Endoscopic mucosal resection-precutting vs conventional endoscopic mucosal resection for sessile colorectal polyps sized 10-20 mm.

BACKGROUND: The optimal method to remove sessile colorectal lesions sized 10-20 mm remains uncertain. Piecemeal and incomplete resection are major limitations in current practice, such as endoscopic mucosal resection (EMR) and cold or hot snare polypectomy. Recently, EMR with circumferential precutting (EMR-P) has emerged as an effective technique, but the quality of current evidence in comparative studies of conventional EMR (CEMR) and EMR-P is limited. AIM: To investigate whether EMR-P is superior to CEMR in removing sessile colorectal polyps. METHODS: This multicenter randomized controlled trial involved seven medical institutions in China. Patients with colorectal polyps sized 10-20 mm were enrolled and randomly assigned to undergo EMR-P or CEMR. EMR-P was performed following submucosal injection, and a circumferential mucosa incision (precutting) was conducted using a snare tip. Primary outcomes included a comparison of the rates of en bloc and R0 resection, defined as one-piece resection and one-piece resection with histologically assessed clear margins, respectively. RESULTS: A total of 110 patients in the EMR-P group and 110 patients in the CEMR group were finally evaluated. In the per-protocol analysis, the proportion of en bloc resections was 94.3% [95% confidence interval (CI): 88.2%-97.4%] in the EMR-P group and 86% (95%CI: 78.2%-91.3%) in the CEMR group (P = 0.041), while subgroup analysis showed that for lesions > 15 mm, EMR-P also resulted in a higher en bloc resection rate (92.0% vs 58.8% P = 0.029). The proportion of R0 resections was 81.1% (95%CI: 72.6%-87.4%) in the EMR-P group and 76.6% (95%CI: 68.8%-84.4%) in the CEMR group (P = 0.521). The EMR-P group showed a longer median procedure time (6.4 vs 3.0 min; P < 0.001). No significant difference was found in the proportion of patients with adverse events (EMR-P: 9.1%; CEMR: 6.4%; P = 0.449). CONCLUSION: In this study, EMR-P served as an alternative to CEMR for removing nonpedunculated colorectal polyps sized 10-20 mm, particularly polyps > 15 mm in diameter, with higher R0 and en bloc resection rates and without increasing adverse events. However, EMR-P required a relatively longer procedure time than CEMR. Considering its potential benefits for en bloc and R0 resection, EMR-P may be a promising technique in colorectal polyp resection.

Analysis of the Influence of Comprehensive Nursing Intervention on Vital Signs and Negative Emotions of Patients with Gastrointestinal Polyps Treated by Digestive Endoscopy.

This research sets out to elucidate the influence of comprehensive nursing intervention (CNI) on vital signs (VSs) and negative emotions (NEs) of patients with gastrointestinal polyps treated by digestive endoscopy. To address this, from January 2020 to February 2021, 92 cases of gastrointestinal polyps treated by digestive endoscopy in the Yuyao People's Hospital of Zhejiang Province were partitioned into two different groups: the control group (CG; n = 46) intervened by routine nursing intervention, and the research group (RG; n = 46) treated by CNI based on routine care. The VSs, NEs, time of first postoperative exhaust and defecation, early food intake, length of stay (LOS), quality of life (QOL), nursing satisfaction, and the incidence of postoperative complications were compared between groups. When entering the operating room, elevated systolic/diastolic (SBP/DBP) was observed in CG compared with RG (P < 0.05) while there was no statistical difference in SBP/DBP in RG before intervention and when entering the operating room (P > 0.05). Statistically, less time of first exhaust and defecation as well as LOS and early food intake were observed in RG (P < 0.05). The HAMA and HAMD scores declined in both arms postintervention, and the decrease was more obvious in RG (P < 0.05). After intervention, the scores of various domains of GQOLI-74 elevated in both arms, and the increase was more obvious in RG (P < 0.05). RG also showed a lower total complication rate and a higher degree of nursing satisfaction than CG (P < 0.05). CNI for patients with gastrointestinal polyps treated by digestive endoscopy can obviously relieve their anxiety and depression, with stable VSs, short LOS, and low incidence of complications.

