Publications by authors named "Yan Ren"

531 Publications

The faecal metabolome in COVID-19 patients is altered and associated with clinical features and gut microbes.

Anal Chim Acta 2021 Apr 31;1152:338267. Epub 2021 Jan 31.

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310003, Hangzhou, China. Electronic address:

Although SARS-CoV-2 can invade the intestine, though its effect on digestion and absorption is not fully understood. In the present study, 56 COVID-19 patients and 47 age- and sex-matched healthy subjects were divided into a discovery cohort and a validation cohort. Blood, faeces and clinical information were collected from the patients in the hospital and at discharge. The faecal metabolome was analysed using gas chromatography-mass spectrometry, and Spearman's correlation analyses of clinical features, the serum metabolome, and the faecal micro- and mycobiota were conducted. The results showed that, the faeces of COVID-19 patients were enriched with important nutrients that should be metabolized or absorbed, such as sucrose and 2-palmitoyl-glycerol; diet-related components that cannot be synthesized by humans, such as 1,5-anhydroglucitol and D-pinitol; and harmful metabolites, such as oxalate, were also detected. In contrast, purine metabolites such as deoxyinosine and hypoxanthine, low-water-soluble long-chain fatty alcohols/acids such as behenic acid, compounds rarely occurring in nature such as D-allose and D-arabinose, and microbe-related compounds such as 2,4-di-tert-butylphenol were depleted in the faeces of COVID-19 patients. Moreover, these metabolites significantly correlated with altered serum metabolites such as oxalate and gut microbesincluding Ruminococcaceae, Actinomyces, Sphingomonas and Aspergillus. Although levels of several faecal metabolites, such as sucrose, 1,5-anhydroglucitol and D-pinitol, of discharged patients were not different from those of healthy controls (HCs), those of oxalate and 2-palmitoyl-glycerol did differ. Therefore, alterations in the faecal metabolome of COVID-19 patients may reflect malnutrition and intestinal inflammation and warrant greater attention. The results of present study provide new insights into the pathogenesis and treatment of COVID-19.
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http://dx.doi.org/10.1016/j.aca.2021.338267DOI Listing
April 2021

Synthesis of methanesulfone-containing tetrasubstituted carbon stereocenters.

Org Biomol Chem 2021 Feb 24. Epub 2021 Feb 24.

National & Local Joint Engineering Research Center for the Exploition of Homology Resources of Southwest Medicine and Food, Guizhou University, Guiyang, Guizhou 550025, P. R. China.

A methanesulfonylation reaction for the synthesis of sulfone-containing tetrasubstituted carbon stereocenters is described for the first time by simple treatment of indanedione-chromanone synthons with Et3N and easily accessible MsCl without any use of organometallic chemistry. This technology gave the corresponding valuable chromone-based 2-methanesulfonylated 1,3-indanediones in good yields (up to 89% yield) under mild conditions. The present work provides an attractive strategy for the construction of biologically interesting sulfone-containing tetrasubstituted carbon stereocenters, which might be valuable in medicinal chemistry.
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http://dx.doi.org/10.1039/d1ob00071cDOI Listing
February 2021

A Semi-Dominant Mutation in OsCESA9 Improves Salt Tolerance and Favors Field Straw Decay Traits by Altering Cell Wall Properties in Rice.

Rice (N Y) 2021 Feb 17;14(1):19. Epub 2021 Feb 17.

Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, 230031, China.

Background: Cellulose synthase (CESA) mutants have potential use in straw processing due to their lower cellulose content, but almost all of the mutants exhibit defective phenotypes in plant growth and development. Balancing normal plant growth with reduced cellulose content remains a challenge, as cellulose content and normal plant growth are typically negatively correlated with one another.

Result: Here, the rice (Oryza sativa) semi-dominant brittle culm (sdbc) mutant Sdbc1, which harbors a substitution (D387N) at the first conserved aspartic acid residue of OsCESA9, exhibits lower cellulose content and reduced secondary wall thickness as well as enhanced biomass enzymatic saccharification compared with the wild type (WT). Further experiments indicated that the OsCESA9 mutation may compete with the wild-type OsCESA9 for interacting with OsCESA4 and OsCESA7, further forming non-functional or partially functional CSCs. The OsCESA9/OsCESA9 heterozygous plants increase salt tolerance through scavenging and detoxification of ROS and indirectly affecting related gene expression. They also improve rice straw return to the field due to their brittle culms and lower cellulose content without any negative effects in grain yield and lodging.

Conclusion: Hence, OsCESA9 allele can improve rice salt tolerance and provide the prospect of the rice straw for biofuels and bioproducts due to its improved enzymatic saccharification.
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http://dx.doi.org/10.1186/s12284-021-00457-0DOI Listing
February 2021

Glycerol Infusion Versus Mannitol for Cerebral Edema: a Systematic Review and Meta-Analysis.

Clin Ther 2021 Feb 10. Epub 2021 Feb 10.

Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China. Electronic address:

Purpose: For the treatment of cerebral edema, the use of glycerol, an osmotic agent, as well as mannitol, is popular in Asia. However, the relative therapeutic benefit of glycerol remains unknown. The goal of this study was to investigate the comparative efficacy and safety of glycerol infusion versus mannitol infusion for cerebral edema.

Methods: A systematic search was performed in PubMed, Cochrane Central Register of Controlled Trials, Web of Science, EMBASE, and Scopus for all eligible articles published before July 2020, with no restrictions on language. Two reviewers independently screened the articles, extracted data, and carefully assessed the quality of the evidence.

Findings: Eight studies (6 clinical, 2 animal) were ultimately included in the qualitative analysis, and five were included in the quantitative analysis. Pooled analyses revealed nonsignificant differences in the successful control of cerebral edema (relative risk [RR], 0.97; 95% CI, 0.81-1.15). The combination therapy with glycerol led to a favorable trend in neurologic improvements. Regarding safety, glycerol was associated with a significantly lower risk of acute kidney injury (RR, 0.27; 95% CI, 0.11-0.69) and electrolyte disturbances (RR, 0.20; 95% CI, 0.06-0.64), as well as a lower possibility of rebound effects. No hemolysis was observed at the final follow-up.

Implications: Although the data are limited, compared with mannitol, glycerol shows a similar level of effectiveness, a more favorable safety profile, and promising neurologic improvement in individuals with cerebral edema. Additional research is needed to confirm these findings.

