Publications by authors named "Yi Zhu"

1,203 Publications

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Mitochondria Homeostasis and Vascular Medial Calcification.

Calcif Tissue Int 2021 Mar 3. Epub 2021 Mar 3.

Department of Cardiology, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, 210009, People's Republic of China.

Vascular calcification occurs highly prevalent, which commonly predicts adverse cardiovascular events. The pathogenesis of calcification, a complicated and multifactorial process, is incompletely characterized. Accumulating evidence shows that mitochondrial dysfunction may ultimately be more detrimental in the vascular smooth muscle cells (VSMCs) calcification. This review summarizes the role of mitochondrial dysfunction and metabolic reprogramming in vascular calcification, and indicates that metabolic regulation may be a therapeutic target in vascular calcification.
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http://dx.doi.org/10.1007/s00223-021-00828-1DOI Listing
March 2021

Radiotherapy versus partial laryngectomy in the management of early glottic cancer with anterior commissure involvement: A propensity score matched study with 256 patients.

Oral Oncol 2021 Feb 26;116:105230. Epub 2021 Feb 26.

Department of Radiation Oncology, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai 200031, China. Electronic address:

Objectives: The study was intended to compare the outcomes for T1-T2N0M0 glottic squamous cell carcinoma with anterior commissure involvement who had undergone partial laryngectomy (PL) or radiotherapy (RT).

Materials And Methods: We retrospectively analyzed 256 patients who were treated by RT (n = 70) or PL (n = 186). Patients received prophylactic irradiation of the neck in RT group whereas PL was not associated with lymphadenectomy. Propensity score matching (PSM) was used to eliminate the baseline variations.

Results: The average age of the RT group (67 years) was significantly higher than that of the PL (59 years). Local recurrence was noted in 14 patients of the RT group and 22 of the PL. While regional recurrence was noted in only 1 patient of the RT group and 23 of the PL. After PSM, the 5-year overall survival (82.8% vs. 83.9%, p = 0.302), 5-year cancer-specific survival (88.3% vs. 89.7%, p = 0.793), 5-year local relapse-free survival (79.3% vs. 84.5%, p = 0.127) were not significantly different between two groups. However, 5-year regional relapse-free survival in the RT group was significantly better than that in the PL (100% vs. 87.1%, p = 0.014). In the PL group, infection, granuloma, laryngeal stenosis, chylous leakage, and pharyngeal fistula were reported in six, 11, 12, one, and two patients, respectively.

Conclusions: RT resulted in comparable rates of survival, local control, and larynx preservation compared to PL. However, RT was associated with higher regional control rate. The complication rates were extremely low in RT group.
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http://dx.doi.org/10.1016/j.oraloncology.2021.105230DOI Listing
February 2021

Innovative fluorescent probes for in vivo visualization of biomolecules in living Caenorhabditis elegans.

Cytometry A 2021 Feb 27. Epub 2021 Feb 27.

Jiangsu Key Laboratory of Infection and Immunity, Institutes of Biology and Medical Sciences, Soochow University, Suzhou, China.

Caenorhabditis elegans (C. elegans) as a well-established multicellular model organism has been widely used in the biological field for half a century. Its numerous advantages including small body size, rapid life cycle, high-reproductive rate, well-defined anatomy, and conserved genome, has made C. elegans one of the most successful multicellular model organisms. Discoveries obtained from the C. elegans model have made great contributions to research fields such as development, aging, biophysics, immunology, and neuroscience. Because of its transparent body and giant cell size, C. elegans is also an ideal subject for high resolution and high-throughput optical imaging and analysis. During the past decade, great advances have been made to develop biomolecule-targeting techniques for noninvasive optical imaging. These novel technologies expanded the toolbox for qualitative and quantitative analysis of biomolecules in C. elegans. In this review, we summarize recently developed fluorescent probes or labeling techniques for visualizing biomolecules at the cellular, subcellular or molecular scale by using C. elegans as the major model organism or designed specifically for the applications in C. elegans. Combining the technological advantages of the C. elegans model with the novel fluorescent labeling techniques will provide new horizons for high-efficiency quantitative optical analysis in live organisms.
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http://dx.doi.org/10.1002/cyto.a.24325DOI Listing
February 2021

Prevalence and predictors of breast cancer-related arm lymphedema over a 10-year period in postoperative breast cancer patients: A cross-sectional study.

Eur J Oncol Nurs 2021 Feb 8;51:101909. Epub 2021 Feb 8.

School of Nursing, Capital Medical University, No. 10, Xitoutiao, You An Men Wai, Feng-Tai District, Beijing, China.

Purpose: Breast cancer (BC) survivors have a lifelong risk of developing lymphedema. This study investigated the prevalence of BC-related arm lymphedema among Chinese BC survivors diagnosed in the last 10 years and examined the demographic and clinical variables as well as lifestyle factors associated with lymphedema status.

Methods: In this cross-sectional study, women with BC (N = 866) who had been diagnosed and followed up in the previous 10 years were recruited from the outpatient clinic of 4 general hospitals and one cancer association in China between August 2018 and October 2019. Lymphedema status was determined using the Norman telephone questionnaire as the patient-reported occurrence of hand/lower arm/upper arm swelling. Multiple logistic regression was used to identify risk factors for lymphedema.

Results: The median time from BC diagnosis was 4.0 years (interquartile range, 2.0-5.0 years). 81.4% of the patients had undergone mastectomy. The prevalence of arm lymphedema among BC survivors was 49.0%. Age ≥50 years, monthly income <3000 RMB, modified radical mastectomy, postsurgical wound infection, chemotherapy, and radiotherapy were associated with an increased risk of BC-related arm lymphedema, whereas exercise of the affected arm, engagement in active physical activity, and timely reporting of symptoms of infection to a physician decreased the risk (P < 0.05).

Conclusions: Arm lymphedema is a common complication for postoperative BC survivors within 10 years. It is essential to identify patients at risk of lymphedema based on demographic, clinical, and lifestyle factors and implement interventions targeting modifiable lifestyle behaviors-eg, active physical activity during the postoperative period.
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http://dx.doi.org/10.1016/j.ejon.2021.101909DOI Listing
February 2021

Associations Between Regional Environment and Cornea-Related Morphology of the Eye in Young Adults: A Large-Scale Multicenter Cross-Sectional Study.

Invest Ophthalmol Vis Sci 2021 Feb;62(2):35

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China.

Purpose: To investigate environmental factors associated with corneal morphologic changes.

Methods: A cross-sectional study was conducted, which enrolled adults of the Han ethnicity aged 18 to 44 years from 20 cities. The cornea-related morphology was measured using an ocular anterior segment analysis system. The geographic indexes of each city and meteorological indexes of daily city-level data from the past 40 years (1980-2019) were obtained. Correlation analyses at the city level and multilevel model analyses at the eye level were performed.

