Publications by authors named "Dong Xu"

1,337 Publications

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Loneliness, depression, anxiety, and post-traumatic stress disorder among Chinese adults during COVID-19: A cross-sectional online survey.

PLoS One 2021 21;16(10):e0259012. Epub 2021 Oct 21.

JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.

Objectives: This study aims to investigate the potential factors associated with mental health outcomes among Chinese adults during the Coronavirus disease 2019 (COVID-19) epidemic.

Methods: This is an online cross-sectional survey conducted among Chinese adults in February 2020. Outcome measurements included the three-item UCLA Loneliness Scale (UCLA-3), two-item Patient Health Questionnaire (PHQ-2), two-item Generalized Anxiety Disorder Questionnaire (GAD-2), and two items from the Clinician-Administered Post-traumatic Stress Disorder (PTSD) Scale. COVID-19 related factors, physical health, lifestyle, and self-efficacy were also measured. Univariable and multivariable logistic regressions were performed.

Results: This study included 1456 participants (age: 33.8±10.5 years; female: 59.1%). The prevalence of depressive symptoms, anxiety symptoms, loneliness, and PTSD symptoms were 11.3%, 7.6%, 38.7%, and 33.9%, respectively. In multivariable analysis, loneliness was associated with being single, separated/divorced/widowed, low level of education, current location, medication, more somatic symptoms, lower self-efficacy, and going out frequently. Depression was associated with fear of infection, binge drinking, more somatic symptoms, lower self-efficacy, and longer screen time. Anxiety was associated with more somatic symptoms and lower self-efficacy. PTSD symptoms were associated with more somatic symptoms, lower self-efficacy, higher perceived risk of infection, fear of infection, and self-rated more negative influence due to the epidemic (p<0.05).

Conclusions: Mental health problems during the COVID-19 epidemic were associated with various biopsychosocial and COVID-19 related factors. Psychological interventions should be aware of these influencing factors and prioritize support for those people at higher risk.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0259012PLOS
October 2021

Observation of Topological Edge States on α-BiBr Nanowires Grown on TiSe Substrates.

J Phys Chem Lett 2021 Oct 21:10465-10471. Epub 2021 Oct 21.

Key Laboratory of Advanced Optoelectronic Quantum Architecture and Measurement, Ministry of Education, School of Physics, Beijing Institute of Technology, Beijing, 100081, China.

A time-reversal invariant two-dimensional (2D) topological insulator (TI) is characterized by the gapless helical edge states propagating along the perimeter of the system. However, the small band gap in the 2D TIs discovered so far hinders their applications. Recently, we predicted that single-layer BiBr is a 2D TI with a remarkable band gap and that α-BiBr crystals can host topological edge states at the step edges. Here we report the growth of α-BiBr nanowires with (102)-oriented top surfaces on the TiSe substrates and the direct observation of the predicted topological edge states at the step edges of the nanowires using scanning tunneling microscopy. The coupling between the edge states leads to the formation of surface states at the (102) top surfaces of the nanowires. Our work demonstrates the existence of topological edge states in α-BiBr and paves the way for developing α-BiBr-based devices for a high-temperature quantum spin Hall effect.
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http://dx.doi.org/10.1021/acs.jpclett.1c02586DOI Listing
October 2021

Correlation of peripheral CD4+GranzB+CTLs with disease severity in patients with primary Sjögren's syndrome.

Arthritis Res Ther 2021 Oct 12;23(1):257. Epub 2021 Oct 12.

Department of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Introduction: Primary Sjögren's syndrome (pSS) is a chronic systemic autoimmune disease which has focal lymphocytic infiltration including a majority of CD4+ T cells. This study was to investigate the correlation of peripheral granzyme B (GranzB)-expressing CD4+ T cells with disease severity and histological lesion in patients with pSS.

Methods: We recruited 116 pSS and 46 health control (HC) using flow cytometry to examine the percentage of CD4+GranzB+CTLs in the peripheral blood, and immunofluorescence to test their expression in the labial gland.

Results: The percentage of CD4+GranzB+CTLs was significantly upregulated in pSS than in HC (7.1 ± 4.9% vs 3.1 ± 1.9%, p < 0.0001) and positive correlation with ESSDAI. The frequency of them was markedly higher in pSS with extraglandular manifestations. After excluding the other risk factors associated with pSS, they were still related to ESSDIA and extraglandular manifestations independently (p < 0.05), and they are the risk factor of extraglandular involvement (odds ratio = 1.928). Moreover, they could be observed in the LSGs. ROC curve analysis indicated that the area under the curve (AUC) of CD4+GranzB+CTLs was 0.796 to predict the activity of pSS and 0.851 to presume extraglandular manifestations. The best diagnostic cutoff point was 4.865 for pSS patients.

Conclusion: In this study, we provide new evidence indicating the involvement of CD4+GranzB+CTLs over activation in the pathophysiology of pSS, which may serve as a new biomarker to evaluate the activity and severity of pSS.
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http://dx.doi.org/10.1186/s13075-021-02632-6DOI Listing
October 2021

Global processing provides malignancy evidence complementary to the information captured by humans or machines following detailed mammogram inspection.

Sci Rep 2021 Oct 11;11(1):20122. Epub 2021 Oct 11.

Discipline of Medical Imaging Sciences, Faculty of Medicine and Health, University of Sydney, 512/Block M, Cumberland Campus, Sydney, NSW, 2006, Australia.

The information captured by the gist signal, which refers to radiologists' first impression arising from an initial global image processing, is poorly understood. We examined whether the gist signal can provide complementary information to data captured by radiologists (experiment 1), or computer algorithms (experiment 2) based on detailed mammogram inspection. In the first experiment, 19 radiologists assessed a case set twice, once based on a half-second image presentation (i.e., gist signal) and once in the usual viewing condition. Their performances in two viewing conditions were compared using repeated measure correlation (rm-corr). The cancer cases (19 cases × 19 readers) exhibited non-significant trend with rm-corr = 0.012 (p = 0.82, CI: -0.09, 0.12). For normal cases (41 cases × 19 readers), a weak correlation of rm-corr = 0.238 (p < 0.001, CI: 0.17, 0.30) was found. In the second experiment, we combined the abnormality score from a state-of-the-art deep learning-based tool (DL) with the radiological gist signal using a support vector machine (SVM). To obtain the gist signal, 53 radiologists assessed images based on half-second image presentation. The SVM performance for each radiologist and an average reader, whose gist responses were the mean abnormality scores given by all 53 readers to each image was assessed using leave-one-out cross-validation. For the average reader, the AUC for gist, DL, and the SVM, were 0.76 (CI: 0.62-0.86), 0.79 (CI: 0.63-0.89), and 0.88 (CI: 0.79-0.94). For all readers with a gist AUC significantly better than chance-level, the SVM outperformed DL. The gist signal provided malignancy evidence with no or weak associations with the information captured by humans in normal radiologic reporting, which involves detailed mammogram inspection. Adding gist signal to a state-of-the-art deep learning-based tool improved its performance for the breast cancer detection.
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http://dx.doi.org/10.1038/s41598-021-99582-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8505651PMC
October 2021

[The Liver Injury and Coagulation Dysfunction in the Patients with Severe/Critical COVID-19].

