Regulation of IFP in solid tumours through acoustic pressure to enhance infiltration of nanoparticles of various sizes.

Numerous nanomedicines have been developed recently that can accumulate selectively in tumours due to the enhanced permeability and retention (EPR) effect. However, the high interstitial fluid pressure (IFP) in solid tumours limits the targeted delivery of nanomedicines. We were previously able to relieve intra-tumoural IFP by low-frequency non-focused ultrasound (LFNFU) through ultrasonic targeted microbubble destruction (UTMD), improving the targeted delivery of FITC-dextran. However, the accumulation of nanoparticles of different sizes and the optimal acoustic pressure were not evaluated. In this study, we synthesised Cy5.5-conjugated mesoporous silica nanoparticles (Cy5.5-MSNs) of different sizes using a one-pot method. The Cy5.5-MSNs exhibited excellent stability and biosafety regardless of size. MCF7 tumour-bearing mice were subjected to UTMD over a range of acoustic pressures (0.5, 0.8, 1.5 and 2.0 MPa), and injected intravenously with Cy5.5-MSNs. Blood perfusion, tumour IFP and intra-tumoural accumulation of Cy5.5-MSNs were analysed. Blood perfusion and IFP initially rose, and then declined, as acoustic pressure intensified. Furthermore, UTMD significantly enhanced the accumulation of differentially sized Cy5.5-MSNs in tumour tissues compared to that of the control group, and the increase was sevenfold higher at an acoustic pressure of 1.5 MPa. Taken together, UTMD enhanced the infiltration and accumulation of Cy5.5-MSNs of different sizes in solid tumours by reducing intra-tumour IFP.

Prognosis of infants with congenital pulmonary airway malformations after surgery: a short and mid-term evaluation.

OBJECTIVE: To investigate the postoperative pulmonary function, imaging descriptions and complications in infants with congenital pulmonary airway malformations (CPAM), and to examine the impact of different surgical resections on the prognosis of infants. METHODS: Data of 30 infants with CPAM who underwent surgery at the department of Pediatric Surgery, Guangzhou Women and Children's Medical Center from June 2021 to June 2022 were retrospectively collected and analyzed. The pulmonary function indexes of the infants during the first month and first year after surgery were analyzed to assess prognosis. Pulmonary function data from healthy individuals at similar age were collected as a control group. RESULTS: The post-operative short-term pulmonary function was recovered to a normal level in 26.7% cases of 30 CPAM infants, with a decrease in tidal volume (VT), ratio inspiratory time to expiratory time (TI/TE), time to peak tidal expiratory flow as a proportion of expiratory time (TPTEF/TE), volume to peak expiratory flow as a proportion of exhaled volume (VPEF/VE) and mean expiratory flow as a proportion of mean inspiratory flow (MEF/MIF) when compared to the control group (all P<0.01). One year after operation, 25 CPAM infants received pulmonary function tests and 52% of them had indexes at normal level. There was no statistically significant difference in results of pulmonary function test between infants who received lobectomy and those who received segmentectomy (P>0.05). The postoperative complication rate was 26.7%. CONCLUSION: Over half of CPAM infants have normalized lung function one year after operation and the choice of lobectomy and segmentectomy had no significant difference on prognosis of infants.

Strategically reducing carbapenem-resistant Acinetobacter baumannii through PDCA cycle-driven antibiotic management.

PURPOSE: With the escalating global challenge of antibiotic resistance, particularly the resistance rate of Acinetobacter baumannii, the need to rationalize carbapenem antibiotic use in clinical settings has become paramount. Our study tapped into a fishbone diagram to uncover the irrationalities in applying these antibiotics and highlight potential influencing factors. METHODS: Based on these analyses, we initiated targeted intervention strategies. A PDCA cycle-based scientific management approach was implemented through the combined efforts of our antimicrobial stewardship team and relevant departments. RESULTS: Our study showed a significant post-intervention increase in the rational use of carbapenem antibiotics (P < 0.01) and a concurrent decrease in the detection of carbapenem-resistant Acinetobacter baumannii. CONCLUSION: Our findings underscore that carbapenem usage can be effectively minimized with the continuous refinements offered by the PDCA cycle, leading to a reduction in multidrug-resistant bacteria, thus fostering rational drug use in healthcare.