Application of difficult endotracheal intubation under fluoroscopy in otorhinolaryngology head and neck surgery.

PURPOSE: Thyroid cancer, laryngeal cancer and retrosternal goiter are common diseases of head and neck, which often causes difficulty breathing and dyspnea. However, it is usually hard to use conventional methods to deal with this problem. The purpose of this study was to evaluate the safety and effectiveness of an interventional technique for difficult endotracheal intubation (DEI) caused by head and neck diseases. METHODS: We retrospectively analyzed the clinical data of 35 patients who underwent an interventional technique for difficult endotracheal intubation and evaluated the efficacy of this approach and observe postoperative pulse oxygen saturation (SpO2), Hugh-Jones grade, and complications. RESULTS: The procedures were successfully completed in all patients who underwent DEI. The technical and clinical success rate of the procedures was 100%. The average procedure duration was 3.2 ± 1.1 min (range 1-5 min). The patients' postoperative SpO2 and Hugh-Jones grade improved, and dyspnea symptoms resolved. There were no serious EI-related complications. CONCLUSIONS: Interventional EI under fluoroscopy is a safe, simple, and fast method for accurate intubation and an effective method for DEI; furthermore, it allows for subsequent clinical treatment.

[Clinical analysis of 17 cases of sarcomatoid carcinoma of head and neck].

Objective:The aim of this study is to investigate the pathological features, treatment and prognosis of sarcomatoid carcinoma of head and neck. Methods:The clinical data of 17 patients with sarcomatoid carcinoma of the head and neck treated in the First Affiliated Hospital of Zhengzhou University from September 2013 to September 2020 were retrospectively analyzed, and the pathological characteristics, treatment and follow-up were summarized. Kaplan-Meier method was used to calculate the overall survival rate. Results:The histopathological examination of all patients showed the coexistence of cancer components and sarcoma components, and there was a transitional transition area between them. In terms of treatment, 12 of the 17 patients received surgical treatment, and 5 patients received palliative treatment because they could not tolerate surgery or distant metastasis; The cumulative 1-year, 3-year and 5-year survival rates of 17 patients with head and neck sarcomatoid carcinoma calculated by Kaplan-Meier method were 64.7%, 26.5%, and 13.2%, respectively. Conclusion:Pathological examination of head and neck sarcomatoid carcinoma is the gold standard for diagnosis. Radical surgery is the first choice for treatment. It has a high degree of malignancy and poor prognosis. Early diagnosis and radical surgery can improve the survival rate of patients to a certain extent.

Circular RNA ITCH attenuates the progression of nasopharyngeal carcinoma by inducing PTEN upregulation via miR-214.

BACKGROUND: Circular RNA itchy E3 ubiquitin protein ligase (circ-ITCH) has previously been reported to play a key role in carcinogenesis. Nevertheless, the role of circ-ITCH in nasopharyngeal carcinoma (NPC) remains to be explored. METHODS: Gene expression analysis was performed using a quantitative real-time polymerase chain reaction, western blotting and immunohistochemistry. The role of circ-ITCH in NPC was explored using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide, colony formation, transwell invasion, scratch healing and xenograft tumor assays. Furthermore, luciferase reporter assay was carried out to assess the interactions among circ-ITCH, microRNA-214 (miR-214) and phosphatase and tensin homolog (PTEN). RESULTS: The levels of circ-ITCH and PTEN were decreased, whereas the level of miR-214 was increased in NPC tissues collected from 28 subjects compared to normal nasopharynx tissues collected from 15 subjects. Moreover, a negative correlation between circ-ITCH and miR-214 expression and a positive correlation between circ-ITCH and PTEN expression were observed in NPC tissues. Downregulation of circ-ITCH expression was also observed in NPC cell lines. In addition, upregulation of circ-ITCH markedly inhibited NPC cell proliferation, migration and invasion. Furthermore, circ-ITCH was confirmed to exert its function by sponging miR-214. PTEN was found to be a direct target gene of miR-214 and its expression was negatively correlated with miR-214 expression in NPC tissues. Moreover, our results showed that the circ-ITCH/miR-214 axis regulated NPC proliferation, migration and invasion through regulating the expression of PTEN. Upregulation of circ-ITCH or PTEN blocked miR-214-mediated promotion of NPC tumorigenesis in vitro. Additionally, upregulation of circ-ITCH also suppressed NPC tumorigenesis in vivo. CONCLUSIONS: The present study demonstrated that circ-ITCH suppressed NPC tumorigenesis by upregulating PTEN expression through interacting with miR-214, thus proposing a novel mechanism for NPC inhibition.