Zhongguo Shi Yan Xue Ye Xue Za Zhi 2021 Oct;29(5):1582-1588

Department of Hematology, The Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China,E-mail:

AbstractObjective: To analyze the liver injury and coagulation dysfunction in COVID-19 severe/critical type patients.

Methods: The clinical data of 53 COVID-19 patients were collected from a single center in Wuhan from February 8, 2020 to March 25, 2020. The patients were divided into severe type group (38 patients) and critical type group (15 patients). The clinical characteristics, indexes of liver function, coagulation function and inflammatory markers were analyzed retrospectively. According to the degree of abnormal liver function in the process of diagnosis and treatment, the patients were divided into three groups: combined liver injury, mild abnormal liver function and normal liver function group. Statistical analysis was performed by using Student t test, Mann-Whitney U test, Kruskal-Wallis test and Chi-square test.

Results: Among the 53 patients, 29 were male (54.7%) and 24 were female (45.3%), the median age was 57(27-80) years old. The time from onset to admission was (11.5±7.7) days. The levels of AST, TBIL, DBIL, ALP, GGT, LDH, D-dimer, PCT and hsCRP in critical patients were higher than those in severe patients (P<0.05). The levels of Alb in critical patients was lower than those in severe patients (P<0.05). Among the 53 patients, 34 (64%) patients showed abnormal elevation of ALT, AST or TBIL, while 4 (7.5%) patients showed the criteria of COVID-19 with liver injury. After the patients were grouping according to the degree of liver dysfunction, the levels of ALP, GGT and D-dimer of the patients in the liver injury group were significantly higher than those in the normal liver function group, D-dimer levels of the patients in the liver injury group was significantly higher than those in the mild abnormal liver function group, while the levels of ALP and GGT in the mild abnormal liver function group were significantly higher than those in the normal liver function group, and the differences were statistically significant(P<0.05).

Conclusion: In this group, the patients with COVID-19 severe/critical type have a certain proportion of liver injury accompanied by significantly increased D-dimer levels, critical type patients have more severe liver function and coagulation dysfunction, which may promote the progression of COVID-19.
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http://dx.doi.org/10.19746/j.cnki.issn.1009-2137.2021.05.033DOI Listing
October 2021

Association Between Red Blood Cell Distribution Width-to-Albumin Ratio and Prognosis of Patients with Aortic Aneurysms.

Int J Gen Med 2021 1;14:6287-6294. Epub 2021 Oct 1.

Department of Vascular Surgery, Affiliated Hangzhou First People's Hospital, ZheJiang University School of Medicine, Hangzhou, Zhejiang, 310014, People's Republic of China.

Objective: Red blood cell distribution width (RDW) is a predictor of adverse outcomes in aortic aneurysms. Recent recommendations suggest that combining RDW with other biomarkers could yield better results. We, therefore, propose evaluating the biomarker of vascular aging, albumin with RDW to predict the risk of aortic aneurysms. This study aims to explore whether the combination of RDW with albumin can effectively predict the prognosis of aortic aneurysm patients.

Methods: This retrospective cohort study was conducted among adults (age >18) with aortic aneurysms in the Medical Information Mart for Intensive Care Database III V1.4 (MIMIC-III). RAR was measured according to the red blood cell distribution width and albumin. The primary outcome was the 30-day mortality rate, and the secondary outcome was the 90-day and one-year mortality rates. Estimation of hazard ratios (HR) was obtained from Cox regression models for all-cause mortality related to red cell distribution width-to-albumin ratio (RAR) values.

Results: In total, 312 patients were involved, with an average age of 74.9 ± 10.9 years and an average RAR value of 5.4 ± 1.6 mL/g. In 30 days for all-cause mortality, the HR (95% CI) in the highest RAR group (>5.8 mL/g) in tertiles was 2.54 (1.25, 5.14) in the unadjusted model, with a significant difference compared with the reference group (P < 0.05). After adjusting for race, gender and age, there was still a correlation (P < 0.05), and the HR (95% CI) was 2.51 (1.23, 5.10). Further adjustment of possible covariates showed similar correlation in model 3 (P < 0.05), and HR (95% CI) was 2.66 (1.17, 6.01). Multivariable logistic regression shows that RAR is an independent risk factor for the outcome of aortic aneurysms after adjusting the covariates. In the subgroup analysis, we analyzed the patient's complications, and no significant interaction was observed.

Conclusion: RAR is a risk factor for patients with aortic aneurysms. However, more in-depth research is warranted to further analyze and substantiate our findings on the role of RAR in aortic aneurysm patients.
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http://dx.doi.org/10.2147/IJGM.S328035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8491781PMC
October 2021

Alginate nanogels-based thermosensitive hydrogel to improve antidepressant-like effects of albiflorin via intranasal delivery.

Drug Deliv 2021 Dec;28(1):2137-2149

State Key Laboratory of Component-based Chinese Medicine, Research Center of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, PR China.

Depression is a primary public health problem. However, current antidepressants work slowly, and together with side effects. Herein, the alginate nanogels were constructed to load albiflorin (albiflorin nanogels), which further formed albiflorin nanogel loaded self-assembled thermosensitive hydrogel system (albiflorin-NGSTH) and were used to improve its antidepressant effects. The nanogel showed a nano-scaled particle size and stronger antioxidant activity. Rheological studies showed that albiflorin-NGSTH had a sol-gel transition at approximately 28 °C. Albiflorin-NGSTH quickly entered the brain by intranasal delivery, and had a continuously release for albiflorin. Preliminary results of mice behavioral despair tests found that albiflorin-NGSTH had no effects on independent exploratory behavior and anxiety of the mice, and significantly decreased immobility duration of the mice in tail suspension test (TST). Moreover, the intranasally administrated albiflorin-NGSTH at a low dose improved depressive behavior, decreased levels of proinflammatory cytokines, and repaired neuronal damage of chronic unpredictable mild stress (CUMS) rats, which indicated an excellent potential for depression therapy. The treatment of albiflorin-NGSTH on depressive disorder was achieved by regulating signal pathway related to depression. Therefore, albiflorin-NGSTH has an excellent potential for clinical application in intranasal drug delivery systems.
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http://dx.doi.org/10.1080/10717544.2021.1986604DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8510626PMC
December 2021

Assessing deep learning methods in cis-regulatory motif finding based on genomic sequencing data.