The Timing of Surgery for Congenital Diaphragmatic Hernia in Infants, on or after Weaning from Extracorporeal Membrane Oxygenation: A Meta-Analysis.

OBJECTIVES: We conducted a meta-analysis of trials to determine the optimal time to conduct surgery for congenital diaphragmatic hernia (CDH) in infants, on or after weaning from extracorporeal membrane oxygenation (ECMO). METHODS: We searched the PubMed, Embase, Scopus, and Cochrane Library databases to identify relevant articles published prior to May 2023 in which surgery was performed to treat CDH in infants. Data were collected, and continuous data were represented by the mean difference (MD) and 95% confidence interval (CI). Dichotomous data were represented by the odds ratio (OR) and 95% CI. Review Manager V.5.4 and Stata were used to synthesize results and to assess publication bias. RESULTS: The results showed that infants undergoing surgery after being weaned from ECMO had reduced mortality (OR, 2.40; 95% CI, 1.23-4.69; p = 0.01) and postoperative bleeding rates (OR, 16.20; 95% CI, 5.73-45.76; p < 0.00001) and reduced ECMO duration (MD, 3.47; 95% CI, 1.89-5.05; p < 0.0001) compared with those who underwent surgery while on ECMO. There was no statistically significant difference in hospital duration (MD, 5.48; 95% CI, -8.66 to 19.62; p = 0.45) or ventilator duration (MD, -1.93; 95% CI, -8.55 to 4.68; p = 0.57). CONCLUSION: We recommend weaning patients with CDH from ECMO before performing surgery.

Association between Statin Use and Diabetes Risk in Patients with Transient Ischemic Attack.

Statin therapy can effectively reduce recurrent transient ischemic attack (TIA) risk. However, studies have reported that statin use is associated with incidence of diabetes mellitus (DM). Whether statin therapy remains associated with higher DM risk in patients with TIA remains unknown. This study investigated whether statin treatment influences incident DM risk in patients with TIA. We conducted a retrospective cohort study using the Longitudinal Health Insurance Database 2000. Participants who were newly diagnosed with TIA (ICD-9-CM code 435) from 1 January 1997 to 31 December 2011 were recruited. The Kaplan-Meier method and Cox proportional risk model of time-dependent covariance were used. We enrolled 8342 patients with newly diagnosed TIA from 1 January 1997 to 31 December 2011. Of these, 1255 patients were classified as statin users and 7087 as nonusers. During the 14-year follow-up, the incidence of newly diagnosed DM was 0.545-fold lower in the statins group compared with nonusers (95% confidence interval [CI] = 0.457-0.650). According to cumulative defined daily doses (cDDDs), the adjusted hazard ratios for DM were 0.689, 0.594, and 0.463 when patients were treated with statins at cDDDs = 28-89, 90-180, and >180, respectively. In patients with TIA, statin use is associated with a lower incident DM risk compared with the nonuse of statins.

Advances in metformin for the treatment of non-alcoholic fatty liver disease in children.

INTRODUCTION: The increased economic and social burdens for NAFLD worldwide make treating such a disease a significant public health issue. Metformin, a kind of insulin sensitizer generally used to treat type 2 diabetes, has been recently found to have efficacy on children's NAFLD in various areas such as glucolipid metabolism, intestinal bacterial metabolism, oxidative stress, and anti-inflammatory response. This article aims to provide an overview of the possible mechanisms of NAFLD in children and the potential therapeutic application of metformin. AREAS COVERED: The Cochrane Library, PubMed, Scopus, and EMBASE database was systematically searched on 12 April 2022, using the keywords metformin; non-alcoholic fatty liver disease; and children to identify similar studies. An additional search for recently published research was performed in June 2020. EXPERT OPINION: Although metformin has been proved to have an excellent therapeutic effect on children's NAFLD; we can still explore its potential impacts and mechanisms from different angles, such as combined medication. At the same time, we should also pay attention to its side effects.

