Publications by authors named "Wei Ye"

668 Publications

Analysis on the imbalance of population flow network during the Spring Festival travel rush in China in 2015.

PLoS One 2021 5;16(4):e0249520. Epub 2021 Apr 5.

School of Geographical Sciences, Northeast Normal University, Changchun, Jilin Province, China.

This paper analyzes the imbalance of interprovincial population flow during the Spring Festival travel rush in China, using big data obtained through Baidu Migration, in terms of population flow during the festival and the normalized unbalanced coefficients of edge and node method for analysis, from which the following findings emerge: (1). The imbalance in population flow network during the Spring Festival travel rush is significant, with unbalanced coefficients and relevant frequencies of the population flow network in the Eastern and Western Regions being significantly higher than in other regions. The unbalanced coefficients in the Central Region are lower, followed by corresponding frequencies, while the unbalanced coefficients in the Northeast Region are evenly distributed with the lowest frequencies. The population flow toward the West and Northwest are relatively concentrated, while the population flow toward the South and Southwest are relatively scattered. (2). The regional imbalance during the Spring Festival travel rush has characteristics of spatial agglomeration, where a strongly-connected Southeast Subsystem and a weakly-connected Western Subsystem are formed; there is a significant leverage effect in Guangdong Province, which greatly affects the regional imbalance. Three characteristics emerge in the distribution of regional population flow-the outflow, inflow, and outflow along the Eastern, Central and Western strips/lines, respectively. The paper emphasizes the importance of researching imbalance issues, clarifies the difference between the imbalance of the population flow network and the imbalance involved in previous population research fields, and discusses the Spring Festival Effect in terms of population flow and deficiencies in research.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0249520PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8021162PMC
September 2021

The Light-Induced WD40-Repeat Transcription Factor DcTTG1 Regulates Anthocyanin Biosynthesis in .

Front Plant Sci 2021 17;12:633333. Epub 2021 Mar 17.

Institute of Food Science and Technology, Chinese Academy of Agricultural Sciences, Beijing, China.

is used as a traditional Chinese medicine and as a raw material in functional foods. stems are green or red, and red stems are richer in anthocyanins. Light is an important environmental factor that induces anthocyanin accumulation in . However, the underlying molecular mechanisms have not been fully unraveled. In this study, we exposed seedlings to two different light intensities and found that strong light increased the anthocyanin content and the expression of genes involved in anthocyanin biosynthesis. Through transcriptome profiling and expression analysis, we identified a WD40-repeat transcription factor, DcTTG1, whose expression is induced by light. Yeast one-hybrid assays showed that DcTTG1 binds to the promoters of , , , and , and a transient GUS activity assay indicated that DcTTG1 can induce their expression. In addition, DcTTG1 complemented the anthocyanin deficiency phenotype of the mutant. Collectively, our results suggest that light promotes anthocyanin accumulation in seedlings the upregulation of DcTTG1, which induces anthocyanin synthesis-related gene expression.
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http://dx.doi.org/10.3389/fpls.2021.633333DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8010245PMC
March 2021

Clinicopathological characteristics and long-term prognosis of monoclonal immunoglobulin light chain associated Fanconi syndrome.

Ther Adv Hematol 2021 30;12:2040620720983127. Epub 2021 Jan 30.

Department of Nephrology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.

Background And Aims: Monoclonal immunoglobulin light chain associated Fanconi syndrome (LC-FS) is a rare disease that involves proximal tubules. As most of the reported cases came from western countries, we aimed to analyze the clinicopathological characteristics of Asian LC-FS and its treatment responses to chemotherapy.

Methods: A total of 26 LC-FS patients in a single-center were retrospectively studied.

Results: At diagnosis, the mean age of the 26 Asian LC-FS patients was 54.7 ± 14.7 years, with females accounting for 57.7%. They presented with different degrees of proximal tubular dysfunctions with normoglycemic glycosuria (88.0%), hyperphosphaturia (84.2%) and aminoaciduria (84.0%) as the most common features. The mean estimated glomerular filtration rate (eGFR) was (68.0 ± 26.4) ml/min per 1.73 m. After chemotherapy, renal response was achieved in 58.3% cases, which was accompanied by hematological response, and tubular response was acquired in 66.7% cases. During 3 years of follow-up, the eGFR levels significantly decreased in the monoclonal gammopathy of renal significance patients, few of whom (21.4%) had received chemotherapy.

Conclusion: Asian LC-FS patients had mild renal function disorder. The chemotherapy could improve both renal and tubular functions, which may be related to the hematological response.
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http://dx.doi.org/10.1177/2040620720983127DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7970675PMC
January 2021

H NMR-based metabolomics of paired esophageal tumor tissues and serum samples identifies specific serum biomarkers for esophageal cancer.

NMR Biomed 2021 06 30;34(6):e4505. Epub 2021 Mar 30.

Radiology Department, Second Affiliated Hospital, Shantou University Medical College, Shantou, China.

Serum metabolites of healthy controls and esophageal cancer (EC) patients have previously been compared to predict cancer-specific profiles. However, the association between metabolic alterations in serum samples and esophageal tissues in EC patients remains unclear. Here, we analyzed 50 pairs of EC tissues and distant noncancerous tissues, together with patient-matched serum samples, using H NMR spectroscopy and pattern recognition algorithms. EC patients could be differentiated from the controls based on the metabolic profiles at tissue and serum levels. Some overlapping discriminatory metabolites, including valine, alanine, glucose, acetate, citrate, succinate and glutamate, were identified in both matrices. These results suggested deregulation of metabolic pathways, and potentially revealed the links between EC and several metabolic pathways, such as the tricarboxylic acid cycle, glutaminolysis, short-chain fatty acid metabolism, lipometabolism and pyruvate metabolism. Perturbation of the pyruvate metabolism was most strongly associated with EC progression. Consequently, an optimal serum metabolite biomarker panel comprising acetate and pyruvate was developed, as these two metabolites are involved in pyruvate metabolism, and changes in their serum levels were significantly correlated with alterations in the levels of some other esophageal tissue metabolites. In comparison with individual biomarkers, this panel exhibited better diagnostic efficiency for EC, with an AUC of 0.948 in the test set, and a good predictive ability of 82.5% in the validation set. Analysis of key genes related to pyruvate metabolism in EC patients revealed patterns corresponding to the changes in serum pyruvate and acetate levels. These correlation analyses demonstrate that there were distinct metabolic characteristics and pathway aberrations in the esophageal tumor tissue and in the serum. Changes in the serum metabolic signatures could reflect the alterations in the esophageal tumor profile, thereby emphasizing the importance of distinct serum metabolic profiles as potential noninvasive biomarkers for EC.
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http://dx.doi.org/10.1002/nbm.4505DOI Listing
June 2021

Proposed modification to the Shamblin's classification of carotid body tumors: A single-center retrospective experience of 116 tumors.