Brief Bioinform 2021 Oct 5. Epub 2021 Oct 5.

Key Laboratory of Symbol Computation and Knowledge Engineering of Ministry of Education, College of Computer Science and Technology, Jilin University, Changchun, 130012, China.

Identifying cis-regulatory motifs from genomic sequencing data (e.g. ChIP-seq and CLIP-seq) is crucial in identifying transcription factor (TF) binding sites and inferring gene regulatory mechanisms for any organism. Since 2015, deep learning (DL) methods have been widely applied to identify TF binding sites and predict motif patterns, with the strengths of offering a scalable, flexible and unified computational approach for highly accurate predictions. As far as we know, 20 DL methods have been developed. However, without a clear and systematic assessment, users will struggle to choose the most appropriate tool for their specific studies. In this manuscript, we evaluated 20 DL methods for cis-regulatory motif prediction using 690 ENCODE ChIP-seq, 126 cancer ChIP-seq and 55 RNA CLIP-seq data. Four metrics were investigated, including the accuracy of motif finding, the performance of DNA/RNA sequence classification, algorithm scalability and tool usability. The assessment results demonstrated the high complementarity of the existing DL methods. It was determined that the most suitable model should primarily depend on the data size and type and the method's outputs.
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http://dx.doi.org/10.1093/bib/bbab374DOI Listing
October 2021

The increased miRNA-150-5p expression of the tonsil tissue in patients with IgA nephropathy may be related to the pathogenesis of disease.

Int Immunopharmacol 2021 Sep 30;100:108124. Epub 2021 Sep 30.

Department of Nephrology, Shenzhen Second People's Hospital, Shenzhen, 518035, China; Health Science Center, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, China.

Background: The microRNA (miRNA) expression of the tonsil tissues in patients with immunoglobulin A (IgA) nephropathy (IgAN) has not been reported in the literature.

Methods: In this study, the expression of nine miRNAs was measured in the tonsil tissues of patients with IgAN, including miRNA-21-5p, miRNA-29a-3p, miRNA-34a-5p, miRNA-146a-5p, miRNA-146b-5p, miRNA-148b-3p, miRNA-150-5p, miRNA-155-5p, and miRNA-181a-5p. Forty patients with proved primary IgA nephropathy were enrolled in our study, 20 IgAN patients with gross hematuria, which induced by tonsillitis (GH-IgAN group) and 20 IgAN patients without gross hematuria in the history (non-GH-IgAN group). Another 20 patients recruited as the control group (CT group) were chronic tonsillitis without kidney disease.

Results: Compared to the CT group, the expression level of miRNA-150-5p in the tonsils was significantly upregulated in the GH-IgAN group, but not in the non-GH-IgAN group (P = 0.031 and P = 0.122, respectively). A correlation analysis was performed between the expression of miRNAs in the tonsils and the clinical data of IgAN patients. The results showed that in the GH-IgAN group, the miRNA-150 expression was positively correlated with systolic blood pressure (β = 2.36, 95% CI 1.11-3.61, P = 0.0016), diastolic blood pressure (β = 1.02, 95% CI 0.22-1.82, P = 0.0224), uric acid (β = 7.43, 95% CI 1.81-13.04, P = 0.0184), leukocyte count (β = 0.22, 95% CI 0.09-0.35, P = 0039), neutrophil count (β = 0.19, 95% CI 0.06-0.32, P = 0.0096), cholesterol (β = 0.09, 95% CI 0.02-0.16, P = 0.0207) and triglyceride level (β = 0.16, 95% CI 0.10-0.22, P < 0.000). Besides, it was negatively correlated with the estimated glomerular filtration rate (eGFR) (β = -2.06, 95% CI: -3.90 - -0.21, P = 0.0421) in the GH-IgAN group; however, no significant correlation was found in the non-GH-IgAN group.

Conclusion: The present findings suggest that miRNA-150-5p may be important in the pathogenesis of IgAN, especially in mucosal immunity against the disease.
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http://dx.doi.org/10.1016/j.intimp.2021.108124DOI Listing
September 2021

Combination of transcatheter arterial chemoembolization and portal vein embolization for patients with hepatocellular carcinoma: a review.

World J Surg Oncol 2021 Oct 1;19(1):293. Epub 2021 Oct 1.

Department of Interventional Ultrasound, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences , No. 1 East Banshan Road, Gongshu District, Hangzhou, 310022, People's Republic of China.

Background: Transcatheter arterial chemoembolization has been widely used in patients with hepatocellular carcinoma. However, double blood supply and the existence of portal vein tumor thrombus influence the efficacy of transcatheter arterial chemoembolization.

Main Body: Theoretically, portal vein embolization combined with transcatheter arterial chemoembolization may bring a breakthrough in the therapeutic effect of hepatocellular carcinoma. The feasibility, efficacy, long-term survival benefits, and side effects of the combined treatment have been explored in previous studies. Chemotherapeutic agents may also be added in the portal vein embolization procedure to further improve the treatment response.

Conclusion: In this study, we review the existing data and studies on the combined treatment in patients with hepatocellular carcinoma and provide an overall view of the strategy.
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http://dx.doi.org/10.1186/s12957-021-02401-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8487116PMC
October 2021

Heterojunction-based electron donators to stabilize and activate ultrafine Pt nanoparticles for efficient hydrogen atom dissociation and gas evolution.

Angew Chem Int Ed Engl 2021 Sep 28. Epub 2021 Sep 28.

Shanghai Jiao Tong University, School of Chemistry and Chemical Engineering, No.800 Dongchuan Road, 200240, Shanghai, CHINA.

Platinum (Pt) is the most effective bench-marked catalyst for producing renewable and clean hydrogen energy by electrochemical water splitting. There is demand for high HER catalytic activity to achieve efficient utilization and minimize the loading of Pt in catalysts. In this work, we significantly boost the HER mass activity of Pt nanoparticles in Pt x /Co to 8.3 times higher than that of commercial Pt/C by using Co/NC heterojunctions as a heterogeneous version of electron donors. The highly coupled interfaces between Co/NC and Pt metal enrich the electron density of Pt nanoparticles to facilitate the adsorption of H + , the dissociation of Pt-H bonds and H 2 release, giving the lowest HER overpotential of 6.9 mV vs. RHE at 10 mA/cm 2 in acid among reported HER electrocatalysts. Given the easy scale-up synthesis due to the stabilization of ultrafine Pt nanoparticles by Co/NC solid ligands, Pt x /Co can even be a promising substitute for commercial Pt/C for practical applications.
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http://dx.doi.org/10.1002/anie.202111920DOI Listing
September 2021

Traditional Chinese medicine in COVID-19.

Acta Pharm Sin B 2021 Sep 20. Epub 2021 Sep 20.

State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.

COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread across the globe, posing an enormous threat to public health and safety. Traditional Chinese medicine (TCM), in combination with Western medicine (WM), has made important and lasting contributions in the battle against COVID-19. In this review, updated clinical effects and potential mechanisms of TCM, presented in newly recognized three distinct phases of the disease, are summarized and discussed. By integrating the available clinical and preclinical evidence, the efficacies and underlying mechanisms of TCM on COVID-19, including the highly recommended three Chinese patent medicines and three Chinese medicine formulas, are described in a panorama. We hope that this comprehensive review not only provides a reference for health care professionals and the public to recognize the significant contributions of TCM for COVID-19, but also serves as an evidence-based in-depth summary and analysis to facilitate understanding the true scientific value of TCM.
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http://dx.doi.org/10.1016/j.apsb.2021.09.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8450055PMC
September 2021

Deep learning analysis and age prediction from shoeprints.

Forensic Sci Int 2021 Oct 30;327:110987. Epub 2021 Aug 30.

Department of Electrical Engineering and Computer Science, Bond Life Sciences Center, University of Missouri, Columbia, MO, United States. Electronic address:

Human gaits are the patterns of limb movements which involve both the upper and lower body parts. These patterns in terms of step rate, gait speed, stance widening, stride, and bipedal forces are influenced by different factors including environmental (such as social, cultural, and behavioral traits) and physical changes (such as age and health status). These factors are reflected on the imprinted shoeprints generated with body forces, which in turn can be used to predict age, a problem not systematically addressed using any computational approach. We collected 100,000 shoeprints of subjects ranging from 7 to 80 years old and used the data to develop a deep learning end-to-end model ShoeNet to analyze age-related patterns and predict age. The model integrates various convolutional neural network models together using a skip mechanism to extract age-related features, especially in pressure and abrasion regions from pair-wise shoeprints. The results show that 40.23% of the subjects had prediction errors within 5-years of age and the prediction accuracy for gender/sex classification reached 86.07%. Interestingly, the age-related features mostly reside in the asymmetric differences between left and right shoeprints. The analysis also reveals interesting age-related and gender-related patterns in the pressure distributions on shoeprints; in particular, the pressure forces spread from the middle of the toe toward outside regions over age with gender-specific variations of forces on heel regions. Such statistics provide insight into new methods for forensic investigations, medical studies of gait pattern disorders, biometrics, and sport studies.
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http://dx.doi.org/10.1016/j.forsciint.2021.110987DOI Listing
October 2021

RNALocate v2.0: an updated resource for RNA subcellular localization with increased coverage and annotation.

Nucleic Acids Res 2021 Sep 22. Epub 2021 Sep 22.

Department of Bioinformatics, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China.

Resolving the spatial distribution of the transcriptome at a subcellular level can increase our understanding of biology and diseases. To facilitate studies of biological functions and molecular mechanisms in the transcriptome, we updated RNALocate, a resource for RNA subcellular localization analysis that is freely accessible at http://www.rnalocate.org/ or http://www.rna-society.org/rnalocate/. Compared to RNALocate v1.0, the new features in version 2.0 include (i) expansion of the data sources and the coverage of species; (ii) incorporation and integration of RNA-seq datasets containing information about subcellular localization; (iii) addition and reorganization of RNA information (RNA subcellular localization conditions and descriptive figures for method, RNA homology information, RNA interaction and ncRNA disease information) and (iv) three additional prediction tools: DM3Loc, iLoc-lncRNA and iLoc-mRNA. Overall, RNALocate v2.0 provides a comprehensive RNA subcellular localization resource for researchers to deconvolute the highly complex architecture of the cell.
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http://dx.doi.org/10.1093/nar/gkab825DOI Listing
September 2021

Identification and Characterization of a Novel Aminoglycoside 3''-Nucleotidyltransferase, ANT(3'')-IId, From .

Front Microbiol 2021 31;12:728216. Epub 2021 Aug 31.

Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, Ministry of Education, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China.

A novel plasmid-encoded aminoglycoside 3''-nucleotidyltransferase ANT(3")-IId, was discovered in strain H7 isolated from a chick on an animal farm in Wenzhou, China. The whole-genome of H7 consisted of one chromosome and five plasmids (pH7-250, pH7-108, pH7-68, pH7-48, and pH7-11). was identified as being encoded on pH7-250, sharing the highest amino acid identity of 50.64% with a function-known resistance gene, (KB849358.1). Susceptibility testing and enzyme kinetic parameter analysis were conducted to determine the function of the aminoglycoside 3"-nucleotidyltransferase. The gene conferred resistance to spectinomycin and streptomycin [the minimum inhibitory concentration (MIC) levels of both increased 16-fold compared with the control strain]. Consistent with the MIC data, kinetic analysis revealed a narrow substrate profile including spectinomycin and streptomycin, with / ratios of 4.99 and 4.45×10M S, respectively. Sequencing analysis revealed that the gene was associated with insertion sequences (IS) element [ΔIS-ΔIS-hp-orf-orf-orf1-], and were identified in plasmids from various species. This study of the novel aminoglycoside 3"-nucleotidyltranferase ANT(3")-IId helps us further understand the functional and sequence characteristics of aminoglycoside 3"-nucleotidyltranferases, highlights the risk of resistance gene transfer among species and suggests that attention should be given to the emergence of new aminoglycoside 3"-nucleotidyltranferase genes.
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http://dx.doi.org/10.3389/fmicb.2021.728216DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8438517PMC
August 2021

MULocDeep: A deep-learning framework for protein subcellular and suborganellar localization prediction with residue-level interpretation.

Comput Struct Biotechnol J 2021 18;19:4825-4839. Epub 2021 Aug 18.

Department of Electrical Engineering and Computer Science, Bond Life Sciences Center, Columbia, MO, USA.

Prediction of protein localization plays an important role in understanding protein function and mechanisms. In this paper, we propose a general deep learning-based localization prediction framework, MULocDeep, which can predict multiple localizations of a protein at both subcellular and suborganellar levels. We collected a dataset with 44 suborganellar localization annotations in 10 major subcellular compartments-the most comprehensive suborganelle localization dataset to date. We also experimentally generated an independent dataset of mitochondrial proteins in cell cultures, tubers, and roots and made this dataset publicly available. Evaluations using the above datasets show that overall, MULocDeep outperforms other major methods at both subcellular and suborganellar levels. Furthermore, MULocDeep assesses each amino acid's contribution to localization, which provides insights into the mechanism of protein sorting and localization motifs. A web server can be accessed at http://mu-loc.org.
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http://dx.doi.org/10.1016/j.csbj.2021.08.027DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8426535PMC
August 2021

Characterization and Hydration Mechanism of Ammonia Soda Residue and Portland Cement Composite Cementitious Material.

