Positional dyspnea due to excessive dynamic airway collapse: A case report.

RATIONALE: Excessive dynamic airway collapse (EDAC) is a form of dynamic central airway obstruction, with characteristic of excessive dynamic invagination of airway posterior wall membrane and structurally intact airway cartilage. We report a rare case of EDAC with a marked positional component. PATIENT CONCERNS: A 73-year-old man was admitted to our hospital owing to dyspnea in right recumbent position (RRP). Also only in RRP, strong rhonchi was auscultated bilaterally through entire respiratory phase. He had gone through 3 episodes of resections on left lung due to hemoptysis caused by bronchiectasis, so he had only segment B1 + 2 and B3 left. DIAGNOSES: The spirometry results indicated that he had chronic obstructive pulmonary disease (COPD). The bronchoscopy revealed that in RRP, there was severe inward bulging of the posterior membrane of right main bronchus (RMB), which was worsened at expiratory phase. The EDAC of RMB was suspected, and was confirmed by an expiratory phase computed tomography (CT) in RRP. The EDAC was likely due to COPD, and the positional component was most likely to be caused by the removal of majority of his left lung. INTERVENTIONS: Considering locality of EDAC and his overall stability, he was given a conservative approach. He was prescribed with budesonide/glycopyrrolate/formoterol for COPD and followed up. OUTCOMES: Two months later, the patient had relived dyspnea and weaker wheezing in RRP, and he had a good social and physical recovery. LESSONS: Dyspnea may present as a diagnostic challenge, and it is rarely accompanied with a positional component. EDAC is an uncommon cause of dyspnea. This case illustrates the possible role of bronchoscopy and dynamic CT in dynamic evaluation of airway.

Hypoxia-inducible factor stabilisation-related lncRNAs in retinopathy of prematurity.

Long non-coding RNAs (lncRNAs) play an important role in the response to many diseases. The previous study reported the transcriptomes of mice that were cured of oxygen-induced retinopathy (OIR, retinopathy of prematurity (ROP) model) by hypoxia-inducible factor (HIF) stabilisation via HIF prolyl hydroxylase inhibition using the isoquinolone Roxadustat or the 2-oxoglutarateanalog dimethyloxalylglycine (DMOG). However, there is little understanding of how those genes are regulated. In the present study, 6918 known lncRNAs and 3654 novel lncRNAs were obtained, and a series of differentially expressed lncRNAs (DELncRNAs) were also identified. By cis- and trans-regulation analyses, the target genes of DELncRNAs were predicted. Functional analysis demonstrated that multiple genes were involved in the MAPK signalling pathway, adipocytokine signalling pathway was regulated by the DELncRNAs. By HIF-pathway analysis, two lncRNAs Gm12758 and Gm15283 were found that can regulate the HIF-pathway by targeting the Vegfa, Pgk1, Pfkl, Eno1, Eno1b and Aldoa genes. In conclusion, the present study provided a series of lncRNAs for further understanding and protecting the extremely premature infant from oxygen toxicity.

What is already known on this subject? Roxadustat can prevent oxygen-induced retinopathy (OIR) by two pathways: direct retinal hypoxia-inducible factor (HIF) stabilisation and induction of aerobic glycolysis or indirect hepatic HIF-1 stabilisation and increased serum angiokines. However, underlying the long non-coding RNAs (lncRNAs) that may regulate the HIF stabilisation-related genes have not been investigated thoroughly.What do the results of this study add? Six thousand nine hundred and eighteen known lncRNAs and 3654 novel lncRNAs were identified. GO and KEGG enrichment analysis showed that the MAPK signalling pathway and adipocytokine signalling pathway were regulated by the differentially expressed lncRNAs (DELncRNAs). Two lncRNAs Gm12758 and Gm15283 were found that may regulate the HIF-pathway by targeting the Vegfa, Pgk1, Pfkl, Eno1, Eno1b and Aldoa genes.What are the implications of these findings for clinical practice and/or further research? It provides a further rationale for protecting severe premature infants from oxygen poisoning.

Phosphorus adsorption by sediment considering mineral composition and environmental factors.