Eur J Surg Oncol 2021 Aug 20;47(8):1953-1960. Epub 2021 Mar 20.

Department of Vascular Surgery, Peking Union Medical College Hospital, Shuaifuyuan 1, Dongcheng District, Beijing, 100730, China. Electronic address:

Objectives: Carotid body tumors (CBTs) are rare head and neck neoplasms, we aimed to propose a modification to the Shamblin's classification of CBTs.

Materials And Methods: This retrospective study included 105 patients (116 CBTs) operated at our institution from March 2013 to July 2020. CBTs were divided by a modified Shamblin's classification into five subtypes (type I-V) based on the radiographic features. Correlations between modified classification and intraoperative bleeding, internal carotid artery (ICA) bypass and postoperative neural complications, as main outcomes, as well as other outcomes were analyzed.

Results: Surgeries for type V and type I CBTs had the most (median: 700 ml, IQR: 375-1575 ml) and least (median: 20 ml, IQR: 20-50 ml) bleeding, respectively. Intraoperatively, ICA bypass was needed in 41.7% (10/24) type V, 18.2% (8/44) type IV and 5.9% (1/17) type III lesions, but not in other subtypes (p = .001). Postoperatively, overall cranial nerve deficits (CND) were found most frequently in type V tumors (17/24, 70.8%) (p = .016). Permanent CND were found in 33.3% (8/24) type V and 4.5% (2/44) type IV lesions, but not in other subtypes (p = .001). Other outcomes including external carotid artery ligation, operation time, blood transfusion, postoperative intensive unit care and postoperative hospitalization also showed significant difference among different subtypes. Patients recovered uneventfully during a follow-up of 23.5 ± 16.2 months except for one ipsilateral recurrence at 42 months after surgery.

Conclusions: The modified classification was correlated with surgical outcomes of CBTs and will be helpful for making surgical plans.
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http://dx.doi.org/10.1016/j.ejso.2021.03.244DOI Listing
August 2021

DcTT8, a bHLH transcription factor, regulates anthocyanin biosynthesis in Dendrobium candidum.

Plant Physiol Biochem 2021 May 8;162:603-612. Epub 2021 Mar 8.

Institute of Food Science and Technology, Chinese Academy of Agricultural Science, Beijing, 100193, China; Laboratory of Quality & Safety Risk Assessment on Agro-products Processing, Ministry of Agriculture and Rural Affairs, Beijing, 100193, China. Electronic address:

Dendrobium candidum stems are used as Chinese medicine and functional food. Red stems of D. candidum are rich in anthocyanins, which attract pollinator insects, protect the plants against environmental stress, and improve human health. The regulatory mechanisms of anthocyanin biosynthesis and stem color differentiation in D. candidum are not fully understood. Using transcriptome profiling, we identified a basic helix-loop-helix transcription factor (DcTT8) involved in anthocyanin biosynthesis in D. candidum stems. Ultraperformance liquid chromatography-tandem mass spectrometry was used to determine pigment contents and compositions in red and green stems, revealing that cyanidin is responsible for the red color. DcTT8 could bind the DcF3'H and DcUFGT promoters and finely regulate DcF3'H and DcUFGT expression. Our data indicate that DcTT8 participates in anthocyanin biosynthesis and offers novel insights into the transcriptional regulation of anthocyanin biosynthesis in D. candidum.
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http://dx.doi.org/10.1016/j.plaphy.2021.03.006DOI Listing
May 2021

Short-Term and Long-Term Outcomes in Mid and Low Rectal Cancer With Robotic Surgery.

Front Oncol 2021 9;11:603073. Epub 2021 Mar 9.

Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.

Objective: To investigate the risk factors for postoperative complications and anastomotic leakage after robotic surgery for mid and low rectal cancer and their influence on long-term outcomes.

Methods: A total of 641 patients who underwent radical mid and low rectal cancer robotic surgery at Zhongshan Hospital Fudan University from January 2014 to December 2018 were enrolled in this study. The clinicopathological factors of the patients were collected. The risk factors for short-term outcomes of complications and anastomotic leakage were analyzed, and their influences on recurrence and overall survival were studied.

Results: Of the 641 patients, 516 (80.5%) underwent AR or LAR procedures, while 125 (19.5%) underwent the NOSES procedure. Only fifteen (2.3%) patients had stoma diversion. One hundred and seventeen patients (17.6%) experienced surgical complications. Anastomotic leakage occurred in 44 patients (6.9%). Eleven patients (1.7%) underwent reoperation within 90 days after surgery. Preoperative radiotherapy did not significantly increase anastomotic leakage in our study (7.4% vs. 6.8%, P = 0.869). The mean postoperative hospital stay was much longer with complication (10.4 vs. 7.1 days, P<0.05) and leakage (12.9 vs. 7.4 days, P < 0.05). Multivariate analysis showed that male sex (OR = 1.855, 95% CI: 1.175-2.923, P < 0.05), tumor distance 5 cm from the anus (OR = 1.563, 95% CI: 1.016-2.404, P < 0.05), and operation time length (OR = 1.563, 95% CI: 1.009-2.421, P < 0.05) were independent risk factors for complications in mid and low rectal cancer patients. The same results for anastomotic leakage: male sex (OR = 2.247, 95% CI: 1.126-4.902, P < 0.05), tumor distance 5 cm from the anus (OR = 2.242, 95% CI: 1.197-4.202, P < 0.05), and operation time length (OR = 2.114, 95% CI: 1.127-3.968, P < 0.05). The 3-year DFS and OS were 82.4% and 92.6% with complication, 88.4% and 94.0% without complication, 88.6% and 93.1% with leakage, and 87.0% and 93.8% without leakage, respectively. The complication and anastomotic leakage showed no significant influences on long-term outcomes.