Prospero: CRD42020187702.
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http://dx.doi.org/10.1016/j.clinthera.2021.01.010DOI Listing
February 2021

Global Profiling of 2-hydroxyisobutyrylome in Common Wheat.

Genomics Proteomics Bioinformatics 2021 Feb 10. Epub 2021 Feb 10.

National Key Laboratory of Wheat and Maize Crop Science / Agronomy College, Henan Agricultural University, Zhengzhou 450046, China. Electronic address:

As a novel post-translational modification (PTM), lysine 2-hydroxyisobutyrylation (Khib) was considered to regulate gene transcriptional activity in eukaryotic cells and yeast, but the function of Khib proteins in plants remains unknown. Here, we report that Khib is an evolutionarily-conserved PTM in wheat and its donators. Proteomic analysis shows that there are 3348 Khib lysine modification sites from 1074 proteins in common wheat (Triticum aestivum L.) using affinity purification and mass spectroscopy of 2-hydroxyisobutyrylome. Bioinformatic data indicates that Khib proteins participate in a wide variety of biological and metabolic pathways. Immunoprecipitation (IP) confirmed that Khib proteins have an in vivo origin. A comparison of Khib and other major PTMs shows that Khib proteins are simultaneously modified by multiple PTMs. Using mutagenesis experiments and Co-IP, we demonstrate that Khib on K206 is a key regulatory modification of phosphoglycerate kinase (PGK) enzymatic activity, and mutation of the Khib site affects protein interactions of PGK and its substrates. Furthermore, Khib production of low-molecular-weight proteins is a response to the deacetylase inhibitors nicotinamide and trichostatin. This study provides evidence that enhances our current understanding of Khib in wheat plants, including the cooperation between this PTM and its metabolic regulation.
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http://dx.doi.org/10.1016/j.gpb.2020.06.008DOI Listing
February 2021

A loss-of-function of the dirigent gene TaDIR-B1 improves resistance to Fusarium crown rot in wheat.

Plant Biotechnol J 2021 Feb 10. Epub 2021 Feb 10.

Agronomy College/National Key Laboratory of Wheat and Maize Crop Science/CIMMYT-China (Henan) Joint Center of Wheat and Maize, Henan Agricultural University, Zhengzhou, China.

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http://dx.doi.org/10.1111/pbi.13554DOI Listing
February 2021

Modelling the number of avoidable new cancer cases in France attributable to alcohol consumption by following official recommendations: a simulation study.

Addiction 2021 Feb 10. Epub 2021 Feb 10.

Nutritional Epidemiology Research Team, University of Paris, Sorbonne Paris Nord University, Bobigny, France.

Aims: To predict the effects of perfect adherence to the French alcohol consumption guidelines, a maximum of 10 standard alcoholic drinks per week with no more than two standard alcoholic drinks per day, during a 36-year period (2014-50).

Design: This simulation study is an adaption of the Sheffield Alcohol Policy Model. The dose-response relationship between alcohol consumption and alcohol-attributable cancer risks was defined by cancer site-specific risk functions, each modelled as a continuous risk. These estimates were used to compute the potential impact fraction (PIF) associated with alcohol consumption by cancer site.

Setting: The French general adult population during a 36-year period (2014-50).

Participants: For the baseline scenario, the current distribution of consumption levels, the counterfactual scenario and perfect adherence to the French alcohol consumption guidelines, we generated for each gender and age group 1000 randomly distributed alcohol consumption values from calibrated group-specific gamma distribution.

Measurements: The predicted number of new cancer cases among men and women in France between 2015 and 2050 that could have been prevented by following the French government's alcohol consumption guidelines.

Findings: The simulation predicted that perfect adherence to the French government's alcohol consumption guidelines would prevent, on average, an estimated 15 952 cancer cases per year after the PIF reached its full effect, which would have represented 4.5% of new cancer cases in 2015. The number of averted cancer cases over the study period were highest for oral cavity, oropharynx and hypopharynx cancer (respectively, 118 462, 95% CI = 113 803-123 022 and 11 167, 95% CI = 10 149-12 229] for men and women; liver and intrahepatic bile ducts cancer (123 447, 95% CI = 112 581-133 404 and 2825, 95% CI = 2208,4095); colorectal cancer (89 859, 95% CI = 84 651-95 355 and 12 847, 95% CI = 11 545-14 245); and female breast cancer (61 649, 95% CI = 56 330-67 452).

Conclusion: This simulation study of the French general population predicted that perfect adherence to the French government's alcohol consumption guidelines (no more than 10 standard alcoholic drinks per week and two per day) would prevent almost 16 000 cancer cases per year.
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http://dx.doi.org/10.1111/add.15426DOI Listing
February 2021

Prognostic factors and prediction models for acute aortic dissection: a systematic review.

BMJ Open 2021 Feb 5;11(2):e042435. Epub 2021 Feb 5.

Chinese Evidence-based Medicine Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China

Objective: Our study aimed to systematically review the methodological characteristics of studies that identified prognostic factors or developed or validated models for predicting mortalities among patients with acute aortic dissection (AAD), which would inform future work.

Design/setting: A methodological review of published studies.

Methods: We searched PubMed and EMBASE from inception to June 2020 for studies about prognostic factors or prediction models on mortality among patients with AAD. Two reviewers independently collected the information about methodological characteristics. We also documented the information about the performance of the prognostic factors or prediction models.

Results: Thirty-two studies were included, of which 18 evaluated the performance of prognostic factors, and 14 developed or validated prediction models. Of the 32 studies, 23 (72%) were single-centre studies, 22 (69%) used data from electronic medical records, 19 (59%) chose retrospective cohort study design, 26 (81%) did not report missing predictor data and 5 (16%) that reported missing predictor data used complete-case analysis. Among the 14 prediction model studies, only 3 (21%) had the event per variable over 20, and only 5 (36%) reported both discrimination and calibration statistics. Among model development studies, 3 (27%) did not report statistical methods, 3 (27%) exclusively used statistical significance threshold for selecting predictors and 7 (64%) did not report the methods for handling continuous predictors. Most prediction models were considered at high risk of bias. The performance of prognostic factors showed varying discrimination (AUC 0.58 to 0.95), and the performance of prediction models also varied substantially (AUC 0.49 to 0.91). Only six studies reported calibration statistic.

