[Surgical treatment of gastroesophageal reflux-related cough].

Gastroesophageal reflux-related cough (GERC) is an extra-esophageal manifestation of gastroesophageal reflux disease (GERD) and a common cause of chronic cough. GERC is the most difficult of the chronic cough to diagnose and treat because of its lack of specificity and its multidisciplinary nature. In recent years, research into GERC has led to a consensus on many key issues. The 2021 edition of the Guidelines for the Diagnosis and Treatment of Cough (Cough guidelines) provides important guidance on the diagnosis and treatment of GERC. However, the surgical treatment of GERC is not well covered in the Cough guidelines. This article summarizes the surgical treatment of GERC in terms of surgical methods, current situation, indications for operation and curative effects.

[Associations of metabolic score for insulin resistance with chronic kidney disease and albuminuria in the Chinese population].

Objective: To explore the relationship between metabolic score for insulin resistance (METS-IR) and chronic kidney disease (CKD) and albuminuria in the Chinese population. Methods: This cross-sectional study was conducted from January to December 2018 among residents aged 20 to 70 years in ten regions of eight provinces in China; all residents had lived in their region for more than 5 years. Various parameters were measured, included fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin (HbA1c), blood lipids, renal function, urinary albumin/creatinine ratio (UACR), etc. Data of 5 060 subjects meeting the criteria were included in the study. CKD was defined as estimated glomerular filtration rate (eGFR)<60 ml·min-1·1.73 m-2 or UACR≥30 mg/g. Albuminuria was defined as UACR≥30 mg/g. METS-IR was calculated and categorized into quartiles: Q1, METS-IR≤32.19; Q2, METS-IR 32.20-37.10; Q3, METS-IR 37.11-42.58; and Q4, METS-IR>42.58. The correlation between METS-IR and CKD and albuminuria was analyzed by binary logistic regression, and subgroup analyses were performed. Results: There were 1 266, 1 266, 1 265, and 1 263 participants included in Q1-Q4 groups, respectively. With the increase of METS-IR quartile, various parameters increased, including age, fasting blood glucose, HbA1c, triglycerides, serum uric acid, waist circumference, body mass index, and systolic and diastolic blood pressure, and the proportion of males also increased (all P<0.05). The proportion of patients with CKD and albuminuria increased significantly with the increase in interquartile range (Q) of METS-IR (all P<0.05). Logistic regression analysis showed that for every 1-unit increment of METS-IR, the risk of CKD and albuminuria were both increased by 2% [for both: odds ratio (OR)=1.02, 95% confidence interval (CI) 1.01-1.03]. Compared with the lowest METS-IR group (Q1), the ORs for CKD and albuminuria in the highest METS-IR group (Q4) were 1.57 (95%CI 1.17-2.10) and 1.46 (95%CI 1.09-1.96), respectively. In the subgroup analyses, increased METS-IR was significantly associated with CKD and albuminuria among women (CKD: OR=1.62, 95%CI 1.14-2.31; albuminuria: OR=1.53, 95%CI 1.07-2.18), individuals with HbA1c<7% (OR=1.64, 95%CI 1.21-2.23; OR=1.55, 95%CI 1.14-2.11), individuals with eGFR≥90 ml·min-1·1.73 m-2 (OR=1.78, 95%CI 1.27-2.49; OR=1.80, 95%CI 1.28-2.53), and the Chinese Han population (OR=1.56, 95%CI 1.13-2.17; OR=1.41, 95%CI 1.01-1.96). Conclusions: METS-IR is significantly associated with CKD and albuminuria in a Chinese population. Furthermore, the higher the METS-IR, the higher the risk of CKD and albuminuria.

[Clinical points of digital dental implant traction technique in mandibular reconstruction].

At present, mandibular defect repair and reconstruction is not only a simple sense of mandibular continuity restoration, but also a restoration of the physiologically positional relationship and movement balance of the upper and lower jaws. Eventually, the implantation of osseointegrated dental implants and implant-supported dental restoration should be accomplished to complete the reconstruction of the functional mandible. The technique can integrate multiple procedures such as fibular bone grafting, simultaneous dental implants and traction osteogenesis, and the perfect integration with digital technology can significantly improve the accuracy of digital dental implant traction technique. This paper will summarize and conclude the key points of the application of digital dental implant traction technique in mandibular defect reconstruction, in order to provide new ideas for the development of digital technique.