Results: In total, 114,067 eyes were used for analysis. In the correlation analyses at the city level, the corneal thickness was positively correlated with the mean values of precipitation (highest r [correlation coefficient]: >0.700), temperature, and relative humidity (RH), as well as the amount of annual variation in precipitation (r: 0.548 to 0.721), and negatively correlated with the mean daily difference in the temperature (DIF T), duration of sunshine, and variance in RH (r: -0.694 to 0.495). In contrast, the anterior chamber (AC) volume was negatively correlated with the mean values of precipitation, temperature, RH, and the amount of annual variation in precipitation (r: -0.672 to -0.448), and positively associated with the mean DIF T (r = 0.570) and variance in temperature (r = 0.507). In total 19,988 eyes were analyzed at the eye level. After adjusting for age, precipitation was the major explanatory factor among the environmental factors for the variability in corneal thickness and AC volume.

Conclusions: Individuals who were raised in warm and wet environments had thicker corneas and smaller AC volumes than those from cold and dry ambient environments. Our findings demonstrate the role of local environmental factors in corneal-related morphology.
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http://dx.doi.org/10.1167/iovs.62.2.35DOI Listing
February 2021

Glucagon blockade restores functional β-cell mass in type 1 diabetic mice and enhances function of human islets.

Proc Natl Acad Sci U S A 2021 Mar;118(9)

Touchstone Diabetes Center, Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8549;

We evaluated the potential for a monoclonal antibody antagonist of the glucagon receptor (Ab-4) to maintain glucose homeostasis in type 1 diabetic rodents. We noted durable and sustained improvements in glycemia which persist long after treatment withdrawal. Ab-4 promoted β-cell survival and enhanced the recovery of insulin islet mass with concomitant increases in circulating insulin and C peptide. In PANIC-ATTAC mice, an inducible model of β-cell apoptosis which allows for robust assessment of β-cell regeneration following caspase-8-induced diabetes, Ab-4 drove a 6.7-fold increase in β-cell mass. Lineage tracing suggests that this restoration of functional insulin-producing cells was at least partially driven by α-cell-to-β-cell conversion. Following hyperglycemic onset in nonobese diabetic (NOD) mice, Ab-4 treatment promoted improvements in C-peptide levels and insulin islet mass was dramatically increased. Lastly, diabetic mice receiving human islet xenografts showed stable improvements in glycemic control and increased human insulin secretion.
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http://dx.doi.org/10.1073/pnas.2022142118DOI Listing
March 2021

Biomaterial Properties Modulating Bone Regeneration.

Macromol Biosci 2021 Feb 22:e2000365. Epub 2021 Feb 22.

Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, Ontario, M5G 1G6, Canada.

Biomaterial scaffolds have been gaining momentum in the past several decades for their potential applications in the area of tissue engineering. They function as three-dimensional porous constructs to temporarily support the attachment of cells, subsequently influencing cell behaviors such as proliferation and differentiation to repair or regenerate defective tissues. In addition, scaffolds can also serve as delivery vehicles to achieve sustained release of encapsulated growth factors or therapeutic agents to further modulate the regeneration process. Given the limitations of current bone grafts used clinically in bone repair, alternatives such as biomaterial scaffolds have emerged as potential bone graft substitutes. This review summarizes how physicochemical properties of biomaterial scaffolds can influence cell behavior and its downstream effect, particularly in its application to bone regeneration.
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http://dx.doi.org/10.1002/mabi.202000365DOI Listing
February 2021

-3 Polyunsaturated Fatty Acids Facilitate the Repair of Peripheral Nerve Defects with Chemically Extracted Acellular Allograft in Rats.

Biomed Res Int 2021 26;2021:2504276. Epub 2021 Jan 26.

Second Affiliated Hospital of Nan Hua University, No. 35 Jiefang Road, Zhengxiang District, Hengyang City, Hunan Province 421001, China.

Acellular allograft (ACA) improves the repair and reconstruction of long peripheral nerve defects. -3 Polyunsaturated fatty acids (PUFAs) carry a neuroprotective potential, and their effects on ACA bridging were elucidated. Thirty rats with long gap sciatic nerve defects (15 mm long) were randomly divided into three groups ( = 10): ACA, ACA + PUFAs, and autograft (AU). Limb condition, wet weight of tibialis anterior muscle (TAM), nerve electrophysiology, S-100, horseradish peroxidase (HRP), and percentage of splenic CD4+ and CD8 + T-lymphocytes were evaluated for 12 weeks after the operation. Rats in the AU and ACA + PUFA groups showed superior condition in affected limbs compared to the ACA group. At 12 wk after surgery, the wet weight of TAM in the ACA + PUFA group was higher than that in the ACA group (0.4519 ± 0.1185 vs. 0.3049 ± 0.1272; < 0.01) but lower than that in the AU group (0.4519 ± 0.1185, 0.5628 ± 0.0092; < 0.05). In all the three groups, sole irritation elicited withdrawal reflex, and S-100 staining was detected in plantar skin. Moreover, horseradish peroxidase staining was overt in both the ventral horn and dorsal root ganglion of the spinal cord. Nerve conduction velocity (m/s), amplitude of action potential (mV), or somatosensory evoked potentials in ACA + PUFAs (28.81 ± 1.04, 2.20 ± 0.27, 6.98 ± 0.29) were significantly different from that in the AU (35.71 ± 1.28, 1.81 ± 0.19, 8.15 ± 0.52; < 0.05) and ACA (20.03 ± 1.94, 2.95 ± 0.36, 5.22 ± 0.53; < 0.01) groups. The percentages of splenic CD4+ and CD8+ cells were similar among the three groups. Omega-3 PUFAs improve the bridging effect of ACA on long gap peripheral nerve defects by promoting neuroprotection without arousing an immune response.
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http://dx.doi.org/10.1155/2021/2504276DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7857881PMC
January 2021

Short-Term Oral Administration of Mesoporous Silica Nanoparticles Potentially Induced Colon Inflammation in Rats Through Alteration of Gut Microbiota.

Int J Nanomedicine 2021 5;16:881-893. Epub 2021 Feb 5.

State Key Laboratory of Quality Research in Chinese Medicine & School of Pharmacy, Macau University of Science and Technology, Taipa, Macau SAR, People's Republic of China.

Purpose: Mesoporous silica (MSNs) have attracted considerable attention for its application in the field of drug delivery and biomedicine due to its high surface area, large pore volume, and low toxicity. Recently, numerous studies revealed that gut microbiota is of critical relevance to host health. However, the toxicological studies of MSNs were mainly based on the degradation, biodistribution, and excretion in mammalian after oral administration for now. Here in this study, we explored the impacts of oral administration of three kinds of MSNs on gut microbiota in rats to assess its potential toxicity.