Artificial intelligence-assisted colonoscopy: A prospective, multicenter, randomized controlled trial of polyp detection.

BACKGROUND: Artificial intelligence (AI) assistance has been considered as a promising way to improve colonoscopic polyp detection, but there are limited prospective studies on real-time use of AI systems. METHODS: We conducted a prospective, multicenter, randomized controlled trial of patients undergoing colonoscopy at six centers. Eligible patients were randomly assigned to conventional colonoscopy (control group) or AI-assisted colonoscopy (AI group). AI assistance was our newly developed AI system for real-time colonoscopic polyp detection. Primary outcome is polyp detection rate (PDR). Secondary outcomes include polyps per positive patient (PPP), polyps per colonoscopy (PPC), and non-first polyps per colonoscopy (PPC-Plus). RESULTS: A total of 2352 patients were included in the final analysis. Compared with the control, AI group did not show significant increment in PDR (38.8% vs. 36.2%, p = 0.183), but its PPC-Plus was significantly higher (0.5 vs. 0.4, p < 0.05). In addition, AI group detected more diminutive polyps (76.0% vs. 68.8%, p < 0.01) and flat polyps (5.9% vs. 3.3%, p < 0.05). The effects varied somewhat between centers. In further logistic regression analysis, AI assistance independently contributed to the increment of PDR, and the impact was more pronounced for male endoscopists, shorter insertion time but longer withdrawal time, and elderly patients with larger waist circumference. CONCLUSION: The intervention of AI plays a limited role in overall polyp detection, but increases detection of easily missed polyps; ChiCTR.org.cn number, ChiCTR1800015607.

Comparative analysis of differences between preoperative endoscopic biopsy and postoperative pathological examination for diagnosis of gastric intraepithelial neoplasia.

OBJECTIVE: This study was performed to compare the differences between preoperative endoscopic biopsy (PEB) and postoperative pathological examination (PPE) for diagnosis of gastric intraepithelial neoplasia (GIN). METHODS: From September 2016 to July 2019, 188 consecutive patients with GIN at Yuyao People's Hospital were retrospectively analyzed. The 188 patients had 218 GIN lesions. All patients underwent PEB and either endoscopic submucosal dissection or surgical treatment. PPE was performed on pathological tissues that had been surgically removed. RESULTS: Among 138 cases of low-grade dysplasia (LGD) diagnosed by PEB, 46 were upgraded to high-grade dysplasia (HGD), 20 were upgraded to early gastric cancer (EGC), and 2 were downgraded to inflammation after PPE. Among 42 cases of HGD, 23 were upgraded to EGC, 2 were downgraded to LGD, and 2 were downgraded to inflammation after PPE. Among 38 cases of EGC, 1 was downgraded to HGD and 2 were downgraded to LGD after PPE. The original diagnosis was maintained after the operation in 120 cases of GIN. CONCLUSION: Biopsy did not fully reflect the lesions of GIN. Biopsy review should be actively performed, and the lesions should be clarified by endoscopic submucosal dissection or surgery.

