Moreover, our results show that the electronic spectra of fluorinated derivatives of the mirtazapine exhibit a red shift toward higher wavelengths compared to the original antidepressant drug. Our calculations show that the difference between G value of the gas and water (ΔG) of fluorinated derivatives of the mirtazapine drug was negative. We also found that the fluorination can increases the first hyperpolarizability of the mirtazapine antidepressant drug. Our results present an efficient strategy to improve the nonlinear optical responses of the antidepressant drugs. Consequently, the results of present study show that the fluorination of mirtazapine could be considered as a promising strategy to design antidepressant drugs with better pharmacological properties.Communicated by Ramaswamy H. Sarma.

Generation of a human induced pluripotent stem cell line (SDUBMSi001-A) from a hereditary spastic paraplegia patient carrying kif1a c.773C>T missense mutation.

KIF1A gene encodes the kinesin 1a protein, an axonal motor protein participating in axonal transport. Variants in KIF1A were identified in different forms of neurodegenerative diseases. Here, we generated induced pluripotent stem cells (iPSCs) from a Chinese hereditary spastic paraplegia (HSP) patient carrying a compound heterozygous c.773C>T(p.T258M) mutation in KIF1A gene by reprogramming peripheral blood cells with non-integrative vectors. The generated iPSC line (SDUBMSi001-A) had a normal karyotype, expressed pluripotency markers and could be differentiated into three germ layers in vitro.

Clinical diagnosis, treatment, and genetic analysis in 4 cases of congenital hyperinsulinemia / 中国新生儿科杂志

Objective:To investigate the clinical diagnosis, treatment, and genetic variations of neonates with congenital hyperinsulinism (CHI).Methods:The clinical data of CHI newborns admitted to the Provincial Hospital Affiliated to Shandong First Medical University from September 2018 to April 2022 were retrospectively analyzed.Results:Four cases of CHI were included, three of whom were full-term infants and all were macrosomic, while one was a premature infant. One infant was born to a mother with gestational diabetes mellitus, and 1 had a family history of hypoglycemia. All the 4 patients presented with weak response, 3 with drowsiness, 1 with hypotonia and 1 with convulsions. Cranial MRI indicated abnormal signals in the occipital lobe cortex in 1 case. Gene sequencing revealed homozygous variation c.799C>G in KCNJ11 gene for 1 case, and heterozygous variations c.4477C>T, c.3540C>G, c.683G>A and c.4536C>A in ABCC8 gene for 3 cases respectively and all these variations were identified as pathogenic mutations. Notably, the c.799C>G variant in KCNJ11 gene as well as the c.3540C>G and c.4536C>A variants in ABCC8 gene were reported for the first time. Among infants with ABCC8 gene variations, two showed no response to diazoxide treatment while one patient with KCNJ11 gene variation responded effectively. The parents of the patient with hypoglycemic brain injury gave up treatment. Three other cases were discharged from hospital after improvement and followed up to 1 year old. 2 patients had stable blood glucose after ceasing medication, and 1 patient still required intermittent oral glucose to maintain normal blood glucose level.Conclusions:CHI can lead to hypoglycemic brain injury. Clinically, infants large for gestational age or with a family history of diabetes and hypoglycemia should be monitored for blood glucose early after birth, to identify CHI as early as possible and actively treat it. Different gene variants have different therapeutic responses.

Overview and Enlightenment of Codes of Ethics for Nurses at Home and Abroad / 中国医学伦理学

Formulating codes of ethics for nurses are not only the need of establishing nurses’ professional image and dignity, but also the demand of nursing discipline development. By combing the relevant documents of codes of ethics for nurses at home and abroad, this paper summarized the main contents and application of codes of ethics for nurses, found that codes of ethics for nurses were based on the basic principle of "patient-oriented", discussing the relationship between nurses and patients, collaborators, environment, society, specialty and personal development, and forming the constraint standard for nurses’ behavior in combination with the expectation of local cultural values for nursing industry. The codes of ethics for nurses in China need to further clarify the scope of nursing, formulate behavioral norms in various specialties, and through clinical evaluation, education, management and other aspects to promote its popularization and implementation.

