Publications by authors named "Gang Xiong"

107 Publications

Cancer-elicited inflammation attenuates response and outcome in tyrosine kinase inhibitor naive patients with advanced NSCLC.

Pharmacol Res 2021 Jun 19;170:105734. Epub 2021 Jun 19.

Biological Resource Center, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China; Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China. Electronic address:

Objective: Cancer elicited inflammation is the main environmental cause leading to carcinogenesis and metastasis of non-small cell lung cancer (NSCLC). Roles of the inflammatory biomarker in predicting the clinical efficacy of tyrosine kinase inhibitor (TKI) and prognosis of naive patients with advanced NSCLC need to be determined, and the best inflammatory predicted biomarker remains unknown.

Methods: A total of 178 eligible advanced NSCLC patients (124 and 54 cases within discovery and validation cohorts, respectively) who received first-line EGFR-TKI between July of 2014 and October of 2020 were enrolled in the present study. We detected circulating immune cell counting, albumin (Alb), pre-albumin (pAlb), ALP, AST, LDH, GGT, HDL-c, and fibrinogen (Fib) concentrations, and calculated 22 inflammatory ratios and scores. Logistic regression and Cox proportional hazards models were used to assess the impact of these ratios and scores on objective response and disease control rate (ORR and DCR) as well as progression-free survival (PFS) in these patients.

Results: Twenty-five percentage and 24.07% of NSCLC patients were observed objective response to the treatment of first-line EGFR-TKI in discovery and validation cohort, respectively. Univariate and multivariate Cox regression showed that high PLR, NPS, SII, SIS, mSIS, GLR and FPR as well as low PNI were significantly associated with poor PFS in discovery cohort. However, only high SII and FPR were found to be associated with unsatisfactory outcome in validation cohort. Time-dependent areas under ROC of FPR were 0.702 (0.517-0.888) in discovery cohort, and 0.767 (0.613-0.921) in validation cohort, which were extremely higher than the other biomarkers. The patients with FPR-SII combined score 2 harbored worse prognosis compared to the combined score 0 in discovery (p = 0.003, adjusted HR = 2.888, 95%CI = 1.500-5.560) and validation cohort (p = 0.001, adjusted HR = 3.769, 95%CI = 1.676-8.478) as well as overall population (p < 0.001, adjusted HR = 3.109, 95%CI = 1.878-5.147), and its time-dependent AUCs were 0.747 (0.594-0.900) and 0.815 (0.688-0.942) in the two cohorts, respectively, which were significantly higher than the single biomarker in the two cohorts. The patients with high FPR and FPR-SII score harbored worse DCR than the low patients in the two cohorts and overall population, respectively. Moreover, the similar poor survival was observed in advanced high-FPR NSCLC patients with different treatment options, however, the survival of low-FPR patients with treatment of single TKI, radiotherapy or chemotherapy or radio-chemotherapy combined TKI was good compared to the high-FPR patients with radio-chemotherapy combined TKI, and the survival differences were observed between TKI (p < 0.001) or radiotherapy combined TKI (p = 0.014) treated low-FPR patients and the high FPR patients. Additionally, FPR-SII combined score could monitor the progression of the disease in real-time, and the median month of the positive score appearance was significantly earlier than CT/MRI detection (p < 0.001 for 3 months vs. 13 months).

Conclusions: High-grade cancer elicited inflammation could attenuates response and outcome in tyrosine kinase inhibitor naive patients with advanced NSCLC. FPR-SII combined score was the best inflammatory biomarker to monitor and predict the progression of advanced NSCLC patients with treatment of TKI.
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http://dx.doi.org/10.1016/j.phrs.2021.105734DOI Listing
June 2021

Circular RNA_0074027 participates in cell proliferation, apoptosis and metastasis of colorectal cancer cells through regulation of miR‑525‑3p.

Mol Med Rep 2021 05 24;23(5). Epub 2021 Mar 24.

Department of General Surgery, Dazhou Central Hospital, Dazhou, Sichuan 635000, P.R. China.

The present study aimed to elucidate the biological function of circular RNAs (circRNA) 0074027 in colorectal cancer (CRC). The expression of circRNA‑0074027 in CRC tissues and cells was determined by reverse transcription‑quantitative PCR. The experiments, including Cell Counting Kit‑8 (CCK‑8) assay, 5‑Ethynyl‑2'‑deoxyuridine assay, flow cytometry and Transwell assay, were applied to evaluate cell proliferation, apoptosis and metastasis ability respectively following downregulation of circRNA‑0074027. The correlation between circRNA‑0074027 and micro (mi)RNA‑525‑3p was determined via dual‑luciferase reporter assay. Finally, western blotting was used to explore the possible regulatory mechanism. CircRNA‑0074027 was upregulated in CRC tissues, while miR‑525‑3p expression was reduced. In addition, patients with CRC and circRNA‑0074027 overexpression were more likely to have low tumor differentiation, lymph node metastasis and advanced TMN stage. Deletion of circRNA‑0074027 could suppress cell proliferation and metastasis through up-regulating p53 expression and forbidding epithelial‑mesenchymal transition signaling pathway. The addition of miRNA‑525‑3p inhibitors could reverse the anti‑tumor effects induced by the deletion of circRNA‑0074027. The downregulation of cirRNA_0074027 inhibited tumor progression via sponging miR‑525‑3p, which could be a promising treatment bio‑marker for CRC.
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http://dx.doi.org/10.3892/mmr.2021.11963DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7974509PMC
May 2021

The complete mitochondrial genome of the Shen and its phylogenetic analyses.

Mitochondrial DNA B Resour 2021 Feb 3;6(2):329-330. Epub 2021 Feb 3.

College of Animal Science and Technology, Hunan Agriculture University, Changsha, Hunan, China.

The mitochondrial genome of one species Shen was sequenced and annotated. The mitogenome is 19,207 bp in length, containing 37 typical genes. The A + T content of the whole mitogenome is 56.6%. All of the protein-condoning genes (PCGs) started with ATG and stopped with TGA. The tRNA-Pro, tRNA-Gln, tRNA-Ala, tRNA-Asn, tRNA-Cys, tRNA-Tyr, tRNA-Ser, tRNA-Glu, andND5 are located in the circular mitochondrial L chain. The phylogeny tree is monophyletic among 14 related species. The Shen cluster was more closely related to Boulenger and Lu, Y.-Y., and P.-P. Li. This mitochondrial genome can be used for further analyses of mitochondrial comparative genomics to improve the understanding of diverse species.
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http://dx.doi.org/10.1080/23802359.2020.1866454DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7872534PMC
February 2021

Clinical application of an automatic facial recognition system based on deep learning for diagnosis of Turner syndrome.