Comparison of application value between conventional air insufflation and water infusion in colonoscopy.

OBJECTIVE: To discuss the feasibility of water infusion colonoscopy and its difference with traditional air insufflation colonoscopy in application value. METHODS: A prospective randomized controlled clinical study was designed to include 200 patients who underwent sedation-free diagnostic colonoscopy. Among them, 100 patients were treated with water infusion colonoscopy (observation group) and 100 patients were treated with air insufflation colonoscopy (control group). All operations were performed independently by the same experienced physician. The differences in colonoscopy related values, colon adenoma detection rate, and follow-up findings between the patients of two groups were compared. RESULTS: There was no significant difference in the Boston bowel preparation scale (BBPS) score of the left hemicolon, transverse colon, right hemicolon, total BBPS scores, and bubble amount between the two groups (P>0.05). In the observation group, the scope-forward time, the time to reach the ileocecal junction, and the total operation time were significantly longer than that of the control group (P<0.01). The proportion of patients in whom the ileocecal junction was successfully reached was significantly higher in the observation group. The intraoperative abdominal pain visual analog scale (VAS) score, abdominal distension VAS score, the proportion of postural change, and the proportion of abdominal compression were all significantly lower in the observation group (P<0.05). There were no significant differences in the endoscope hardness adjustment rate, the scope withdrawal time, total detection rate of adenomas, and the size or location of colon adenomatous lesions between the two groups (P>0.05). Compared with control group, the incidence of abdominal pain and VAS scores were significantly lower in the observation group (P<0.05), and the willingness of patients to perform colonoscopy again was significantly higher (P<0.01). CONCLUSION: Patients' tolerance and examination satisfaction are significantly better when using water infusion colonoscopy compared with traditional air insufflation colonoscopy, but the operation times are longer.

Inhibition of Histone Deacetylation by MS-275 Alleviates Colitis by Activating the Vitamin D Receptor.

BACKGROUND: Ulcerative colitis [UC] is a common chronic inflammatory bowel disease without curative treatment. METHODS: We conducted gene set enrichment analysis to explore potential therapeutic agents for UC. Human colon tissue samples were collected to test H3 acetylation in UC. Both in vivo and in vitro colitis models were constructed to verify the role and mechanism of H3 acetylation modification in UC. Intestine-specific vitamin D receptor [VDR]-/- mice and VD [vitamin D]-deficient diet-fed mice were used to explore downstream molecular mechanisms accordingly. RESULTS: According to the Connectivity Map database, MS-275 [class I histone deacetylase inhibitor] was the top-ranked agent, indicating the potential importance of histone acetylation in the pathogenesis of UC. We then found that histone H3 acetylation was significantly lower in the colon epithelium of UC patients and negatively associated with disease severity. MS-275 treatment inhibited histone H3 deacetylation, subsequently attenuating nuclear factor kappa B [NF-κB]-induced inflammation, reducing cellular apoptosis, maintaining epithelial barrier function, and thereby reducing colitis activity in a mouse model of colitis. We also identified VDR as be a downstream effector of MS-275. The curative effect of MS-275 on colitis was abolished in VDR-/- mice and in VD-deficient diet-fed mice and VDR directly targeted p65. In UC patients, histone H3 acetylation, VDR and zonulin-1 expression showed similar downregulation patterns and were negatively associated with disease severity. CONCLUSIONS: We demonstrate that MS-275 inhibits histone deacetylation and alleviates colitis by ameliorating inflammation, reducing apoptosis, and maintaining intestinal epithelial barrier via VDR, providing new strategies for UC treatment.

Downregulated long non-coding RNA SNHG7 restricts proliferation and boosts apoptosis of nasopharyngeal carcinoma cells by elevating microRNA-140-5p to suppress GLI3 expression.