Determination of chemical component and quality control evaluation of Paeoniae Radix Alba / 国际中医中药杂志

Objective:To establish a method for the determination of four effective components in Paeoniae Radix Alba and evaluate its quality of Paeoniae Radix Alba by principal component analysis. Methods:The effective components of Paeoniae Radix Alba were extracted by ultrasonic extraction method with ethanol. Wondasil WR C18 chromatographic column (250 mm×4.6 mm,5 μm) was used, and the mobile phase was acetonitrile-water, the flow rate was set at 1 ml/min, the column temperature was set at 30 ℃, and the total operation time was 65 min. The mass score of active components was imported into SPSS for principal component analysis. Results:The linear ranges of Paeoniflorin, Paeoniflorin, Benzoyl Paeoniflorin and Pallyl Paeoniflorin were 0.020 1-3.820 0 μg ( r2=0.999 4), 0.015 9-2.850 0 μg ( r2=0.999 2), 0.008 2- 1.820 0 μg ( r2=0.999 1), 0.003 2-0.970 0 μg ( r2=0.999 5). The quality of the 10 batches of Paeoniae Radix Alba samples from Anhui province was the best, while that from Sichuan province was the worst. Conclusions:HPLC method was established for the determination of four effective components in Paeoniae Radix Alba, and principal component analysis and evaluation of 10 batches of Paeoniae Radix Alba. Bozhou, Anhui Province, was identified as the main production area of Paeoniae Radix Alba, which can provide reference for the quality control and preparation production of Paeoniae Radix Alba.

Comparison of analgesic efficacy and postoperative recovery between multi-point and single-point fascia iliaca compartment block in patients with hip fracture: a randomized controlled trial / 中华全科医师杂志

Objective:To compare the analgesic effect and postoperative recovery between multi-point and single-point ultrasound-guided fascia iliaca compartment block (FCIB) in elderly patients with hip fracture.Methods:From June 2019 to April 2020, 96 patients aged (71.1±5.4) years undergoing elective surgery for hip fracture in Renji Hospital were randomly assigned in multi-point block group or single-point block group, and the multi-point or single-point ultrasound-guided FCIB was performed for the two groups, respectively. The primary outcomes were the success rate for block of femoral nerve, lateral femoral cutaneous nerve and obturator nerve, and the 24 hours postoperative pain visual analog scale (VAS) score at rest and passive movement. The secondary outcomes were the onset time of sensory blocks of the above three nerves, complications of FICB, the satisfaction score of pain control during 48 hours after surgery and postoperative recovery of patients.Results:The success rate for block of lateral femoral cutaneous nerve in multi-point block group was 97.9% (47/48), which was significantly higher than that in single-point block group (83.3%(40/48)) ( P=0.031). The success rate for block of obturator nerve in multi-point block group was 95.8% (46/48), which was significantly higher than that in single-point block group which was 81.3% (39/48) ( P=0.025). The success rate of femoral nerve block in both groups was 97.9% (47/48) ( P=1.000). The 24 hours postoperative VAS scores at rest and passive movement in the multi-point block group were significantly lower than those in the single-point block group ( P<0.05). The onset time for block of lateral femoral cutaneous nerve and obturator nerve in multi-point block group was shorter than that in single-point block group ( P=0.025 and P<0.01). There was no significant difference in the onset time for block of femoral nerve between the two groups ( P=0.343). The satisfaction score of patients at 48 hours after surgery in multipoint block group was higher than that in single point block group ( P=0.024). The length of hospital stay in the multi-point block group was shorter than that in the single-point block group ( P=0.042), the proportion of intravenous analgesic drugs used after surgery was lower than that in the single-point block group ( P=0.041), and the complication rate within 30 days after surgery was also lower than that in the single point block group ( P=0.026). Conclusion:Compared with single-point block, ultrasound-guided multi-point block in iliac fascia space has advantages of increasing analgesic efficacy and promoting postoperative recovery in elderly patients with hip fracture.

Summary of the best evidence for pain management in emergency adult patients with trauma / 中华急诊医学杂志

Objective:To retrieve,evaluate and integrate the best evidence of pain management in emergency adult patients with trauma,and to provide references for clinical nursing practice.Methods:The best evidence of pain management in emergency adult patients with trauma were systematically searched in domestic and international databases.The retrieval period is from the establishment of databases to December,2022.There were 2 researchers evaluating the quality of the literature and extracting the data.Results:Total of 16 articles were selected,including 5 top clinical decisions,6 guidelines,3 expert consensuses,2 systematic review. 36 pieces of best evidence were formed from 6 aspects,including pain management principles, pain assessment methods, pain medication principles, pharmacological interventions, non pharmacological interventions and dynamic monitoring of pain management.Conclusions:Medical staff can formulate corresponding nursing measures in clinical applications based on the actual situation of trauma patients, and use scientific methods to solve the pain problem of emergency adult trauma patients and improve their quality of life.