Conclusion: Being male, having a lower tumor location, and having a prolonged operation time were independent risk factors for complications and anastomotic leakage in mid and low rectal cancer. Complications and anastomotic leakage might have no long-term impact on oncological outcomes for mid and low rectal cancer with robotic surgery.
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http://dx.doi.org/10.3389/fonc.2021.603073DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7985529PMC
March 2021

Connective tissue growth factor promotes retinal pigment epithelium mesenchymal transition via the PI3K/AKT signaling pathway.

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

Department of Ophthalmology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China.

Proliferative vitreoretinopathy (PVR) is a disease leading to the formation of contractile preretinal membranes (PRMs) and is one of the leading causes of blindness. Connective tissue growth factor (CTGF) has been identified as a possible key determinant of progressive tissue fibrosis and excessive scarring. Therefore, the present study investigated the role and mechanism of action of CTGF in PVR. Immunohistochemical staining was performed to detect the expression of CTGF, fibronectin and collagen type III in PRMs from patients with PVR. The effects and mechanisms of recombinant human CTGF and its upstream regulator, TGF‑β1, on epithelial‑mesenchymal transition (EMT) and the synthesis of extracellular matrix (ECM) by retinal pigment epithelium (RPE) cells were investigated using reverse transcription‑quantitative PCR, western blotting and a [H]proline incorporation assay. The data indicated that CTGF, fibronectin and collagen type III were highly expressed in PRMs. , CTGF significantly decreased the expression of the epithelial markers ZO‑1 and E‑cadherin and increased that of the mesenchymal markers fibronectin, N‑cadherin and α‑smooth muscle actin in a concentration‑dependent manner. Furthermore, the expression of the ECM protein collagen type III was upregulated by CTGF. However, the trends in expression for the above‑mentioned markers were reversed after knocking down . The incorporation of [H]proline into RPE cells was also increased by CTGF. In addition, 8‑Bromoadenosine cAMP inhibited CTGF‑stimulated collagen synthesis and transient transfection of RPE cells with a antisense oligonucleotide inhibited TGF‑β1‑induced collagen synthesis. The phosphorylation of PI3K and AKT in RPE cells was promoted by CTGF and TGF‑β1 and the latter promoted the expression of CTGF. The results of the present study indicated that CTGF may promote EMT and ECM synthesis in PVR via the PI3K/AKT signaling pathway and suggested that targeting CTGF signaling may have a therapeutic or preventative effect on PVR.
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http://dx.doi.org/10.3892/mmr.2021.12028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8008218PMC
May 2021

[Treatment of Concomitant Intra-abdominal Malignancy and Abdominal Aortic Aneurysm].

Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2021 Feb;43(1):37-41

Department of Vascular Surgery,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.

Objective To explore the outcomes in patients who receive the endovascular abdominal aortic aneurysm repair(EVAR)and have concomitant intra-abdominal malignancy.Methods Between January 2014 and December 2019,all the patients who underwent surgery for malignancy and/or EVAR were retrospectively reviewed.Results Twenty-eight abdominal aortic aneurysm(AAA)patients with concomitant intra-abdominal malignancy were included.The patients were treated by two-stage operation and the priority was given for EVAR in 21 patients.There was no perioperative death or major complications.In the follow-up,one patient developed graft thrombosis and one had type Ⅱ endoleak.There was no AAA-associated death.Conclusions It is preferred that EVAR should come first followed by operation for malignancy.Details of treatment strategy still need further investigation.
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http://dx.doi.org/10.3881/j.issn.1000-503X.12597DOI Listing
February 2021

Machine-learning-enhanced time-of-flight mass spectrometry analysis.

Patterns (N Y) 2021 Feb 21;2(2):100192. Epub 2021 Jan 21.

Max-Planck-Institut für Eisenforschung, Max-Planck-Strasse 1, 40237 Düsseldorf, Germany.

Mass spectrometry is a widespread approach used to work out what the constituents of a material are. Atoms and molecules are removed from the material and collected, and subsequently, a critical step is to infer their correct identities based on patterns formed in their mass-to-charge ratios and relative isotopic abundances. However, this identification step still mainly relies on individual users' expertise, making its standardization challenging, and hindering efficient data processing. Here, we introduce an approach that leverages modern machine learning technique to identify peak patterns in time-of-flight mass spectra within microseconds, outperforming human users without loss of accuracy. Our approach is cross-validated on mass spectra generated from different time-of-flight mass spectrometry (ToF-MS) techniques, offering the ToF-MS community an open-source, intelligent mass spectra analysis.
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http://dx.doi.org/10.1016/j.patter.2020.100192DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7892357PMC
February 2021

Publisher Correction: Temporal lung changes on thin-section CT in patients with COVID-19 pneumonia.

Sci Rep 2021 Feb 23;11(1):4892. Epub 2021 Feb 23.

State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, No. 1023, Shatai Road South, Baiyun District, Guangzhou, 510515, Guangdong Province, China.

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http://dx.doi.org/10.1038/s41598-021-84454-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7901161PMC
February 2021

RNA sequencing-based exploration of the effects of far-red light on lncRNAs involved in the shade-avoidance response of .

PeerJ 2021 12;9:e10769. Epub 2021 Feb 12.

College of Resources and Chemical Engineering, Sanming University, Sanming, China.

() is a valuable medicinal plant with a low natural survival rate, and its shade-avoidance response to far-red light is as an important strategy used by the plant to improve its production efficiency. However, the lncRNAs that play roles in the shade-avoidance response of have not yet been investigated. This study found that an appropriate proportion of far-red light can have several effects, including increasing the leaf area and accelerating stem elongation, in . The effects of different far-red light treatments on were analysed by RNA sequencing technology, and a total of 69 and 78 lncRNAs were differentially expressed in experimental group 1 (FR1) versus the control group (CK) (FR1-CK) and in experimental group 4 (FR4) versus the CK (FR4-CK), respectively. According to GO and KEGG analyses, most of the differentially expressed lncRNA targets are involved in the membrane, some metabolic pathways, hormone signal transduction, and O-methyltransferase activity, among other functions. Physiological and biochemical analyses showed that far-red light promoted the accumulation of flavonoids, alkaloids, carotenoids and polysaccharides in . The effect of far-red light on might be closely related to the cell membrane and Ca transduction. Based on a Cytoscape analysis and previous research, this study also found that MSTRG.38867.1, MSTRG.69319.1, and MSTRG.66273.1, among other components, might participate in the far-red light signalling network through their targets and thus regulate the shade-avoidance response of . These findings will provide new insights into the shade-avoidance response of .
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http://dx.doi.org/10.7717/peerj.10769DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883695PMC
February 2021

Weighted Gene Co-expression Network Analysis Identifies Crucial Genes Mediating Progression of Carotid Plaque.