Methods: Forty rats were divided into four groups: control group; Mobil Composition of Matter No. 41 type mesoporous silica (MCM-41) group; Santa Barbara Amorphous-15 type mesoporous silica (SBA-15) group, and biodegradable dendritic center-radial mesoporous silica nanoparticle (DMSN) group. Fecal samples were collected 3 days and 7 days after the intake of MSNs and analyzed with high throughput sequencing. Gastric tissues in rats were obtained after dissection for the histological study.

Results: Three different MSNs (MCM-41, SBA-15, and DMSN) were successfully prepared in this study. The pore size of three MSNs was calculated similarly as (3.54 ± 0.15) nm, (3.48 ± 0.21) nm, and (3.45 ± 0.17) nm according to the BET & BJH model, respectively, while the particle size of MCM-41, SBA-15 and DMSN was around 209.2 nm, 1349.56 nm, and 244.4 nm, respectively. In the gene analysis of 16S rRNA, no significant changes in the diversity and richness were found between groups, while decreased and increased in MCM-41 treated groups. Meanwhile, no inflammatory and erosion symptoms were observed in the morphological analysis of the colons, except the MCM-41 treated group.

Conclusion: Three different MSNs, MCM-41, SBA-15, and DMSN were successfully prepared, and this study firstly suggested the impact of MSNs on the gut microbiota, and further revealing the potential pro-inflammatory effects of oral administration of MCM-41 was possibly through the changing of gut microbiota.
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http://dx.doi.org/10.2147/IJN.S295575DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7872941PMC
February 2021

Bioinspired surfaces with special micro-structures and wettability for drag reduction: which surface design will be a better choice?

Nanoscale 2021 Feb;13(6):3463-3482

Ministry of Education Key Laboratory for the Green Preparation and Application of Functional Materials, School of Materials Science & Engineering and Hubei Key Laboratory of Polymer Materials, Hubei University, Wuhan 430062, China. and State Key Laboratory of Solid Lubrication, Lanzhou Institute of Chemical Physics, Chinese Academy of Sciences, Lanzhou 730000, China.

Human beings learn from creatures in nature and imitate them to solve challenges in daily life. Thus, the use of bioinspired surfaces for drag reduction has attracted extensive attention in recent years due to their important applications in many fields, such as pipeline systems, maritime transportation, and military weapons. Herein, we introduce some typical plants and animals with low drag surfaces that exist in nature, focusing on their drag reduction patterns. There are two main mechanisms to explain how surfaces reduce frictional drag, where one is to design a suitable surface geometry to change the flow distribution of surrounding fluid and the other is to introduce a low friction lubricating layer (usually air or non-toxic silicone oil) to partially or completely replace the solid-liquid interface. Hence, by mimicking these organisms, some surfaces have been fabricated to reduce frictional drag, including riblets, superhydrophobic surfaces, and slippery liquid-infused porous surfaces. With the increasing research on drag-reducing surfaces, the drag reduction rate of different types of surface designs has greatly improved in recent years. This review provides a holistic overview that facilitates direct comparisons between these surface types. To select an optimal surface for drag reduction in practical applications, the merits and deficiencies of different surface designs are analysed and compared. Finally, based on the current challenges, we present some future prospects for the application of bioinspired surfaces in drag reduction.
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http://dx.doi.org/10.1039/d0nr07664cDOI Listing
February 2021

Degradation of refractory organics in dual-cathode electro-Fenton using air-cathode for HO electrogeneration and microbial fuel cell cathode for Fe regeneration.

J Hazard Mater 2021 Feb 1;412:125269. Epub 2021 Feb 1.

School of Environmental Science and Engineering, Huazhong University of Science and Technology, Wuhan 430074, PR China; Hubei Provincial Engineering Laboratory of Solid Waste Treatment, Disposal and Recycling, 1037 Luoyu Road, Wuhan, Hubei 430074, PR China.

The electrogeneration of HO and electro-regeneration of ferrous are conflicting matters in electro-Fenton system. In this research, the degradation of Rhodamine B, methyl orange (MO) and 4-chlorophenol (4-CP) was investigated using a novel dual-cathode microbial fuel cell (MFC) electro-Fenton (EF) hybrid system. An air-cathode of an EF system was used for HO electrogeneration and a carbon felt cathode of a MFC was used to accelerate Fe regeneration. Synergistic improvement of MFC power generation and the degradation of the above refractory organics through EF reaction was achieved. The EF air-cathode was fabricated by adopting activated carbon/graphite powder mixture and PVDF binder, which showed higher HO generation but slower Fe reduction rate than MFC carbon felt cathode. The Rhodamine B removal rate constant and mineralization current efficiency of the MFC coupled EF were 64% and 42% higher than that of uncoupled EF, respectively. The MFC-EF coupled system also exhibited significantly higher removal efficiency for MO and 4-CP than that of un-coupled EF system. Moreover, the power density of MFC was greatly enhanced by coupling EF due to higher Fe/Fe redox potential than oxygen reduction.
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http://dx.doi.org/10.1016/j.jhazmat.2021.125269DOI Listing
February 2021

Detection and characterization of Fusarium wilt ( f. sp. ) race 4 causing Fusarium wilt of cotton seedlings in New Mexico, USA.

Plant Dis 2021 Feb 5. Epub 2021 Feb 5.

New Mexico State University, Environmental Plant Sciences, 945 College Dr., New Mexico State University, Las Cruces, New Mexico, United States, 88003;

Fusarium wilt (FW), caused by f. sp. (Atk.) W.C. Snyder & H.N. Hans (FOV), is one of the most destructive diseases in cotton ( spp.) worldwide. FOV race 4 (FOV4) is a highly virulent nominal race of this pathogen and is a significant threat to cotton production in the western and southwestern US and potentially the entire Cotton Belt. A field survey in three southern counties of New Mexico was conducted in 619 cotton fields in 2018-2020 to identify FOV4. From 132 samples of cotton plants that exhibited wilt symptoms, spp. were the most frequently isolated group of fungal species with an isolation frequency of 57.4%. Eighty-four spp. isolates were subsequently characterized by a DNA sequence analysis of three genes, , and encoding for translation elongation factor, phosphate permease and β-tubulin, respectively. Forty-two isolates were identified to be FOV4 from 10 cotton fields and confirmed with a positive 500 bp fragment that is diagnostic for FOV4. Twenty-six (62%) of the 42 FOV4 isolates were T type and the remainder (38%) were Null type with and without a Tfo1 insertion in PHO, respectively; and each FOV4-infested field contained the same FOV4 genotype. Ten representative FOV4 isolates with one each from the 10 FOV4-infested fields were evaluated for their pathogenicity on resistant Pima PHY 841 RF and susceptible Upland PHY 725 RF at 7, 14, 21, and 28 days post inoculation under temperature-controlled conditions at 21-22°C. Based on disease severity rating (DSR), mortality rate (MR) and the area under the disease progress curve (AUDPC) value, all the 10 isolates were pathogenic to both cotton cultivars and differed in virulence in that four isolates of the T genotype as a whole were more virulent than the six isolates of the N genotype. PHY 841 RF had significantly higher levels of resistance than PHY 725 RF to all FOV4 isolates. The results provide the first comprehensive account of the occurrence, distribution and virulence of FOV4 in cotton production in New Mexico and will be useful in developing an effective strategy to manage FW in both the state of New Mexico and entire southwestern Cotton Belt.
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http://dx.doi.org/10.1094/PDIS-10-20-2174-REDOI Listing
February 2021

Robot-assisted laparoscopic resection of a pelvic solitary fibrous tumor.