Intervention effect of physical exercise on silicotic mice / 环境与职业医学

Background Pneumoconiosis is the most serious occupational disease in China, and silicosis accounts for about half of it. Any intervention effect of physical exercise as the key and core of lung rehabilitation training on silicosis is still unclear. Objective To explore potential intervention effect of physical exercise on silicotic mice. Methods Forty SPF C57BL/6 male mice were randomly divided into four groups, 10 in each group, including a control group, a physical exercise group, a silicosis model group, and a silicosis model + physical exercise intervention group. Silicotic mouse model was established by using 50 μL SiO2 suspension (200 mg·mL−1). A treadmill was used to prepare mice receiving physical exercise at 0° inclination, 12.3 m·min−1, 60 min·d−1, 5 d·week−1 for 4 weeks. Pathological morphology of lung tissues was evaluated after hematoxylin-eosin (HE) staining; deposition of collagen in lung tissues was evaluated after Van Gieson (VG) staining; expression of p-protein kinase R-like endoplasmic reticulum kinase (PERK) was detected by immunofluorescence staining; expressions of cyclin dependent kinase inhibitors (p21) and p-p38 mitogen activated protein kinase (p38) were detected by immunohistochemistry. The protein expressions of endoplasmic reticulum stress signal factors [p-inositol-requiring enzyme-1α (p-IRE-1α), p-PERK, and p-eukaryotic initiation factor-2α (p-eIF-2α)], senescence signal factors (p-p53, p21, and p16), mitogen-activated protein kinase (MAPK) signal factors [p-p38, p-extracellular regulated protein kinases (p-ERK), and p-stress-activated protein kinase (p-JNK)] were detected by Western blotting. Results After designed acute SiO2 exposure, the images of micro computed tomography (CT) showed high density shadows in lung tissues of the silicotic mice and less shadows in lung tissues of the physical exercise intervention mice. After HE staining, the proportions of silicotic nodule area in lung tissues was (18.67±3.89) % in the silicosis model group, and significantly decreased to (8.78±1.05) % in the silicosis model + physical exercise intervention group (P<0.05). After VG staining, the proportion of collagen fiber area of lung tissues was (10.37±2.18) % in the silicosis model group, and significantly decreased to (4.35±0.89) % in the silicosis model + physical exercise intervention group (P<0.05). The results of immunofluorescence staining showed that in the silicosis model group, the expression of p-PERK increased at the location of silicotic nodules, while in the silicotic model + physical exercise intervention group, the expression of p-PERK decreased. The immunohistochemical staining results showed that the expression of p21 and p-p38 increased in the lung tissues of the silicosis model group; the expression of p21 and p-p38 decreased in the lung tissues of the silicosis model + physical exercise intervention group. The results of Western blotting showed that compared with the control group, the expression levels of p-IRE-1α (0.11±0.03), p-PERK (0.95±0.40), p-eIF-2α (3.53±0.91), p-p53 (1.78±0.07), p21 (1.98±0.10), p16 (1.26±0.17), p-p38 (0.41±0.09), p-ERK (0.42±0.05), and p-JNK (3.20±1.23) of the silicosis model group were all upregulated (P<0.05). Compared with the silicosis model group, the expression levels of p-IRE-1α (0.03±0.01), p-PERK (0.31±0.12), p-eIF-2α (0.30±0.06), p-p53 (0.76±0.08), p21 (0.18±0.11), p16 (0.70±0.24), p-p38 (0.03±0.00), p-ERK (0.19±0.03), and p-JNK (0.46±0.21) of the silicosis model + physical exercise intervention group were downregulated (P<0.05). Conclusion Physical exercise may alleviate pulmonary fibrosis in silicotic mice, and inhibit abnormal expressions of endoplasmic reticulum stress signal, MAPK signal, and senescent signal.