Front Physiol 2021 5;12:601952. Epub 2021 Feb 5.

Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Background: Surface rupture of carotid plaque can cause severe cerebrovascular disease, including transient ischemic attack and stroke. The aim of this study was to elucidate the molecular mechanism governing carotid plaque progression and to provide candidate treatment targets for carotid atherosclerosis.

Methods: The microarray dataset GSE28829 and the RNA-seq dataset GSE104140, which contain advanced plaque and early plaque samples, were utilized in our analysis. Differentially expressed genes (DEGs) were screened using the "limma" R package. Gene modules for both early and advanced plaques were identified based on co-expression networks constructed by weighted gene co-expression network analysis (WGCNA). Gene Ontology (GO) and Kyoto Encyclopedia of Genes Genomes (KEGG) analyses were employed in each module. In addition, hub genes for each module were identified. Crucial genes were identified by molecular complex detection (MCODE) based on the DEG co-expression network and were validated by the GSE43292 dataset. Gene set enrichment analysis (GSEA) for crucial genes was performed. Sensitivity analysis was performed to evaluate the robustness of the networks that we constructed.

Results: A total of 436 DEGs were screened, of which 335 were up-regulated and 81 were down-regulated. The pathways related to inflammation and immune response were determined to be concentrated in the black module of the advanced plaques. The hub gene of the black module was (Rho GTPase activating protein 18). (neutrophil cytosolic factor 2), (IQ motif containing GTPase activating protein 2) and (CD86 molecule) had the highest connectivity among the crucial genes. All crucial genes were validated successfully, and sensitivity analysis demonstrated that our results were reliable.

Conclusion: To the best of our knowledge, this study is the first to combine DEGs and WGCNA to establish a DEG co-expression network in carotid plaques, and it proposes potential therapeutic targets for carotid atherosclerosis.
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http://dx.doi.org/10.3389/fphys.2021.601952DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7894049PMC
February 2021

Built-in electric field for photocatalytic overall water splitting through a TiO/BiOBr P-N heterojunction.

Nanoscale 2021 Mar;13(8):4496-4504

College of Material, Chemistry and Chemical Engineering, Hangzhou Normal University, Hangzhou, Zhejiang 311121, P. R. China.

Photocatalytic overall water splitting to simultaneously obtain abundant hydrogen and oxygen is still the mountain that stands in the way for the practical applications of hydrogen energy, in which composite semiconductor photocatalysts are critical for providing both electrons and holes to promote the following redox reaction. However, the interface between different components forms a deplete layer to hinder the charge transfer to a large extent. In order to enhance the charger transfer from an interface to the surface and promote the spatial separation of electron-hole pairs, a built-in electric field induced by a p-n heterojunction emerges as the best choice. As a touchstone, a p-n heterojunction of TiO2/BiOBr with a strong built-in electric field has been constructed, which presents a wide spectrum response owing to its interleaved band gaps after composition. The built-in electric field greatly enhances the separation and transportation of photogenerated carriers, resulting in fluorescence quenching due to the carrier recombination. The sample also displayed exceptional photoelectron responses: its photocurrent density (43.3 μA cm-2) was over 10 times that of TiO2 (3.5 μA cm-2) or BiOBr (4.2 μA cm-2). In addition, the sample with a molar ratio of 3 : 1 between TiO2 and BiOBr showed the best photocatalytic overall water splitting performance under visible light (λ > 420 nm): the hydrogen and oxygen production rate were 472.7 μmol gcat.-1 h-1 and 95.7 μmol gcat.-1 h-1, respectively, which are the highest values under visible light without other cocatalysts to have been reported in literature for the photocatalyst.
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http://dx.doi.org/10.1039/d0nr08928aDOI Listing
March 2021

Treatment of venous thromboembolism in cancer patients: a systematic review and meta-analysis on the efficacy and safety of different direct oral anticoagulants (DOACs).

Ann Transl Med 2021 Jan;9(2):162

Department of Vascular Surgery, Peking Union Medical College Hospital, Beijing, China.

Background: To evaluate the efficacy and safety of different direct oral anticoagulants (DOACs) compared with low molecular weight heparins (LMWHs) in the treatment of venous thromboembolism (VTE) in cancer patients.

Methods: Literature was searched in databases including Cochrane Library, EMBASE (Ovid), and MEDLINE (PubMed). Eligible studies were included, and data were collected independently by 2 reviewers. We conducted a systematic review of the efficacy and safety of DOACs in the treatment of VTE in cancer patients. The odds ratios (ORs) of different DOACs compared with LMWHs for VTE, deep vein thrombosis (DVT), pulmonary embolism (PE) recurrence, major bleeding, and clinically relevant non-major bleeding (CRNMB), were calculated in meta-analyses and subgroup analyses.

Results: A total of 18 articles were eligible for analyses, including 4 randomized controlled trials (RCTs) and 14 retrospective studies. Both RCTs and retrospective studies confirmed that DOACs decreased the risk of VTE recurrence [RCTs: OR, 0.60; 95% confidence interval (CI), 0.45-0.80; retrospective studies: OR, 0.73; 95% CI, 0.59-0.90] and DVT recurrence (RCTs: OR, 0.54; 95% CI, 0.36-0.80; retrospective studies: OR, 0.20; 95% CI, 0.06-0.63), but not PE recurrence or fatal PE in cancer patients. Subgroup analyses revealed an important role of rivaroxaban in decreasing recurrent VTE. Meanwhile, major bleeding events were not increased in the DOAC group, but the risks of CRNMBs were significantly elevated. Subgroup analyses confirmed the role of rivaroxaban in increasing the risk of major bleeding events and CRNMBs.