Long non-coding RNAs (lncRNAs) have been proposed to correlate with various carcinomas, yet the role of lncRNA SNHG7 in nasopharyngeal carcinoma (NPC) is hardly studied. This study intends to examine the molecular mechanism of SNHG7 on NPC cells. The NPC tissues and nasopharyngeal tissues of mild inflammation of nasopharyngeal mucosa were obtained. SNHG7, miR-140-5p, and GLI3 mRNA and protein expression in tissues and in the CNE1, HONE1, C666-1, CNE2, and normal NP69 cell lines was detected. IC50 and the protein expression of related drug-resistant genes of CNE2 and CNE2/DDP cells were determined. Proliferative ability, cell colony formation rate, cell cycle, and apoptosis of CNE2 and CNE2/DDP cells were also detected. SNHG7, miR-140-5p, and GLI3 mRNA and protein expression in CNE2 and CNE2/DDP cells in each group was detected. SNHG7's cell localization, the binding sites of SNHG7 and miR-140-5p along with miR-140-5p and GLI3 were detected. Overexpressed SNHG7 and GLI3, and underexpressed miR-140-5p were found in NPC tissues and cells. SNHG7 silencing and miR-140-5p elevation declined the drug resistance of drug-resistant NPC cells and their parent cells, restrained NPC cell colony formation ability and proliferation, and boosted cell apoptosis. SNHG7 specially bound to miR-140-5p, and SNHG7 silencing elevated miR-140-5p expression. GLI3 was a direct target gene of miR-140-5p and miR-140-5p elevation diminished GLI3 expression. MiR-140-5p inhibition reversed the impacts of SNHG7 silencing on NPC cells. In summary, our study reveals that downregulated SNHG7 restricts GLI3 expression by upregulating miR-140-5p, which further suppresses cell proliferation, and promotes apoptosis of NPC.

Convolutional neural network for the diagnosis of early gastric cancer based on magnifying narrow band imaging.

BACKGROUND: Magnifying endoscopy with narrow band imaging (M-NBI) has been applied to examine early gastric cancer by observing microvascular architecture and microsurface structure of gastric mucosal lesions. However, the diagnostic efficacy of non-experts in differentiating early gastric cancer from non-cancerous lesions by M-NBI remained far from satisfactory. In this study, we developed a new system based on convolutional neural network (CNN) to analyze gastric mucosal lesions observed by M-NBI. METHODS: A total of 386 images of non-cancerous lesions and 1702 images of early gastric cancer were collected to train and establish a CNN model (Inception-v3). Then a total of 341 endoscopic images (171 non-cancerous lesions and 170 early gastric cancer) were selected to evaluate the diagnostic capabilities of CNN and endoscopists. Primary outcome measures included diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value. RESULTS: The sensitivity, specificity, and accuracy of CNN system in the diagnosis of early gastric cancer were 91.18%, 90.64%, and 90.91%, respectively. No significant difference was spotted in the specificity and accuracy of diagnosis between CNN and experts. However, the diagnostic sensitivity of CNN was significantly higher than that of the experts. Furthermore, the diagnostic sensitivity, specificity and accuracy of CNN were significantly higher than those of the non-experts. CONCLUSIONS: Our CNN system showed high accuracy, sensitivity and specificity in the diagnosis of early gastric cancer. It is anticipated that more progress will be made in optimization of the CNN diagnostic system and further development of artificial intelligence in the medical field.

Limonin enhances the radiosensitivity of nasopharyngeal carcinoma cells via attenuating Stat3-induced cell stemness.