Cost-effectiveness of empagliflozin as a treatment for heart failure with reduced ejection fraction: an analysis from the Chinese healthcare perspective.

Background: The effect of empagliflozin on the cardiovascular outcome is consistent in heart failure with reduced ejection fraction (HFrEF) patients regardless of the presence or absence of diabetes. More evidence is needed regarding the cost-effectiveness of empagliflozin in HFrEF patients. This study sought to evaluate the economic outcomes of adding empagliflozin to the standard treatment for HFrEF patients from the perspective of the Chinese healthcare system, and thus to provide information for decision makers. Methods: Based on the EMPEROR-Reduced clinical trial and other published literature data, the direct medical costs and quality-adjusted life years (QALYs) of patients with HFrEF over a 15-year study period were simulated by a Markov model, and the incremental cost-effectiveness ratio (ICER) was calculated. The price of empagliflozin referred to the data released by Menet, the hospitalization expenses and utility values were derived from published studies in China. A one-way sensitivity analysis and probabilistic sensitivity analysis were conducted to evaluate the robustness of the model. Results: The results of the cost-effectiveness analysis showed that the cost of the combination arm was $5,220.98, with a utility of 4.86 QALYs, and the cost of the standard arm was $4,873.96, with a utility of 4.68 QALYs, which equated to an ICER of $1,893.59 per QALY gained. The subgroup analysis showed that patients with HFrEF and diabetes in empagliflozin group had a higher QALY (4.62 vs. 4.35) and a lower cost ($5,213.28 vs. $5,958.60) than standard group. The corresponding ICER for non-diabetic patients was $2,568.15 per QALY. Deterministic sensitivity analysis showed robust results. At the willingness-to-pay threshold of 3 times gross domestic product (GDP) per capita ($31,510.57), almost all of the scattered points in three scenarios were below the threshold line. Conclusions: At a willingness-to-pay threshold of $31,510.57, adding empagliflozin to standard treatment is a very cost-effective option for HFrEF patients with or without diabetes in China.

Comparative efficiency and safety of insulin degludec/aspart with insulin glargine in type 2 diabetes: a meta-analysis of randomized controlled trials.

Recent studies have found compared with insulin glargine (IGlar), insulin degludec/aspart (IDeg/Asp) may provide adequate glycemic control and prevent hypoglycemia events in type 2 diabetes mellitus (T2DM). Consequently, we performed a meta-analysis to appraise and compare the efficiency and safety of IDeg/Asp and IGlar in the treatment of T2DM. We sought the databases including PubMed, Embase, Scopus, Cochrane library to confirm related articles which inspected the effect of IDeg/Asp versus IGlar for the treatment of T2DM until May 2021. Finally, six randomized controlled trials (RCTs) of 1,346 patients were included. The results showed that IDeg/Asp significantly decreased the mean hemoglobin A1c (HbA1c) level but was prone to serious adverse events, and IGlar increased the nocturnal confirmed hypoglycemia events. Besides, there were no significant changes in other indicators, including mean fasting plasma glucose (FPG) level, nine-point self-measured plasma glucose (SMPG) level, and adverse events. What's more, we found that there was no significant difference in the occurrence of hypoglycemia overall, but our subgroup analysis of confirmed hypoglycemia revealed the population in this subgroup (duration of diabetes ≤11 years) might has its particularity effecting the hypoglycemia outcome. Concerning efficiency, IDeg/Asp may have advantages in controlling the mean HbA1c level. Regarding safety, IGlar might increase the risk of nocturnal confirmed hypoglycemia. Further evidence is needed to compare better the efficiency and safety of IDeg/Asp versus IGlar therapy.

Non-Canonical NF-κB Signaling Stratifies LGG into Subtypes with Distinct Molecular and Cellular Characteristic and Survival Expectancy.