J Int Med Res 2021 Feb;49(2):300060520981479

Department of Urology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.

Solitary fibrous tumor (SFT) is a rare soft tissue neoplasm of mesenchymal origin. SFT is most commonly located in the thoracic cavity (in approximately 80% of cases), but can also develop rarely in the pelvis. A 47-year-old man presented to our hospital with a pelvic tumor that was discovered during a health checkup. We performed transperitoneal robotic resection of the pelvic tumor. Intraoperative blood loss and the console time were 100 mL and 2 hours 42 minutes, respectively, and no intraoperative or postoperative complications were recorded. Histologic analysis revealed a pelvic SFT with negative surgical margins. The patient was followed-up for 13 months with no evidence of tumor recurrence. To our knowledge, this is the first report of robot-assisted laparoscopic resection of a pelvic SFT.
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http://dx.doi.org/10.1177/0300060520981479DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871082PMC
February 2021

Brain-Derived Neurotrophic Factor, a New Predictor of Coronary Artery Calcification.

Clin Appl Thromb Hemost 2021 Jan-Dec;27:1076029621989813

Department of Cardiology, Xishan Hospital, Wuxi, People's Republic of China.

Brain-derived neurotrophic factor (BDNF) plays a functional role in vascular endothelium homeostasis and the alleviation of atherosclerosis. Matrix gla protein (MGP) and Nε-(1-carboxymethyl)-l-lysine (CML) are both confirmed to be VC predictors. This study investigated the association between BDNF, MGP, CML and coronary artery calcification (CAC). Plasma BDNF, MGP, and CML levels were measured in 274 patients who underwent computed tomography to determine the CAC score (Agatston score). It was found that patients with CAC exhibited lower BDNF and MGP and higher CML levels than those without CAC. Plasma BDNF levels in patients with diabetes or hypertension were lower compared with the control groups. In logistic regression analysis, age, hypertension, BDNF, and MGP were independent predictors of CAC. Plasma BDNF and MGP levels were both correlated with the Agatston score even after adjustment for age, total cholesterol level, triglycerides, low-density lipoprotein level, creatinine clearance rate, and the presence of hypertension and diabetes mellitus. In 167 patients with CAC, circulating BDNF level was inversely associated with CML level and positively related to MGP level. In the receiver operating characteristic analysis for CAC, the areas under the curves for BDNF, MGP, and CML were 0.757, 0.777 and 0.653, respectively. In summary, plasma BDNF levels are associated with the Agatston score, and BDNF further predicts the occurrence of CAC.
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http://dx.doi.org/10.1177/1076029621989813DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7863173PMC
February 2021

Research on Early Warning Mechanism and Model of Liver Cancer Rehabilitation Based on CS-SVM.

J Healthc Eng 2021 12;2021:6658776. Epub 2021 Jan 12.

School of Public Health, North China University of Science and Technology, Tangshan, 063021, China.

Since the 20 century, cancer has become one of the main diseases threatening human health. Liver cancer is a malignant tumor with extremely high clinical morbidity and fatality rate and easy recurrence after surgery. Research on the postoperative recurrence time and recurrence location of patients with liver cancer has a crucial influence on the postoperative intervention of patients. Evaluation of the clinical manifestations of patients after liver cancer surgery is conducted according to medical knowledge or national standards to determine the main factors affecting liver cancer rehabilitation. In order to better study the mechanism of liver cancer recurrence, this paper uses CS-SVM to predict the recurrence time of liver cancer patients, so as to timely intervene the patients. There are five evaluation indicators which are basic indicators, immune indicators, microenvironment indicators, psychological indicators, and nutritional indicators, respectively. This paper collects the clinical evaluation data of postoperative follow-up visits for patients with liver cancer in a hospital, improves the parameter selection process of the support vector machine by using the search ability of the cuckoo algorithm, and establishes an algorithm-optimized prediction model of support vector machine for the prognosis of liver cancer to predict the location and approximate time of recurrence. According to the clinical evaluation data of patients with liver cancer after surgery, logistics regression, BP neural network, and other related methods are used to predict the prognosis of liver cancer patients after surgery. The prediction effects of several methods are compared, and the superiority of the model is discussed. At the end of this article, we conducted an empirical analysis on the clinical evaluation data of patients with liver cancer after surgery. For the collected samples of 776 liver cancer recurrences after surgery, the established liver cancer prognosis outcome prediction model was used to predict the recurrence time and recurrence location, respectively. The mean square error of recurrence time prediction is 9.2101, which is much smaller than the prediction mean square error of BP neural network of 177.9451; the prediction accuracy of recurrence location is 95.7%, which is much higher than the 63.14% of logistic regression. The empirical analysis results show that the improved support vector machine model based on cuckoo established in this paper can effectively predict the time and location of cancer recurrence.
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http://dx.doi.org/10.1155/2021/6658776DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817298PMC
January 2021

Metformin attenuates hyperlipidaemia-associated vascular calcification through anti-ferroptotic effects.

Free Radic Biol Med 2021 Jan 26;165:229-242. Epub 2021 Jan 26.

Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University 87 Dingjiaqiao, Nanjing, 210009, PR China. Electronic address:

Ferroptosis is a form of regulated cell death that involves metabolic dysfunction resulting from iron-dependent excessive lipid peroxidation. Elevated plasma levels of free fatty acids are tightly associated with cardiometabolic risk factors in patients with obesity, diabetes mellitus, and metabolic syndrome. Metformin (Met) is an antidiabetic drug with beneficial cardiovascular disease effects. The aim of this study was to determine the effects of Met on ferroptosis induced by lipid overload and the effects of these changes on vascular smooth muscle cells (VSMCs) calcification. We developed a hyperlipidaemia-related vascular calcification in vivo model with rats fed a high-fat diet combined with vitamin D3 plus nicotine, and palmitic acid (PA), the most abundant long-chain saturated fatty acid in plasma, was used to induce lipid overload and develop an oxidative stress-related calcification model in vitro. The results showed that Met inhibits hyperlipidaemia-associated calcium deposition in the rat aortic tissue. In vitro, treatment of VSMCs with PA stimulates ferroptosis concomitant with increased calcium deposition in VSMCs, while pretreatment with Met attenuates these effects. Furthermore, PA also promotes the protein expression of the extracellular matrix protein periostin (POSTN) and its secretion into the extracellular environment. More importantly, upregulation of POSTN increased the sensitivity of cells to ferroptosis. Mechanistically, upregulation of POSTN suppresses SLC7A11 expression through the inhibition of p53 in VSMCs, which contributes to a decrease in glutathione synthesis and therefore triggers ferroptosis. Interestingly, overexpression of p53 attenuates the inhibitory effect of POSTN on SLC7A11 expression, accompanied by increased Gpx4 expression. Furthermore, p53 knockdown suppresses Met-mediated anti-ferroptosis effects in PA-treated VSMCs, which may be related to the downregulation of SLC7A11 expression. In addition, supplementation of VSMCs with Met enhances the antioxidative capacity of VSMCs through Nrf2 signalling activation. Collectively, targeting POSTN in VSMCs may provide a new strategy for vascular calcification prevention or treatment.
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http://dx.doi.org/10.1016/j.freeradbiomed.2021.01.033DOI Listing
January 2021

Screening and identifying hepatobiliary diseases through deep learning using ocular images: a prospective, multicentre study.

Lancet Digit Health 2021 Feb;3(2):e88-e97

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China; Centre for Precision Medicine, Sun Yat-sen University, Guangzhou, China. Electronic address:

Background: Ocular changes are traditionally associated with only a few hepatobiliary diseases. These changes are non-specific and have a low detection rate, limiting their potential use as clinically independent diagnostic features. Therefore, we aimed to engineer deep learning models to establish associations between ocular features and major hepatobiliary diseases and to advance automated screening and identification of hepatobiliary diseases from ocular images.

Methods: We did a multicentre, prospective study to develop models using slit-lamp or retinal fundus images from participants in three hepatobiliary departments and two medical examination centres. Included participants were older than 18 years and had complete clinical information; participants diagnosed with acute hepatobiliary diseases were excluded. We trained seven slit-lamp models and seven fundus models (with or without hepatobiliary disease [screening model] or one specific disease type within six categories [identifying model]) using a development dataset, and we tested the models with an external test dataset. Additionally, we did a visual explanation and occlusion test. Model performances were evaluated using the area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, and F1* score.

Findings: Between Dec 16, 2018, and July 31, 2019, we collected data from 1252 participants (from the Department of Hepatobiliary Surgery of the Third Affiliated Hospital of Sun Yat-sen University, the Department of Infectious Diseases of the Affiliated Huadu Hospital of Southern Medical University, and the Nantian Medical Centre of Aikang Health Care [Guangzhou, China]) for the development dataset; between Aug 14, 2019, and Jan 31, 2020, we collected data from 537 participants (from the Department of Infectious Diseases of the Third Affiliated Hospital of Sun Yat-sen University and the Huanshidong Medical Centre of Aikang Health Care [Guangzhou, China]) for the test dataset. The AUROC for screening for hepatobiliary diseases of the slit-lamp model was 0·74 (95% CI 0·71-0·76), whereas that of the fundus model was 0·68 (0·65-0·71). For the identification of hepatobiliary diseases, the AUROCs were 0·93 (0·91-0·94; slit-lamp) and 0·84 (0·81-0·86; fundus) for liver cancer, 0·90 (0·88-0·91; slit-lamp) and 0·83 (0·81-0·86; fundus) for liver cirrhosis, and ranged 0·58-0·69 (0·55-0·71; slit-lamp) and 0·62-0·70 (0·58-0·73; fundus) for other hepatobiliary diseases, including chronic viral hepatitis, non-alcoholic fatty liver disease, cholelithiasis, and hepatic cyst. In addition to the conjunctiva and sclera, our deep learning model revealed that the structures of the iris and fundus also contributed to the classification.

Interpretation: Our study established qualitative associations between ocular features and major hepatobiliary diseases, providing a non-invasive, convenient, and complementary method for hepatobiliary disease screening and identification, which could be applied as an opportunistic screening tool.

Funding: Science and Technology Planning Projects of Guangdong Province; National Key R&D Program of China; Guangzhou Key Laboratory Project; National Natural Science Foundation of China.
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http://dx.doi.org/10.1016/S2589-7500(20)30288-0DOI Listing
February 2021

Influence of Sex on Outcomes After Thoracic Endovascular Repair for Type B Aortic Dissection.

Angiology 2021 Jan 28:3319720987956. Epub 2021 Jan 28.

Department of Cardiovascular, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, 569066Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.

We aimed to investigate whether sex differences influence the clinical outcomes of patients who undergo thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD). We retrospectively analyzed a prospectively maintained single-center cohort of patients with TBAD who underwent TEVAR between January 2010 and June 2017. We evaluated the in-hospital and long-term mortality and composite end point. Of the 913 patients, 793 (86.8%) were male and 120 (13.1%) were female. Compared to male patients, the female patients were older, more likely to have diabetes mellitus, but less likely to smoke or have hypertension. The proximal landing zone in 0 and 1 was higher in male patients ( = .023), who were more likely to require an aortic arch bypass. Endoleak, delirium, and ICU stay after stent-graft implantation were also more frequent in men. Sex factor was not associated with in-hospital or long-term mortality or the composite end point in the multivariable regression analyses and Cox regression model. The mean estimated survival time was similar between males and females (2462.9 ± 141.2 vs 2804.1 ± 117.4 days, = .167) in the propensity score-matched cohort. Despite distinct characteristics between sex, there was no sex-related difference in long-term clinical outcomes after TEVAR for TBAD.
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http://dx.doi.org/10.1177/0003319720987956DOI Listing
January 2021

Multi-organ proteomic landscape of COVID-19 autopsies.

Cell 2021 02 9;184(3):775-791.e14. Epub 2021 Jan 9.

Key Laboratory of Structural Biology of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou 310024, China; Center for Infectious Disease Research, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou 310024, China; Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou 310024, China. Electronic address:

The molecular pathology of multi-organ injuries in COVID-19 patients remains unclear, preventing effective therapeutics development. Here, we report a proteomic analysis of 144 autopsy samples from seven organs in 19 COVID-19 patients. We quantified 11,394 proteins in these samples, in which 5,336 were perturbed in the COVID-19 patients compared to controls. Our data showed that cathepsin L1, rather than ACE2, was significantly upregulated in the lung from the COVID-19 patients. Systemic hyperinflammation and dysregulation of glucose and fatty acid metabolism were detected in multiple organs. We also observed dysregulation of key factors involved in hypoxia, angiogenesis, blood coagulation, and fibrosis in multiple organs from the COVID-19 patients. Evidence for testicular injuries includes reduced Leydig cells, suppressed cholesterol biosynthesis, and sperm mobility. In summary, this study depicts a multi-organ proteomic landscape of COVID-19 autopsies that furthers our understanding of the biological basis of COVID-19 pathology.
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http://dx.doi.org/10.1016/j.cell.2021.01.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794601PMC
February 2021

Harmine alleviates atherogenesis by inhibiting disturbed flow-mediated endothelial activation via protein tyrosine phosphatase PTPN14 and YAP.