Conclusions: The methods used for prognostic studies on mortality among patients with AAD-including prediction models or prognostic factor studies-were suboptimal, and the model performance highly varied. Substantial efforts are warranted to improve the use of the methods in this population.
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http://dx.doi.org/10.1136/bmjopen-2020-042435DOI Listing
February 2021

Comparison of the Multiple Platforms to Identify Various Species.

Front Microbiol 2020 18;11:625961. Epub 2021 Jan 18.

State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.

We compared several identification methods for genus members, including traditional biochemical testing, multiplex-PCR amplification, mass spectrometry identification, whole-genome sequencing, multilocus phylogenetic analysis (MLPA), and , and - gene sequencing. Isolates ( = 62) belonging to the genus, which were came from the bacterial bank in the laboratory, were used to assess the identification accuracy of the different methods. Whole-genome sequencing showed that the spp. isolates comprised ( = 21), ( = 18), ( = 8), ( = 7), ( = 5), ( = 2), and ( = 1). Using the whole-genome sequencing results as the standard, the consistency of the other methods was compared with them. The results were 46.77% (29/62) for biochemical identification, 83.87% (52/62) for mass spectrometric identification, 67.74% (42/62) for multiplex-PCR, 100% (62/62) for MLPA typing, 72.58% for , and 59.68% for and -. MLPA was the most consistent, followed by mass spectrometry. Therefore, in the public health laboratory, both MLPA and whole-genome sequencing methods can be used to identify various species. However, rapid and relatively accurate mass spectrometry is recommended for clinical lab.
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http://dx.doi.org/10.3389/fmicb.2020.625961DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7848130PMC
January 2021

Multiethnic genome-wide association study of differentiated thyroid cancer in the EPITHYR consortium.

Int J Cancer 2021 Feb 2. Epub 2021 Feb 2.

University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, Team "Epidemiology of radiations", Villejuif, France.

Incidence of differentiated thyroid carcinoma (DTC) varies considerably between ethnic groups, with particularly high incidence rates in Pacific Islanders. DTC is one of the cancers with the highest familial risk suggesting a major role of genetic risk factors, but only few susceptibility loci were identified so far. In order to assess the contribution of known DTC susceptibility loci and to identify new ones, we conducted a multiethnic genome-wide association study (GWAS) in individuals of European ancestry and of Oceanian ancestry from Pacific Islands. Our study included 1554 cases/1973 controls of European ancestry and 301 cases/348 controls of Oceanian ancestry from seven population-based case-control studies participating to the EPITHYR consortium. All participants were genotyped using the OncoArray-500K Beadchip (Illumina). We confirmed the association with the known DTC susceptibility loci at 2q35, 8p12, 9q22.33 and 14q13.3 in the European ancestry population and suggested two novel signals at 1p31.3 and 16q23.2, which were associated with thyroid-stimulating hormone levels in previous GWAS. We additionally replicated an association with 5p15.33 reported previously in Chinese and European populations. Except at 1p31.3, all associations were in the same direction in the population of Oceanian ancestry. We also observed that the frequencies of risk alleles at 2q35, 5p15.33 and 16q23.2 were significantly higher in Oceanians than in Europeans. However, additional GWAS and epidemiological studies in Oceanian populations are needed to fully understand the highest incidence observed in these populations.
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http://dx.doi.org/10.1002/ijc.33488DOI Listing
February 2021

Modulation of the immune response and metabolism in germ-free rats colonized by the probiotic Lactobacillus salivarius LI01.

Appl Microbiol Biotechnol 2021 Feb 19;105(4):1629-1645. Epub 2021 Jan 19.

State Key Laboratory for Diagnosis, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

The gut microbiota plays an important role in multifaceted physiological functions in the host. Previous studies have assessed the probiotic effects of Lactobacillus salivarius LI01. In this study, we aimed to investigate the potential effects and putative mechanism of L. salivarius LI01 in immune modulation and metabolic regulation through the monocolonization of germ-free (GF) Sprague-Dawley (SD) rats with L. salivarius LI01. The GF rats were separated into two groups and administered a gavage of L. salivarius LI01 or an equal amount of phosphate-buffered saline. The levels of serum biomarkers, such as interleukin (IL)-1α, IL-5, and IL-10, were restored by L. salivarius LI01, which indicated the activation of Th0 cell differentiation toward immune homeostasis. L. salivarius LI01 also stimulated the immune response and metabolic process by altering transcriptional expression in the ileum and liver. A Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis revealed significant enrichment of the 5'-adenosine monophosphate-activated protein kinase (AMPK) signaling pathway, which indicated that L. salivarius LI01 exerts an effect on energy accumulation. The LI01 group showed alterations in fecal carbohydrates accompanied by an increased body weight gain. In addition, L. salivarius LI01 produced indole-3-lactic acid (ILA) and enhanced arginine metabolism by rebalancing the interconversion between arginine and proline. These findings provide evidence showing that L. salivarius LI01 can directly impact the host by modulating immunity and metabolism. KEY POINTS : • Lactobacillus salivarius LI01 conventionalizes the cytokine profile and activates the immune response. • LI01 modulates carbohydrate metabolism and arginine transaction. • LI01 generates tryptophan-derived indole-3-lactic acid. • The cytochrome P450 family contributes to the response to altered metabolites.
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http://dx.doi.org/10.1007/s00253-021-11099-zDOI Listing
February 2021

Probiotic Lactobacillus casei Shirota prevents acute liver injury by reshaping the gut microbiota to alleviate excessive inflammation and metabolic disorders.

Microb Biotechnol 2021 Jan 25. Epub 2021 Jan 25.

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, China.

Millions of people die from liver diseases annually, and liver failure is one of the three major outcomes of liver disease. The gut microbiota plays a crucial role in liver diseases. This study aimed to explore the effects of Lactobacillus casei strain Shirota (LcS), a probiotics used widely around the world, on acute liver injury (ALI), as well as the underlying mechanism. Sprague Dawley rats were intragastrically administered LcS suspensions or placebo once daily for 7 days before induction of ALI by intraperitoneal injection of D-galactosamine (D-GalN). Histopathological examination and assessments of liver biochemical markers, inflammatory cytokines, and the gut microbiota, metabolome and transcriptome were conducted. Our results showed that pretreatment with LcS reduced hepatic and intestinal damage and reduced the elevation of serum gamma-glutamyltranspeptidase (GGT), total bile acids, IL-5, IL-10, G-CSF and RANTES. The analysis of the gut microbiota, metabolome and transcriptome showed that LcS lowered the ratio of Firmicutes to Bacteroidetes; reduced the enrichment of metabolites such as chenodeoxycholic acid, deoxycholic acid, lithocholic acid, d-talose and N-acetyl-glucosamine, reduce the depletion of d-glucose and l-methionine; and alleviated the downregulation of retinol metabolism and PPAR signalling and the upregulation of the pyruvate metabolism pathway in the liver. These results indicate the promising prospect of using LcS for the treatment of liver diseases, particularly ALI.
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http://dx.doi.org/10.1111/1751-7915.13750DOI Listing
January 2021

Prevalence and Genotype Distribution of Hepatitis C Virus from 1,668 Individuals of Sichuan Area in China.