Introduction: NF-κB signaling is involved in a wide range of biological processes including cell proliferation, cell survival and immunity. Meanwhile, as one of the major oncogenic pathways, its upregulation has been observed in many cancer types. Compared with canonical NF-κB signaling, its non-canonical branch was much less studied in cancerous context. Methods: In this study, we leveraged multi-omics data across multiple platforms to investigate the activity of non-canonical NF-κB signaling in low-grade glioma (LGG) and explore its connection with molecular characteristics of LGG. Results: We found that non-canonical NF-κB signaling could classify LGG patients into subgroups with significant survival difference. Non-canonical NF-κB-low group enriched with oligodendroglioma featured by CIC mutations and 1p19q co-deletion. On the another hand, LGG in non-canonical NF-κB-high group showed high frequency of EGFR mutations but relatively low frequency of IDH mutations. In addition, LGG in this group reflected immunosuppressive environment characterized by high level of cytotoxic T cell exhaustion and macrophage M2 infiltration. More comprehensive evaluation implied that LGG in non-canonical NF-κB-high group reflected significantly higher immunogenicity. Through a series of feature selection technique, we developed a model that can predict the prognosis of LGG patients in a cost-effective way. Conclusion: Our analysis demonstrated the prognostic value of non-canonical NF-κB signaling in LGG. The survival difference between non-canonical NF-κB stratified groups may be explained by their distinct molecular characteristics as well as cellular context. Our prognostic model may help in offering better therapeutic strategy and clinical management.

Effects of dapagliflozin in the progression of atherosclerosis in patients with type 2 diabetes: a meta-analysis of randomized controlled trials.

AIMS: At present, an increasing number of studies are trying to determine whether dapagliflozin has a significant effect on the occurrence and development of atherosclerosis in patients with type 2 diabetes mellitus (T2DM), but there is no consensus. In addition, the former meta-analyses, relying on only a few previous studies and a minimal number of research indicators, have not been able to draw sufficient conclusions simultaneously. Consequently, we conducted a meta-analysis to evaluate the effectiveness of dapagliflozin in the occurrence and development of atherosclerosis in patients with T2DM. METHODS: We searched electronic databases (PubMed, Embase, Cochrane, and Scopus) and reference lists in relevant papers for articles published in 2011-2021. We selected studies that evaluated the effects of dapagliflozin on the risk factors related to the occurrence or development of atherosclerosis in patients with T2DM. A fixed or random-effect model calculated the weighted average difference of dapagliflozin on efficacy, and the factors affecting heterogeneity were determined by Meta-regression analysis. RESULTS: Twelve randomized controlled trials (18,758 patients) were incorporated in our meta-analysis. In contrast with placebo, dapagliflozin was associated with a significantly increase in high density lipoprotein-cholesterol (HDL-C) [MD = 1.39; 95% CI (0.77, 2.01); P < 0.0001], Δflow-mediated vasodilatation (ΔFMD) [MD = 1.22; 95% CI (0.38, 2.06); P = 0.005] and estimated Glomerular Filtration Rate(eGFR) [MD = 1.94; 95% CI (1.38, 2.51); P < 0.00001]. Furthermore, dapagliflozin had a tremendous advantage in controlling triglycerides (TG) in subgroups whose baseline eGFR < 83 ml/min/1.73m2 [MD = - 10.38; 95% CI (- 13.15, - 7.60); P < 0.00001], systolic blood pressure (SBP) [MD = - 2.82; 95% CI (- 3.22, - 2.42); P < 0.00001], HbA1c, BMI, body weight and waist circumference. However, dapagliflozin has an adverse effect on increasing total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C). Besides, there were no significant changes in other indicators, including adiponectin and C-peptide immunoreactivity. CONCLUSIONS: Our pooled analysis suggested that dapagliflozin has a terrifically better influence over HDL-C, ΔFMD, and eGFR, and it concurrently had a tremendous advantage in controlling TG, SBP, DBP, HbA1c, BMI, body weight, and waist circumference, but it also harms increasing TC and LDL-C. Furthermore, this study found that the effect of dapagliflozin that decreases plasma levels of TG is only apparent in subgroups of baseline eGFR < 83 ml/min/1.73m2, while the subgroup of baseline eGFR ≥ 83 ml/min/1.73m2 does not. Finally, the above results summarize that dapagliflozin could be a therapeutic option for the progression of atherosclerosis in patients with T2DM. Systematic review registration PROSPERO CRD42021278939.