Endocrine 2021 06 10;72(3):865-873. Epub 2020 Nov 10.

State Key Laboratory for Management and Control of Complex Systems, Beijing Engineering Research Center of Intelligent Systems and Technology, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China.

Purpose: Automated facial recognition technology based on deep learning has achieved high accuracy in diagnosing various endocrine diseases and genetic syndromes. This study attempts to establish a facial diagnostic system for Turner syndrome (TS) based on deep convolutional neural networks.

Methods: Photographs of 207 TS patients and 1074 female controls were collected from July 2016 to April 2019. Finally, 170 patients diagnosed with TS and 1053 female controls were included. Deep convolutional neural networks were used to develop the facial diagnostic system. A prospective study, which included two TS patients and 35 controls, was conducted to test the efficacy in the real clinical setting.

Results: The average areas under the curve (AUCs) in three different scenarios were 0.9540 ± 0.0223, 0.9662 ± 0.0108 and 0.9557 ± 0.0119, separately. The average sensitivity and specificity of the prospective study were 96.7% and 97.0%, respectively.

Conclusions: The facial diagnostic system achieved high accuracy. Prospective study results demonstrated the application value of this system, which is promising in the screening of Turner syndrome.
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http://dx.doi.org/10.1007/s12020-020-02539-3DOI Listing
June 2021

Circular RNA circNELL2 Acts as the Sponge of miR-127-5p to Promote Esophageal Squamous Cell Carcinoma Progression.

Onco Targets Ther 2020 16;13:9245-9255. Epub 2020 Sep 16.

Department of Thoracic Surgery, Southern Medical University Nanfang Hospital, Guangzhou City, Guangdong Province 510515, People's Republic of China.

Introduction: Owing to its involvement in both the initiation and progression of various cancers, aberrant circular RNA (circRNA) expression has been researched extensively in the recent times. In the present study, we aim to investigate the effect of a novel circRNA has_circ_0025933 (circNELL2) in the progression of esophageal squamous cell carcinoma (ESCC).

Materials And Methods: Sanger sequencing and the detection of circNELL2 level after RNase R or actinomycin D treatment were performed to identify the existence of cirNELL2 in ESCC cells. WST, EDU staining and colony-formation assay were used to assess the proliferation while transwell assay was used to evaluate the migration of ESCC cells. Luciferase assay, RNA pull down and the FISH assay were performed to verify the interaction between circNELL2 and miR-127-5p as well as miR-127-5p and CDC6. Xenograft model was carried out to evaluate the effect of circNELL2 in vivo.

Results: circNELL2 was proved to exist in ESCC cells. The up-regulated expression of circNELL2 in the clinical ESCC specimens was also verified. Next, function studies suggested that circNELL2 knockdown inhibited the proliferation of ESCC cells in vitro and in vivo, while circNELL2 overexpression promotes that of ESCC cells. Besides, this study mechanically predicted and verified the target miR of circNELL2, which is miR-127-5p. It was found that miR-127-5p was capable of reversing the effect of circNELL2 on ESCC cells. Moreover, miR-127-5p was also found to target CDC6 to participate in the regulation of cell phenotype.

Discussion: circNELL2 promoted the progression of ESCC cells via sponging miR-127-5p, and it has the potential to serve as a novel prognostic and therapeutic target for ESCC.
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http://dx.doi.org/10.2147/OTT.S247847DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7502390PMC
September 2020

PRDX1 stimulates non-small-cell lung carcinoma to proliferate via the Wnt/β-Catenin signaling.

Panminerva Med 2020 Sep 3. Epub 2020 Sep 3.

Department of Oncology, Guangdong Provincial People's Hospital's Nanhai Hospital, The Second People's Hospital Of Nanhai District, Foshan, China.

Background: Previous studies have shown that PRDX1 is upregulated in some types of malignant tumors. The role of PRDX1 in non-small-cancer lung carcinoma (NSCLC) remains unclear. This study aims to identify the role of PRDX1 in influencing in vitro biological functions of NSCLC and the molecular mechanism.

Patients And Methods: We collected 50 cases of fresh NSCLC and adjacent non-tumoral tissues for detecting differential expressions of PRDX1 by quantitative real-time polymerase chain reaction (qRT-PCR). Survival time of NSCLC patients, defined as the period from the operation to the latest follow-up or death due to recurrence or metastasis, was recorded for assessing the relationship between PRDX1 and prognosis in NSCLC. Using lentivirus transfection, PRDX1 level was downregulated in NSCLC cells. Subsequently, proliferative and apoptotic abilities, and expression levels of vital genes in the Wnt/β-Catenin signaling were examined. Finally, the significance of activated Wnt/β-Catenin signaling during PRDX1-regulated NSCLC proliferation was explored.

Results: Using GEPIA database and NSCLC tissues we collected, PRDX1 was detected to be upregulated in NSCLC samples than controls. PRDX1 level was related to tumor staging and prognosis in NSCLC. Knockdown of PRDX1 attenuated proliferative ability and stimulated apoptosis in NSCLC. Protein levels of Wnt5A was downregulated in H1299 and SPC-A1 cells with PRDX1 knockdown. Overexpression of β-Catenin enhanced proliferative ability and inhibited apoptosis in NSCLC cells with PRDX1 knockdown.

Conclusions: PRDX1 is upregulated in NSCLC samples, and linked to tumor staging and prognosis. It stimulates NSCLC to proliferate by activating the Wnt/β-Catenin signaling.
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http://dx.doi.org/10.23736/S0031-0808.20.03978-6DOI Listing
September 2020

The manufacturing procedure of 3D printed models for endoscopic endonasal transsphenoidal pituitary surgery.

Technol Health Care 2020 ;28(S1):131-150

State Key Laboratory for Management and Control of Complex Systems, Beijing Engineering Research Center of Intelligent Systems and Technology, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.

Background: Endoscopic endonasal transsphenoidal pituitary surgery is usually difficult and risky. With limited sources of cadaveric skulls, traditional methods of using virtual images to study the surgery are difficult for neurosurgeons and students because the surgery requires spatial imagination and good understanding of the patient's conditions as well as practical experience. The three-dimensional (3D) printing technique has played an important role in clinical medicine due to its advantages of low cost, high-efficiency and customization.