Materials (Basel) 2021 Aug 24;14(17). Epub 2021 Aug 24.

Key Laboratory of the Ministry of Education of China for High-Efficient Mining and Safety of Metal Mines, University of Science and Technology Beijing, Beijing 100083, China.

The use of ammonia soda residue (ASR) to prepare building materials is an effective way to dispose of ASR on a large scale, but this process suffers from a lack of data and theoretical basis. In this paper, a composite cementitious material was prepared using ASR and cement, and the hydration mechanism of cementitious materials with 5%, 10%, and 20% ASR was studied. The XRD and SEM results showed that the main hydration products of ASR-cement composite cementitious materials were an amorphous C-S-H gel, hexagonal plate-like Ca(OH) (CH), and regular hexagonal plate-like Friedel's salt (FS). The addition of ASR increased the heat of hydration of the cementitious material, which increased upon increasing the ASR content. The addition of ASR also reduced the cumulative pore volume of the hardened paste, which displayed the optimal pore structure when the ASR content was 5%. In addition, ASR shortened the setting time compared with the cement group, and the final setting times of the pastes with 5%, 10%, and 20% ASR were 30 min, 45 min, and 70 min shorter, respectively. When the ASR content did not exceed 10%, the 3-day compressive strength of the mortar was significantly improved, but the 28-day compressive strength was worse. Finally, the hydration mechanism and potential applications of the cementitious material are discussed. The results of this paper promote the use of ASR in building materials to reduce CO emissions in the cement industry.
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http://dx.doi.org/10.3390/ma14174794DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432485PMC
August 2021

Fluorescent wood with non-cytotoxicity for effective adsorption and sensitive detection of heavy metals.

J Hazard Mater 2021 08 20;416:126166. Epub 2021 May 20.

College of Materials Science and Engineering, Central South University of Forestry and Technology, Changsha 410004, China.

Heavy metal pollution is one of the primary challenges of water pollution, and the fabrication of highly effective, green and non-toxic adsorbents for heavy metals is urgently required on the basis of environmental and sustainable development strategies. Here, we report a novel fluorescent wood (FW) with effective adsorption ability (maximum theoretical adsorption capacity of 98.14 mg/g for hexavalent chromium [Cr(VI)]), good fluorescence properties (absolute quantum yield of 12.8%), non-cytotoxicity (cell viability of >90%) and high detection sensitivity and selectivity for Cr(VI). The FW was formed using a process involving delignification, infiltration with carbon dots, and free-radical polymerization with acrylic acid. Mechanistic analysis confirmed that the reconstructed 3D porous structure of the FW provided many effective sorption sites, such as amino, hydroxyl and carboxyl groups. This improved the adsorption ability and stabilized the fluorescence signal, which enhanced the detection ability. These factors give the novel FW considerable potential for use in the removal of Cr(VI) ions from wastewater.
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http://dx.doi.org/10.1016/j.jhazmat.2021.126166DOI Listing
August 2021

Encapsulation of cesium with a solid waste-derived sulfoaluminate matrix: A circular economy approach of treating nuclear wastes with solid wastes.

J Hazard Mater 2021 08 21;416:126156. Epub 2021 May 21.

Shandong Engineering Laboratory for Solid Waste Green Materials, National Engineering Laboratory for Reducing Emissions from Coal Combustion, Engineering Research Center of Environmental Thermal Technology of Ministry of Education, Shandong Key Laboratory of Energy Carbon Reduction and Resource Utilization, School of Energy and Power Engineering, Shandong University, Jinan 250014, China. Electronic address:

It is of great importance to safely dispose nuclear wastes with the development of nuclear industries. Past approaches to this problem have included immobilizing radioactive cesium in Portland cement-based matrices; however, the leaching rates of cesium are relatively high, especially as the leaching temperature increases. This paper explores a high-efficiency and cost-effective approach for encapsulating cesium using a sulfoaluminate cement (SAC) matrix, which was prepared via synergetic use of industrial solid wastes. Leaching results showed that, the apparent diffusion coefficient values of cesium were only ~1.4 × 10 cm/s and ~5 × 10 cm/s at 25 ℃ and 90 ℃ leaching conditions, respectively. These values were several orders of magnitude lower when compared with previously reported values, indicating the excellent encapsulation performance of the solid-waste-based SAC for cesium. Moreover, the heavy metals contained in the industrial solid waste were also effectively immobilized. A mechanistic analysis revealed that cesium was encapsulated in the SAC matrices stably by a physical effect. Finally, a life cycle assessment and economic analysis indicated that this approach was environmental-friendly, cost-effective, and energy-saving. This work provides a promising strategy for effective encapsulation of cesium and synergetic treatment of industrial solid wastes.
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http://dx.doi.org/10.1016/j.jhazmat.2021.126156DOI Listing
August 2021

Hypoglycemic and lipid lowering effects of theaflavins in high-fat diet-induced obese mice.

Food Funct 2021 Oct 19;12(20):9922-9931. Epub 2021 Oct 19.

State Key Laboratory of Tea Plant Biology and Utilization/Key Laboratory of Tea Biology and Tea Processing of Ministry of Agriculture/Anhui Provincial Laboratory of Tea Plant Biology and Utilization, Anhui Agricultural University, Hefei, China.

Theaflavins (TFs) are the characteristic components of black tea and have been widely acknowledged for their health benefits. The current study aimed to investigate the effects and mechanism of TFs, TF1, TF2a and TF3 on glycolipid metabolism in obese mice induced by a high-fat diet (HFD). Mice were randomly divided into seven groups ( = 8 per group) as follows: low-fat diet (LFD), HFD, HFD + metformin (Met, 100 mg kg d), HFD + TFs (TFs, 200 mg kg d), HFD + TF1 (TF1, 100 mg kg d), HFD + TF2a (TF2a, 100 mg kg d), and HFD + TF3 (TF3, 100 mg kg d). All groups were studied for 9 weeks continuously. The levels of serum glucose, insulin, TC, TG, LDL and HLD in the plasma, lipid accumulation in the liver, and injury of the liver were investigated. In addition, the effects of TFs and their monomers on the SIRT6/AMPK/SREBP-1/FASN pathway were also evaluated. The results showed that oral administration of TFs, TF1, TF2a and TF3 not only dramatically suppressed weight gain, reduced blood glucose level, and ameliorated insulin resistance but also obviously lowered the levels of serum TC, TG and LDL, suppressed the activities of ALT and AST, and ameliorated hepatic damage in mice fed a HFD when compared to the HFD group. Western blot analysis showed that TFs, TF1, TF2a and TF3 treatments increased the expression of SIRT6 and suppressed the expression levels of SREBP-1 and FASN significantly in mice fed a HFD as compared to the HFD group. The phosphorylation of AMPK in mice fed a HFD was obviously elevated by TF2a and TF3 when compared to the HFD group. These results proved for the first time that TF1, TF2a and TF3 improved the glucolipid metabolism of mice fed a HFD, and activated the SIRT6/AMPK/SREBP-1/FASN signaling pathway to inhibit the synthesis and accumulation of lipids in the liver to ameliorate obesity in mice fed a HFD. These findings indicate that TFs, TF1, TF2a and TF3 as the main functional components of black tea might potentially be used as a food additive for improving glycolipid metabolism and ameliorating obesity, and TF3 may be the best choice.
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http://dx.doi.org/10.1039/d1fo01966jDOI Listing
October 2021

Diversity and Biocontrol Potential of Culturable Endophytic Fungi in Cotton.