Effect of triclosan on the pathogenesis of allergic diseases among children.

BACKGROUND: Few studies have assessed associations between allergic diseases and antibacterial agents in Taiwanese children. OBJECTIVE: This study aimed to investigate the association of triclosan (TCS) exposure with allergic diseases among preschoolers, disease-specific IgE titers, and a child's sex. METHODS: Pediatric data were obtained from the Childhood Environment and Allergic Diseases Study (CEAS; 2010) cohort, and their urine and blood samples were used to analyze TCS and IgE concentrations (age 3 group). Three years later, clinical data were obtained again from the age 3 group (age 6 group). Correlations of TCS levels at ages 3 and 6 years with IgE levels and allergic diseases were evaluated. RESULTS: The TCS levels were higher at age 3 than at age 6 (geometric mean, 1.05 ng/ml vs 0.37 ng/ml). TCS levels were positively correlated with serum IgE levels at ages 3 and 6 years. Asthma and atopic dermatitis were significantly associated with TCS (adjusted OR 1.14, 95% confidence interval [CI] 1.01-1.29; OR 1.22, 95% CI 1.05-1.41). Sex-stratified analysis revealed that TCS levels were positively correlated with IgE levels among boys in the age 6 group and significantly associated with asthma, allergic rhinitis, and atopic dermatitis among boys. SIGNIFICANCE: TCS exposure is associated with IgE levels and a potentially high risk of pediatric atopic disorders.

Application of the Ottawa Charter Five Priority Areas of Action for Public Health to an Institution-Wide Diabetes Care Promotion.

This study was the first institution-wide health promotion program in Taiwan to apply the five priority areas for taking action in public health highlighted in the Ottawa Charter for diabetes patients. We aimed to improve the quality of home care received by diabetic patients by training health care professionals in health promotion. This program consisted of developing personal skills, reorienting health services, strengthening community actions, creating supportive environments, and building healthy public policy. It was applied in the Yunlin Christian Hospital located in central Taiwan from August 2011 to November 2011. A health-promoting education course consisting of weight control, diabetes care, and quality management for diabetes was developed and applied to all 323 hospital staff. Then, hospital staff volunteers and diabetes patients were recruited to participate in the program. A total of 61 staff volunteers and 90 diabetes patients were involved in this study. Staff volunteers were trained to participate in communities to provide care and guidance to patients with diabetes. The World Health Organization Quality of Life(WHOQOL)-BREF-Taiwan Version questionnaires were investigated before and after implementation of this program for the patients. A health-promoting lifestyle profile questionnaire was filled by the staff. The investigation data were then analyzed by statistical methods. The diabetes patients experienced a significant increase in their satisfaction with health and health-related quality of life as well as significant improvements in health-promotion and self-management behaviors (p < 0.05). In addition, staff volunteers significantly consumes food from the five major groups than the other staff (p < 0.05). Various improvements in health-promoting behaviors were observed amongst the hospital staff and the diabetic patients. Our project could be a reference for other medical organizations to implement an institution-wide health-promotion program for diabetic patients.

CRISPR/Cas12a Based Rapid Molecular Detection of Acute Hepatopancreatic Necrosis Disease in Shrimp.