Br J Pharmacol 2021 Jan 20. Epub 2021 Jan 20.

Tianjin Key Laboratory of Metabolic Diseases, Collaborative Innovation Center of Tianjin for Medical Epigenetics and Department of Physiology and Pathophysiology, Tianjin Medical University, Tianjin, China.

Background And Purpose: Disturbed flow induces endothelial dysfunction and contributes to uneven distribution of atherosclerotic plaque. Emerging evidence suggests that harmine, a natural constituent of extracts of Peganum harmala, has potent beneficial activities. Here, we investigated if harmine has an atheroprotective role under disturbed flow and the underlying mechanism.

Experimental Approach: Mice of ApoE , LDLR , and endothelial cell (EC)-specific overexpression of yes-associated protein (YAP) in ApoE background were fed with a Western diet and given harmine for 4 weeks. Atherosclerotic lesion size, cellular composition, and expression of inflammatory genes in the aortic roots were assessed. HUVECs were treated with oscillatory shear stress (OSS) and harmine and also used for proteomic analysis.

Key Results: Harmine retarded atherogenesis in both ApoE and LDLR mice by inhibiting the endothelial inflammatory response. Mechanistically, harmine blocked OSS-induced YAP nuclear translocation and EC activation by reducing phosphorylation of YAP at Y357. Overexpression of endothelial YAP blunted the beneficial effects of harmine in mice. Proteomic study revealed that protein tyrosine phosphatase non-receptor type 14 (PTPN14) could bind to YAP. Moreover, harmine increased PTPN14 expression by stabilizing its protein level and inhibiting its degradation in proteasomes. PTPN14 knockdown blocked the effects of harmine on YAP and EC activation. Finally, overexpression of PTPN14 mimicked the effects of harmine and ameliorated atherosclerosis, and knockdown of PTPN14 blunted the atheroprotective effects of harmine and accelerated atherosclerosis, in a partial ligation mouse model.

Conclusion And Implications: Harmine alleviated OSS-induced EC activation via a PTPN14/YAP pathway and had a potent atheroprotective role.
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http://dx.doi.org/10.1111/bph.15378DOI Listing
January 2021

Whole-body senescent cell clearance alleviates age-related brain inflammation and cognitive impairment in mice.

Aging Cell 2021 02 20;20(2):e13296. Epub 2021 Jan 20.

Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA.

Cellular senescence is characterized by an irreversible cell cycle arrest and a pro-inflammatory senescence-associated secretory phenotype (SASP), which is a major contributor to aging and age-related diseases. Clearance of senescent cells has been shown to improve brain function in mouse models of neurodegenerative diseases. However, it is still unknown whether senescent cell clearance alleviates cognitive dysfunction during the aging process. To investigate this, we first conducted single-nuclei and single-cell RNA-seq in the hippocampus from young and aged mice. We observed an age-dependent increase in p16 senescent cells, which was more pronounced in microglia and oligodendrocyte progenitor cells and characterized by a SASP. We then aged INK-ATTAC mice, in which p16 -positive senescent cells can be genetically eliminated upon treatment with the drug AP20187 and treated them either with AP20187 or with the senolytic cocktail Dasatinib and Quercetin. We observed that both strategies resulted in a decrease in p16 exclusively in the microglial population, resulting in reduced microglial activation and reduced expression of SASP factors. Importantly, both approaches significantly improved cognitive function in aged mice. Our data provide proof-of-concept for senolytic interventions' being a potential therapeutic avenue for alleviating age-associated cognitive impairment.
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http://dx.doi.org/10.1111/acel.13296DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7884042PMC
February 2021

A Ni-doping-induced phase transition and electron evolution in cobalt hexacyanoferrate as a stable cathode for sodium-ion batteries.

Phys Chem Chem Phys 2021 Jan;23(3):2491-2499

School of Materials Science and Engineering and, Hefei University of Technology, 230009, Hefei, People's Republic of China.

Prussian blue analogues are potential competitive energy storage materials due to their diverse metal combinations and wide three-dimensional ion channels. Here, we prepared a new highly crystalline monoclinic nickel-doped cobalt hexacyanoferrate via a feasible and simple one-step co-precipitation method. In the process of sodium-ion de-intercalation, three stable charge and discharge platforms, which are consistent with the cyclic voltammetry performance, are seen for the first time, showing the function of nickel ions in Prussian blue. Furthermore, the charge transfer and structural evolution caused by the transmission of sodium ions were well revealed via ex situ XRD, ex situ XPS, and in situ EIS studies. Simulation calculations are performed relating to the energy band structure and the highest-occupied bonding orbitals of the system in different charge states, revealing the charge and discharge mechanism of the nickel-doped material and the reason for the emergence of the new platform at low voltages. In addition, NaNi0.17Co0.83Fe(CN)6 also delivers a striking capacity of 146 mA h g-1 and superior cyclability, with 93% capacity retention over 100 cycles; it can be considered as a promising alternative cathode material for use in sodium-ion batteries.
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http://dx.doi.org/10.1039/d0cp05665kDOI Listing
January 2021

A numerical study of fish adaption behaviors in complex environments with a deep reinforcement learning and immersed boundary-lattice Boltzmann method.

Sci Rep 2021 Jan 18;11(1):1691. Epub 2021 Jan 18.

School of Engineering and Information Technology, University of New South Wales, Canberra, ACT, 2600, Australia.

Fish adaption behaviors in complex environments are of great importance in improving the performance of underwater vehicles. This work presents a numerical study of the adaption behaviors of self-propelled fish in complex environments by developing a numerical framework of deep learning and immersed boundary-lattice Boltzmann method (IB-LBM). In this framework, the fish swimming in a viscous incompressible flow is simulated with an IB-LBM which is validated by conducting two benchmark problems including a uniform flow over a stationary cylinder and a self-propelled anguilliform swimming in a quiescent flow. Furthermore, a deep recurrent Q-network (DRQN) is incorporated with the IB-LBM to train the fish model to adapt its motion to optimally achieve a specific task, such as prey capture, rheotaxis and Kármán gaiting. Compared to existing learning models for fish, this work incorporates the fish position, velocity and acceleration into the state space in the DRQN; and it considers the amplitude and frequency action spaces as well as the historical effects. This framework makes use of the high computational efficiency of the IB-LBM which is of crucial importance for the effective coupling with learning algorithms. Applications of the proposed numerical framework in point-to-point swimming in quiescent flow and position holding both in a uniform stream and a Kármán vortex street demonstrate the strategies used to adapt to different situations.
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http://dx.doi.org/10.1038/s41598-021-81124-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7814145PMC
January 2021

Efficacy and safety of OM-85 in paediatric recurrent respiratory tract infections which could have a possible protective effect on COVID-19 pandemic: A meta-analysis.