Conclusions: Compared with LMWHs, DOACs (especially rivaroxaban) significantly reduce the risk of VTE and DVT, but not PE recurrence, in patients with cancer. Although DOACs did not increase the major bleeding events in pooled analysis, rivaroxaban showed an elevated risk of this adverse effect in subgroup analysis. In addition, the risk of CRNMB events was increased after the application of DOACs including rivaroxaban.
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http://dx.doi.org/10.21037/atm-20-8156DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7867886PMC
January 2021

Comprehensive analysis of prognostic value of lymph node staging classifications in patients with head and neck squamous cell carcinoma after cervical lymph node dissection.

Eur J Surg Oncol 2021 Jul 30;47(7):1710-1717. Epub 2021 Jan 30.

Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. Electronic address:

Purpose: To determine the optimal threshold of examined lymph node (ELN) number from cervical lymph node dissection for head and neck squamous cell carcinoma (HNSCC). Further to compare the prognostic value of multiple lymph node classification systems and to determine the most suitable scheme to predict survival.

Methods: A total of 20991 HNSCC patients were included. Odds ratios (ORs) for negative-to-positive node stage migration and hazard ratios (HRs) for survival were fitted using the LOWESS smoother. Structural breakpoints were determined by the Chow test. The R square, C-index, likelihood ratio, and Akaike information criterion (AIC) were used to compare the prognostic abilities among AJCC N stage, number of positive lymph nodes (pN), positive lymph node ratio (LNR) and log odds of positive lymph nodes (LODDS) stages.

Results: A minimal threshold ELN number of fifteen had the discriminatory capacities for both stage migration and survival. LODDS stages had the highest R square value (0.208), C-index (0.736) and likelihood ratio (2467) and the smallest AIC value (65874). LODDS stages also showed prognostic value in estimating patients with AJCC N0 stage. A novel staging system was proposed and showed good prognostic performance when stratified by different primary sites.

Conclusion: Fifteen lymph nodes should be examined for HNSCC patients. LODDS stage allows better prognostic stratification, especially in N0 stage. The proposed staging system may serve as precise evaluation tools to estimate postoperative prognoses.
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http://dx.doi.org/10.1016/j.ejso.2021.01.020DOI Listing
July 2021

Changes in levels of coagulation parameters in different trimesters among Chinese pregnant women.

J Clin Lab Anal 2021 Apr 5;35(4):e23724. Epub 2021 Feb 5.

Department of Laboratory Medicine, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Wuhan, China.

Background: This article is to explore changes in levels of coagulation parameters in different trimesters among healthy pregnant women in China.

Methods: A total of 760 eligible women were enrolled (first-trimester group: n = 183, second-trimester group: n = 183, third-trimester group: n = 263, non-pregnant group: n = 131). Seven parameters including prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), D-dimer (DD), fibrinogen degradation products (FDP), and antithrombin III (ATIII), of all participants were collected. The non-parametric 2.5th-97.5th percentiles reference intervals were calculated for each parameter.

Results: The reference intervals for FIB, PT, APTT, TT, FDP, DD, and ATIII at first trimester were 2.11-4.32 g/L, 10.90-13.85 s, 24.60-39.28 s, 12.95-15.88 s, 0.04-2.55 μg/mL, 0.03-1.15 μg/mL, and 75.57%-125.31%, respectively. The reference intervals at second trimester were 2.31-4.77 g/L, 9.70-12.64 s, 24.16-35.43 s, 12.95-15.88 s, 0.15-7.40 μg/mL, 0.08-2.13 μg/mL, and 74.35%-119.28%, respectively. For the third-trimester, the intervals were 2.39-4.96 g/L, 9.20-11.95 s, 23.90-35.51 s, 13.41-18.00 s, 0.55-13.43 μg/mL, 0.15-3.60 μg/mL, and 71.61%-118.29%, respectively. The third-trimester group showed decreased PT, APTT, and ATIII and increased FIB, TT, DD and FDP as compared with the other groups.

Conclusion: In this study, level changes of coagulation parameters in different trimesters were observed. And the ranges for coagulation parameters were presented, which may provide some reference for clinicians to more accurately monitor the coagulation and fibrinolytic system in pregnant women.
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http://dx.doi.org/10.1002/jcla.23724DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8059730PMC
April 2021

Diffusion-weighted imaging with background body signal suppression (DWIBS) distinguishes benign lesions from malignant pulmonary solitary lesions.

Am J Transl Res 2021 15;13(1):88-101. Epub 2021 Jan 15.

Department of Radiology, People's Hospital of Guangxi Zhuang Autonomous Region Nanning, China.

This study aimed to determine applicable value of DWIBS in diagnosis of solitary pulmonary lesions. This study involved 32 solitary lung disease patients. T1W1, T2W1, T2WI-SPAIR were examined using MRI scanner and analyzed with View-forum 6.0 workstation. Imaging characteristics of pulmonary solitary lesions on DWIBS and ADC when b=300, 500 and 800 s/mm were observed. Signal-to-noise ratio (SNR), contrast-noise-ratio (CNR) and ADC value of lesions under different b-values were measured. Image quality in different b-values was compared by analyzing SNR and CNR. ADC values of benign and malignant lesions in different b-value groups were tested using -test. ROC curve was used to evaluate diagnostic efficacy of ADC value, and obtain diagnostic threshold. The results indicated that SNR and CNR value of 300 and 500 s/mm group was significantly higher compared to 800 s/mm group (<0.05). When b-value was assigned as 500 s/mm, DWIBS demonstrated better and ideal images. ADC value of malignant lesions in different b-values was significantly lower compared to benign lesions (<0.05), suggesting ADC value is a feasible approach for distinguishing benign from malignant lesions. AUC value of b=500 s/mm was significantly higher compared to b=300 and b=800 s/mm group (<0.05). When b-value was assigned as 500 s/mm, the best ADC threshold value was 1.435×10 mm/s, with high sensitivity, specificity and accuracy of 80.0%, 83.3% and 84.4%, respectively. In conclusion, quantitative analysis of DWIBS examination and ADC value was helpful for qualitative diagnosis of pulmonary solitary lesions, and demonstrated potential to distinguish benign and malignant pulmonary solitary lesions.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847530PMC
January 2021

Continuous hypergammaglobulinemia and proteinuria after the recovery of the visceral Leishmaniasis: a case report.