Acute hepatopancreatic necrosis disease (AHPND), formerly called early mortality syndrome (EMS), causes high mortality in cultured penaeid shrimp, particularly Penaeus vannamei and Penaeus monodon. AHPND is mainly caused by Vibrio species carrying the pVA1 plasmid encoding the virulence genes Photorhabdus insect-related (pir) pir VP A and pir VP B. We developed a new molecular assay that combines recombinase polymerase amplification (RPA) and CRISPR/Cas12a technology (RPA-CRISPR/Cas12a) to detect pir VP A and pir VP B, with a fluorescent signal result. The fluorescence RPA-CRISPR/Cas12a assay had a detection limit of 20 copies/µL for pir VP A and pir VP B. To improve usability and visualize RPA-CRISPR/Cas12a assay results, a lateral flow strip readout was added. With the lateral flow strip, the RPA-CRISPR/Cas12a assay had a lower limit of detection of 200 copies/µL (0.3 fmol/L). The lateral flow assay can be completed in 2 h and showed no cross-reactivity with pathogens causing other shrimp diseases. In a field test of 60 shrimp samples, the RPA-CRISPR/Cas12a lateral flow assay showed 92.5% positive predictive agreement and 100% negative predictive agreement. As the new RPA-CRISPR/Cas12a assay is rapid, specific, and does not require complicated experimental equipment, it may have important field applications for detecting AHPND in farmed shrimp.

Vitamin E in paediatric non-alcoholic fatty liver disease: a meta-analysis.

AIMS: There is currently no specific treatment for non-alcoholic fatty liver disease (NAFLD) in children, but recent studies have shown that vitamin E may be effective. Therefore, we conducted a meta-analysis of trials in which vitamin E was used to treat paediatric NAFLD. METHODS: We searched the PubMed, Embase, Scopus and Cochrane Library databases to identify related articles published prior to March 2020 that examined the effect of vitamin E for the treatment of paediatric NAFLD. RESULTS: The results showed that vitamin E significantly decreased low-density lipoprotein (LDL) and total cholesterol (TCHO) levels. However, no significant changes were found in other indicators, including body mass index (BMI), triglyceride (TG) levels, high-density lipoprotein (HLD) levels, fasting insulin levels, homeostatic model assessment (HOMA-IR), alanine transaminase (ALT) levels, aspartate aminotransferase (AST) levels, glutamate transpeptidase (GGT) levels, ballooning degeneration and fibrosis (P > 0.05). Although the P value of NAS was less than 0.05, the evidence was not strong enough. We also found that treatment with vitamin E significantly increased fasting glucose (FSG) levels if the intervention time was ≤12 months. CONCLUSIONS: Vitamin E therapy can improve blood lipids to some extent, but its effect on children's liver function and liver tissue is not apparent, and the finding that this therapy increases FSG levels still needs more research. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020177663.

Microvascular decompression for trigeminal neuralgia caused by vertebrobasilar dolichoectasia: interposition technique versus transposition technique.

BACKGROUND: Various techniques of microvascular decompression have been proposed for trigeminal neuralgia (TN) caused by vertebrobasilar dolichoectasia (VBD) with two main modalities: interposition and transposition. This retrospective study compares the outcomes of two techniques belonging to different modalities for VBD-associated TN. METHODS: From January 2011 to April 2017, 39 patients underwent MVD for VBD-associated TN. The transposition method chosen was the biomedical glue sling technique. Patients were divided into the interposition group (n = 16) and the transposition group (n = 23). The radiologic data, intraoperative findings, complications, and outcomes were analyzed. RESULTS: The 1-, 3-, and 5-year pain-free (BNI class I) maintenance rates were 100.0, 91.1, and 91.1%, respectively, in the transposition group and 87.5, 74.5, and 58.7% in the interposition group (p = 0.032). Postoperative complications were similar in both groups, but there was a trend for higher incidence of postoperative facial hypoesthesia using the interposition technique (p = 0.06). CONCLUSION: In cases of VBD-associated TN, the transposition technique using biomedical glue was superior to the traditional interposition technique in maintaining a pain-free status, with no increase in the incidence of complication.

DAP1 negatively regulates autophagy induced by cardamonin in SKOV3 cells.