Objective: CT images are used as the source data of 3D printing. The data obtained directly from the CT machine has limited accuracy, which cannot be printed without processing. Some commercial platforms can help build an accurate model but the cost and customization are not satisfactory. In this situation, a tactile, precise and low-cost 3D model is highly desirable.

Methods: Five kinds of computer software are used in the manufacturing of medical 3D models and the processing procedure is easy to understand and operate.

Results: This study proposes a practical and cost-effective method to obtain the corrected digital model and produce the 3D printed skull with complete structures of nasal cavity, sellar region and different levels of pituitary tumors. The model is used for the endoscopic endonasal transsphenoidal pituitary surgery preparation.

Conclusion: The 3D printed medical model can directly help neurosurgeons and medical students to practice their surgery skills on both general and special cases with customized structures and different levels of tumors.
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http://dx.doi.org/10.3233/THC-209014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7369091PMC
April 2021

Striking dual functionality of a novel [email protected] nanocatalyst in C(sp)-C(sp) bond-forming and CO fixation reactions.

Dalton Trans 2020 May;49(19):6368-6376

Key Laboratory of Inorganic Molecule-Based Chemistry of Liaoning Province, Shenyang University of Chemical Technology, Shenyang 110142, China.

Pd nanoparticles were immobilized on a highly porous, hydrothermally stable Eu-MOF via solution impregnation and H2 reduction to yield a novel [email protected] nanocatalyst. This composite was characterized by scanning electron microscopy (SEM), transmission electron microscopy (TEM), energy dispersive spectroscopy (EDS), inductively coupled plasma optical emission spectroscopy (ICP-OES), powder X-ray diffraction (PXRD) and X-ray photoelectron spectroscopy (XPS). Unprecedentedly, the [email protected] nanocatalyst could be applied with excellent results in two strikingly different, mechanistically distinct, reactions i.e., Suzuki-Miyaura cross-coupling and cycloaddition of CO2 to a range of epoxides. Under the best reaction conditions, 98-99% yields have been attained in both catalytic processes. Moreover, in either case the heterogeneous catalyst was easily recovered and efficiently reused for more than four cycles, indicating its high stability and reproducibility. PXRD, TEM and XPS measurements on the recycled catalyst confirmed that it maintained its original structure and morphology; no Pd NP agglomeration was observed.
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http://dx.doi.org/10.1039/d0dt00770fDOI Listing
May 2020

Hydrocarbon Dew Point Measurement and Model Evaluation of Synthetic and Real Natural Gases.

ACS Omega 2020 Apr 7;5(15):8463-8473. Epub 2020 Apr 7.

Research Institute of Natural Gas Technology, PetroChina Southwest Oil and Gasfield Company, CNPC, No. 218, Tian Yan Road, HuaYang Town, TianFu New District, Chengdu 610213, Sichuan, China.

Hydrocarbon dew point (HCDP) is one of the most important quality specifications of natural gas. Measuring and predicting the HCDP accurately are essential for the natural gas industry. However, the comprehensive experimental HCDP curve data are still rare, and knowledge about adopting proper prediction models remains unclear. In view of this, HCDP determination work by use of an improved test system and model evaluation based on more than 1000 dew points data have been done to improve the aforementioned dilemma. HCDP curve data of three gravimetrically prepared synthetic natural gases (SNGs) and one real gas (RG) are determined first. Then, one set of data containing 712 dew points from 28 SNGs and 334 dew points from 14 RGs is used to evaluate the performance of eight different HCDP prediction models including Soave-Redlich-Kwong (SRK), SRK-Twu, Peng-Robinson (PR), Twu-Sim-Tassone (TST), predictive SRK (PSRK), GERG-2008, PSRK, and perturbed-chain statistical associating fluid theory (PC-SAFT) models. Considerable prediction deviation of these models in the high-pressure region (pressure above 6.0 MPa) is observed compared to that in the low-pressure region (under 6.0 MPa), and the reasons for that difference are discussed. Evaluation results reveal that among the eight prediction models, GERG-2008 has the best performance (overall average absolute deviation (AAD): 1.44 °C) for SNGs, and PSRK and SRK-Twu fits the experimental data best for RGs (overall AAD: 2.50 °C). Therefore, GERG-2008 is recommended for HCDP prediction of relatively lean gas, whereas PSRK and SRK-Twu are recommended for calculating the HCDP of relatively heavy natural gases in low-pressure and high-pressure regions, respectively.
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http://dx.doi.org/10.1021/acsomega.9b03469DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7178342PMC
April 2020

MiR-202-3p Inhibits Foam Cell Formation and is Associated with Coronary Heart Disease Risk in a Chinese Population.

Int Heart J 2020 Jan 17;61(1):153-159. Epub 2020 Jan 17.

Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University.

A previous study and a gene-annotation enrichment analysis for potential targets of the microRNA miR-202-3p both suggest that this microRNA might be implicated in cardiovascular and metabolic diseases. In the present study, the role of miR-202-3p in the pathogenesis of coronary heart disease (CHD) was explored. We conduct a case-control study to detect the expression levels of miR-202-3p in peripheral blood cells and found that miR-202-3p expression was significantly higher in CHD cases than in controls (P < 0.001). miR-202-3p levels were negatively correlated with platelet distribution width (r = -0.348, P = 0.002) and mean platelet volume (r = -0.29, P = 0.01). Further functional analyses suggested that stimulation with oxidized low-density lipoprotein (ox-LDL) induced miR-202-3p expression, and that this microRNA suppressed the formation of ox-LDL-induced macrophage foam cells derived from THP-1 cells in a feedback manner. In addition, miR-202-3p overexpression modulated the expression of several key genes involved in foam cell formation, including that of ABCG4, NCEH1I, and SCARB2. In summary, miR-202-3p was associated with CHD, exerting a protective role against CHD by feedback suppression of ox-LDL-induced macrophage foam cell formation.
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http://dx.doi.org/10.1536/ihj.19-033DOI Listing
January 2020

TiDEC: A Two-Layered Integrated Decision Cycle for Population Evolution.

IEEE Trans Cybern 2020 Jan 16;PP. Epub 2020 Jan 16.