[Association between occupational hazard exposures and small airway function among middle-aged and elderly people].

Objective: To investigate the association between occupational hazard exposures and small airway function among middle-aged and elderly people. Methods: From July to December in 2015, a multistage cluster random sampling method was used to select 3 600 residents aged 40 years old and above from 6 chronic obstructive pulmonary disease surveillance points in Jiangsu province. A cross-sectional survey was conducted to collect relevant information. Multivariable linear regression model was performed to determine the relationship between occupational hazard exposures and small airway function. Results: A total of 3 347 participants were included in the final analysis, and 44.6% of participants had been exposed to occupational hazard exposures. Compared with participants without the exposure history of occupational hazards, the significantly lower post-bronchodilator FEF50%, FEF75% and MMEF levels were observed in those with the exposure history of occupational hazards (ß=-82.74, -55.43 and -91.57, respectively). Post-bronchodilator FEF75% and MMEF (ß=-51.78 and -79.47, respectively) in the participants with the exposure history of occupational dust and post-bronchodilator FEF50%, FEF75% and MMEF (ß=-96.84, -32.87 and -75.72, respectively) in the participants with the exposure history of occupational harmful gas all showed a lower level. Post-bronchodilator FEF75% was negatively associated with occupational hazard exposures in males (ßmale=-91.65 vs. ßfemale=-27.21, P for interaction=0.022). Conclusions: The small airway function is worse in the middle-aged and elderly population with the exposure history of occupational hazards, and it is more significant in the male population.

[Correlation between spatial navigation disorder and white matter hyperintensity in patients with mild cognitive impairment].

Objective: To investigate the relationship between white matter lesions and spatial navigation ability in patients with mild cognitive impairment (MCI). Methods: A total of 32 MCI patients [age (66±11) years, 16 males and 16 females] who were treated in the Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2015 to February 2018 were selected, and matched with age, gender and education level of 28 healthy controls (NC) [age (70±11) years, 19 males and 9 females] underwent spatial navigation ability test and neuropsychology scale evaluation. In the cross-sectional study, all subjects simultaneously underwent 3.0T magnetic resonance three-dimensional liquid inversion recovery sequence and high-resolution T(1) weighted imaging scan. The Wisconsin White Matter Hyperintensities Segmentation Toolbox (W2MHS) was used to automatically mark and extract the volume of the white matter hyperintensity. Results: The average error distances of egocentric virtual (P=0.002) and allocentric virtual (P=0.039) of MCI patients are greater than that of the control group, but the average error distance of mixed (allocentric-egocentric virtual) navigation had no statistic difference between two groups (P=0.070). The volume of the whole white matter hyperintensity, periventricular white matter hyperintensity, and deep white matter hyperintensity showed no significant differences between two groups (all P>0.05). Partial correlation analysis showed that after controlling for age, gender, education level and whole brain volume, the average error distance of mixed (allocentric-egocentric virtual) navigation in MCI patients was positively correlated to the volume of the whole white matter hyperintensity, deep white matter intensity, and periventricular white matter hyperintensity (r=0.469, 0.434, 0.512, all P<0.05). The average error distance of allocentric virtual navigation is positively correlated with the volume of periventricular white matter hyperintensity (r=0.403, P=0.033). There is no correlation between the average error distance of egocentric virtual navigation and the hyperintensity of white matter. Conclusions: The spatial navigation ability of patients with MCI is related to white matter lesions, which is of great significance for further research on the potential biological mechanisms affecting human spatial navigation ability.

[Characteristics of subtypes and transmission of HIV-1 infected persons among student MSM in Zhejiang province, 2013-2015].