Autophagy is closely related to the formation and development of multiple human tumors including ovarian cancer. As a major regulator of this process, the role of mTOR (mammalian target of rapamycin) has been well proven. Cardamonin, a kind of flavonoid from plants, has effects on induction of autophagy and thus antiproliferation of cancer cells. However, the detailed mechanism remains unclear. DAP1 (death-associated protein 1) is a proline-rich protein, which is involved in the regulation of cellular growth and programmed cell death including autophagy and apoptosis. The aim of this study was to investigate whether DAP1 is involved in proliferation inhibition and autophagy induced by cardamonin in tumor cells. Using online bioinformatics tools, we found that DAP1 expression is closely related to the survival of patients with ovarian cancer. Our study showed that autophagy induced by cardamonin was associated with mTOR inhibition, and DAP1 was involved in this process. Silence of DAP1 decreased cell proliferation but enhanced the antiproliferative effect of cardamonin in SKOV3 cells. The level of autophagy was elevated by DAP1 silencing in SKOV3 cells. Notably, cardamonin showed higher autophagy flux in the DAP1 small interfering RNA group. Taken together, our results implied that DAP1 negatively regulates autophagy induced by cardamonin, and it may be a potential target for ovarian cancer therapy.

Hyperlipidemia and Statins Use for the Risk of New Diagnosed Sarcopenia in Patients with Chronic Kidney: A Population-Based Study.

Background: Previous research found that statins, in addition to its efficiency in treating hyperlipidemia, may also incur adverse drug reactions, which mainly include myopathies and abnormalities in liver function. Aim: This study aims to assess the risk for newly onset sarcopenia among patients with chronic kidney disease using statins. Material and Method: In a nationwide retrospective population-based cohort study, 75,637 clinically confirmed cases of chronic kidney disease between 1997 and 2011were selected from the National Health Insurance Research Database of Taiwan. The selection of the chronic kidney disease cohort included a discharge diagnosis with chronic kidney disease or more than 3 outpatient visits with the diagnosis of chronic kidney disease found within 1 year. After consideration of patient exclusions, we finally got a total number of 67,001 cases of chronic kidney disease in the study. The Cox proportional hazards model was used to perform preliminary analysis on the effect of statins usage on the occurrence of newly diagnosed sarcopenia; the Cox proportional hazards model with time-dependent covariates was conducted to take into consideration the individual temporal differences in medication usage, and calculated the hazard ratio (HR) and 95% confidence interval after controlling for gender, age, income, and urbanization. Results: Our main findings indicated that patients with chronic kidney disease who use statins seem to effectively prevent patients from occurrences of sarcopenia, high dosage of statins seem to show more significant protective effects, and the results are similar over long-term follow-up. In addition, the risk for newly diagnosed sarcopenia among patients with lipophilic statins treatment was lower than that among patients with hydrophilic statins treatment. Conclusion: It seems that patients with chronic kidney disease could receive statin treatment to reduce the occurrence of newly diagnosed sarcopenia. Additionally, a higher dosage of statins could reduce the incidence of newly diagnosed sarcopenia in patients with chronic kidney disease.

The Integration of Recipes with a Standardizable Food Description FACET for Cadmium Exposure Risk Assessment.

Existing food classification and description systems provide users with limited information related to exposure assessment. Our aim in this work is to propose a standardized food description facet called the Taiwan Food Recipe (TFR) system as an emerging tool for food composition, with detailed food ingredient information, including names, proportions, weights of uncooked and cooked foods, etc. The composite foods listed in the Taiwan Nutrition and Health Survey were collected into a list and as consumption data. The TFR system is intended to help analysts reduce potential estimation bias, where, for example, risk assessment results may be overestimated or underestimated due to the complexity of the composition in the composite foods. Based on a Taiwanese food database, we further illustrate and demonstrate how the TFR system can be applied to the assessment of risk of cadmium (Cd) exposure in rice ingredients in the composite food products. In the original system (HFDFC system), the composite food intakes used total weight to estimate the hazard index (HI) of cadmium in the exposure risk assessment, but the percentage of rice was not 100%. The proposed TFR system estimates the percentage of rice and actual intakes in composite foods. Fried rice, sushi, and rice balls in the study were the most common foods containing rice and had higher consumption rates among Taiwan's rice-based composite foods. The HIs of fried rice, sushi, and rice balls were 0.09, 0.10, and 0.13, respectively, in the HFDFC system. In the TFR system, the HIs of rice in fried rice, sushi, and rice balls were 0.06, 0.04 and 0.05, respectively. The HI of other components in fried rice, sushi, and rice balls were 0.03, 0.06 and 0.08, respectively. More precise HIs were thus shown. The TFR system contributes to global food classification and description systems by providing an appropriate, standardized, and generalized framework for exposure assessments.