The inhibitory effects of limonin have been disclosed in various tumors, however, its roles in nasopharyngeal carcinoma (NPC) progression are never been revealed. In the current work, we collected NPC cells with a higher stemness compared with bulk cells through isolating the side population (SP) cells. It was found that limonin exhibited a stronger inhibitory effect on SP cells than that in bulk cells, which was evident by a lower IC50 value. Additionally, limonin attenuated the stemness and migration ability of SP cells with the higher stemness, characterized as decreasing the spheroid formation ability, expression of stemness markers and migration ability. Moreover, the proportion of SP cells in G0 phase was remarkably higher than that in bulk cells. Notably, upon limonin treatment, the proportion of SP cells in G0 was decreased and S/G2/M increased. Furthermore, limonin enhanced the radiosensitivity of NPC cells. The mechanistic studies based on RNA-sequencing analysis revealed that limonin inhibited the gene transcription driven by Stat3 (signal transducer and activator of transcription 3) and an activator of Stat3 (Colivelin or IL-6) rescued the inhibitory effects of limonin. Therefore, these results demonstrate that limonin could reduce the stemness of NPC cells and thus the radiosensitivity through suppressing Stat3 transcriptional activity.

Evaluation of endoscopic coblation treatment for obliteration of congenital pyriform sinus fistula.

BACKGROUND: Congenital pyriform sinus fistula is a very rare branchial apparatus malformation. Conventional open surgery for fistulectomy might fail to excise the lesion completely, leading to continual recurrence. The aim of this study was to provide an innovative endoscopic coblation technique for patients with pyriform sinus fistula and evaluate its intermediate-term effectiveness. METHODS: Retrospective case series with 112 patients (age range 3-36 years) between 2013 and 2016 and underwent endoscopic coblation of the sinus fistula. Data collected including patient demographics, presenting symptoms, diagnostic methods, prior and subsequent treatments, length of hospital stay, and recurrence were analyzed. RESULTS: Of the 112 cases, there were no postoperative complications observed except temporary reddish swelling in three patients. Four cases were lost to follow-up. Of 108 patients, 106 experienced no recurrence after their first endoscopic coblation of the sinus tract. The remaining two patients with recurrence in the follow-up were ultimately treated with recoblation without complications or further recurrences. Also, Endoscopic coblation can be used to treat seven patients with recurrence who had experienced open resection. In our series, median follow-up period was 1.5 years. CONCLUSION: Endoscopic coblation is an effective approach for most patients. We advocate using this minimally invasive technique as first line of treatment for pyriform sinus fistula.

[Expression and significance of p-Stat3 and its downstream gene c-myc in laryngeal squamous cell carcinoma tissue and cell line].

OBJECTIVE: To detect the expressions of p-Stat3 and c-myc in human laryngeal squamous cell carcinoma (LSCC) tissue and Hep2 cell line, and to find the relationship between them. METHOD: Immunohistochemistry was used to detect the expressions of p-Stat3 and c-myc in 60 cases of LSCC and 30 cases of vocal cord polyp tissue. The protein levels of p-Stat3 and c-myc in Hep2 cell line was determined by immunocytochemistry. Western blotting was used to determine the protein levels of p-Stat3 and c-myc in Hep2 after treating with different concentrations of Stattic. RESULT: The positive rates of p-Stat3 and c-myc were 65% and 70% in the LSCC tissue, compared with that in the vocal cord polyp tissue, with significant difference (P < 0.05). The expression of p-Stat3 in LSCC tissue was associated with that of c-myc (r = 0.273, P < 0.05). The protein levels of p-Stat3 and c-myc were detected in the Hep2 cell line. Stattic inhibited Stat3 phosphorylation and c-myc in the Hep2 cell line in a concentration-dependent manner. CONCLUSION: p-Stat and c-myc were up regulated in the tissue of laryngeal squamous cell carcinoma and the Hep2 cell line. Stattic inhibits the constitutively active p-Stat3 signaling pathway, and downregulats the expression of c-myc. The strong constitutive p-Stat3 signaling pathway in LSCC makes p-Stat3 a target for the development of novel therapeutic strategies.

Probiotic supplementation does not improve eradication rate of Helicobacter pylori infection compared to placebo based on standard therapy: a meta-analysis.