Front Microbiol 2021 13;12:698930. Epub 2021 Aug 13.

Key Laboratory of Integrated Pest Management Crops in Central China, Ministry of Agriculture, Hubei Academy of Agricultural Sciences, Wuhan, China.

Healthy cotton samples were collected and 93 endophytic fungal strains were isolated: 23 strains from the roots and 70 strains from the stems. Morphological characterization and ITS sequence analysis were used for the identification of these isolates. The results showed that the 93 strains including 20 species were highly diverse in terms of their taxonomy. Simpson's and Shannon's diversity indices were 0.915 and 3.848, respectively. and were the two dominant genera, constituting 19.4% of the total strains. Then, 72 spore-producing strains were tested for the suppression of cotton wilt (CVW) caused by in a greenhouse. Five strains exhibited effective suppression of CVW with average efficacy values higher than 50%. One of the effective strains, namely, 10R-7, was selected for the investigation of the role of fusaric acid, a secondary metabolite of strain 10R-7, in the suppression of and CVW. The results showed that 10R-7 could produce fusaric acid, and this metabolite exhibited 100% inhibition of mycelial growth of at concentrations higher than 20 μg/ml. However, fusaric acid at 2.5 to 80 μg/ml was not effective in the suppression of CVW, compared with the control treatment with alone. 10R-7 was labeled with green fluorescent protein (GFP), and the GFP-tagged strain was found to be able to colonize inside the taproots of cotton, suggesting that 10R-7 is a true endophyte of cotton and endophytic colonization may play a role in the suppression of infection of cotton by .
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http://dx.doi.org/10.3389/fmicb.2021.698930DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8415002PMC
August 2021

Ultrasound-guided fine needle aspiration cytology of Para-aortic lymph node metastasis in uterine cervical cancer: diagnostic accuracy and impact on clinical decision making.

BMC Cancer 2021 Aug 27;21(1):964. Epub 2021 Aug 27.

Department of Ultrasound, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), No.1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang Province, China.

Objective: The main aim of this study was to ascertain the effectiveness of ultrasound-guided fine needle aspiration cytology (US-FNAC) in the diagnosis of para-aortic lymph node (PALN) metastasis in uterine cervical cancer and to establish its potential impact on clinical therapeutic decision making.

Methods: We retrospectively reviewed clinical data from 92 patients diagnosed with cervical cancer with PALN enlargement between 2010 and 2018. Cytological results obtained with US-FNAC were classified by the same experienced cellular pathologists. Diagnostic indicators were determined on the basis of biopsy, imaging and clinical follow-up results. Univariate and multivariate analyses were used to assess the differences of influencing factors. The effect of US-FNAC on clinical decision making was evaluated.

Results: Cytological results of US-FNAC were categorized as malignancy (n = 62; 67.4%), suspicious malignancy (n = 11; 12.0%), undetermined (n = 5; 5.4%), benign (n = 10; 10.9%), and inadequate (n = 4; 4.3%). Satisfactory biopsy samples were obtained from 95.7% of PALNs sampled (88/92). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNAC in distinguishing benign from malignant cases were 90.1% (95% CI: 0.809-0.953), 100% (95% CI: 0.561-1), 100% (95% CI: 0.938-1), 46.7% (95% CI: 0.223-0.726) and 90.9% (95% CI: 0.848-0.970), respectively. Univariate analysis indicated significant differences in experience of puncture physicians (radiologists) between the correct and wrong diagnosis groups (P < 0.05), which was further confirmed as an independent predictor of diagnostic accuracy in multivariate analysis (p = 0.031, OR = 0.077, 95% CI: 0.354-0.919). All patients tolerated the US-FNAC procedure well and only nine presented slight abdominal discomfort. The therapeutic strategies for 74 patients (80.4%) were influenced by US-FNAC findings.

Conclusions: US-FNAC was a relatively safe and effective technique for examination of enlarged para-aortic lymph nodes and may therefore serve as a routine diagnostic tool to guide clinical decision making for management of cervical cancer.
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http://dx.doi.org/10.1186/s12885-021-08492-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8393715PMC
August 2021

Variation in Gene Expression between Two Lines Differing in Innate Immunity Response.

Plants (Basel) 2021 Jul 27;10(8). Epub 2021 Jul 27.

Divisions of Plant Science and Technology and Biochemistry, C. S. Bond Life Sciences Center, University of Missouri, Columbia, MO 65211, USA.

Microbe associated molecular pattern (MAMPs) triggered immunity (MTI) is a key component of the plant innate immunity response to microbial recognition. However, most of our current knowledge of MTI comes from model plants (i.e., ) with comparatively less work done using crop plants. In this work, we studied the MAMP triggered oxidative burst (ROS) and the transcriptional response in two genotypes, BTx623 and SC155-14E. SC155-14E is a line that shows high anthracnose resistance and the line BTx623 is susceptible to anthracnose. Our results revealed a clear variation in gene expression and ROS in response to either flagellin (flg22) or chitin elicitation between the two lines. While the transcriptional response to each MAMP and in each line was unique there was a considerable degree of overlap, and we were able to define a core set of genes associated with the sorghum MAMP transcriptional response. The GO term and KEGG pathway enrichment analysis discovered more immunity and pathogen resistance related DEGs in MAMP treated SC155-14E samples than in BTx623 with the same treatment. The results provide a baseline for future studies to investigate innate immunity pathways in sorghum, including efforts to enhance disease resistance.
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http://dx.doi.org/10.3390/plants10081536DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8399927PMC
July 2021

Impact of the gate-keeping policies of China's primary healthcare model on the future burden of tuberculosis in China: a protocol for a mathematical modelling study.

BMJ Open 2021 08 25;11(8):e048449. Epub 2021 Aug 25.

Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China.

Introduction: In the past three decades, China has made great strides in the prevention and treatment of tuberculosis (TB). However, the TB burden remains high. In 2019, China accounted for 8.4% of global incident cases of TB, the third highest in the world, with a higher prevalence in rural areas. The Healthy China 2030 highlights the gate-keeping role of primary healthcare (PHC). However, the impact of PHC reforms on the future TB burden is unclear. We propose to use mathematical models to project and evaluate the impacts of different gate-keeping policies.