Clin Lab 2021 Jan;67(1)

Background: Hepatitis C virus (HCV) is one of the main causes of liver fibrosis, chronic hepatitis, and liver cirrhosis. The aim of this study is to determine the prevalence of HCV, age-dependent prevalence and genotypes distribution in a large number of clinical samples in Sichuan area of China.

Methods: In the past five years from 2014 to 2018, a total number of 4,508 individuals received the serum HCV-RNA analysis in the Sichuan Provincial People's Hospital. Viral nucleic acid was extracted from the serum samples and amplified using COBAS AmpliPre/COBAS TaqMan Detection Platform. Five HCV genotypes (1b, 2a, 3a, 3b, and 6a) of serum samples from 469 HCV positive individuals collected from 2016 to 2018 were analyzed using the PCR-fluorescence probe technique.

Results: A total of 1,668 individuals had positive results by high precision HCV-RNA quantitative technique, corresponding to a crude prevalence of 37.0% (95% confidence interval: 33.6 - 40.3%). The majority of HCV positive individuals were aged over 41 years, accounting for 80.7% (1,346/1,668, CI: 72.3 - 87.1%). Among the nine age groups, the 41 - 50-year age group had the highest HCV prevalence of 29.8% (497/1,668, CI: 25.6 - 32.3%). Of the 469 HCV-RNA positive serum samples collected in 2016 - 2018, genotype 1b was the most frequent type found in 357 individuals, corresponding to a prevalence of 76.1% (CI: 72.3 - 80.0%).

Conclusions: Positive rates of HCV in the years of 2014 to 2018 showed a downward trend year by year, of which a majority of positive cases were aged over 41 years. HCV was distributed with multi-genotype features while genotype 1b yielded a very high prevalence in the Sichuan area. The results have potential for prevention and treatment of HCV infection, as well as epidemiological research.
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http://dx.doi.org/10.7754/Clin.Lab.2020.200335DOI Listing
January 2021

Systematic evaluation of IgG responses to SARS-CoV-2 spike protein-derived peptides for monitoring COVID-19 patients.

Cell Mol Immunol 2021 03 22;18(3):621-631. Epub 2021 Jan 22.

Shanghai Center for Systems Biomedicine, Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Jiao Tong University, Shanghai, China.

Serological tests play an essential role in monitoring and combating the COVID-19 pandemic. Recombinant spike protein (S protein), especially the S1 protein, is one of the major reagents used for serological tests. However, the high cost of S protein production and possible cross-reactivity with other human coronaviruses pose unavoidable challenges. By taking advantage of a peptide microarray with full spike protein coverage, we analyzed 2,434 sera from 858 COVID-19 patients, 63 asymptomatic patients and 610 controls collected from multiple clinical centers. Based on the results, we identified several S protein-derived 12-mer peptides that have high diagnostic performance. In particular, for monitoring the IgG response, one peptide (aa 1148-1159 or S2-78) exhibited a sensitivity (95.5%, 95% CI 93.7-96.9%) and specificity (96.7%, 95% CI 94.8-98.0%) comparable to those of the S1 protein for the detection of both symptomatic and asymptomatic COVID-19 cases. Furthermore, the diagnostic performance of the S2-78 (aa 1148-1159) IgG was successfully validated by ELISA in an independent sample cohort. A panel of four peptides, S1-93 (aa 553-564), S1-97 (aa 577-588), S1-101 (aa 601-612) and S1-105 (aa 625-636), that likely will avoid potential cross-reactivity with sera from patients infected by other coronaviruses was constructed. The peptides identified in this study may be applied independently or in combination with the S1 protein for accurate, affordable, and accessible COVID-19 diagnosis.
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http://dx.doi.org/10.1038/s41423-020-00612-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7821179PMC
March 2021

Exploration Of The Seated Saline Suppression Test For The Diagnosis Of Primary Aldosteronism In The Chinese Population.

Endocr Pract 2020 Aug;26(8):891-899

From the Department of Endocrinology and Metabolism, Adrenal Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China. Electronic address:

Objective: We prospectively investigated the accuracy of the seated saline suppression test (SSST) in 113 patients with hypertension (including 93 primary aldosteronism [PA] and 20 essential hypertension patients) in the Department of Endocrinology and Metabolism.

Methods: Each patient underwent a recumbent saline suppression test (RSST) and SSST. The accuracy of the SSST for a confirmative PA diagnosis and subtype classification was evaluated and compared with the RSST.

Results: The area under the receiver operating characteristic (ROC) curve of plasma aldosterone concentration (PAC) for the SSST was significantly greater than that for the RSST (0.945±0.0199 vs. 0.828 ± 0.0404; P<.05). The ROC analysis showed that the optimal PAC cut-off values were 12.94 ng/dL for the SSST (sensitivity 86.02%, specificity 95%; Youden index [YI] 0.810) and 12.04 ng/dL for the RSST (sensitivity 83.15%, specificity 57%; YI 0.401). The optimal PAC cut-off value for classifying aldosterone-producing adenoma and idiopathic hyperaldosteronism was 18.12 ng/dL for the SSST (sensitivity 73.5%, specificity 79.5%). No patients experienced adverse events during the SSST.

Conclusion: The SSST is safe and convenient for PA diagnosis. The accuracy of the SSST for a confirmatory diagnosis of PA was better than that of the RSST. The SSST is a reliable alternative for PA confirmation in Chinese individuals.

Abbreviations: APA = aldosterone-producing adenoma; ARR = aldosterone to renin ratio; AVS = adrenal vein sampling; CT = computed tomography; EH = essential hypertension; IHA = idiopathic hyperaldosteronism; MRI = magnetic resonance imaging; PA = primary aldosteronism; PAC = plasma aldosterone concentration; PRA = plasma renin activity; ROC = receiver operating characteristic; RSST = recumbent saline suppression test; SSST = seated saline suppression test; YI = Youden index.
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http://dx.doi.org/10.4158/EP-2020-0064DOI Listing
August 2020

Characterization of the complete mitochondrial genome of from China and its phylogenetic analysis.