Objective: To investigate the characteristics of subtype diversity and transmission on HIV-1 among 12 to 30 years old student MSM in Zhejiang province. Methods: A total of 290 newly diagnosed HIV infected student MSM were selected as the research objects for molecular studies on HIV, in Zhejiang province during 2013 to 2015. Data on epidemiology and plasma samples of these people were collected. HIV-1 nucleotide sequences of pol gene regions were amplified using the RT-PCR/nested PCR method and sequenced. Phylogenetic analysis was performed to determine the HIV-1 genotypes. Characteristics of transmission mode among these cases were also analyzed. Results: A total of 290 cases, 50.3% were diagnosed in Hangzhou and 81.0% had college or above degrees. 178 sequences including 10 subtypes, were obtained, with the main subtypes as CRF01_AE (49.4%, 88/178) and CRF07_BC (39.3%, 70/178). A total of 18 molecular transmission clusters were formed (42 cases, cluster size from 2 to 4), with the proportions of clusters as 23.6% (42/178). 61.9% (26/42) of student MSM with their schools located in the same district within the transmission clusters. Their sexual partners would include both student MSM and non-student MSM. The proportion of clusters among middle school students was 38.2% (13/34), higher than that of college students (20.1%, 29/144) ( χ(2)=4.996, P<0.05). Conclusions: The HIV-1 subtypes of student MSM in Zhejiang province appeared diversity, which indicated with the diversity of sources of infection. The geographical distribution of cluster cases is relatively centralized. In order to effectively control the spread of AIDS, more attention should be paid to the sexual partners involved and to specific programs on intervention.

[Reliability and validity of Stanford Presenteeism Scale (SPS-6) in Chinese occupational population].

Objective: To investigate the reliability and validity of Stanford attendance scale (sps-6) in the study of attendance among professional groups. Methods: In August, 2018, the 1455 employees from 81 workplaces in Beijing, Shanghai, Jiangsu and Guangdong were randomly investigated as the subjects. The reliability and validity of sps-6 were analyzed by using the internal consistency reliability (Cronbach's coefficient) , half split half coefficient, content validity, integration validity, discrimination validity, cluster analysis and structural validity analysis. Results: Cronbach's coefficients of sps-6 scale, working process and work results were 0.692, 0.918 and 0.907, respectively; Guttman of scales and dimensions The split half coefficients were 0.792, 0.803 and 0.794, respectively; Pearson correlation coefficients of the total score of each item and scale were 0.526-0.673 (P<0.01) ; the qualification rate of set validity and differentiation validity were 100%; the results of cluster analysis supported the theoretical basis for the formation of the scale. The general non-standard fitting index (TLI) =0.982, approximate error mean square root mean square (RMSEA) =0.071, comparative fit index (CFI) =0.990, fit goodness index (GFI) =0.987, modified fit goodness index (AGFI) =0.965, Norm fit index (NFI) =0.990. The results showed that the scale had higher structural validity, and the results of sps-6 in the occupational population were (21.36±4.04) , and the distribution was normal (deviation was 0.053, peak was 0.023) . The scores of sps-6 scale were statistically different in various charactoristics of gender, age, education level, marital status, annual income, position, position level and industry (P< 0.01) . Conclusion: Stanford attendance scale has high reliability and validity, and can be applied to the study of attendance in professional groups.

[Frailty progress and related factors in the elderly living in community: a prospective study].

Objective: To investigate frailty progress status and related factors in the elderly living in communities. Methods: A cohort of elderly people aged 65 and over in Pingyi community of Dujiangyan, Sichuan province, was established. Face-to-face questionnaire survey was conducted by trained interviewers. The frailty status, cognitive function, nutrition status and other functions of the subjects surveyed were evaluated at baseline survey and during follow-up. The socio-demographic and clinical characteristics of the subjects surveyed were assessed at baseline survey. Binary logistic regressions were used to identify factors associated with frailty progress. Results: A total of 653 elderly people were surveyed in January 2014, and 507 elderly people were followed up while 146 elderly people terminated further follow-up in January 2017. The prevalence rates of frailty and pre-frailty at baseline survey were 11.2% (n=57) and 26.2% (n=133), respectively. After 3 years, 205 subjects (40.4%) surveyed experienced frailty progress, 276 (54.5%) remained to be in frailty state at baseline survey, and 26 (5.1%) had improvement. Disability (OR=8.27, 95%CI: 1.62-42.26), visual problem (OR=2.02, 95%CI: 1.27-3.22), cognitive impairment (OR=1.94, 95%CI: 1.08-3.48), poor self-rated health (OR=1.89, 95%CI: 1.07-3.31), chronic pain (OR=1.57, 95%CI: 1.03-2.40) and older age (OR=1.12, 95%CI: 1.08-1.17) were independently associated with the progress of frailty. In contract, overweight was a protective factor (OR=0.54, 95%CI: 0.34-0.85). Conclusions: Frailty is a dynamic syndrome affected by several socio-demographic factors and geriatric factors. The results of the study can be used in the prevention of frailty progress in the elderly in communities.