Quick guideline for diagnosis and treatment of novel coronavirus Omicron variant infection / 中华临床感染病杂志

Novel coronavirus Omicron variant infection can cause severe illness and even death in certain populations. Omicron variant infection may lead to systemic inflammatory response, coagulation disorder, multi-organ dysfunction and other pathophysiological changes, which are different from other Novel coronavirus variants to a certain extent, so therapeutic strategies should not be the same. The National Medical Center for Major Public Health Events invited experts in fields of infectious diseases, respiratory medicine, intensive care, pediatrics and fever clinic to develop this quick guideline based on the current best evidence and extensive clinical practices. This quick guideline aims to standardize the diagnosis and treatment of novel coronavirus Omicron infection, and to improve the disease management abilities of clinicians.

Overview and Enlightenment of Codes of Ethics for Nurses at Home and Abroad / 中国医学伦理学

Formulating codes of ethics for nurses are not only the need of establishing nurses’ professional image and dignity, but also the demand of nursing discipline development. By combing the relevant documents of codes of ethics for nurses at home and abroad, this paper summarized the main contents and application of codes of ethics for nurses, found that codes of ethics for nurses were based on the basic principle of "patient-oriented", discussing the relationship between nurses and patients, collaborators, environment, society, specialty and personal development, and forming the constraint standard for nurses’ behavior in combination with the expectation of local cultural values for nursing industry. The codes of ethics for nurses in China need to further clarify the scope of nursing, formulate behavioral norms in various specialties, and through clinical evaluation, education, management and other aspects to promote its popularization and implementation.

Mechanism of 3-arylcoumarin derivatives inhibiting vascular calcification / 中国药科大学学报

@#To reveal the pharmacological mechanism of 3-arylcoumarin derivative 3-(4′-hydroxyphenyl)-6-hydroxycoumarin (SJ-6) against vascular calcification, advanced glycation end products (AGEs) were used to induce the calcification of human aortic vascular smooth muscle cells (HCASMCs), and calcification was identified by alizarin red staining and quantification.The effects of SJ-6 on alkaline phosphatase (ALP) activity, cell proliferation rate, calcium content, and total reactive oxygen species (ROS), superoxide dismutase (SOD), AGEs, and tetra methylethlene diamine proteinase factor-α (TNF-α), interleukin-6 (1L-6), interleukin-β (1L-β), runt-related transcription factor 2 mRNA (Runx2 mRNA), the receptor of advanced glycation endproducts (RAGE), nuclear factor kappa-B (NF-κB), napdh oxidase-1 (NoX-1), protein kinase C(PKC), protein kinase b(AKT), p38 mitogen-activated protein kinase (p38 MAPK), and smooth muscle actin-α (SMA-α) protein expression were determined.According to our results, SJ-6 significantly decreased AGEs content, ALP activity, intracellular calcium content, ROS content, Runx2 mRNA and inflammatory factors TNF-α, 1L-6 and 1L-β (P < 0.05) and increased SOD content (P < 0.01), with similar to those of the positive control drug aminoguanidine hydrochloride (AGH).Therefore, we investigated the pharmacological mechanism of compound SJ-6, which was found to significantly inhibit the expression of RAGE, NF-κB, NoX-1, PKC, Akt, p-p38 and other essential signaling proteins in the calcified cell model (P < 0.01) and increas the expression of smooth actin SMA-α (P < 0.01).SJ-6 inhibits vascular calcification by inhibiting oxidative stress and the expression of AGEs/RAGE, Akt/PKC and NF-κB signaling pathways, suggesting that it may be a novel drug for the treatment of vascular calcification.

Trend of maternal mortality ratio and death causes in Tianjin from 2011 to 2020 / 中华围产医学杂志