Mitochondrial DNA B Resour 2020 Jun 16;5(3):2473-2474. Epub 2020 Jun 16.

Zhejiang Academy of Science and Technology for Inspection and Quarantine, Hangzhou, PR China.

The complete mitochondrial genome (mitogenome) of (Diptera: Tephritidae: Dacinae) was sequenced and annotated. The mitochondrial genome is 15,614 bp (GenBank No. MT265380), containing 80.4% A + T (A 39.1%, C 7.3%, G 12.2%, and T 41.3%), that is heavily biased toward A and T nucleotides. All PCGs were started with ATN (ATA/ATG/ATT/ATC) and were terminated with TAR (TAA/TAG) excepting ND4, which ended with single T. Additionally, the phylogenetic tree confirmed that clustered with , and sp. The current study would be enrich the mitogenomes of the Lymantriinae.
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http://dx.doi.org/10.1080/23802359.2020.1778563DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7782165PMC
June 2020

Rare Primary Pulmonary Primitive Neuroectodermal Tumor: A Case Report and Literature Review.

Onco Targets Ther 2021 8;14:139-144. Epub 2021 Jan 8.

Department of Pathology, Shihezi University School of Medicine, The First Affiliated Hospital to Shihezi University School of Medicine, Shihezi, Xinjiang 832002, People's Republic of China.

Primitive neuroectodermal tumors (PNETs) arising from the lung without thoracic wall involvement are extremely rare and particularly aggressive neoplasms. Herein, we present the case of a 41-year-old woman with pulmonary PNET diagnosed following histopathological, immunohistochemical, and molecular pathological examination of a surgical biopsy specimen. The case report is accompanied by a literature review of primary pulmonary PNETs.
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http://dx.doi.org/10.2147/OTT.S283967DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802914PMC
January 2021

The additive effects of kidney dysfunction on left ventricular function and strain in type 2 diabetes mellitus patients verified by cardiac magnetic resonance imaging.

Cardiovasc Diabetol 2021 Jan 7;20(1):11. Epub 2021 Jan 7.

Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.

Background: Patients with type 2 diabetes mellitus (T2DM) are susceptible to coexisted with chronic kidney disease (CKD), which may increase cardiovascular mortality in these patients. The present study aimed to verify whether CKD aggravates the deterioration of left ventricular (LV) myocardial strain in T2DM patients and to explore the risk factors associated with LV strain.

Materials And Methods: In total, 105 T2DM patients and 52 healthy individuals were included and underwent cardiac magnetic resonance examination. Patients were divided into the following two groups: T2DM with CKD (n = 33) and T2DM without CKD (n = 72). The baseline clinical and biochemical indices were obtained from hospital records before the cardiac magnetic resonance scan. Cine sequences, including long-axis views (2-chamber and 4-chamber) and short-axis views, were acquired. LV function and global strain parameters were measured based on cine sequences and compared among three groups. Pearson's analysis was performed to investigate the correlation between LV strain parameters and clinical indices. Multiple linear regression analysis was used to identify the independent indicators of LV strain.

Results: Compared with normal controls, T2DM patients without CKD had a significantly decreased magnitude of peak strain (PS; radial), peak systolic strain rate (radial), and peak diastolic strain rate (radial and circumferential) (all P < 0.05). Furthermore, T2DM patients with CKD displayed markedly lower magnitudes of PS (radial, circumferential, and longitudinal) and peak diastolic strain rate (circumferential and longitudinal) than both normal controls and T2DM patients without CKD (all P < 0.05). The eGFR was positively associated with the magnitude of PS (R = radial, 0.392; circumferential, 0.436; longitudinal, 0.556), while uric acid was negatively associated with the magnitude of PS (R = radial, - 0.361; circumferential, - 0.391; longitudinal, - 0.460) (all P < 0.001). Multivariable linear regression indicated that the magnitude of PS was independently associated with eGFR (β = radial, 0.314; circumferential, 0.292; longitudinal, 0.500) and uric acid (β = radial, - 0.239; circumferential, - 0.211; longitudinal, - 0.238) (all P < 0.05).

Conclusions: Kidney dysfunction may aggravate the deterioration of LV strain in T2DM patients. LV strain is positively associated with the estimated glomerular filtration rate and negatively associated with uric acid, which may be independent risk factors for predicting reduction of LV strain.
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http://dx.doi.org/10.1186/s12933-020-01203-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7792094PMC
January 2021

On the conditioning of basis materials and its impact on multimaterial decomposition-based spectral imaging in photon-counting CT.

Med Phys 2021 Jan 7. Epub 2021 Jan 7.

Imaging and Medical Physics, Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1701 Uppergate Dr., C-5018, Atlanta, GA, 30322, USA.

Purpose: Material-specific imaging and virtual monochromatic imaging/analysis are the two forms of spectral imaging in CT implemented via either energy-integration or photon-counting data acquisition. Aimed at further understanding the fundamentals and providing guidelines on its design and implementation, we quantitatively investigate the conditioning (sufficiency in dimensionality, well-posedness in basis functions, and matching of K-edge materials) of basis materials and its impact on the performance of spectral imaging in photon-counting CT.

Materials And Methods: Initially, singular value decomposition (SVD) is employed to investigate the dimensionality of material space for multimaterial decomposition-based spectral imaging in photon-counting CT over the energy range [18 150] keV. Then, the SVD is extended to study the well-posedness of basis functions, its relationship with the dimensionality of materials to be imaged, and its impact on imaging performance. A number of phantoms are designed to mimic the soft and bony tissues in the head and contrast enhancement materials (iodine and gadolinium). Simulation studies, in which the geometry of photon-counting CT is similar to a clinical CT, are carried out to evaluate and verify the proposed approach of conditioning analysis and the relationship between the conditioning of basis materials and the performance of spectral imaging in photon-counting CT.

Results: The preliminary data show that the dimensionality of biological tissues, including both soft and bony tissues, is effectively equal to two. The dimensionality increments with inclusion of K-edge materials into the materials to be imaged. The well-posedness of basis functions depends on the correlation between the functions and impacts the noise in material decomposition substantially, but affects the noise in virtual monochromatic imaging/analysis moderately. If a K-edge material is in the materials to be imaged, the same K-edge material has to be one of the basis materials, but its concentration does not affect the accuracy of material decomposition significantly. Moreover, inclusion of K-edge material into the basis material makes the tuning of correlation among the basis functions feasible and thus improves the performance of spectral imaging in photon-counting CT.