Methods And Analysis: We will develop a deterministic, population-level, compartmental model to capture the dynamics of TB transmission within adult rural population. The model will incorporate seven main TB statuses, and each compartment will be subdivided by service providers. The parameters involving preference for healthcare seeking will be collected using discrete choice experiment (DCE) method. We will solve the deterministic model numerically over a 20-year (2021-2040) timeframe and predict the TB prevalence, incidence and cumulative new infections under the status quo or various policy scenarios. We will also conduct an analysis following standard protocols to calculate the average cost-effectiveness for each policy scenario relative to the status quo. A numerical calibration analysis against the available published TB prevalence data will be performed using a Bayesian approach.

Ethics And Dissemination: Most of the data or parameters in the model will be obtained based on secondary data (eg, published literature and an open-access data set). The DCE survey has been reviewed and approved by the Ethics Committee of the School of Public Health, Sun Yat-sen University. The approval number is SYSU [2019]140. Results of the study will be disseminated through peer-reviewed journals, media and conference presentations.
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http://dx.doi.org/10.1136/bmjopen-2020-048449DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8390147PMC
August 2021

Preclinical efficacy and clinical safety of clinical-grade nebulized allogenic adipose mesenchymal stromal cells-derived extracellular vesicles.

J Extracell Vesicles 2021 Aug 14;10(10):e12134. Epub 2021 Aug 14.

Department of Pulmonary and Critical Care Medicine Rui-jin Hospital Shanghai Jiao-tong University School of Medicine Shanghai China.

Mesenchymal stromal cell-derived extracellular vesicles (MSC-EVs) turn out to be a promising source of cell-free therapy. Here, we investigated the biodistribution and effect of nebulized human adipose-derived MSC-EVs (haMSC-EVs) in the preclinical lung injury model and explored the safety of nebulized haMSC-EVs in healthy volunteers. DiR-labelled haMSC-EVs were used to explore the distribution of nebulized haMSC-EVs in the murine model. -induced murine lung injury model was established, and survival rate, as well as WBC counts, histology, IL-6, TNF-α and IL-10 levels in bronchoalveolar lavage fluid (BALF) were measured to explore the optimal therapeutic dose of haMSC-EVs through the nebulized route. Twenty-four healthy volunteers were involved and received the haMSC-EVs once, ranging from 2 × 10 particles to 16 × 10 particles (). Nebulizing haMSC-EVs improved survival rate to 80% at 96 h in -induced murine lung injury model by decreasing lung inflammation and histological severity. All volunteers tolerated the haMSC-EVs nebulization well, and no serious adverse events were observed from starting nebulization to the 7th day after nebulization. These findings suggest that nebulized haMSC-EVs could be a promising therapeutic strategy, offering preliminary evidence to promote the future clinical applications of nebulized haMSC-EVs in lung injury diseases.
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http://dx.doi.org/10.1002/jev2.12134DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8363910PMC
August 2021

Rational engineering the DNA tetrahedrons of dual wavelength ratiometric electrochemiluminescence biosensor for high efficient detection of SARS-CoV-2 RdRp gene by using entropy-driven and bipedal DNA walker amplification strategy.

Chem Eng J 2022 Jan 9;427:131686. Epub 2021 Aug 9.

NHC Key Laboratory of Nuclear Medicine, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu 214063, China.

Fast and effective detection of epidemics is the key to preventing the spread of diseases. In this work, we constructed a dual-wavelength ratiometric electrochemiluminescence (ECL) biosensor based on entropy-driven and bipedal DNA walker cycle amplification strategies for detection of the RNA-dependent RNA polymerase (RdRp) gene of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The entropy-driven cyclic amplification reaction was started by the SARS-CoV-2 RdRp gene to generate a bandage. The bandage could combine with two other single-stranded S1 and S2 to form a bipedal DNA walker to create the following cycle reaction. After the bipedal DNA walker completed the walking process, the hairpin structures at the top of the DNA tetrahedrons (TDNAs) were removed. Subsequently, the [email protected]@AuNPs-S7 probes were used to combine with the excised hairpin part of TDNAs on the surface of Au-g-CN, and the signal change was realized employing electrochemiluminescence resonance energy transfer (ECL-RET). By combining entropy-driven and DNA walker cycle amplification strategy, the ratiometric ECL biosensor exhibited a limit of detection (LOD) as low as 7.8 aM for the SARS-CoV-2 RdRp gene. As a result, detecting the SARS-CoV-2 RdRp gene in human serum still possessed high recovery so that the dual-wavelength ratiometer biosensor could be used in early clinical diagnosis.
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http://dx.doi.org/10.1016/j.cej.2021.131686DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8349740PMC
January 2022

Identification of a robust signature for clinical outcomes and immunotherapy response in gastric cancer: based on N6-methyladenosine related long noncoding RNAs.

Cancer Cell Int 2021 Aug 16;21(1):432. Epub 2021 Aug 16.

Xijing Hospital, Airforce Medical University, Xi'an, 710032, China.

Background: Gastric cancer (GC) is a globally prevalent cancer, ranking fifth for incidence and fourth for mortality worldwide. The N6-methyladenosine (mA) related long noncoding RNAs (lncRNAs) were widely investigated in recent studies. Nevertheless, the underlying prognostic implication and tumor immune mechanism of mA-related lncRNA in GC remain unknown.

Methods: We systematically assessed the mA modification expression of 407 GC clinical samples based on 23 mA regulators and comprehensively associated these genes with lncRNAs. Then, we constructed a mA-related lncRNA prognostic signature (mA-LPS) to evaluate both status and prognosis of the disease. Immune-related mechanisms were explored via dissecting tumor-infiltrating cells as well as applying tumor immune dysfunction and the exclusion algorithm. Furthermore, we validated the latent regulative mechanism of mA-related lncRNA in GC cell lines.

Results: The mA-LPS containing nine hub lncRNAs was built, which possessed a superior capability to predict the outcomes of GC patients. Meanwhile, we found an intimate correlation between the mA-LPS and tumor infiltrating cells, and that the low-risk group had a higher expression of immune checkpoints and responsed more to immunotherapy than the high-risk group. Clinically, these crucial lncRNAs expression levels were verified in ten pairs of GC samples. In in vitro experiments, the abilities of migration and proliferation were significantly enhanced via downregulating the lncRNA AC026691.1. Both migrative and proliferative capabilities of tumor cells were significantly enhanced via downregulating the lncRNA AC026691.1. in vitro.