Int J Clin Pract 2021 Jan 6:e13981. Epub 2021 Jan 6.

Hospital Infection Management Office, The Hospital of Xinjiang Production and Construction Corps, Wulumuqi, P.R. China.

Introduction: The OM-85 (Broncho-Vaxom) consumption has drawn considerable attention in the prevention of recurrent respiratory tract infections. However, it has been reported that the relationship between OM-85 consumption and recurrent respiratory tract infections is variable. This meta-analysis was performed to evaluate this relationship.

Methods: A systematic literature search up-to May 2020 was performed and 14 studies were detected with 1859 paediatric subjects, of them 890 consumed OM-85. They were reporting relationships between OM-85 consumption and recurrent respiratory tract infections. Odds ratio (OR) or mean differences (MD) with 95% confidence intervals (CIs) was calculated to evaluate the prognostic role of OM-85 consumption and recurrent respiratory tract infections using the dichotomous or continuous method with a random or fixed-effect model.

Results: OM-85 consumption was significantly related to lower frequency of respiratory tract infections (MD, -1.16; 95% CI, -1.66 to -0.65, P < .001); lower total duration of respiratory tract infections (MD, -19.51; 95% CI, -23.00 to -16.01, P < .001); lower incidence of respiratory tract infections (OR, 0.40; 95% CI, 0.21-0.77, P = .006); lower number of antibiotic courses (MD, -1.40; 95% CI, -2.63 to 0.17, P = .03); and lower antibiotic use (OR, 0.38; 95% CI, 0.29-0.52, P < .001). However, OM-85 consumption was not significantly related to adverse event rate (OR, 1.02; 95% CI, 0.52-2.03, P = .94); or to wheezing attacks frequency (MD, -0.25; 95% CI, -0.59 to 0.08, P = .14).

Conclusions: The impact of OM-85 consumption on recurrent respiratory tract infections may have a great effect as a tool to improve subjects' immunity against recurrent respiratory tract infections, which could be helpful in crucial situations, eg, COVID-19 pandemic. OM-85 non-consumers had an independent risk relationship with recurrent respiratory tract infections. This relationship forces us to recommend OM-85 consumption with those with a high risk of recurrent respiratory tract infections to avoid any possible complications.
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http://dx.doi.org/10.1111/ijcp.13981DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883224PMC
January 2021

An evolutionary systematic framework to quantify short-term and long-term watershed ecological compensation standard and amount for promoting sustainability of livestock industry based on cost-benefit analysis, linear programming, WTA and WTP method.

Environ Sci Pollut Res Int 2021 Jan 6. Epub 2021 Jan 6.

College of Resources, Environment and Materials, Guangxi University, Nanning, 530004, People's Republic of China.

In order to achieve at better water quality of a given trans-boundary river mainly contributed by high-intensive and spatially dispersed pig farming at upstream area, an effective ecological compensation system is in urgent need. In this study, an evolutionary bottom-up framework of ecological compensation system was proposed to analyze the tradeoffs of behavior among the pig farmers, government of upstream area, and government of downstream area. Shutting down pig farms, upgrading traditional piggeries to elevated bed piggeries, and adopting centralized facilities for disposing wastes from small-scale pig farms are three effective measures to control pollution from pig farming and were considered into this study. The combined use of cost-benefit analysis, linear programming, willingness to accept and willingness to pay method, and its application to a typical case of Jiuzhou River, China, showed good performance to quantify short-term and long-term watershed ecological compensation standard and amount for promoting sustainability of livestock industry. Besides, we also proposed a framework of long-term reward and punishment compensation mechanism binding upon both sides for maintaining good water quality. The proposed systematic and feasible framework of methodology has important theoretical and application significance for other similar related researches and enriched the field in paying for good water quality.
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http://dx.doi.org/10.1007/s11356-020-11769-xDOI Listing
January 2021

π-phase modulated monolayer supercritical lens.

Nat Commun 2021 Jan 4;12(1):32. Epub 2021 Jan 4.

Guangdong Provincial Key Laboratory of Optical Fiber Sensing and Communications, Institute of Photonics Technology, Jinan University, Guangzhou, 510632, China.

The emerging monolayer transition metal dichalcogenides have provided an unprecedented material platform for miniaturized opto-electronic devices with integrated functionalities. Although excitonic light-matter interactions associated with their direct bandgaps have received tremendous research efforts, wavefront engineering is less appreciated due to the suppressed phase accumulation effects resulting from the vanishingly small thicknesses. By introducing loss-assisted singular phase behaviour near the critical coupling point, we demonstrate that integration of monolayer MoS on a planar ZnO/Si substrate, approaching the physical thickness limit of the material, enables a π phase jump. Moreover, highly dispersive extinctions of MoS further empowers broadband phase regulation and enables binary phase-modulated supercritical lenses manifesting constant sub-diffraction-limited focal spots of 0.7 Airy units (AU) from the blue to yellow wavelength range. Our demonstrations downscaling optical elements to atomic thicknesses open new routes for ultra-compact opto-electronic systems harnessing two-dimensional semiconductor platforms with integrated functionalities.
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http://dx.doi.org/10.1038/s41467-020-20278-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7782844PMC
January 2021

The Two-Way Switch Role of ACE2 in the Treatment of Novel Coronavirus Pneumonia and Underlying Comorbidities.

Molecules 2020 Dec 31;26(1). Epub 2020 Dec 31.

School of Pharmacy and State Key Laboratory for the Quality Research of Chinese Medicine, Macau University of Science and Technology, Macau 999078, China.