Down-regulation of miR-29a facilitates apoptosis of colorectal carcinoma cell SW480 and suppresses its Paclitaxel resistance.

OBJECTIVE: PTEN can suppress PI3K/AKT activity, and regulate cell proliferation, apoptosis, and drug resistance. The previous study showed that up-regulation of miR-29a played an essential role in the occurrence of colorectal carcinoma. This study aimed to investigate the role and related mechanism of miR-29a in mediating Paclitaxel sensitivity of colorectal carcinoma cells. MATERIALS AND METHODS: Bioinformatics analysis was performed to study the existence of binding sites between miR-29a and targeting gene mRNA. Dual luciferase reporter assay was conducted to validate the targeted regulation. The expressions were compared between CCD841 CoN cells, colorectal carcinoma cell line SW480, and drug-resistant cell line SW480/Paclitaxel. Cell apoptosis and proliferation were measured by flow cytometry. In vitro cultured SW480/Paclitaxel cells were transfected with miR-29a or pcDNA3.1-PTEN. MiR-29a and PTEN expressions were measured by quantitative Reverse Transcription-Polymerase Chain Reaction (qRT-PCR) and Western blot, followed by flow cytometry on the detection of cell apoptosis as well as proliferation assay. RESULTS: A targeted regulatory relationship existed between miR-29a and PTEN. Comparing to CCD841 CoN cells, high level of miR-29a and decreasing expression of PTEN were found in SW480 cells. Moreover, further higher miR-29a and lower PTEN expressions were observed in SW480/Paclitaxel cells. Paclitaxel remarkably inhibited proliferation and facilitated apoptosis of SW480 cells but not SW480/Paclitaxel cells. Transfection of miR-29a inhibitor or pcDNA3.1-PTEN remarkably elevated PTEN expression, suppressed p-AKT expression, weakened proliferation, and enhanced apoptosis of SW480/Paclitaxel cells. CONCLUSIONS: Our data demonstrated that suppression of miR-29a enhanced PTEN expression, inhibited cancer cell proliferation, facilitated apoptosis, and weakened drug resistance, which provides academic basis for the treatment of colorectal cancer.

The association between subclass-specific IgG Fc N-glycosylation profiles and hypertension in the Uygur, Kazak, Kirgiz, and Tajik populations.

Hypertension results from the interaction of genetic and acquired factors. IgG occurs in the form of different subclasses, of which the effector functions show significant variation. The detailed differences between the glycosylation profiles of the individual IgG subclasses may be lost in a profiling method for total IgG N-glycosylation. In this study, subclass-specific IgG Fc glycosylation profile was investigated in the four northwestern Chinese minority populations, namely, Uygur (UIG), Kazak (KZK), Kirgiz (KGZ), and Tajik (TJK), composed of 274 hypertensive patients and 356 healthy controls. The results showed that ten directly measured IgG N-glycan traits (i.e., IgG1G0F, IgG2G0F, IgG2G1FN, IgG2G1FS, IgG2G2S, IgG4G0F, IgG4G1FS, IgG4G1S, IgG4G2FS, and IgG4G2N) representing galactosylation and sialylation are significantly associated with hypertension, with IgG4 consistently showing weaker associations of its sialylation, across the four ethnic groups. We observed a modest improvement on the AUC of ROC curve when the IgG Fc N-glycan traits are added into the glycan-based model (difference between AUCs, 0.044, 95% CI: 0.016-0.072, P = 0.002). The AUC of the diagnostic model indicated that the subclass-specific IgG Fc N-glycan profiles provide more information reinforcing current models utilizing age, gender, BMI, and ethnicity, and demonstrate the potential of subclass-specific IgG Fc N-glycosylation profiles to serve as a biomarker for hypertension. Further research is however required to determine the additive value of subclass-specific IgG Fc N-glycosylation on top of biomarkers, which are currently used.

[Effectiveness of self-management behavior intervention on type 2 diabetes based on self-determination theory].