Agent-based simulation is a useful approach for the analysis of dynamic population evolution. In this field, the existing models mostly treat the migration behavior as a result of utility maximization, which partially ignores the endogenous mechanisms of human decision making. To simulate such a process, this article proposes a new cognitive architecture called the two-layered integrated decision cycle (TiDEC) which characterizes the individual's decision-making process. Different from the previous ones, the new hybrid architecture incorporates deep neural networks for its perception and implicit knowledge learning. The proposed model is applied in China and U.S. population evolution. To the best of our knowledge, this is the first time that the cognitive computation is used in such a field. Computational experiments using the actual census data indicate that the cognitive model, compared with the traditional utility maximization methods, cannot only reconstruct the historical demographic features but also achieve better prediction of future evolutionary dynamics.
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http://dx.doi.org/10.1109/TCYB.2019.2957574DOI Listing
January 2020

A low-shrinkage dental composite with epoxy-polyhedral oligomeric silsesquioxane.

J Mech Behav Biomed Mater 2020 03 2;103:103515. Epub 2019 Nov 2.

State Key Laboratory of Chemical Resource Engineering, Beijing University of Chemical Technology, Beijing, 100029, People's Republic of China; Key Laboratory of Carbon Fiber and Functional Polymers, Ministry of Education, Beijing University of Chemical Technology, Beijing, 100029, People's Republic of China; College of Material Science and Engineering, Beijing University of Chemical Technology, Beijing, 100029, People's Republic of China. Electronic address:

Polymerization shrinkage and mechanical properties affect the service life of dental restorative composites. Polyhedral oligomeric silsesquioxanes (POSS) can be an efficient strategy to improve the shrinkage properties and mechanical properties simultaneously. In this work, epoxycyclohexyl POSS (E-POSS) was used to modify the Bis-GMA/TEGDMA dental resins. E-POSS were introduced into the acrylic resin system via ring-opening reaction, and a cationic/free radical hybrid system was obtained. Double bond conversion, glass transition temperature, heterogeneity, crosslink density of dental resins and volumetric shrinkage, water sorption/solubility, flexural strength/modulus of dental composites were investigated. As the introduction of E-POSS caused higher double bond conversion and lower crosslink density, the polymerization shrinkage was significantly reduced to 2.91% (p < 0.05) and the flexural strength increased to 117.19 MPa (p < 0.05) compared to the control sample (5.06%, 99.16 MPa, p<0.05). Lower water sorption and solubility were also observed in composites contained E-POSS (p < 0.05).
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http://dx.doi.org/10.1016/j.jmbbm.2019.103515DOI Listing
March 2020

Genetic variation in the Chinese soft-shell turtles ( spp.) revealed by sequences of mitochondrial gene.

Mitochondrial DNA A DNA Mapp Seq Anal 2019 12 25;30(8):874-879. Epub 2019 Nov 25.

Hunan Biological and Electromechanical Polytechnic, Changsha, China.

Genetic diversity is an important component of biodiversity and investigating and protecting the wild genetic diversity of species has always been an important research topic in conservation biology. Due to habitat destruction and over catching, wild Chinese soft-shell turtles ( spp.) have been severely damaged, resulting in the species being listed on the IUCN Red List of Threatened Species in 2000. However, only few studies with contradictory results on the genetic diversity of turtles have been reported. To investigate the genetic diversity and population structure of turtles, 123 specimens were collected from five localities in East Asia, and their genetic variation was analyzed on the basis of a 922-bp partial sequence of the mitochondrial gene. Forty-nine polymorphic sites were detected, revealing 56 haplotypes. A pattern of high haplotype diversity (Hd = 0.994) and nucleotide diversity (π = 0.01655) was found in the examined range. A maximum likelihood phylogenetic tree and median-joining network analyses indicated that the turtles divided in four populations throughout East Asia, and the turtles probably originate from the Yangtze River and was introduced to Yellow River, Taiwan, and Japan through Xijiang River. These results served a helpful resource for conservation of turtles.
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http://dx.doi.org/10.1080/24701394.2019.1693551DOI Listing
December 2019

The Current Situation of Esophageal Cancer Staging and Perioperative Strategies Determination in Central and Southern China: A Cross Sectional Survey.

Front Oncol 2019 22;9:1098. Epub 2019 Oct 22.

Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.

We aim to investigate the current esophageal cancer staging according to the 7th edition TNM classification for esophageal carcinoma proposed by American Joint Committee on Cancer (AJCC) among oncology-related physicians in China. A specifically-designed 14-item questionnaire was distributed to 366 doctors who were working with esophageal cancer patients. We collected and analyzed the feedbacks and explored the possible associations within different departments, including thoracic surgery, the internal medicine of gastroenterology, oncology, and/ radiotherapy in eight different hospitals from central and southern China. Among all the responses, 31.42% of them were from thoracic surgery department, 40.44% were from oncology and/or radiation therapy and 28.14% were from the internal medicine of gastroenterology, respectively. Surprisingly, in total 66.12% of all the physicians were unaware that the 7th edition of esophageal carcinoma TNM classification was released in 2009; only 21.86 and 16.67% of physicians recognized cervical nodes and celiac nodes as regional lymph nodes. Furthermore, 67.21% physicians didn't know that tumor location, histologic grade, and histopathology were accepted as new prognostic factors in the latest TNM system; and 51.37% physicians could not determine the correct TNM classification of esophagogastric junction cancers. Intriguingly, over 50% of them could still design appropriate perioperative strategies. The 7th edition of the TNM classification for esophageal carcinoma is poorly recognized and understood in central and southern China, which might contribute to the relatively low rates of appropriate perioperative procedures applied for esophageal cancer patients.
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http://dx.doi.org/10.3389/fonc.2019.01098DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6817579PMC
October 2019

Predicting post-stroke pneumonia using deep neural network approaches.

Int J Med Inform 2019 12 1;132:103986. Epub 2019 Oct 1.

Department of Information, The Second Affiliated Hospital of Nanchang University, Nanchang, China.

Background And Purpose: Pneumonia is a common complication after stroke, causing an increased length of hospital stay and death. Therefore, the timely and accurate prediction of post-stroke pneumonia would be highly valuable in clinical practice. Previous pneumonia risk score models were often built on simple statistical methods such as logistic regression. This study aims to investigate post-stroke pneumonia prediction models using more advanced machine learning algorithms, specifically deep learning approaches.