Conclusion: The extension of SVD for systematic analysis of multimaterial decomposition-based spectral imaging in photon-counting CT is of innovation and significance. In addition to providing more information on the fundamentals, the approach used in this study and the data obtained so far may provide guidelines on the implementation of spectral imaging in either photon-counting or energy-integration CT, as well as other x-ray-related imaging modalities such as radiography and tomosynthesis.
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http://dx.doi.org/10.1002/mp.14708DOI Listing
January 2021

Metabolomic profiling reveals amino acid and carnitine alterations as metabolic signatures in psoriasis.

Theranostics 2021 1;11(2):754-767. Epub 2021 Jan 1.

Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China.

High-throughput metabolite profiling provides the opportunity to reveal metabolic mechanisms and identify biomarkers. Psoriasis is an immune-mediated chronic inflammatory disease. However, the role of metabolism in psoriasis pathogenesis remains unclear. Plasma samples of individuals (45 psoriasis and 45 sex-, age-, and BMI-matched healthy controls) were collected. Non-targeted metabolomics and amino acid- or carnitine-targeted metabolomics were conducted, then, plasma samples of mice induced by imiquimod (IMQ) were subjected to the amino acid- and carnitine-targeted metabolomic profiling. Flow cytometry was used to study the effect of L-carnitine (LC(C0)) on IMQ-induced psoriatic inflammation. Through the non-targeted metabolomics approach, we detected significantly altered amino acids and carnitines in psoriasis patients. Amino acid-targeted metabolomic profiling identified 37 amino acids altered in psoriasis, of these 23 were markedly upregulated, including essential amino acids (EAAs), and branched-chain amino acids (BCAAs), whereas glutamine, cysteine, and asparagine were significantly down-regulated. Carnitine-targeted metabolomic profiling identified 40 significantly altered carnitines, 14 of which included palmitoylcarnitine (C16) and were markedly downregulated in psoriasis, whereas hexanoylcarnitine (C6) and 3-OH-octadecenoylcarnitine (C18:1-OH) were significantly upregulated. Interestingly, glutamine, asparagine, and C16 levels were negatively correlated with the PASI score. Moreover, a higher abundance of LC(C0) was associated with markedly reduced IMQ-induced epidermal thickening and infiltration of Th17 cells in skin lesions, indicating LC(C0) supplementation as a potential therapy for psoriasis treatment. Our results suggested the metabolism of amino acids and carnitines are significantly altered in psoriasis, especially the metabolism of EAAs, BCAAs, and LC(C0), which may play key roles in the pathogenesis of psoriasis.
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http://dx.doi.org/10.7150/thno.51154DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7738860PMC
January 2021

Metabolic Profiling in Bipolar Disorder Patients During Depressive Episodes.

Front Psychiatry 2020 16;11:569612. Epub 2020 Dec 16.

Department of Psychiatry, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Taiyuan, China.

Bipolar disorder (BD) is a common and debilitating mental disorder. Bipolar depression is the main episode of BD. Furthermore, there are no objective biomarkers available for diagnosing the disorder. In this research, a Nuclear Magnetic Resonance (NMR) spectroscopy based on a metabonomics technique was used to analyze serum samples from 37 patients with bipolar depression and 48 healthy control participants to determine potential biomarkers for bipolar depression. In total, seven different metabolites were identified that could effectively distinguish patients from healthy controls. The metabolites indicated that disturbances of amino acid and energy metabolisms might be involved in the pathogenesis of BD. Finally, a panel consisting of four potential biomarkers (lactate, trimethylamine oxide, N-acetyl glycoprotein, and α-glucose) was identified, which showed a higher combined diagnostic ability with an area under the curve of 0.893. Our findings may contribute to the development of an objective method for diagnosing bipolar depression.
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http://dx.doi.org/10.3389/fpsyt.2020.569612DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7772141PMC
December 2020

On the conditioning of spectral channelization (energy binning) and its impact on multi-material decomposition based spectral imaging in photon-counting CT.

IEEE Trans Biomed Eng 2021 Jan 1;PP. Epub 2021 Jan 1.

Objective: The conditioning (well-posedness) of basis materials (functions) and spectral channelization play important roles in determining the performance of spectral imaging (material specific imaging and virtual monochromatic imaging/analysis) in photon-counting CT. Aimed at further understanding the fundamentals of photon-counting spectral CT and providing guidelines on its design and implementation, we propose a singular value decomposition and analysis based approach in this work to assess the conditioning of spectral channelization and its impact on the performance of spectral imaging under both ideal and realistic detector spectral response.

Methods: Via simulation studies, in which the geometry of photon-counting CT is similar to a clinical CT, the condition number acquired via singular value decomposition and analysis is employed to assess the conditioning of spectral channelization in photon-counting CT and its impact on the performance of spectral imaging. The simulation study runs over two- and three- material decomposition based spectral imaging (material specific imaging and virtual monochromatic imaging/analysis over the energy range [18 150] keV). Under both ideal and realistic detector spectral response, a specially designed phantom that mimics the soft and bony tissues in the head is utilized to quantitatively reveal the relationship between the conditioning (condition number) of spectral channelization in photon-counting CT and the performance (mainly noise and contrast-to-noise ratio) of spectral imaging. The simulation study is also extended over the cases wherein up to 50% spectral overlapping occurs.

Results: The results show that, under ideal detector spectral response, the condition number of spectral channelization reaches the minimum while no overlapping occurs in spectral channels. The condition number of spectral channelization increments with increasing spectral overlapping in the channels. The distortion in detector's spectral response induced by scattering, charge-sharing and fluorescent escaping results in spectral overlapping in spectral channels and thus degrades the conditioning (larger condition number) of spectral channelization. Respectively, the noise increases and contrast-to-noise ratio decreases in material- specific imaging and virtual monochromatic imaging/analysis, while the condition number of spectral channelization increments with increasing spectral overlapping.

Conclusion: The singular value decomposition and analysis based approach can be utilized to systematically analyze the conditioning of spectral channelization and its impact on the performance of spectral imaging in photon-counting CT.