Objective:To analyze the trend of maternal mortality ratio (MMR) and death causes in Tianjin from 2011 to 2020 and to guide the management of maternal health.Methods:All the reviews data of 89 maternal death cases in Tianjin from 2011 to 2020 were retrospectively collected to analyze the trend of MMR, rank order of death causes, and death review results using Chi-square test. Results:(1) The average MMR in Tianjin was 7.97/100 000 during the study period, showing an overall fluctuating decline. The highest MMR was 12.61/100 000 in 2014 and the lowest was 3.85/100 000 in 2019. (2) Among the dead pregnant women and parturients, non-registered residents had higher proportion of women with advanced age, no steady occupation/unemployment, below junior college education, multipara, or without maternal health manual compared with the registered residents [33.33% (8/24) vs 20.00% (13/65), χ2=46.18; 100.00%(24/24) vs 69.23%(45/65), χ2=9.53; 87.50% (21/24) vs 64.62% (42/65), χ2=4.44; 79.17% (19/24) vs 44.62% (29/65), χ2=8.42; 75.00%(18/24) vs 13.85% (9/65), χ2=31.02; all P<0.05]. (3) Direct obstetric factors and indirect factors that caused death were accounted for 57.30% (51/89) and 42.70% (38/89). The top five death causes were postpartum hemorrhage, hypertensive disease during pregnancy, sudden death, venous thrombosis and pulmonary embolism, and amniotic fluid embolism. (4) In terms of the maternal death review results, 39.33% (35/89) of maternal deaths were avoidable, among which 94.29% (33/35) were caused by direct obstetric factors and 5.71% (2/35) were indirect. (5) The main influencing factors of avoidable death causes were knowledge and skills inadequacy in the health care system (62.86%, 22/35), of which 86.36% (19/22) happened in health facilities at and below the district/county level. Conclusion:It is suggested to strengthen the medical care of health facilities at and below the district/county level and the maternal health management of the non-permanent residents to ensure maternal and infant safety and to further reduce the MMR.

Geochemical source, deposition, and environmental risk assessment of cadmium in surface and core sediments from the Bohai Sea, China.

Geochemical sources, spatio-temporal distribution, and associated environmental risk of Cd in the Bohai Sea were investigated using data from 405 surface sediment samples and two sediment cores. Local point Cd sources, TOC content, and currents are the main controlling factors of Cd distribution. The contribution of Cd from river discharge surpasses that from atmospheric deposition. Sediment-quality guidelines, enrichment factors, and chemical fraction analysis were used to assess metal toxicity in the collected sediments. Results show that Bohai Sea sediments have a moderate Cd enrichment level. This enrichment poses a high risk due to the relatively high mobility and bioavailability of Cd despite measured levels below sediment-quality guidelines at most stations. Vertical profiles of Cd concentrations, Al-normalized enrichment factors, and excess burial fluxes combined with 210Pb dating reveal the history of Cd pollution in the Bohai Sea over the last century. Data show Cd unvaried before the 1800s, a slight increase from the 1800s to the late 1950s, a decrease from the late 1960s to the 1970s, and an increase from the 1980s to 2001, including a relatively high value in 1998. Historic variation in Cd is closely associated with both natural and anthropogenic activities.

[A preliminary study on the autophagy level of human periodontal ligament cells regulated by nicotine].

OBJECTIVE: To explore the effect of nicotine on the autophagy level of human periodontal ligament cells (hPDLCs). METHODS: Periodontal tissues collected from premolars for orthodontic treatment reasons were used to culture hPDLCs. Western blot analysis was performed to test the most optimal time and concentration of nicotine on the autophagy level of the hPDLCs. Transmission electron microscope and immunofluorescence observation were carried out to detect the form of autophagosomes and expression of autophagy related protein LC3 in hPDLCs under this optimal condition. RESULTS: Protein expression of LC3Ⅱ was up regulated with the 12 h nicotine stimulating. Besides that, the up regulation of the protein expression of LC3Ⅱ was concentration dependent and nicotine with a concentration of 1×10⁻5 mol·L⁻¹ was the most optimal condition. Transmission electron microscope and immunofluorescence observations indicated that nicotine would activate the autophagy level of hPDLCs by increasing the number of autophagosomes and up regulating the expression of autophagy related protein LC3. CONCLUSIONS: Nicotine could increase autophagy level of hPDLCs, thus affecting the occurrence and development of smoking related periodontitis.