Methods: Using a hospital's electronic health record(EHR) data from 2007-2017, 13,930 eligible patients with acute ischaemic stroke (AIS) were identified to build and evaluate the models (85% of the patients were used for training, and 15% were used for testing). In total, 1012 patients (7.23%) contracted pneumonia during hospitalization. A number of machine learning methods were developed and compared to predict pneumonia in the stroke population in China. In addition to the classic methods (i.e., logistic regression (LR), support vector machines (SVMs), extreme gradient boosting (XGBoost)), methods based on multiple layer perceptron (MLP) neural networks and recurrent neural network (RNNs) (i.e., attention-augmented gated recurrent unit (GRU)) are also implemented to make use of the temporal sequence information in electronic health record (EHR) systems. Prediction models for pneumonia were built for two time windows, i.e., within 7 days and within 14 days after stroke onset. In particular, pneumonia occurring within the 7-day window is considered highly associated with stroke (stroke-associated pneumonia, SAP).

Main Findings: The attention-augmented GRU model achieved the best performance based on an area under the receiver operating characteristic curve (AUC) of 0.928 for pneumonia prediction within 7 days and an AUC of 0.905 for pneumonia prediction within 14 days. This method outperformed the other machine learning-based methods and previously published pneumonia risk score models. Considering that pneumonia prediction after stroke requires a high sensitivity to facilitate its prevention at a relatively low cost (i.e., increasing the nursing level), we also compared the prediction performance using other evaluation criteria by setting the sensitivity to 0.90. The attention-augmented GRU achieved the optimal performance, with a specificity of 0.85, a positive predictive value (PPV) of 0.32 and a negative predictive value (NPV) of 0.99 for pneumonia within 7 days and a specificity of 0.82, a PPV of 0.29 and an NPV of 0.99 for pneumonia within 14 days.

Conclusions: The deep learning-based predictive model is feasible for stroke patient management and achieves the optimal performance compared to many classic machine learning methods.
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http://dx.doi.org/10.1016/j.ijmedinf.2019.103986DOI Listing
December 2019

Extreme Gradient Boosting Model Has a Better Performance in Predicting the Risk of 90-Day Readmissions in Patients with Ischaemic Stroke.

J Stroke Cerebrovasc Dis 2019 Dec 16;28(12):104441. Epub 2019 Oct 16.

Medical Big-Data Center, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi China. Electronic address:

Object: Ischemic stroke readmission within 90 days of hospital discharge is an important quality of care metric. The readmission rates of ischemic stroke patients are usually higher than those of patients with other chronic diseases. Our aim was to identify the ischemic stroke readmission risk factors and establish a 90-day readmission prediction model for first-time ischemic stroke patients.

Methods: The readmission prediction model was developed using the extreme gradient boosting (XGboost) model, which can generate an ensemble of classification trees and assign a predictive risk score to each feature. The patient data were split into a training set (5159) and a validation set (911). The prediction results were evaluated with the receiver operating characteristic (ROC) curve and time-dependent ROC curve, which were compared with the outputs from the logistic regression (LR) model.

Results: A total of 6070 adult patients (39.6% female, median age 67 years) without any ischemic attack (IS) history were included, and 520 (8.6%) were readmitted within 90 days. The XGboost-based prediction model achieved a standard area under the curve (AUC) value of .782 (.729-.834), and the best time-dependent AUC value was .808 in 54 days for the validation set. In contrast, the LR model yielded a standard AUC value of .771 (.714-.828) and best time-dependent AUC value of .797.

Conclusions: The XGboost model obtained a better risk prediction for 90-day readmission for first-time ischemic stroke patients than the LR model. This model can also reveal the high risk factors for stroke readmission in first-time ischemic stroke patients.
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.104441DOI Listing
December 2019

Survival-related risk score of lung adenocarcinoma identified by weight gene co-expression network analysis.

Oncol Lett 2019 Nov 4;18(5):4441-4448. Epub 2019 Sep 4.

Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China.

The present study aimed to identify the novel biomarkers and underlying molecular mechanisms of lung adenocarcinoma (LAC) to aid in its diagnosis, prognosis, prediction, disease monitoring and emerging therapies. Data from a total of 498 LAC samples were collected from The Cancer Genome Atlas and divided into two sets by stratified randomization based on pathological Tumor-Node-Metastasis stage. The training set was comprised of 348 samples and the validation set was comprised of 150 samples. A total of 123 samples from the training set for patients who completed follow-up were analyzed by weighted gene co-expression network analysis. A module was identified that contained 113 protein-coding genes that were positively associated with overall survival (OS). A least absolute shrinkage and selection operator (LASSO) Cox regression model was constructed and four survival-associated genes (OPN3, GALNT2, FAM83A and KYNU) were retained. Risk score, calculated by the linear combination of each gene expression multiplied by the LASSO coefficient, could successfully discriminate between patients with LAC exhibiting low and high OS time in both sets. The results from the present study indicate that this risk score may contribute to potential diagnostic and therapeutic strategies for LAC management.
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http://dx.doi.org/10.3892/ol.2019.10795DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6781564PMC
November 2019

Quercetin Inhibits Inflammatory Response Induced by LPS in Human Gingival Fibroblasts via Suppressing NF-B Signaling Pathway.

Biomed Res Int 2019 20;2019:6282635. Epub 2019 Aug 20.

Experimental Center for Medical Research, Weifang Medical University, Weifang 261053, China.

Quercetin, a natural flavonol existing in many food resources, has been reported to be an effective antimicrobial and anti-inflammatory agent for restricting the inflammation in periodontitis. In this study, we aimed to investigate the anti-inflammatory effects of quercetin on () lipopolysaccharide- (LPS-) stimulated human gingival fibroblasts (HGFs). HGFs were pretreated with quercetin prior to LPS stimulation. Cell viability was evaluated by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay. The levels of inflammatory cytokines, including interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor- (TNF-), along with chemokine interleukin-8 (IL-8), were determined by enzyme-linked immunosorbent assay (ELISA). The mRNA levels of IL-1, IL-6, IL-8, TNF-, IB, p65 subunit of nuclear factor-kappa B (NF-B), peroxisome proliferator-activated receptor- (PPAR-), liver X receptor (LXR), and Toll-like receptor 4 (TLR4) were measured by real-time quantitative PCR (RT-qPCR). The protein levels of IB, p-IB, p65, p-p65, PPAR-, LXR, and TLR4 were characterized by Western blotting. Our results demonstrated that quercetin inhibited the LPS-induced production of IL-1, IL-6, IL-8, and TNF- in a dose-dependent manner. It also suppressed LPS-induced NF-B activation mediated by TLR4. Moreover, the anti-inflammatory effects of quercetin were reversed by the PPAR- antagonist of GW9662. In conclusion, these results suggested that quercetin attenuated the production of IL-1, IL-6, IL-8, and TNF- in LPS-treated HGFs by activating PPAR- which subsequently suppressed the activation of NF-B.
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http://dx.doi.org/10.1155/2019/6282635DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6720363PMC
February 2020

Facile Fabrication of Flexible, Robust, and Superhydrophobic Hybrid Aerogel.