Conclusions: Collectively, the mA-LPS could provide a novel prediction insight into the prognosis of GC patients and serve as an independent clinical factor for GC. These mA-related lncRNAs might remodel the tumor microenvironment and affect the anti-cancer ability of immune checkpoint blockers. Importantly, lncRNA AC026691.1 could inhibit both migration and proliferation of GC by means of FTO regulation.
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http://dx.doi.org/10.1186/s12935-021-02146-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8365962PMC
August 2021

New Internet-Based Warfarin Anticoagulation Management Approach After Mechanical Heart Valve Replacement: Prospective, Multicenter, Randomized Controlled Trial.

J Med Internet Res 2021 08 13;23(8):e29529. Epub 2021 Aug 13.

Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Background: Mechanical heart valve replacement (MHVR) is an effective method for the treatment of severe heart valve disease; however, it subjects patient to lifelong warfarin therapy after MHVR with the attendant risk of bleeding and thrombosis. Whether internet-based warfarin management reduces complications and improves patient quality of life remains unknown.

Objective: This study aimed to compare the effects of internet-based warfarin management and the conventional approach in patients who received MHVR in order to provide evidence regarding alternative strategies for long-term anticoagulation.

Methods: This was a prospective, multicenter, randomized, open-label, controlled clinical trial with a 1-year follow-up. Patients who needed long-term warfarin anticoagulation after MHVR were enrolled and then randomly divided into conventional and internet-based management groups. The percentage of time in the therapeutic range (TTR) was used as the primary outcome, while bleeding, thrombosis, and other events were the secondary outcomes.

Results: A total of 721 patients were enrolled. The baseline characteristics did not reach statistical differences between the 2 groups, suggesting the random assignment was successful. As a result, the internet-based group showed a significantly higher TTR (mean 0.53, SD 0.24 vs mean 0.46, SD 0.21; P<.001) and fraction of time in the therapeutic range (mean 0.48, SD 0.22 vs mean 0.42, SD 0.19; P<.001) than did those in the conventional group. Furthermore, as expected, the anticoagulation complications, including the bleeding and embolic events had a lower frequency in the internet-based group than in the conventional group (6.94% vs 12.74%; P=.01). Logistic regression showed that internet-based management increased the TTR by 7% (odds ratio [OR] 1.07, 95% CI 1.05-1.09; P<.001) and reduced the bleeding and embolic risk by 6% (OR 0.94, 95% CI 0.92-0.96; P=.01). Moreover, low TTR was found to be a risk factor for bleeding and embolic events (OR 0.87, 95% CI 0.83-0.91; P=.005).

Conclusions: The internet-based warfarin management is superior to the conventional method, as it can reduce the anticoagulation complications in patients who receive long-term warfarin anticoagulation after MHVR.

Trial Registration: Chinese Clinical Trial Registry ChiCTR1800016204; http://www.chictr.org.cn/showproj.aspx?proj=27518.

International Registered Report Identifier (irrid): RR2-10.1136/bmjopen-2019-032949.
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http://dx.doi.org/10.2196/29529DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8398748PMC
August 2021

Twelve-month systemic consequences of COVID-19 in patients discharged from hospital: a prospective cohort study in Wuhan, China.

Clin Infect Dis 2021 Aug 14. Epub 2021 Aug 14.

National Medical Center for Major Public Health Events, Wuhan, China.

Background: Follow-up study of Coronavirus disease 2019 (COVID-19) survivors has rarely been reported. We aimed to investigate longitudinal changes in the characteristics of COVID-19 survivors after discharge.

Methods And Findings: A total of 594 COVID-19 survivors discharged from Tongji Hospital in Wuhan from February 10 to April 30, 2020 were included and followed up until May 17, 2021. Laboratory and radiological findings, pulmonary function tests, electrocardiogram, symptoms and signs were analyzed. 257 (51.2%) patients had at least one symptom at 3 months post-discharge, which decreased to 169 (40.0%) and 138 (28.4%) at 6-month and 12-month visit respectively. During follow-up period, insomnia, chest tightness, and fatigue were the most prevalent symptoms. Most laboratory parameters returned to normal, whereas increased incidence of abnormal liver and renal function and cardiovascular injury was evidenced after discharge. Fibrous stripes (213; 42.4%), pleural thickening and adhesions (188; 37.5%) and enlarged lymph nodes (120; 23.9%) were the most common radiographical findings at 3 months post-discharge. The abnormalities of pulmonary function included obstructive, restrictive, and mixed, which were 5.5%, 4.0%, 0.9% at 6 months post, and 1.9%, 4.7%, 0.2% at 12 months. Electrocardiogram abnormalities occurred in 256 (51.0%) patients at 3 months post-discharge, including arrhythmia, ST-T change and conduction block, which increased to 258 (61.1%) cases at 6-month visit and were maintained at high frequency (242;49.8%) at 12-month visit.

Conclusions: Physiological, laboratory, radiological or electrocardiogram abnormalities, particularly those related to renal, cardiovascular, liver functions are common in patients who recovered from COVID-19 up to 12months post-discharge.
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http://dx.doi.org/10.1093/cid/ciab703DOI Listing
August 2021

Adherence to Traditional Chinese Postpartum Practices and Postpartum Depression: A Cross-Sectional Study in Hunan, China.

Front Psychiatry 2021 27;12:649972. Epub 2021 Jul 27.

Xiangya School of Public Health, Central South University, Changsha, China.

The relationship between adherence to traditional Chinese postpartum practices (known as "doing-the-month") and postpartum depression (PPD) remains unknown. Practices including restrictions on diet, housework and social activity, personal hygiene, and cold contact, could introduce biological, psychological, and socio-environmental changes during postpartum. The cross-sectional study included 955 postpartum women in obstetric clinics in Hunan Province of China between September 2018 to June 2019. Thirty postpartum practices were collected by a self-report online structured questionnaire. Postpartum depression symptoms were assessed by the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS). Multivariable linear regression was used to estimate the differences in EPDS scores according to adherence to postpartum practices. Firth's bias-reduced logistic regression was employed to analyze the binary classification of having PPD symptoms (EPDS ≥ 10). Overall, both moderate and low adherence to postpartum practices appeared to be associated with higher EPDS scores (adjusted difference 1.07, 95% CI 0.20, 1.94 for overall moderate adherence; and adjusted difference 1.72, 95% CI 0.84, 2.60 for overall low adherence). In analyses by practice domain, low adherence to housework-related and social activity restrictions was associated with having PPD symptoms compared with high adherence (OR 1.61, 95% CI 1.07, 2.43). Low adherence to traditional Chinese postpartum practices was associated with higher EPDS scores indicating PPD symptoms, especially in the domain of housework-related and social activity restrictions. Psychosocial stress and unsatisfactory practical support related to low adherence to postpartum practices might contribute to PPD. Longitudinal study and clinical assessment would be needed to confirm these findings.
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http://dx.doi.org/10.3389/fpsyt.2021.649972DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8353075PMC
July 2021
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