Significance: The approach proposed by us is of innovation and significance. In addition to providing information for insightful understanding of the fundamentals, the approach proposed in this study and the data obtained so far may provide guidelines on the implementation of spectral imaging in photon-counting CT and energy-integration CT as well, along with its applicability to other x-ray related imaging modalities such as radiography and tomosynthesis.
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http://dx.doi.org/10.1109/TBME.2020.3048661DOI Listing
January 2021

A Weighted Gene Co-expression Network Analysis Reveals lncRNA Abnormalities in the Peripheral Blood Associated With Ultra-High-Risk for Psychosis.

Front Psychiatry 2020 15;11:580307. Epub 2020 Dec 15.

Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China.

The primary study aim was to identify long non-coding RNA (lncRNA) abnormalities associated with ultra-high-risk (UHR) for psychosis based on a weighted gene co-expression network analysis. UHR patients were screened by the structured interview for prodromal syndromes (SIPS). We performed a WGCNA analysis on lncRNA and mRNA microarray profiles generated from the peripheral blood samples in 14 treatment-seeking patients with UHR who never received psychiatric medication and 18 demographically matched typically developing controls. Gene Ontology (GO) analysis and canonical correlation analysis were then applied to reveal functions and correlation between lncRNAs and mRNAs. The lncRNAs were organized into co-expressed modules by WGCNA, two modules of which were strongly associated with UHR. The mRNA networks were constructed and two disease-associated mRNA modules were identified. A functional enrichment analysis showed that mRNAs were highly enriched for immune regulation and inflammation. Moreover, a significant correlation between lncRNAs and mRNAs were verified by a canonical correlation analysis. We identified novel lncRNA modules related to UHR. These results contribute to our understanding of the molecular basis of UHR from the perspective of systems biology and provide a theoretical basis for early intervention in the assumed development of schizophrenia.
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http://dx.doi.org/10.3389/fpsyt.2020.580307DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7769947PMC
December 2020

is a potential marker for the diagnosis of human cervical cancer.

Biomark Med 2021 Jan 14;15(1):57-67. Epub 2020 Dec 14.

Department of Pathology & Key Laboratory for Xinjiang Endemic & Ethnic Diseases (Ministry of Education) /Department of Pathology, the First Affiliated Hospital, Shihezi University School of Medicine, Xinjiang, 832000, China.

The aim is to study ANXA2 biomarkers for early diagnosis of cervical cancer. The study used bioinformatics analysis and experimental verification of expression in cervical cancer. expression was higher in cancer tissues than in non-cancer tissues (p = 0.002). was expressed in cell membranes of non-cancer tissues, whereas in cancer tissues it was expressed in both the cell membranes and the cytoplasm. Moreover, expression was more pronounced in squamous cell carcinomas. expression decreased overall survival of patients, and the data suggested that protein expression was associated with invasion and migration of tumors. has high specificity and sensitivity as a detection marker for cervical cancer and can assist in the diagnosis of cervical cancer.
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http://dx.doi.org/10.2217/bmm-2020-0629DOI Listing
January 2021

The role of plant-specific VQ motif-containing proteins: An ever-thickening plot.

Plant Physiol Biochem 2021 Feb 7;159:12-16. Epub 2020 Dec 7.

Jiangsu Key Laboratory of Crop Genetics and Physiology/Co-Innovation Center for Modern Production Technology of Grain Crops, Yangzhou University, Yangzhou 225009, China; Joint International Research Laboratory of Agriculture and Agri-Product Safety, The Ministry of Education of China, Yangzhou University, Yangzhou, China. Electronic address:

VQ proteins are a class of plant-specific proteins containing the conserved motif FxxhVQxhTG(h denotes hydrophobic residues and x represents any amino acid)and are named VQ for the V and Q residues. By analyzing the structure of VQ members it was found that most VQ genes do not contain introns and the number of encoded amino acids is less than 300 aa. A majority of VQ proteins are located in the nucleus. Accumulated evidence has highlighted the importance of VQ proteins mainly participating in signal pathways through interacting with partners (eg. WRKYs and MAPKs) to regulate plant growth and development and respond to biotic and abiotic stresses. This review primarily focuses on the structure of VQ members in plant kingdom and the biological function and the mechanism of VQ protein action, and discusses recent advances in understanding the pivotal role of VQ-motif, which provides a solid foundation for further exploration on VQ proteins.
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http://dx.doi.org/10.1016/j.plaphy.2020.12.005DOI Listing
February 2021

Personalized Body Constitution Inquiry Based on Machine Learning.

J Healthc Eng 2020 12;2020:8834465. Epub 2020 Nov 12.

Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Geriatric Institute, Guangzhou, China.

Background: Body constitution (BC) is the abstract concept indicating the state of a person's health in Traditional Chinese Medicine (TCM). The doctor identifies the body constitution of the patient through inspection and inquiry. Previous research simulates doctors to identify BC types according to a patient's objective physical indicators. However, the lack of subjective feeling information can reduce the accuracy of the machine to imitate the doctor's diagnosis. The Constitution in Chinese Medicine Questionnaire (CCMQ) is used to collect subjective information but suffers from low acquisition efficiency.

Methods: This paper presents a personalized body constitution inquiry method based on a machine learning technique. It employs a random generator, a feature extractor, and a classifier to simulate the doctor inquiry and generate a personalized questionnaire. Specifically, the feature extractor evaluates and sorts the question of the constitution in the CCMQ based on the recognition results of the tongue coating image of patients. The sorted questions and relevant BC label are inputted into the classifier; the best questions are screened out for patients.

Results: The experimental results show that our method can select personalized questions from the CCMQ for the patients, significantly reducing the time and the number of questions to answer. It also improves the accuracy of recognizing BC. Compared with the CCMQ, patients had 68.3% fewer questions to answer and the time occupied by answering is reduced by 80.3%.

Conclusions: The proposed method can simulate the doctor's inquiry and pick out personalized questions for patients. It can act as auxiliary diagnosis tools to collect subjective patient feelings and help make further judgments on the patient's BC types.
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http://dx.doi.org/10.1155/2020/8834465DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7676967PMC
November 2020

Long non-coding maternally expressed gene 3 regulates cigarette smoke extract-induced apoptosis, inflammation and cytotoxicity by sponging miR-181a-2-3p in 16HBE cells.

Oncol Lett 2021 Jan 17;21(1):45. Epub 2020 Nov 17.

Department of Nephrology, Changning County Hospital of Traditional Chinese Medicine, Yibin, Sichuan 644300, P.R. China.