Sediment, composed of a complex assemblage of minerals, controls the fate and behaviour of P in aqueous environments and affects trophic status. In this study, P adsorption was studied on minerals including quartz, hematite, potassium feldspar, montmorillonite, kaolin, and calcite (i.e., the main components of sediment) and sediment from the Guanting Reservoir. A general formula for P adsorption was proposed that considers mineral composition through the component additivity method, also incorporating the effects of environmental factors, including the aqueous P concentration (Ce), pH, sediment concentration (S), and ionic strength (IS). The P adsorption capacity gradually decreased with increasing particle size, and the contributions from kaolin and montmorillonite to P adsorption were significant despite representing only a small fraction of sediment (with a maximum amount of P adsorption of 0.92 and 0.36 mg/g, respectively). The content of quartz accounted for approximately 40-60% of sediment; however, its P adsorption capacity was only 0.13 mg/g. These minerals exhibited different adsorption characteristics due to their different surface morphologies and lattice structures. Multivariable regression analysis was used to show that the amount of P adsorption was strongly correlated with Ce, followed by S, IS, and pH.

Particulate organic carbon dynamics with sediment transport in the upper Yangtze River.

Understanding the behaviour of particulate organic carbon (POC) with sediment transport allows for a more accurate estimation of global carbon cycling and the conditions of aquatic ecosystems. River damming alters POC dynamics profoundly by the retention of sediments on which organic carbon (OC) is adsorbed. In this study, we developed a mechanism-based approach to investigate organic carbon (OC) adsorption on river sediment, integrating sediment particle properties (particle size, particle density, surface site density, and particle morphology) and environmental factors (dissolved OC concentration, pH, and suspended sediment concentration). We used this approach to assess the POC concentration in the dammed upper Yangtze River and to compare it with observed POC values in literature; model results and observations correlated very well (R2 = 0.89; NSE = 0.83; p < 0.001). OC adsorption on sediment was found to correlate positively with dissolved organic carbon concentration and negatively with pH and suspended sediment concentration. We found that hydroelectric cascade development contributed to a decrease in suspended sediment concentration, with a significant increase in POC concentration both at reservoir sites, and upstream and downstream. The average suspended sediment concentration near the watershed outlet decreased from 2.08 kg m-3 (individual reservoir period) to 1.57 kg m-3 (early stage of reservoir construction/operation) and then to 0.01 kg m-3 (cascade reservoir period). In contrast, the average POC concentration in the dammed river increased from less than, or around 1%, to 1% and finally to 3% during each of these three periods, respectively. Our results highlight the pronounced impacts of cascade reservoirs on river sediment and POC dynamics. By providing a method for assessing OC adsorption on sediment and the dynamics of POC in aquatic systems, this work advances our understanding of carbon cycling in aquatic systems in times of global change.

NR3C2 gene polymorphism is associated with risk of gestational hypertension in Han Chinese women.

BACKGROUND: The influence of genetic polymorphisms on the development of gestational hypertension (GH) is unclear. The aim of this study was to examine whether single-nucleotide polymorphisms (SNPs) of the nuclear receptor subfamily 3, group C, member 2 (NR3C2) genes, rs5522, rs2070951, rs5534, s2248038, and s9992256 are associated with GH in Han Chinese women. METHOD: Sanger sequencing was used to analyze the genotypes of rs5522, rs2070951, rs5534, rs2248038, and rs9992256 loci of the NR3C2 gene in 450 patients with GH and 450 healthy controls. RESULTS: The rs5522 dominant model (odds ratio [OR] = 1.30, 95% confidence interval [CI]: 1.13-1.47, P < .001) and the recessive model (OR = 1.64, 95% CI: 1.33-1.86, P < .001) had higher GH risk. The rs2070951 dominant model (OR = 1.18, 95% CI: 1.03-1.35, P = .02) had higher risk of GH, and the recessive model (OR = 1.09, 95% CI: 0.84-1.34, P = .55) was not significant for GH risk. The rs5534 dominant model (OR = 1.25, 95% CI: 1.09-1.43, P = .001) had a higher GH risk. The rs2248038 and rs9992256 sites were not significantly related to GH risk. Gene-gene interactions at the rs5522, rs2070951, and rs5534 loci affected GH risk (OR = 1.34, 95% CI: 1.12-1.64, P < .001). CONCLUSION: The SNPs of the NR3C2 gene rs5522, rs2070951, and rs5534 are associated with GH in Han Chinese women.

Long non-coding RNA TTN-AS1 facilitates tumorigenesis of papillary thyroid cancer through modulating the miR-153-3p/ZNRF2 axis.