lncRNA-CCHE1 is involved in migration and invasion but not in proliferation of pancreatic adenocarcinoma cells possibly by interacting with ROCK1.

Cervical carcinoma high-expressed long non-coding RNA (lncRNA) 1 (lncRNA-CCHE1) serves an oncogenic role in cervical and liver cancer. The present study aimed to explore the role of CCHE1 in pancreatic adenocarcinoma. CCHE1 expression was detected by reverse transcription-quantitative polymerase chain reaction, and rho associated coiled-coil containing protein kinase 1 (ROCK1) levels were detected using an ELISA assay. Diagnostic analysis was performed by receiver operating characteristic curve analysis. The effects of CCHE1 on ROCK1 were analyzed by western blotting. Cell migration and invasion were analyzed by Transwell migration and invasion assays. The results of the present study demonstrated that, compared with healthy controls, CCHE1 and ROCK1 were upregulated in the serum of patients with metastatic pancreatic adenocarcinoma. CCHE1 overexpression distinguished patients with metastatic pancreatic adenocarcinoma from patients with non-metastatic pancreatic adenocarcinoma and healthy controls. A significant positive correlation between serum levels of CCHE1 and ROCK1 was identified in patients with metastatic pancreatic adenocarcinoma. Furthermore, CCHE1 overexpression led to upregulated ROCK1 in human pancreatic adenocarcinoma cell lines, whereas no significant effects of ROCK1 overexpression upon CCHE1 expression were identified. CCHE1 overexpression promoted the migration and invasion of human pancreatic adenocarcinoma cell lines, but no significant effects on cell proliferation were identified. ROCK1 small interfering RNA-induced silencing partially reversed the enhancing effects of CCHE1 overexpression on cancer cell migration and invasion. Therefore, lncRNA-CCHE1 may be involved in migration and invasion but not in proliferation of pancreatic adenocarcinoma cells, possibly by interacting with ROCK1.

Can Systemic Inflammatory Markers Be Used to Predict the Pathological Grade of Meningioma Before Surgery?

BACKGROUND: We sought to determine whether systemic inflammatory markers (SIMs) can be used to predict the pathological grade of meningioma before surgery. METHODS: Patients with histopathologically proven intracranial meningiomas who had undergone surgery from January 2014 to April 2018 were identified. The 14 most recent SIM levels measured before surgery were retrieved. The Mann-Whitney U test was used to determine the statistically significant differences between groups. Receiver operating characteristic curves were constructed, and the areas under the curve (AUC) were calculated to assess the diagnostic value of each biomarker. Predictive models built with biomarker pairs using logistic regression or support vector machine classifiers were used to assess their combined performance. RESULTS: A total of 672 patients with 575 and 97 low-grade and high-grade meningiomas, respectively, were investigated. Of the 14 SIMS, 7 differed significantly between the 2 meningioma groups. However, receiver operating characteristic analysis showed that none of these 7 SIMs alone could predict for the meningioma grade; the highest AUC was 0.61. Two biomarkers (erythrocyte and neutrophil/lymphocyte ratio) were incorporated into the logistic regression model; the corresponding AUC was 0.64. Moreover, 21 biomarker pairs were used to train the support vector machine classifiers; the AUCs of 6 pairs were >0.55; the maximum AUC was 0.60. CONCLUSIONS: SIMs obtained from routine preoperative laboratory testing had a limited ability to differentiate low- and high-grade meningioma in our cohort of 672 patients. Further prospective, multicenter studies with larger sample sizes are warranted to confirm this finding.