OBJECTIVE: To provide autonomy support from three dimensions based on self-determination theory (SDT), i.e. professional support, peer support, family support, and to investigate whether this intervention can improve diabetes self-management behavior and glycemic control of diabetic patients, and to analyze the influencing factors of the effect. METHODS: Using convenient sampling method, three communities were selected respectively in Beijing. Each community selected health service stations with similar conditions as different intervention groups. The diabetic patients managed by the station who were eligible for inclusion were recruited into this intervention group. The community stations were divided into three groups. The routine intervention group only issued knowledge manuals and conducted health management according to the requirements of basic public health services. Peer support groups were divided into small groups and carried out doctor-led group activities. Based on doctor-led peer support activities, the doctors and peers were trained to provide autonomy support based on self-determination theory, and their family members were trained in the form of manuals to provide autonomy support, forming a concerted support of the three dimensions. Activity processes and materials were also designed based on SDT. The intervention duration was 3 months, and the main evaluation indexes were HbA1c and patients' self-management behaviors, skills, knowledge, and self-efficacy scores. RESULTS: Before and after the intervention, the HbA1c of routine intervention group were 7.40%±1.37%, 7.30%±1.18%. The HbA1c of peer support group before and after the intervention were 7.33%±1.15% and 7.13%±1.27%. The HbA1c of autonomy support group before and after the intervention were 7.42%±1.22% and 6.78%±0.80%. Before and after the intervention, the self-management score in routine intervention group was 10.54±2.28 and 10.80±2.15, the score in peer support group was 11.09±1.89 and 11.40±1.78, the score in autonomy support group was 10.34±1.99 and 11.10±1.65, respectively. The HbA1c and self-management score increased higher in autonomy support group than in the other two groups. After intervention, the control rate in autonomy support group was higher than in the other two groups. According to the multi-factor analysis, the value of HbA1c after intervention was positively related to the baseline HbA1c, and negatively related to self-management behavior. The value in autonomy support group was higher than in routine intervention group. Baseline self-management behavior, self-efficacy, knowledge, skill, family support, autonomy support, peer support and age were positively correlated with the change of behavior. CONCLUSION: self-management behavior intervention based on self-determination theory can effectively promote self-management behavior and glycemic control of diabetic patients, and the effect is better than single peer support activities.

[Effect of frailty syndrome on falls in Chinese elderly diabetics in the communities: a prospective cohort study].

Objective: To explore the relationship between frailty syndrome and falls in the elderly diabetics, in the communities. Methods: A three-year cohort study involving 653 community-dwelling adults who were over 65 years of age and participated in the Survey of Disease, Psychological and Social Needs in Dujiangyan Pingyi Community. Diabetic patients would include those who self-reported as having histories of diabetes or on anti-hyperglycemic therapies. Frailty, functional and other geriatric status were assessed respectively. Falls was defined as having had multiple falls or at least one event but with injury. Results: The highest prevalence of falls was found in the group of frail diabetic group (62.5%). Data showed that baseline frailty was associated with falls in both diabetic and non-diabetic groups but the odds ratio in the diabetic group was higher than that of the non-diabetic group (OR=3.87, 95%CI: 1.45-10.28 vs. OR=6.68, 95%CI: 1.14-38.99). Conclusion: Frailty could be used as a strong clinical predictor to prevent falls, for the elderly diabetic Chinese living in the communities.

Carbon monoxide releasing molecule-2 suppresses proliferation, migration, invasion, and promotes apoptosis in non-small cell lung cancer Calu-3 cells.

OBJECTIVE: Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, which is the leading cause of cancer-related morbidity and mortality worldwide. The carbon monoxide-releasing molecules (CO-RMs) are transition metal carbonyls with the capacity to release carbon monoxide (CO). The aims of our study were to assess the effects and underlying mechanisms of CO-releasing molecules-2 (CORM-2) on proliferation, migration, invasion and apoptosis in NSCLC cells, and to evaluate its potential application for lung cancer. MATERIALS AND METHODS: NSCLC cells Calu-3 were treated with CORM-2, negative control and blank control. Cell proliferation, migration and invasion were assessed by cell Counting Kit-8 (CCK-8), scratch assay and matrigel invasion chamber experiment, respectively. Apoptosis was measured by flow cytometry. Real-time PCR and Western blot were applied to examine the expression of apoptosis-related molecules on mRNA and protein levels. RESULTS: CORM-2 markedly attenuated proliferation, migration and invasion of Calu-3 cells. CORM-2 treatment also significantly reduced the ratio of B cell lymphoma 2 (Bcl-2)/B cell lymphoma 2 associated X protein (Bax) while increased expression of caspase-3 and cytochrome c. The optimal dose of CORM-2 for Calu-3 cells was 100 µM. CONCLUSIONS: CORM-2 modulates biological functions of NSCLC cells and may provide a novel therapeutic strategy for lung cancer.