BMC Infect Dis 2021 Jan 28;21(1):124. Epub 2021 Jan 28.

Department of Nephrology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.

Background: Kidney involvement of visceral Leishmaniasis is previously reported, but knowledge is limited. Hypergammaglobulinemia is common in visceral leishmaniasis patients. Whether hypergammaglobulinemia after leishmaniasis depletion can cause kidney injury is not well reported yet.

Case Presentation: We reported a patient who recovered from visceral Leishmaniasis but showed persistent hypergammaglobulinemia and elevated urinary protein. Kidney biopsy showed glomerular hypertrophy with mild segmental mesangial proliferation without tubulointerstitial involvement in light microscopy. No immune complex deposit was found in the mesangial area by neither immunofluorescent staining nor electronic microscope. Increased lysosomes were observed in proximal tubules by electronic microscope. Valsartan was administered to decrease urinary protein, and no immune-suppressive therapy was added. The urinary protein and serum IgG level gradually dropped, and serum creatinine level remained stable during three- month follow up.

Conclusions: Hypergammaglobulinemia is unlikely to cause renal structural or functional damage in the short term. Angiotensin blockade significantly reduced urine protein, with a minor effect on IgG elimination.
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http://dx.doi.org/10.1186/s12879-021-05819-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7844912PMC
January 2021

Ascidian-Inspired Heparin-Mimetic Magnetic Nanoparticles with Potential for Application in Hemodialysis as Recycling Anticoagulants.

ACS Biomater Sci Eng 2020 04 24;6(4):1998-2006. Epub 2020 Mar 24.

Department of Chemistry and Biochemistry, Georgia Southern University, P.O. Box 8064, Statesboro, Georgia 30460, United States.

In the present study, heparin-mimetic magnetic nanoparticles (HMNPs), which might be used as recycling anticoagulants, were synthesized by coating heparin-mimetic sodium alginate (HLSA) on the surface of iron oxide magnetic nanoparticles (MNPs), using 3,4,5-trihydroxyphenylalanine (TOPA) as a biological adhesive. HLSA was successfully immobilized on the MNP surface, as revealed by Fourier transform infrared spectroscopy and thermal gravimetric analysis, and the core (MNP)-shell (TOPA, HLSA) structure was confirmed by transmission electron microscopy observations. In addition, in vitro studies of protein adsorption, blood clotting time, and contact activation confirmed that the blood compatibility of the HMNP was significantly enhanced compared with the bare MNP. The improved hemocompatibility was attributed to the introduction of the multiple heparin-mimetic groups (-SONa, -COONa, and -OH). In addition, the HMNP showed outstanding recycle stability and, thus, can be reused if needed. The synthesized HMNP appeared to be a suitable biomaterial to safely replace heparin as an anticoagulant in patients undergoing long-term hemodialysis.
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http://dx.doi.org/10.1021/acsbiomaterials.9b01865DOI Listing
April 2020

Improved Blood Compatibility and Endothelialization of Titanium Oxide Nanotube Arrays on Titanium Surface by Zinc Doping.

ACS Biomater Sci Eng 2020 04 18;6(4):2072-2083. Epub 2020 Mar 18.

Faculty of Mechanical and Material Engineering, Huaiyin Institute of Technology, Huai'an 223003, China.

Titanium dioxide nanotube arrays are widely used in biomaterials due to their unique tubular structure and tunable biocompatibility. In the present study, titanium oxide nanotube arrays with different diameters were prepared on the titanium surface by anodization, followed by zinc doping using hydrothermal treatment to enhance the biocompatibility. Both the nanotube dimensions and zinc doping had obvious influences on the hydrophilicity, protein adsorption, blood compatibility, and endothelial cell behaviors of the titanium surface. The increase of the diameter and zinc doping can improve the hydrophilicity of the titanium surface. The increase of nanotube diameter could reduce the albumin adsorption while increasing the fibrinogen adsorption. However, zinc doping can simultaneously promote the adsorption of albumin and fibrinogen, and the effect was more obvious for albumin. Zinc doping can significantly improve the blood compatibility of the titanium oxide nanotubes because it cannot only increase the activity of cyclophosphate guanylate (cGMP) but also significantly reduce the platelets adhesion and hemolysis rate. Moreover, it was also found that both the smaller diameter and zinc doping nanotubes can enhance the endothelial cell adhesion and proliferation as well as up-regulate the expression of NO and VEGF. Therefore, the zinc doped titanium dioxide nanotube array can be used to simultaneously improve the blood compatibility and promote endothelialization of the titanium-based biomaterials and implants, such as intravascular stents.
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http://dx.doi.org/10.1021/acsbiomaterials.0c00187DOI Listing
April 2020

Highly vulnerable communities and the Affordable Care Act: Health insurance coverage effects, 2010-2018.

Soc Sci Med 2021 02 6;270:113670. Epub 2021 Jan 6.

Claremont Graduate University, United States. Electronic address:

Initially implemented in 2014 in some U.S. states, the Medicaid expansions under the Affordable Care Act (ACA) aimed to make health insurance coverage more accessible to the low-income population. This paper aims to quantify the impact of the ACA Medicaid expansions on insurance coverage among racial/ethnic minorities, immigrants, single mothers, veterans, and low-education whites-i.e., the sectors of the population identified with some of the highest healthcare needs. We focus on individuals 18-64 years of age earning 138% or less of the federal poverty level from the American Community Survey, 2010-2018 (n = 2,927,402). We use difference-in-differences (DD) and difference-in-difference-in-differences (DDD) approaches with propensity scores matched comparison groups to estimate pre-post ACA insurance coverage differences between individuals living in states that participated in the ACA Medicaid expansions and those living in non-participating states, and to estimate if such differences vary across subgroups. We find that insurance coverage rates increased for all subgroups; yet, the ACA benefits have not been evenly distributed across them. Low-education whites, non-Hispanic whites, females, and non-Hispanic Native Americans exhibited the highest improvements in insurance coverage. Our results contribute to the understanding of recent trends in racial and socioeconomic disparities in healthcare and the appropriate policy prescriptions to ameliorate them.
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http://dx.doi.org/10.1016/j.socscimed.2021.113670DOI Listing
February 2021

Novel thermally activated delayed fluorescence nano-micelle for tumor imaging.