Accumulating evidence has suggested that long non-coding (lnc)RNAs are widely involved in the progression of multiple diseases, including chronic obstructive pulmonary disease (COPD). The aim of the present study was to explore the function and molecule mechanism of maternally expressed gene 3 (MEG3) in cigarette smoke extract (CSE)-treated 16HBE cells. Cell viability and apoptosis were evaluated using Cell Counting Kit-8 analysis and flow cytometry, respectively. Western blot analysis was carried out to determine the protein levels of Bcl-2, Bax and cleaved caspase-3. ELISA assays were utilized to measure the protein levels of IL-1β and IL-6 and TNF-α. Cytotoxicity was assessed using a lactate dehydrogenase release assay. The expression levels of MEG3 and microRNA (miR)-181a-2-3p were detected using reverse transcription-quantitative PCR. The interaction between miR-181a-2-3p and MEG3 was predicted using DIANA tools and verified by a dual-luciferase reporter assay and RNA Immunoprecipitation assay. MEG3 expression was enhanced while miR-181a-2-3p abundance was reduced in the serum of patients with COPD and CSE-treated 16HBE cells. MEG3-knockdown or miR-181a-2-3p-overexpression inhibited CSE-induced apoptosis, inflammation and cytotoxicity in 16HBE cells. Moreover, miR-181a-2-3p directly bind to MEG3 and its knockdown reversed the inhibitory effect of MEG3 interference on apoptosis, inflammation and cytotoxicity in CSE-treated 16HBE cells. Overall, MEG3-knockdown suppressed CSE-induced apoptosis, inflammation and cytotoxicity in 16HBE cells by upregulating miR-181a-2-3p, providing a promising therapeutic target for treatment of CSE-induced COPD.
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http://dx.doi.org/10.3892/ol.2020.12306DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7693283PMC
January 2021

Antibacterial application and toxicity of metal-organic frameworks.

Nanotoxicology 2020 Dec 1:1-20. Epub 2020 Dec 1.

School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China.

Metal-organic frameworks (MOFs), which are also referred to as coordination polymers, have been widely used in adsorption separation and catalysis, especially in the field of physical chemistry in the past few years, because of their unique physical structure and potential chemical properties. In recent years, particularly with the continuous expansion of the research field, deepening of research levels, and sustained advancements in science and technology, powerful and diverse MOFs that have demonstrated great biomedical application potential have been successively developed. Consequently, this study summarizes the origin, development, and common synthesis methods of MOFs, with major emphasis on their antibacterial application and safety evaluation in biomedicine.
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http://dx.doi.org/10.1080/17435390.2020.1851420DOI Listing
December 2020

The value of the post-captopril aldosterone/renin ratio for the diagnosis of primary aldosteronism and the influential factors: A meta-analysis.

J Renin Angiotensin Aldosterone Syst 2020 Oct-Dec;21(4):1470320320972032

Department of Endocrinology and Metabolism, Adrenal Center, Sichuan University West China Hospital, Chengdu, Sichuan, China.

Objective: The procedure for the captopril challenge test (CCT) in diagnosing primary aldosteronism (PA) is not standardized. We performed a meta-analysis to evaluate the controversial diagnostic value and influential factors of the post-captopril aldosterone/renin ratio (ARR).

Methods: We searched literature in databases for eligible studies (until October 1, 2020). We extracted information regarding study and patient characteristics, CCT methods, outcome data. We pooled studies using the random-effect model. We performed meta-regression and six pre-specified subgroup analyses to explore heterogeneity.

Results: Nineteen studies involving 4568 subjects were included. The pooled sensitivity and specificity were 0.825 (95% CI 0.804-0.844) and 0.919 (95% CI 0.908-0.928). The area under the summary receiver operating characteristic curve was 0.9487 (95% CI 0.9207-0.9767). Meta-regression revealed that heterogeneity might derive from time interval ( = 0.0117) and study population ( = 0.0033). Subgroup analyses showed significant differences between the subgroups stratified by the dose, posture, study region, time interval, cut-off value and study population for sensitivity and/or specificity ( < 0.05).

Conclusion: Post-captopril ARR is comparably valuable for diagnosing PA at cut-offs from 12.0 to 50.0. Conducting the CCT in the supine position with 25 mg of captopril may attain greater sensitivity. Conducting the CCT in the seated position with 50 mg of captopril may attain greater specificity. A 90-min time interval may perform best in both the sensitivity and specificity.
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http://dx.doi.org/10.1177/1470320320972032DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7691929PMC
November 2020

The value of the post-captopril aldosterone/renin ratio for the diagnosis of primary aldosteronism and the influential factors: A meta-analysis.

J Renin Angiotensin Aldosterone Syst 2020 Oct-Dec;21(4):1470320320972032

Department of Endocrinology and Metabolism, Adrenal Center, Sichuan University West China Hospital, Chengdu, Sichuan, China.

Objective: The procedure for the captopril challenge test (CCT) in diagnosing primary aldosteronism (PA) is not standardized. We performed a meta-analysis to evaluate the controversial diagnostic value and influential factors of the post-captopril aldosterone/renin ratio (ARR).

Methods: We searched literature in databases for eligible studies (until October 1, 2020). We extracted information regarding study and patient characteristics, CCT methods, outcome data. We pooled studies using the random-effect model. We performed meta-regression and six pre-specified subgroup analyses to explore heterogeneity.

Results: Nineteen studies involving 4568 subjects were included. The pooled sensitivity and specificity were 0.825 (95% CI 0.804-0.844) and 0.919 (95% CI 0.908-0.928). The area under the summary receiver operating characteristic curve was 0.9487 (95% CI 0.9207-0.9767). Meta-regression revealed that heterogeneity might derive from time interval ( = 0.0117) and study population ( = 0.0033). Subgroup analyses showed significant differences between the subgroups stratified by the dose, posture, study region, time interval, cut-off value and study population for sensitivity and/or specificity ( < 0.05).

Conclusion: Post-captopril ARR is comparably valuable for diagnosing PA at cut-offs from 12.0 to 50.0. Conducting the CCT in the supine position with 25 mg of captopril may attain greater sensitivity. Conducting the CCT in the seated position with 50 mg of captopril may attain greater specificity. A 90-min time interval may perform best in both the sensitivity and specificity.
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http://dx.doi.org/10.1177/1470320320972032DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7691929PMC
November 2020