BACKGROUND: Long non-coding RNAs (lncRNAs) are crucial modulators in the tumorigenesis of numerous cancers, including papillary thyroid cancer (PTC). However, it is unclear whether lncRNA TTN antisense RNA 1 (TTN-AS1) can regulate PTC progression. The present study aimed to reveal the mechanism and function of TTN-AS1 in PTC. METHODS: TTN-AS1 expression in 92 pairs PTC tissues and four PTC cells was measured via a quantitative reverse transcriptase-polymerase chain reaction assay. The relationship of TTN-AS1 expression and clinical pathological features of PTC patients was analyzed using a chi-squared test. The biofunction of TTN-AS1 in PTC was identified by loss or gain-of-function assays. Based on bioinformatics analysis and mechanism experiments, the molecular mechanism of TTN-AS1 was analyzed and identified. RESULTS: A high level of TTN-AS1 was observed in PTC tissues and cells. The expression level of TTN-AS1 is possibly associated with lymphatic metastasis, TNM stage and the overall survival of PTC patients. Functionally, TTN-AS1 knockdown inhibited cell proliferation, migration, invasion and epithelial-mesenchymal transition in PTC, whereas overexpression of TTN-AS1 led to the opposite results. Mechanistically, TTN-AS1 acted as a competing endogenous RNA by sponging microRNA-153-3p (miR-153-3p) to elevate zinc and ring finger 2 (ZNRF2) expression. Additionally, a high level of TTN-AS1 in PTC was closely correlated with the activity of the phosphoinositide 3-kinase (PI3K)/Akt/mechanistic target of rapamycin (mTOR) pathway. CONCLUSIONS: The findings obtained in the present study indicate that TTN-AS1 facilitated PTC progression by regulating the miR-153-3p/ZNRF2 axis and activating the PI3K/Akt/mTOR pathway.

Efficacy of robotic radical hysterectomy for cervical cancer compared with that of open and laparoscopic surgery: A separate meta-analysis of high-quality studies.

BACKGROUND: To perform a meta-analysis of high-quality studies comparing robotic radical hysterectomy (RRH) vs laparoscopic radical hysterectomy (LRH), and open radical hysterectomy (ORH) for the treatment of cervical cancer. METHODS: A systematic search of PubMed, Embase, Cochrane Library, and Web of Science was performed to identify studies that compared RRH with LRH or ORH. The selection of high-quality, nonrandomized comparative studies was based on a validated tool (methodologic index for nonrandomized studies) since no randomized controlled trials have been published. Outcomes of interest included conversion rate, operation time, intraoperative estimated blood loss (EBL), length of hospital stay (LOS), morbidity, mortality, number of retrieved lymph nodes (RLNs), and long-term oncologic outcomes. RESULTS: Twelve studies assessing RRH vs LRH or ORH were included for this meta-analysis. In comparison with LRH, there was no difference in operation time, EBL, conversion rate, intraoperative or postoperative complications, LOS, and tumor recurrence (P > .05). Compared with ORH, patients underwent RRH had less EBL (weighted mean difference [WMD] = -322.59 mL; 95% confidence interval [CI]: -502.75 to -142.43, P < .01), a lower transfusion rate (odds ratio [OR] = 0.14, 95% CI: 0.06-0.34, P < .01), and shorter LOS (WMD = -2.71 days; 95% CI: -3.74 to -1.68, P < .01). There was no significant difference between RRH and LRH with respect to the operation time, intraoperative or postoperative complications, RLN, and tumor recurrence (P > .05). CONCLUSION: Our results indicate that RRH is safe and effective compared to its laparoscopic and open counterpart and provides favorable outcomes in postoperative recovery.

Phosphorus adsorption onto clay minerals and iron oxide with consideration of heterogeneous particle morphology.

Particle morphology plays an important role in solid-water interface adsorption, which affects the fate and behavior of phosphorus (P) in rivers and lakes and the resulting eutrophication. In this paper, three minerals including kaolinite, montmorillonite and hematite were considered to investigate the contributions of particle morphology to P adsorption using adsorption experiments and microscopic examinations. The Taylor expansion method is applied to quantitatively characterize the heterogeneity of surface morphology. The results reveal that local concave or convex micro-morphology characterized by the second order term of Taylor expansion F2, can affect the local adsorption capacity due to its effect on the distribution of surface charge and reactive sites. Moreover, the adsorbed P at different F2 here fits to a Weibull distribution, which can further define the representative average adsorption onto individual particles. A weighted average morphology factor F2a is derived to characterize the surface heterogeneity, and correlated with average P adsorption of particular mineral particles. In addition, the Sips model can successfully fit the experimental data of different minerals, and the heterogeneity parameters γ and adsorption capacity Qm in the model are proved to be functions with the basic mineral properties, including particle size, surface site density and morphology characterization as well. It is concluded that the complex surface morphology plays a significant role in particle adsorption and the morphological role need to be considered in the adsorption model in order to better describe the adsorption in system with heterogeneous solid surface.