Langmuir 2019 Jul 20;35(26):8692-8698. Epub 2019 Jun 20.

State Key Laboratory of Chemical Resource Engineering , Beijing University of Chemical Technology , Beijing 100029 , P. R. China.

Silica aerogels, which are constructed with silica nanoparticles and numerous nanoscale pores, have many outstanding attributes, but they are usually brittle and hydrophilic. For the construction of a robust aerogel, the novel polyhedral oligomeric silsesquioxane (POSS) was introduced to prepare a series of aerogels possessing particles covered with elastic cushion to improve the mechanical property. The multialkoxy POSS, which possessed stiff Si-O-Si nanocages and flexible alkyl chains, was synthesized via thiol-ene click chemistry. After a facile and efficient approach, a partially ordered structure of SiO nanoparticles and organic elastic cushion would form spontaneously within the aerogels. With the POSS as the only precursor, several outstanding attributes were achieved in a single aerogel such as high specific surface area (SSA), high compression strength, high compression modulus, and noticeable compression flexibility. Meanwhile, the aerogel was superhydrophobic of which the contact angle (CA) was higher than 153°. Moreover, the potential application of oil-water separation is also presented.
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http://dx.doi.org/10.1021/acs.langmuir.9b00521DOI Listing
July 2019

Differential effects of adjuvant EGFR tyrosine kinase inhibitors in patients with different stages of non-small-cell lung cancer after radical resection: an updated meta-analysis.

Cancer Manag Res 2019 2;11:2677-2690. Epub 2019 Apr 2.

Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China,

Purpose: A survival improvement was achieved with adjuvant chemotherapy in non-small-cell lung cancer (NSCLC) patients, but its differential effects among patients with different stages remained controversial. This study aimed to compare the beneficial effects of adjuvant tyrosine kinase inhibitor (TKI) therapy with those of traditional therapy on NSCLC patients, specifically on EGFR-mutant and stage II-IIIA patients, who might benefit most from such treatment.

Methods: MEDLINE, Embase, and the Cochrane Library were searched, and the results were screened independently according to certain criteria by two authors. Disease-free survival (DFS) and overall survival (OS) with HRs were used as the summary statistics.

Results: A total of 2,915 publications were identified and screened. Six randomized control trials and three retrospective cohort studies of 2,467 patients with acceptable quality were included. The overall EGFR mutation rate was 48.62%. DFS was significantly improved in all the patients (HR, 0.77; 95% CI, 0.68-0.88) and in the subgroup of EGFR-mutant patients (HR, 0.49; 95% CI, 0.40-0.61). The difference of 5-year OS in the subgroup of EGFR-mutant patients (HR, 0.48; 95% CI, 0.31-0.72) was statistically significant, while in all the patients (HR, 1.01; 95% CI, 0.85-1.19), the difference was not significant. In the subgroups of studies in which <50% of patients were in stage I (HR, 0.46; 95% CI, 0.35-0.60) and >30% of patients were in stage IIIA (HR, 0.46; 95% CI, 0.35-0.60), DFS was significantly improved, while in the subgroups of studies in which <30% of patients were in stage IIIA (HR, 0.90; 95% CI, 0.77-1.04) and >50% of patients were in stage I (HR, 0.90; 95% CI, 0.77-1.04), DFS was not significantly improved.

Conclusion: Stage IIIA NSCLC patients might benefit more from adjuvant TKIs than stage I NSCLC patients after radical resection.
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http://dx.doi.org/10.2147/CMAR.S187940DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6450185PMC
April 2019

The process of 3D printed skull models for anatomy education.

Comput Assist Surg (Abingdon) 2019 10 23;24(sup1):121-130. Epub 2019 Apr 23.

Department of Endocrinology, Endocrine Key Laboratory of Ministry of Health, PUMCH, CAMS & PUMC , Beijing , China.

In general, the 3 D printed medical models are made based on virtual digital models obtained from machines such as the computed tomography scanner. However, due to the limited accuracy of CT scanning technology, which is usually 1 millimeter, there are differences between scanned results and the real structure. Besides, the collected data can hardly be printed directly because of some errors in the model. In this paper, we present a general and efficient procedure to process the digital skull data to make the printed structures meet the requirements of anatomy education, which combines the use of five 3 D manipulation tools and the procedure can be finished within 6 hours. Then the model is printed and compared with the cadaveric skull from frontal, left, right and anterior views respectively. The printed model can describe the correct structure and details of the skull clearly, which can be considered as a good alternative to the cadaveric skull. The manipulation procedure presented in this study is an easily available and cost-effective way to obtain a printed skull model from the original CT data, which has a considerable economic and social benefit for the medical education. The steps of the data processing can be performed easily. The cost for the 3 D printed model is also low. Outcomes of this study can be applied widely in processing skull data.
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http://dx.doi.org/10.1080/24699322.2018.1560101DOI Listing
October 2019

Upregulation of a novel lncRNA LINC01980 promotes tumor growth of esophageal squamous cell carcinoma.

Biochem Biophys Res Commun 2019 05 29;513(1):73-80. Epub 2019 Mar 29.