The productions of atrial natriuretic peptide and arginine vasopressin in small cell lung cancer with brain metastases and their associations with hyponatremia.

OBJECTIVE: Hyponatremia is one of the most frequently encountered electrolyte disorder in small cell lung cancer (SCLC) patients. It was shown that some SCLC cell lines could produce atrial natriuretic peptide (ANP) and arginine vasopressin (AVP). The aim of the study was to assess the secretion of ANP, AVP and their relative contributions to hyponatremia in SCLC patients, especially in patients with brain metastases. PATIENTS AND METHODS: In total, 194 SCLC patients including 51 patients with brain metastases were collected. The levels of ANP and AVP were measured with radioimmunoassay kits. And then their associations with serum sodium were investigated. The progression-free survival (PFS) was compared between the hyponatremia group and the normal serum sodium group. RESULTS: Serum sodium was negatively correlated with the plasma levels of ANP (r=-0.171, p=0.017) and AVP (r = -0.244, p=0.001) in all SCLC patients. In the brain metastatic subgroup, there was also a negative correlation between serum sodium and ANP (r=-0.399, p=0.004), while there was no correlation between serum sodium and AVP (r=-0.232, p=0.101). The occurrence rate of hyponatremia (serum sodium values below 135 mmol/l) in patients with brain metastases (21/51, 41.18%) was higher than that in patients without brain metastases (37/143, 25.87%) (p=0.040). The progression-free survival (PFS) in the hyponatremia group was significantly shorter than that in patients of the group without hyponatremia (p=0.010). Moreover, compared with patients which regained normal serum sodium after the treatment, the PFS of patients still with hyponatremia after the treatment was significantly shorter (p=0.049). CONCLUSIONS: ANP might play a leading role in the formation of hyponatremia of SCLC patients with brain metastases. Correcting hyponatremia timely and appropriately could improve SCLC patients' prognosis.

[To evaluate the clinicopathologic characteristics and outcome of tumor cells spreading through air spaces in patients with adenocarcinoma of lung].

Objective: To investigate the clinicopathologic features, molecular characteristics and prognosis of spread through air space (STAS) in patients with adenocarcinoma of the lung. Methods: Two hundred and eighty-eight lung adenocarcinoma patients with complete clinicopathologic and follow-up data were included. The patients were divided into STAS positive (178 cases) and negative (110 cases) groups.EGFR and KRAS gene mutations were detected by amplification refractory mutation system (ARMS), and ALK and ROS1 gene fusion were detected by fluorescence in situ hybridization method. The relationship between STAS and clinicopathologic, molecular features, and patient outcome was analyzed. Results: STAS was present in 61.8%(178/288) of lung adenocarcinomas. The positive rate of STAS in tumors >3 cm was significantly higher than that in tumors ≤3 cm (P=0.009), and was significantly higher in tumors with pleural invasion (P<0.01), venous invasion (P<0.01), lymphatic invasion (P<0.01), perineural invasion (P=0.029) and tumors with necrosis (P<0.01). STAS was also correlated with tumor recurrence (P<0.01) and advanced pathologic TNM stage (P=0.002). There was no significant correlation with patients' gender, age and smoking history. Histologically, STAS was present in 58.0%(91/157), 67.6%(50/74), 2/6, 64.3%(27/42) and 8/9 of acinar, papillary, lepidic, solid and micropapillary adenocarcinomas, respectively. In addition, the positive rates of STAS in tumor with micropapillary (>5%) and without micropapillary pattern were 80.9%(55/68) and 55.9%(123/220), respectively (P<0.01). STAS was significantly higher in EGFR negative group (P=0.034), ALK gene rearrangement group (P=0.003) and ROS1 gene rearrangement group (P=0.012), but there was no significant correlation with KRAS mutation. Univariate survival analysis showed that patients with STAS had a shorter progression-free survival (PFS, P<0.01) and overall survival (P=0.013). Multivariate analysis confirmed that STAS was an independent predictor of PFS in lung adenocarcinoma patients (HR: 2.749, 95%CI: 1.550-4.876, P=0.001). Conclusions: The presence of STAS in lung adenocarcinoma suggests high risk of recurrence and invasion and is thus an important prognostic factor. In addition, STAS is associated with EGFR mutation, ALK and ROS1 gene rearrangement.