This meta-analysis included eligible randomized controlled trials (RCTs) with the aim of determining whether probiotic supplementation can improve H. pylori eradication rates. PUBMED, EBSCO, Web of Science, and Ovid databases were searched. We included RCTs that investigated the effect of combining probiotics, with or without a placebo, with standard therapy. A total of 21 RCTs that reported standard therapy plus probiotics were included. Compared to the placebo group, the probiotics group was 1.21(OR 1.21, 95% CI: 0.86, 1.69) and 1.28 (OR 1.28, 95% CI: 0.88, 1.86) times more likely to achieve eradication of H. pylori infection in intent-to-treat (ITT) analysis and per protocol (PP) analysis, respectively. Probiotics with triple therapy plus a 14-day course of treatment did not improve the eradication of H. pylori infection (OR 1.44, 95% CI: 0.87, 2.39) compared to the placebo. Moreover, the placebo plus standard therapy did not improve eradication rates compared to standard therapy alone (P = 0.816). However, probiotics did improve the adverse effects of diarrhea and nausea. These pooled data suggest that the use of probiotics plus standard therapy does not improve the eradication rate of H. pylori infection compared to the placebo.

Prevalence and Predisposing Factors for Depressive Status in Chinese Patients with Obstructive Sleep Apnoea: A Large-Sample Survey.

BACKGROUND AND OBJECTIVE: Recently, there are few studies reporting on depressive status and obstructive sleep apnoea (OSA) in China. A large-sample survey was to be performed to explore the prevalence of depressive status and related factors in Chinese patients with OSA. METHODS: From among a randomly-selected group of OSA patients, 1,327 met inclusion criteria. After screening with the Symptom Checklist 90 (SCL-90) and Self-Rating Depression Scale (SDS), patients were assigned to OSA without depressive status (control group, n = 698) and OSA with depressive status (n = 629) groups. Using chi-squared testing, the correlation analyses between the depressive status and OSA patient demographic and clinical variables were tested. Then depression-related risk factors in OSA patients were analysed using stepwise linear regression analysis. The effects of family and social factors on depressive status in OSA patients were investigated using Mann-Whitney U (one of nonparametric test). RESULTS: The prevalence of depressive status was 47.4% in OSA patients. Depressive status was significantly associated with female gender, single status, Family Burden Scale of Disease (FBS), Family APGAR Index (APGAR), apnoea-hypopnea index (AHI), and Perceived Social Support Scale (PSSS). Stepwise linear regression analysis further indicated that single status, hypoxemia, APGAR, AHI, PSSS, AHI, and FBS were all risk factors for depressive status in OSA patients. The total of the FBS score and three of its sub-factors scores (family daily activities, family relationships and mental health of family members) were higher, and the total of the APGAR score and two of its sub-factors scores (adaptability and affection) were lower in OSA with depressive status compared with the control group. Besides, the total score for the PSSS and scores for its two sub-factors (family support and social support) were all lower in OSA patients with depressive status than those of the control group. CONCLUSIONS: Depressive status has high comorbid rate in Chinese OSA patients and is significantly associated with single status, apnoea-hypopnea index, hypoxemia, family and social supports.

Construction and identification of small hairpin RNA plasmids targeting neuropilin-1 gene and their inhibitory effect on human nasopharyngeal carcinoma CNE-2Z cell proliferation in vitro and in vivo.