Photodiagnosis Photodyn Ther 2021 Mar 8;33:102178. Epub 2021 Jan 8.

Department of Radiology, Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China. Electronic address:

A novel aromatic-imide-based, thermally activated delayed fluorescence material nano-micelle (TADF-NM) compound was prepared after being encapsulated with DSPE-mPEG amphiphilic copolymers. TADF-NM has preferential characteristics such as biocompatibility, non-toxic and targeted ability, and importantly TADF-NM efficiently isolated oxygen to enhance the fluorescence lifetime, and prevented quenching for using time-resolved fluorescence imaging (TRFI) in tumor cells. The fluorescence lifetime of TADF-NM was about 212 μs in PBS and 112 μs in tumor cells, which was the longest in fluorescence lifetime images based on TADF materials. These studies have shown that TADF-NM have excellent potential ability to overcome the interference of auto-fluorescence while being applied in confocal fluorescence tumor imaging.
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http://dx.doi.org/10.1016/j.pdpdt.2021.102178DOI Listing
March 2021

Tetravalent SARS-CoV-2 Neutralizing Antibodies Show Enhanced Potency and Resistance to Escape Mutations.

bioRxiv 2020 Dec 21. Epub 2020 Dec 21.

Neutralizing antibodies (nAbs) hold promise as effective therapeutics against COVID-19. Here, we describe protein engineering and modular design principles that have led to the development of synthetic bivalent and tetravalent nAbs against SARS-CoV-2. The best nAb targets the host receptor binding site of the viral S-protein and its tetravalent versions can block entry with a potency that exceeds the bivalent nAbs by an order of magnitude. Structural studies show that both the bivalent and tetravalent nAbs can make multivalent interactions with a single S-protein trimer, observations consistent with the avidity and potency of these molecules. Significantly, we show that the tetravalent nAbs show much increased tolerance to potential virus escape mutants. Bivalent and tetravalent nAbs can be produced at large-scale and are as stable and specific as approved antibody drugs. Our results provide a general framework for developing potent antiviral therapies against COVID-19 and related viral threats, and our strategy can be readily applied to any antibody drug currently in development.
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http://dx.doi.org/10.1101/2020.10.31.362848DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7781305PMC
December 2020

Targeting CDK7 suppresses super enhancer-linked inflammatory genes and alleviates CAR T cell-induced cytokine release syndrome.

Mol Cancer 2021 01 4;20(1). Epub 2021 Jan 4.

Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.

Background: Cytokine release syndrome (CRS) is a systemic inflammatory response characterized by the overexpression of inflammatory genes. Controlling CRS is essential for improving the therapeutic effects of chimeric antigen receptor (CAR) engineered T cells. However, current treatment options are limited given the complexity of cytokine interactions so it is important to seek a mild strategy with broad-spectrum inhibition to overcome this challenge.

Methods: Using THZ1, a covalent inhibitor of cyclin-dependent kinase 7 (CDK7), we demonstrated the transcriptional suppression of inflammatory genes in activated macrophages. RNA sequencing and ChIP sequencing were conducted to identify the key target genes of the inflammatory response. Pathogen- and CAR T cell-induced CRS models were also established to assess the efficacy and safety of targeting CDK7.

Results: CDK7 blockade attenuated cytokine release, mitigated hyperinflammatory states and rescued mice from lethal CRS. Targeting CDK7 preferentially suppressed a set of inflammatory genes, of which STAT1 and IL1 were the key targets associated with super enhancers. Furthermore, we confirmed the potent efficacy of THZ1 in alleviating the CRS induced by CAR T cell infusion without causing tissue injury or impairing antitumor effects.

Conclusions: Our work indicates the CDK7-dependent transcription addiction of inflammatory genes. Targeting CDK7 is a promising strategy for treating CRS by inhibiting multiple cytokines.
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http://dx.doi.org/10.1186/s12943-020-01301-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7780220PMC
January 2021

A selected small molecule prevents inflammatory osteolysis through restraining osteoclastogenesis by modulating PTEN activity.

Clin Transl Med 2020 Dec;10(8):e240

Department of Biomedical Materials Science, Third Military Medical University (Army Medical University), Chongqing, PR China.

Background: Inflammatory osteolysis is a severe infectious bone disorder that occurs during orthopaedic surgery and is caused by disruptions in the dynamic balance of bone matrix homeostasis, which makes this condition a burden on surgical procedures. Developing novel therapeutic drugs about inhibiting excessive osteoclastogenesis acts as an efficient approach to preventing inflammatory bone destruction.

Methods: To study this, we explored the potential effects and mechanisms of compound 17 on inflammatory osteolysis in vitro. Meanwhile, a lipopolysaccharide (LPS)-induced calvarial osteolysis mouse model was used to evaluate the protective effect of compound 17 on inflammatory bone destruction in vivo.

Results: In our study, we found that compound 17 could inhibit osteoclast (OC) differentiation and bone resorption during RANKL and LPS stimulation in a time- and dose-dependent manner, while compounds 5 and 13 did not have the same effects. Mechanistically, compound 17 promoted phosphatase and tensin homologue (PTEN) activity by reducing PTEN ubiquitination, thereby restraining the RANKL-induced NF-κB pathway, resulting in the inhibition of the expression of osteoclastogenesis-related genes and the formation of the NLRP3 inflammasome. Additionally, we also investigated whether compound 17 could negatively modulate macrophage polarization and repolarization due to its anti-inflammatory effects. Moreover, compound 17 also plays an important role in osteoblast differentiation and mineralization. In vivo experiments showed that compound 17 could effectively protect mice from LPS-induced inflammatory bone destruction by inhibiting osteoclastogenesis and inflammation.

Conclusions: Taken together, these results show that compound 17 might play protective role in inflammatory bone destruction through inhibiting osteoclastogenesis and inflammation. These findings imply a possible role of compound 17 in inflammatory osteolysis-related diseases.
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http://dx.doi.org/10.1002/ctm2.240DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7708775PMC
December 2020

Development and validation of a UPLC-MS/MS method for quantification of C-005, a novel third-generation EGFR TKI, and its major metabolite in plasma: Application to its first-in-patient study.

J Chromatogr B Analyt Technol Biomed Life Sci 2021 Jan 7;1162:122475. Epub 2020 Dec 7.