December 2019 saw the emergence of the coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which has spread across the globe. The high infectivity and ongoing mortality of SARS-CoV-2 emphasize the demand of drug discovery. Angiotensin-converting enzyme II (ACE2) is the functional receptor for SARS-CoV-2 entry into host cells. ACE2 exists as a membrane-bound protein on major viral target pulmonary epithelial cells, and its peptidase domain (PD) interacts SARS-CoV-2 spike protein with higher affinity. Therefore, targeting ACE2 is an important pharmacological intervention for a SARS-CoV-2 infection. In this review, we described the two-way switch role of ACE2 in the treatment of novel coronavirus pneumonia and underlying comorbidities, and discussed the potential effect of the ACE inhibitor and angiotensin receptor blocker on a hypertension patient with the SARS-CoV-2 infection. In addition, we analyzed the S-protein-binding site on ACE2 and suggested that blocking hot spot-31 and hot spot-353 on ACE2 could be a therapeutic strategy for preventing the spread of SARS-CoV-2. Besides, the recombinant ACE2 protein could be another potential treatment option for SARS-CoV-2 induced acute severe lung failure. This review could provide beneficial information for the development of anti-SARS-CoV-2 agents via targeting ACE2 and the clinical usage of renin-angiotensin system (RAS) drugs for novel coronavirus pneumonia treatment.
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http://dx.doi.org/10.3390/molecules26010142DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794970PMC
December 2020

The value and implementation of routine ophthalmic examination in the era of HAART.

EClinicalMedicine 2021 Jan 22;31:100646. Epub 2020 Dec 22.

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510000, China.

Background: The high prevalence of ocular manifestations (OMs) in patients with human immunodeficiency virus (HIV) infection and chronic diseases such as diabetes has become a global health issue. However, there is still a lack of an appropriate ophthalmic diagnostic procedure for the early detection of OMs in this population, leading to the risk of an irreversible visual impairment that substantially affects the quality of life of these patients.

Methods: The Guangzhou HIV Infection Study was a retrospective study that enrolled hospitalised HIV-infected patients in Guangzhou between January 2005 and December 2016, period corresponding to the highly active antiretroviral therapy (HAART) era in China. We collected data on OMs, systemic diseases, hospitalisation, and demographic characteristics. We classified the patients into 3 groups according to the ophthalmic examination mode they underwent: the non-ophthalmologist examination group (patients hospitalised in 2005-2011 who were only treated by infectious disease physicians), the on-demand ophthalmic examination group (patients hospitalised in 2012-2013 who were referred for a consultation with an ophthalmologist), and the routine ophthalmic examination group (patients hospitalised in 2014-2016 who routinely underwent standard ophthalmic examinations). Binary logistic regression models were used to investigate the factors related to OMs.

Findings: A total of 8,743 hospitalised HIV-infected patients were enrolled. The prevalence of detected OMs were 1.5% in the non-ophthalmologist examination group, 1.9% in the on-demand ophthalmic examination group, and 12.8% in the routine ophthalmic examination group. The odds of detection of OMs were highest in the routine ophthalmic examination group (adjusted odds ratio [aOR]=9.24, [95%CI, 6.51-13.12], compared to the non-ophthalmologist examination group). The detection of all types of OMs increased substantially, with keratitis, retinitis and vascular abnormalities increased the most (by 15.8-20.0 times). In the routine examination group, patients who were older than 50 years, males, with medical insurance, and were not resident in Guangzhou, had higher odds to have OMs. Several systemic diseases also increased the odds of OMs, with the highest odds among patients with a cytomegalovirus infection (aOR=5.59, [95%CI, 4.12-7.59]). Patients with retinitis, retinopathy and conjunctivitis had higher odds of having a CD4 T cell counts less than 200 cells/μL compared to the patients that did not have these referred OMs.

Interpretation: The implementation of a routine ophthalmic examination has improved the odds of OM detection by approximately 9 times and increased the diagnosis rates of all types of OMs. Therefore, we encourage all HIV-infected patients to undergo regular ophthalmic examinations. Patients with OMs, especially retinopathy and retinitis, need to be evaluated for immune function (such as CD4 T cell counts) and systemic diseases.
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http://dx.doi.org/10.1016/j.eclinm.2020.100646DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7772547PMC
January 2021

Development and validation of a deep learning system to screen vision-threatening conditions in high myopia using optical coherence tomography images.

Br J Ophthalmol 2020 12 21. Epub 2020 Dec 21.

Centre of Precision Medicine, Sun Yat-sen University, Guangzhou, China.

Background/aims: To apply deep learning technology to develop an artificial intelligence (AI) system that can identify vision-threatening conditions in high myopia patients based on optical coherence tomography (OCT) macular images.

Methods: In this cross-sectional, prospective study, a total of 5505 qualified OCT macular images obtained from 1048 high myopia patients admitted to Zhongshan Ophthalmic Centre (ZOC) from 2012 to 2017 were selected for the development of the AI system. The independent test dataset included 412 images obtained from 91 high myopia patients recruited at ZOC from January 2019 to May 2019. We adopted the InceptionResnetV2 architecture to train four independent convolutional neural network (CNN) models to identify the following four vision-threatening conditions in high myopia: retinoschisis, macular hole, retinal detachment and pathological myopic choroidal neovascularisation. Focal Loss was used to address class imbalance, and optimal operating thresholds were determined according to the Youden Index.

Results: In the independent test dataset, the areas under the receiver operating characteristic curves were high for all conditions (0.961 to 0.999). Our AI system achieved sensitivities equal to or even better than those of retina specialists as well as high specificities (greater than 90%). Moreover, our AI system provided a transparent and interpretable diagnosis with heatmaps.

Conclusions: We used OCT macular images for the development of CNN models to identify vision-threatening conditions in high myopia patients. Our models achieved reliable sensitivities and high specificities, comparable to those of retina specialists and may be applied for large-scale high myopia screening and patient follow-up.
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http://dx.doi.org/10.1136/bjophthalmol-2020-317825DOI Listing
December 2020

Single door laminoplasty plus posterior fusion for posterior atlantoaxial dislocation with congenital malformation: A case report and review of literature.

World J Clin Cases 2020 Dec;8(23):6136-6143

Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China.

Background: Posterior atlantoaxial dislocation (PAD) is a rare type of upper cervical spine disease. We sought to describe a unreported case of old PAD with os odontoideum (OO) and atlas hypoplasia (AH) and our unique treatment approach consisting of C1 single door laminoplasty with C1-3 posterior fixation and fusion.

Case Summary: A 70-year-old male patient who suffered from progressive aggravating numbness and limb weakness for 4 years without trauma, was diagnosed with old PAD with OO and AH. The patient underwent closed reduction and C1 single door laminoplasty with C1-3 posterior fixation and fusion instead of C1 laminectomy with occipitocervical fusion. During the 3-year follow-up, he was able to walk by himself instead of using a wheelchair and with a ± 25° range of head rotation as well as a ± 10° range of flexion-extension. Three-year follow-up images showed satisfactory reduction and fusion.

Conclusion: C1 single door laminoplasty with cervical fusion in PAD combined with spinal cord compression could be a suitable and effective surgical option. Compared with laminectomy and occipitocervical fusion, it retains more cervical range of motion, has a smaller incision and provides an adequate bone grafting space for atlantoaxial fusion.
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http://dx.doi.org/10.12998/wjcc.v8.i23.6136DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7723728PMC
December 2020