We observed the effects of small hairpin RNA (shRNA) plasmids targeting neuropilin-1 (NRP-1) gene on human nasopharyngeal carcinoma (NPC) CNE-2Z cell growth in vitro and in vivo. Three fluorescein-labeled shRNA eukaryotic expression vectors targeting NRP-1 gene, including pSilencer-shRNA1, pSilencer-shRNA2 and pSilencer-shRNA3 were constructed. The three plasmids were, respectively, transfected into human NPC CNE-2Z cells. The most effective plasmid was injected into xenograft tumors in nude mice. The sequencing for these recombinant plasmids was consistent with that of designed shRNA templates. Green fluorescence was seen in the transfected CNE-2Z cells and xenograft tumors in nude mice. MTT assay indicated that CNE-2Z cell proliferation was significantly inhibited. PT-PCR and Western blot displayed that both mRNA and protein of NRP-1 gene were all decreased, particularly in the cells treated with shRNA3. At the end of the experiment, xenograft tumors in plasmid group (0.599 ± 0.002 cm(3)) were significantly inhibited with a tumor inhibition rate of 48.6 %, as compared to those in negative (1.141 ± 0.013 cm(3)) and blank control groups (1.165 ± 0.308 cm(3)) (all P < 0.05). shRNA targeting NRP-1 gene can effectively inhibit human NPC CNE-2Z cell proliferation in vitro and in vivo. This provides an experiment basis for NPC gene therapy.

Uric acid regulates hepatic steatosis and insulin resistance through the NLRP3 inflammasome-dependent mechanism.

BACKGROUND & AIMS: Hyperuricemia significantly increases risk of non-alcoholic fatty liver disease (NAFLD) and insulin resistance. However, the mechanisms responsible for this association are as yet unclear. This study aimed to investigate the effects and underlying mechanisms of uric acid on development of NAFLD and insulin resistance. METHODS: We initially analyzed the impact of uric acid on the development of hepatic steatosis and insulin resistance in mice and in two cell models, HepG2 and L02. Subsequently, we studied the role of the NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome in uric acid-induced fat accumulation and insulin signaling impairment. RESULTS: We found that uric acid directly induces hepatocyte fat accumulation, insulin resistance, and insulin signaling impairment both in vivo and in vitro. We also found that uric acid-induced NLRP3 inflammasome activation, whereas lowering uric acid by allopurinol inhibited NLRP3 inflammasome activation in a high fat diet mouse model of NAFLD. Moreover, knocking down NLRP3 expression significantly attenuated uric acid-induced fat accumulation both in HepG2 cells and L02 cells. Knocking down NLRP3 expression also rescued uric acid-induced insulin signaling impairment in both cell types. CONCLUSIONS: Uric acid regulates hepatic steatosis and insulin resistance through the NLRP3 inflammasome. Uric acid may be a new therapeutic target for NAFLD and insulin resistance.

[NRP-1/shRNA silencing suppresses nasopharyngeal carcinoma cell growth in vitro and in vivo].

OBJECTIVE: To investigate the effect of RNA interference (RNAi) targeting NRP-1 gene on the growth and proliferation of nasopharyngeal carcinoma (NPC) CNE-2Z cells. METHODS: Short hairpin RNA (shRNA) plasmids targeting NRP-1 were designed and synthesized. These plasmids were respectively transfected into human NPC CNE-2Z cells and xenograft tumors in nude mice. The expressions of Fluorescein-labeled plasmids in NPC CNE-2Z cells and xenograft tumors were observed by fluorescence microscopy. Cell proliferation was detected by MTT assay. The inhibitory effects on target genes were evaluated with RT-PCR and Western blotting, respectively. The inhibitory effect of plasmids with the most effective sequence on xenograft tumors in nude mice was observed. RESULTS: CNE-2Z cell proliferation was significantly inhibited by NRP-1/shRNA silencing. RT-PCR showed NRP-1 mRNA expression was significantly decreased. Western blotting demonstrated the NRP-1/shRNA silencing can effectively inhibit the expression of target proteins in CNE-2Z cells. After six weeks, there were significant differences in the mean tumor volumes in nude mice between plasmid group and negative control group [(0.599±0.002) vs (1.141±0.013) cm(3), P<0.05] or blank control group [(0.599±0.002) vs (1.165±0.308) cm(3), P<0.05], and the inhibitory rate of tumor growth was 48.6%. CONCLUSION: RNA interference targeting NRP-1 can remarkably inhibit the growth of CNE-2Z cells in vitro and in vivo.