Department of Medical Genetics, College of Basic Medical Science, Third Military Medical University, Chongqing, China. Electronic address:

An increasing number of long noncoding RNAs (lncRNAs) have been discovered, and dysregulation of lncRNAs plays critical roles in tumorigenesis and tumor progression. In this study, we identified a novel lncRNA LINC01980, located in both the cytoplasm and nucleus, which was significantly upregulated in esophageal squamous cell carcinoma (ESCC) tissues through microarray profiling. Further analysis revealed that LINC01980 overexpression was positively correlated with deeper invasion of cancer, positive lymph node metastasis, and advanced TNM stage. Additionally, high LINC01980 expression in ESCC tissues was associated with poor prognosis. In vitro and in vivo experiments demonstrated that LINC01980 promoted ESCC growth. EdU incorporation assay implied that LINC01980 accelerated ESCC proliferation. Flow cytometry analysis showed that knockdown of LINC01980 induced cell cycle arrest and increased apoptosis. Microarray analysis indicated that LINC01980 upregulated the expression of growth arrest and DNA damage inducible 45 alpha (GADD45A). Further experiments demonstrated that GADD45A promoted ESCC cell growth, indicating that GADD45A may be a downstream target of LINC01980. In conclusion, this study identified LINC01980 as a novel potential oncogene in ESCC, which can be a promising biomarker for prognosis and therapeutic targeting in ESCC.
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http://dx.doi.org/10.1016/j.bbrc.2019.03.012DOI Listing
May 2019

The overexpression of lncRNA H19 as a diagnostic marker for coronary artery disease.

Rev Assoc Med Bras (1992) 2019 Feb;65(2):110-117

Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute of Wuhan University, Hubei Key Laboratory of Cardiology, Jiefang Road 238, Wuchang, 430060, Wuhan, PR China.

Objective: Our study aimed to investigate the diagnostic value of lncRNA H19 for coronary artery disease (CAD) and to explore its possible mechanisms.

Methods: A total of 30 CAD patients and 30 healthy individuals, as well as patients with different cardiovascular diseases, were included in this study. Blood was drawn from each participant to prepare serum samples, and the expression of lncRNA H19 was detected using qRT-PCR. The ROC curve analysis was used to analyze the diagnostic value of H19 for CAD. The effects of patients' basic information and lifestyle on H19 expression were analyzed. The plasma level of TGF-β1 was measured by ELISA. The H19 overexpression in the human primary coronary artery endothelial cell (HCAEC) line was constructed, and the effects of H19 overexpression on the TGF-β1 expression were analyzed using Western blot. The results of H19 expression were specifically upregulated in patients with CAD but not in healthy individuals and patients with other types of cardiovascular diseases. The ROC curve analysis showed that the H19 expression level could be used to predict CAD accurately. Gender, age, and patients' lifestyle had no significant effects on H19 expression, but H19 expression was higher in patients with a longer course of disease in comparison with the controls. H19 expression was positively correlated with the serum level of TGF-β1, and H19 overexpression significantly increased TGF-β1 protein level in HCAEC.

Conclusion: H19 overexpression participates in the pathogenesis of CAD by increasing the expression level of TGF-β1, and H19 expression level may serve as a diagnostic marker for CAD.
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http://dx.doi.org/10.1590/1806-9282.65.2.110DOI Listing
February 2019

A Learning-Based Framework for Error Compensation in 3D Printing.

IEEE Trans Cybern 2019 Nov 4;49(11):4042-4050. Epub 2019 Mar 4.

As a typical cyber-physical system, 3D printing has developed very fast in recent years. There is a strong demand for mass customization, such as printing dental crowns. However, the accuracy of the 3D printed objects is low compared with traditional methods. The main reason is that the model to be printed is arbitrary and usually the quantity is small. The deformation is affected by the shape of the object and there is a lack of a universal method for the error compensation. It is neither easy nor economical to perform the compensation manually. In this paper, we present a framework for the automatic error compensation. We obtain the shape by technologies such as 3D scanning. And we use the "3D deep learning" method to train a deep neural network. For a specific task, such as dental crown printing, the network can learn the function of deformation when a large amount of data is used for training. To the best of our knowledge, this is the first application of the deep neural network to the error compensation in 3D printing. And we propose the "inverse function network" to compensate for the error. We use four types of deformations of the dental crowns to verify the performance of the neural network: 1) translation; 2) scaling up; 3) scaling down; and 4) rotation. The convolutional AutoEncoder structure is employed for the end-to-end learning. The experiments show that the network can predict and compensate for the error well. By introducing the new method, we can improve the accuracy with little need for increasing the hardware cost.
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http://dx.doi.org/10.1109/TCYB.2019.2898553DOI Listing
November 2019

Case report: Crizotinib is effective in a patient with ROS1-rearranged pulmonary inflammatory myofibroblastic tumor.

Lung Cancer 2019 02 17;128:101-104. Epub 2018 Dec 17.

Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, China. Electronic address:

Objectives: Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal tumor and is prevalent among children and adolescents. In recent years, following the emergence of high-throughput sequencing techniques, rearrangements in genes, such as ALK, ROS1, NTRK, RET, and PDGFRβ, have been detected in a considerable proportion of IMT patients. However, the practice of targeted therapy for those patients remains extremely limited. In this study, we report about a 14-year-old boy diagnosed with pulmonary IMT with a mass measuring 12 × 8 cm in the right lower lobe.

Materials And Methods: Immunohistochemistry (IHC) assay and comprehensive next-generation sequencing (NGS) were performed on the biopsied tumor tissue.

Results: The IHC assay revealed an ALK-negative tumor, while NGS detected aTFG-ROS1 rearrangement. The patient achieved continuous remission after treatment with crizotinib (250 mg, bid).

Conclusion: This case broadens the experience regarding targeted therapy forROS1-rearranged IMT and supports the use of broad molecular profiling testing for optimizing therapeutic options.
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http://dx.doi.org/10.1016/j.lungcan.2018.12.016DOI Listing
February 2019

A time-gated multi-channel x-ray crystal spectrometer on the Shenguang-III laser facility.

Rev Sci Instrum 2018 Aug;89(8):083108

Laser Fusion Research Center, China Academy of Engineering Physics, Mianyang 621900, China.

An eight-channel x-ray flat crystal spectrometer was developed for high energy density physics research at the Shenguang-III (SG-III) laser facility. The spectrometer uses trihydroxymethylaminomethane crystals (2 = 8.78 Å) to record Ti K-shell emission in the photon energy range of 4.65-5.05 keV. The spectrometer couples to an x-ray framing camera to achieve time-resolution. This has four microstrips, and each strip records two snapshots of the emission image. Based on the intersection positioning system with a dual-charge coupled device, the alignment system is easily operated and efficient. The instrument was tested and used for Au hohlraum plasma diagnosis experiments on SG-III. The He- line and its Li-like satellites and the Ly- line of a Ti tracer were detected, from which the spectral resolution of the instrument was analyzed. The spectral resolution /Δ at the Ti He- line ranges from about 500 to 880 and mainly limited by the x-ray source size.
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http://dx.doi.org/10.1063/1.5033359DOI Listing
August 2018

Combination of peripheral blood mononuclear cell miR-19b-5p, miR- 221, miR-25-5p, and hypertension correlates with an increased heart failure risk in coronary heart disease patients.