Ionizing radiation promotes epithelial-mesenchymal transition of cervical cancer cell line Siha through increasing the secretion of exosomes / 中华放射医学与防护杂志

Objective:To observe the occurrence of epithelial-mesenchymal transition (EMT) in cervical cancer cell line Siha irradiated by X-rays with clinical conventional fraction radiotherapy model and investigate the role of exosomes in this process.Methods:Siha cells were irradiated by 6 MV-X rays with 50 Gy in 25 fractions. EMT was evaluated by cell morphology, EMT biomarkers and cell migration and invasion ability. Exosomes released from cells were detected by transmission electron microscopy and nanoparticle tracking analysis (NTA), and its function in EMT was explored by using an exosome inhibitor GW4869 (10 μmol/L).Results:After irradiation, EMT phenomenon was induced in the survived Siha cells, including the incidence of mesenchymal phenotype, upregulation of epithelial marker E-cadherin ( t=9.66, P<0.05), downregulation of mesenchymal marker N-cadherin ( t=41.61, P<0.05), and increase of cell migration and invasion abilities ( t=6.11, 13.22; P<0.05). Meanwhile, the secretion of exosomes was also increased after irradiation ( t=7.51, P<0.05). When the cells were pre-treated with GW4869, radiation-induced exosome secretion was reduced ( t=7.28, P<0.05), so that radiation-induced EMT was reversed. Conclusions:Ionizing radiation with clinical conventional fraction radiotherapy model promotes EMT of cervical cancer cells through increasing the secretion of exosomes.

Expert consensus on early childhood caries management / 国际口腔科学杂志·英文版

Early childhood caries (ECC) is a significant chronic disease of childhood and a rising public health burden worldwide. ECC may cause a higher risk of new caries lesions in both primary and permanent dentition, affecting lifelong oral health. The occurrence of ECC has been closely related to the core microbiome change in the oral cavity, which may be influenced by diet habits, oral health management, fluoride use, and dental manipulations. So, it is essential to improve parental oral health and awareness of health care, to establish a dental home at the early stage of childhood, and make an individualized caries management plan. Dental interventions according to the minimally invasive concept should be carried out to treat dental caries. This expert consensus mainly discusses the etiology of ECC, caries-risk assessment of children, prevention and treatment plan of ECC, aiming to achieve lifelong oral health.

Expert consensus on diagnosis and treatment of severe fever with thrombocytopenia syndrome / 中华临床感染病杂志

Since 2010, the incidence of severe fever with thrombocytopenia syndrome (SFTS) has been increased. Owing the progress in diagnosis and treatment, the overall mortality of SFTS in China has decreased, while the mortality in critical SFTS patients is still high. In order to provide guidance and working procedures for clinicians to diagnose and treat critical SFTS, the National Medical Center for Major Public Health Events invited experts to discuss and formulate this consensus based on their experience and up-to-date knowledge on SFTS.

Application value of contrast-enhanced ultrasound combined with thyroid imaging reporting and data system classification in the differential diagnosis of benign and malignant thyroid nodules / 中国基层医药

Objective:To investigate the application value of contrast-enhanced ultrasound (CEUS) combined with thyroid imaging reporting and data system (TI-RADS) classification in the differential diagnosis of benign and malignant thyroid nodules.Methods:The clinical data of 157 thyroid nodules from 122 participants who underwent conventional ultrasound and CEUS examination from January 2016 to January 2017 in the First Hospital of Shanxi Medical University, China were collected. The image features were analyzed for conventional ultrasound and TI-RADS classification. According to CEUS results, the thyroid nodules were classified by TI-RADS. Based on pathological results, the efficacy of CEUS combined with TI-RADS classification versus conventional ultrasound combined with TI-RADS classification in the differential diagnosis of benign and malignant thyroid nodules was investigated. Results:The area under the curve of CEUS combined with TI-RADS classification (AUC = 0.900) was greater than that of conventional ultrasound combined with TI-RADS classification (AUC = 0.808). The sensitivity, specificity, accuracy, positive and negative predictive values of conventional ultrasound combined with TI-RADS classification in the differential diagnosis of benign and malignant thyroid nodules were 81.6% (80/98), 67.8% (40/59), 76.4% (120/157), 80.8% (80/99), 68.9% (40/58), respectively. They were 98.0% (96/98), 78.0% (34/59), 90.4% (142/157), 88.1% (96/109), 95.8% (46/48), respectively for CEUS combined with TI-RADS classification. The sensitivity of CEUS combined with TI-RADS classification in the differential diagnosis of benign and malignant thyroid nodules was significantly higher than that of conventional ultrasound combined with TI-RADS classification ( χ2 = 12.50, P < 0.001). Conclusion:CEUS combined with TI-RADS classification is more effective in the differential diagnosis of benign and malignant thyroid nodules than conventional ultrasound combined with TI-RADS classification.