Long non-coding RNA CARLo-5 upregulation associates with poor prognosis in patients suffering gastric cancer.

OBJECTIVE: Accumulating evidence has demonstrated that microRNAs (miRNAs) play critical roles in cancer initiation and development. The present study aims to explore the clinical significance of long noncoding RNA CARLo-5 (CARLo-5) in gastric cancer. PATIENTS AND METHODS: CARLo-5 expression in normal gastric tissue, gastric cancer were quantified by Quantitative reverse transcription PCR. The relationship between CARLo-5 expression and the clinical features of gastric cancer was assessed. Kaplan-Meier method with log-rank test was applied to compare survival curves. The univariate and multivariate Cox regression models were employed to evaluate the prognostic value of the CARLo-5 expression in overall survival (OS) and relapse-free survival (RFS). RESULTS: We observed that the relative expression of CARLo-5 in gastric cancer tissues was significantly higher than that of their matched adjacent normal tissues (p < 0.001). High CARLo-5 expression was found to be closely correlated with advanced T stage (p = 0.003), positive distant metastasis (p = 0.009), lymph node involvement (p = 0.001), and poor differentiation (p = 0.001). Furthermore, Kaplan-Meier analysis demonstrated that gastric cancer patients with high CARLo-5 expression had poorer OS (p < 0.001) and RFS (p < 0.001). Finally, univariate and multivariate Cox analysis indicated that high CARLo-5 expression were independent predictors for both OS and RFS. CONCLUSIONS: Our findings implicated that CARLo-5 could be considered promising biomarkers for prognosis of gastric cancer.

A Strategy for Quality Control of Menispermum dauricum DC Based on Cytotoxic Activity and HPLC Fingerprint Analysis.

The rhizome of Menispermum dauricum DC known as a traditional Chinese medicine, with high content of alkaloids, has been found to possess antitumor activity. In this research, an attempt to correlate fingerprinting with bioactivity was made for quality control of M. dauricum. Firstly, the cytotoxicity of extracts from ten batches of samples against human breast MCF-7 cancer cells was estimated by [3-(4, 5-dimethylthiazole-2-yl)-2, 5-diphenyltetrazoliumbromide] assay. Then, cytotoxic activity-integrated fingerprints were established by high performance liquid chromatography. Eight peaks were selected as the common peaks to evaluate the similarities of samples and hierarchical clustering analysis was used to identify and classify different samples into groups. Assays for determinations of total alkaloids and dauricine contents enabled cytotoxicity coefficient of each extract. The potential usefulness of employing cytotoxicity coefficient was investigated by a combination of Pearson correlation coefficients and multiple linear regression analysis as being the reliable parameter to evaluate the herbal extracts. The results indicated that the level of dauricine (peak 8 in the fingerprint) correlated closely with cytotoxicity and played a significant role in the cytotoxicity of Bei Dou-Gen and could be related to its antitumor properties. It is proposed that the cytotoxicity coefficient value with a cytotoxic activity-integrated fingerprint of key biomarkers (dauricine) may be useful indicators to adopt for the quality control of M. dauricum. The analysis of cytotoxic-activity-integrated fingerprint could correlate fingerprinting with bioactivities and would provide a reasonable strategy for quality control of complex mixture of herbal medicines.

Characterization of the Microbial Communities in the Ant Lion Euroleon coreanus (Okamoto) (Neuroptera: Myrmeleontidae).

Euroleon coreanus (Okamoto) is widely distributed in China, and the larval stage can be treated as traditional Chinese medicine. However, the host-bacterium relationship remains unexplored, as there is a lack of knowledge on the microbial community of ant lions. Hence, in the current study, we explored the microbial community of the larval ant lion E. coreanus using Illumina MiSeq sequencing. Results indicated that a total of 10 phyla, 126 genera, and 145 species were characterized from the second instars of E. coreanus, and most of the microbes were classified in the phylum Proteobacteria. Cronobacter muytjensii was the most abundant species characterized in the whole body and gut of E. coreanus, and the unclassified species in the genera Brevundimonas and Lactobacillus were relatively more abundant in the head and carcass. In addition, no Wolbachia-like bacteria were detected, whereas bacteria like Francisella tularensis subsp. Holarctica OSU18 and unclassified Rickettsiella were first identified in ant lion E. coreanus.