Anatol J Cardiol 2018 Aug;20(2):100-109

Department of Cardiology, Renmin Hospital of Wuhan University, Hubei General Hospital; Cardiovascular Research Institute of Wuhan University, Hubei Key Laboratory of Cardiology; Wuhan-China.

Objective: The aim of this study was to explore the differences in microRNA (miRNA) profiles in peripheral blood mononuclear cells (PBMCs) between coronary heart disease (CHD) patients with and without heart failure (HF) and to assess the values of differentially expressed miRNAs (DEMs) regarding HF risk in CHD patients.

Methods: Six CHD patients with HF and six age- and gender-matched CHD patients without HF were enrolled in the exploration stage, and 44 CHD patients with HF and 42 age- and gender-matched CHD patients without HF were recruited in the validation stage. Peripheral blood samples were collected from all the participants, and PBMCs were separated for miRNA detection. miRNA microarray and quantitative polymerase chain reaction were performed to assess the miRNA expression.

Results: In the exploration stage, heat map analysis showed that CHD patients with HF could be distinguished from those without HF using PMBC miRNA expressions; 63 downregulated DEMs and 84 upregulated DEMs in PBMCs were identified in CHD patients with HF using volcano map, and top 8 DEMs were selected based on their p values. In the validation stage, PBMC miR-221, miR-19b-5p, and miR-25-5p were found to be markedly dysregulated in CHD patients with HF. Multiple logistic regression analysis showed PBMC miR-221, miR-19b-5p, miR-25-5p, and hypertension to be the independent predictive factors for HF in CHD patients. A receiver operating characteristic curve demonstrated that area under curve of the combination of miR-221, miR-19b-5p, miR-25-5p, and hypertension was 0.871 (95% CI: 0.794-0.944).

Conclusion: CHD patients with and without HF could be differentiated according to PBMC miRNA profiles, and the combination of PBMC miR-19b-5p, miR-221, miR-25-5p, and hypertension correlates with an increased HF risk in CHD patients.
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http://dx.doi.org/10.14744/AnatolJCardiol.2018.43255DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6237960PMC
August 2018

Tailoring the structure, pH sensitivity and catalytic performance in Suzuki-Miyaura cross-couplings of Ln/Pd MOFs based on the 1,1'-di(p-carboxybenzyl)-2,2'-diimidazole linker.

Dalton Trans 2018 Jul;47(26):8755-8763

Key Laboratory of Inorganic Molecule-Based Chemistry of Liaoning Province, Shenyang University of Chemical Technology, Shenyang 110142, China.

An array of heterobimetallic Pd/Ln MOFs (1-4) with Sm, Eu, Tb, Dy as preferred metal nodes and 1,1'-di(p-carboxybenzyl)-2,2'-diimidazole (H2L) as a fairly suitable bifunctional organic linker have been synthesized, fully characterized and tested as catalysts in cross-coupling reactions. These robust MOFs, ensuring a uniform distribution of Pd, showed excellent stability in air and high catalytic activity in Suzuki-Miyaura reactions conducted in neat water, neat ethanol as well as water-ethanol mixture. Depending on the solvent, complex 1 could be effectively recycled 4-8 times without significant loss of catalytic activity. Importantly, this complex was found to be pH responsive in a reversible way, enabling convenient recovery from acidic aqueous solutions, indicating good recyclability as well as environment-friendly separation of the metal residues after the reaction.
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http://dx.doi.org/10.1039/c8dt01288aDOI Listing
July 2018

A Retrospective Cohort Study of Patients with Type 2 Diabetes in China: Associations of Hypoglycemia with Health Care Resource Utilization and Associated Costs.

Diabetes Ther 2018 Jun 5;9(3):1073-1082. Epub 2018 Apr 5.

School of Biomedical Informatics, The University of Texas, Health Science Center at Houston, 7000 Fannin, Houston, TX, 77030, USA.

Introduction: This study aimed to examine the associations of hypoglycemia with health care resource utilization (HCRU) and health care costs among patients with type 2 diabetes mellitus (T2DM) in China.

Methods: This retrospective cohort study was conducted with 23,680 T2DM patients >18 years old who visited the Second Affiliated Hospital of Nanchang University between 1 January 2011 and 31 December 2015. Univariate descriptive statistics were used to relate the HCRU and associated costs to patient characteristics, and regression analysis was used to examine the association between hypoglycemia and HCRU, controlling for other confounding factors.

Results: In the T2DM patients with or without insulin treatment, when compared with nonhypoglycemic patients, hypoglycemia was associated with more medical visits (all T2DM patients 19.48 vs. 10.46, insulin users 23.45 vs. 14.12) and higher diabetes-related medical costs (all T2DM patients ¥5187.54 vs. ¥3525.00, insulin users ¥6948.84 vs. ¥3401.15) and medication costs (T2DM patients ¥1349.40 vs. ¥641.92, insulin users: ¥1363.87 vs. ¥853.96). Controlling for age, gender, and Charlson comorbidity index (CCI) score, hypoglycemia and insulin intake were associated with greater health care resource utilization. As compared to nonhypoglycemic patients, hypoglycemic T2DM patients and those on insulin therapy performed more outpatient visits (proportions of hypoglycemic vs nonhypoglycemic T2DM patients performing 3+ visits: 72.69% vs. 65.49%; proportions of hypoglycemic vs nonhypoglycemic patients on insulin therapy performing 3+ visits: 78.26% vs. 71.73%) and were hospitalized more often (proportions of hypoglycemic vs nonhypoglycemic T2DM patients with 3+ admissions 75.90% vs. 50.24%; proportions of hypoglycemic vs nonhypoglycemic patients on insulin therapy with 3+ admissions: 83.19% vs. 58.51%).

Conclusion: Hypoglycemia in diabetes patients was associated with increased healthcare resource utilization and health-related expenditure, especially for patients on insulin treatment. Insulin treatment regimens should be more individualized and account for hypoglycemia risk.
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http://dx.doi.org/10.1007/s13300-018-0409-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5984912PMC
June 2018
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