GCP Center/Institute of Clinical Pharmacology, West China Hospital of Sichuan University, Chengdu 610041, China. Electronic address:

C-005 is a novel third-generation EGFR tyrosine kinase inhibitor for the treatment of non-small cell lung cancer (NSCLC). To support its clinical trial, we developed a rapid and sensitive bioanalytical method based on ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) technique for the quantification of C-005 and its major metabolite in NSCLC patients following international bioanalytical guidelines. After a simple and quick protein precipitation step, the supernatant was injected to a Waters Acquity BEH C column (2.1 × 50 mm i.d., 1.7 mm), and the column was eluted with a gradient of buffer A (5 mM ammonium acetate and 0.1% formic acid in water) and buffer B (formic acid-acetonitrile (1:1000, v/v)). The eluates were subsequently detected by an AB QTRAP 5500 mass spectrometer with electrospray ionization using multiple-reaction monitoring mode. The method showed good linearity from 2.00 to 1000 ng/mL for C-005 and 1.00 to 500 ng/mL for M1. In conclusion, the validation results demonstrated the robustness of the method and its well-poised to support the first-in-patient study of C-005 in NSCLC patients.
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http://dx.doi.org/10.1016/j.jchromb.2020.122475DOI Listing
January 2021

Corrigendum: Remdesivir (GS-5734) Impedes Enterovirus Replication Through Viral RNA Synthesis Inhibition.

Front Microbiol 2020 23;11:621197. Epub 2020 Nov 23.

Department of Microbiology, School of Preclinical Medicine, Fourth Military Medical University, Xi'an, China.

[This corrects the article DOI: 10.3389/fmicb.2020.01105.].
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http://dx.doi.org/10.3389/fmicb.2020.621197DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732440PMC
November 2020

Identification and validation of key genes mediating intracranial aneurysm rupture by weighted correlation network analysis.

Ann Transl Med 2020 Nov;8(21):1407

Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Background: Rupture of intracranial aneurysm (IA) is the leading cause of subarachnoid hemorrhage. However, there are few pharmacological therapies available for the prevention of IA rupture. Therefore, exploring the molecular mechanisms which underlie IA rupture and identifying the potential molecular targets for preventing the rupture of IA is of vital importance.

Methods: We used the Gene Expression Omnibus (GEO) datasets GSE13353, GSE15629, and GSE54083 in our study. The 3 datasets were merged and normalized. Differentially expressed gene (DEG) screening and weighted correlation network analysis (WGCNA) were conducted. The co-expression patterns between ruptured IA samples and unruptured IA samples were compared. Then, the DEGs were mapped into the whole co-expression network of ruptured IA samples, and a DEG co-expression network was generated. Molecular Complex Detection (MCODE) (http://baderlab.org/Software/MCODE) was used to identify key genes based on the DEG co-expression network. Finally, key genes were validated using another GEO dataset (GSE122897), and their potential diagnostic values were shown using receiver operating characteristic (ROC) analysis.

Results: In our study, 49 DEGs were screened while 8 and 6 gene modules were detected based on ruptured IA samples and unruptured IA samples, respectively. Pathways associated with inflammation and immune response were clustered in the salmon module of ruptured IA samples. The DEG co-expression network with 35 nodes and 168 edges was generated, and 14 key genes were identified based on this DEG co-expression network. The gene with the highest degree in the key gene cluster was CXCR4. All key genes were validated using GSE122897, and they all showed the potential diagnostic value in predicting IA rupture.

Conclusions: Using a weighted gene co-expression network approach, we identified 8 and 6 modules for ruptured IA and unruptured IA, respectively. After that, we identified the hub genes for each module and key genes based on the DEG co-expression network. All these key genes were validated by another GEO dataset and might serve as potential targets for pharmacological therapies and diagnostic markers in predicting IA rupture. Further studies are needed to elucidate the detailed molecular mechanisms and biological functions of these key genes which underlie the rupture of IA.
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http://dx.doi.org/10.21037/atm-20-4083DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7723540PMC
November 2020

Henoch-Schönlein purpura in a patient with oesophageal cancer: A case report.

Medicine (Baltimore) 2020 Dec;99(49):e23492

Department of Nephrology.

Rationale: Understanding the association between Henoch-Schönlein purpura (HSP) and malignancy is essential for early diagnosis and treatment of the potential lethal disease. To the best of our knowledge, there has been only one published case of HSP coexisting with oesophageal cancer. Here, we report another patient diagnosed with HSP and oesophageal squamous carcinoma simultaneously.

Patient Concerns: A 60-year-old Chinese male was referred to our hospital because of intermittent abdominal pain, abdominal distension, melena, lower extremities purpura. Positive laboratory values included pancytopenia, microscopic hematuria, nephrotic proteinuria, hematochezia, hypoalbuminemia, hyperlipidaemia, hypocomplementemia, and increased levels of hepatobiliary enzymes and immunoglobulin (Ig) A. Gastrocolonoscopy showed multiple erosion lesion on descending duodenum, terminal ileum, and ileal flap. Biopsy of these lesions suggested non-specific inflammation.

Diagnoses: HSP (IIIb type) was diagnosed based on renal pathology examination in accordance with the International Study of Kidney Disease in Children (ISKDC) classification. Liver biopsy confirmed the diagnosis of nodular cirrhosis (Ishak 5). Gastroscopy unintentionally revealed three oesophagus lesions. Pathology study suggested intermediate differentiated squamous cell carcinoma (cTNM IB).

Interventions: Before admission, he was administered intravenous Ig 10 g once daily(qd) for 10 days, methylprednisolone 40 mg qd for a week, followed by prednisolone 50 mg qd for almost 8 weeks. Endoscopic submucosal dissection (ESD) was performed to remove all lesions with negative margin after prednisolone was tapered (5 mg per week until 10 mg qd).

Outcomes: Despite prednisone being tapered to 2.5 mg qd within 2 months, complete remission of HSP and esophageal malignancy was achieved after the resection of the esophagus lesions during 12 months follow-up.

Lessons: We report a rare case of oesophageal squamous cell carcinoma initially presented as HSP. This case suggests the importance of evaluating adult patients with HSP for an underlying malignancy.
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http://dx.doi.org/10.1097/MD.0000000000023492DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7717740PMC
December 2020
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