circRNA-mediated upregulation of HOXC9 is correlated with poor outcome and immune microenvironment infiltrates in LUAD.

PURPOSE: To assess HOXC9 expression in non-small cell lung cancer (NSCLC) using bioinformatics analysis with experimental validation and to investigate its role and potential mechanisms in NSCLC. METHODS: Public databases were explored to investigate the gene expression, clinical outcomes, immune infiltration, and potential molecular mechanisms of HOXC9 in NSCLC. Next, HOXC9 expression levels in NSCLC were verified by RT-PCR and nucleic acid electrophoresis. In vitro experiments were performed to assess the effects of HOXC9 on proliferation, migration, and invasion of NSCLC cells. RESULTS: HOXC9 expression was increased in NSCLC and correlated with poor prognosis in lung adenocarcinoma. In addition, HOXC9 expression levels were significantly correlated with immune cell infiltration of tumors and biomarkers of immune cells. Overexpression of HOXC9 promoted NSCLC cell proliferation, migration, and invasion in vitro. Finally, the circCENPF/hsa-miR-184 axis was identified as the most promising upstream regulatory pathway of HOXC9 in lung adenocarcinoma. CONCLUSION: HOXC9 expression may reflect the prognosis and immune microenvironment infiltration in NSCLC, emerging as a potential oncogene and a new target for immunotherapy.

Anti-HMGB1 antibody is a potential characteristic autoantibody for Sjögren's syndrome.

Sjögren's syndrome (SS) is a common chronic inflammatory autoimmune disease that affects about 0.33-0.77% population in China. The positive for antinuclear antibodies (ANA) is one of the key features of SS, which shows a nuclear fine speckled (AC-4) pattern in an indirect immunofluorescent antibody test (IIFT). About 70% of ANA-positive SS patients have detectable anti-SS-A and/or SS-B antibodies, which indicates that other autoantibodies may present in SS patients. The anti-HMGB1 antibodies in 93 SS patients and 96 healthy controls were investigated with in-house developed ELISA and immunoblotting, and the locations of HMGB1 and fluorescent pattern of anti-HMGB1 antibody were investigated with IIFT. The contribution of anti-HMGB1 antibody in ANA-IF was evaluated with Cas9-induce HMGB1 knockout B16 cells. The anti-HMGB1 antibody level is higher in SS patients (9.96 ± 5.55 RU/ml) than in healthy controls (4.9 ± 1.4 RU/ml). With ROC curve analysis, when taking 8 RU/ml as the cutoff value, the sensitivity, specificity, and the area under the curve were 64.5%, 96.9%, and 0.83, respectively. A total of 18 patients (20.7%) with nuclear fine speckled (AC-4) pattern in ANA-IF test were anti-HMGB1 antibody positive only. With commercial antibody, anti-HMGB1 antibody showed the same nuclear fine speckled (AC-4) pattern. The serum from ANA-IF (+), SS-A (-), and SS-B (-) SS patients showed nuclear fine speckled (AC-4) pattern in wildtype B16 cells, but no fluorescence in HMGB1 knockout B16 cells. Anti-HMGB1 antibody may be one of the characteristic autoantibodies of SS in addition to anti-SS-A and SS-B. The detection of anti-HMGB1 antibody can provide more laboratory evidence for clinical diagnosis of SS.

HMGB1, anti-HMGB1 antibodies, and ratio of HMGB1/anti-HMGB1 antibodies as diagnosis indicator in fever of unknown origin.

To evaluate the feasibility of serum HMGB1, anti-HMGB1 antibodies, and HMGB1/anti-HMGB1 ratio as a diagnosis indicator of initial clinical classification in patients with fever of unknown origin (FUO). Ninety-four patients with classical FUO and ninety healthy controls were enrolled in this study. The subjects' clinical data and serum were collected. The serum concentration of HMGB1 was detected by a commercial HMGB1 ELISA kit, while the serum concentration of anti-HMGB1 antibodies were detected by an in-house built anti-HMGB1 antibodies ELISA kit and further confirmed by immunoblotting. According to the hospital diagnosis on discharge, ninety-four FUO patients were divided into four groups, Infectious disease subgroup, autoimmune disease subgroup, malignant tumor subgroup, and undetermined subgroup. The concentrations of HMGB1 in the infectious disease subgroup and autoimmune disease subgroup were higher than those in the malignant tumor subgroup, undetermined subgroup, and healthy control group. The concentration of anti-HMGB1 antibodies in autoimmune disease subtype group was higher than those in other subgroups as well as healthy control group. According to the distribution of HMGB1 and anti-HMGB1 in scatter plots of the patients with FUO, we found that the ratio of serum HMGB1/anti-HMGB1 is an ideal clinical indicator for differential diagnosis of different subtypes of FUO. The best cut-off was 0.75, and the sensitivity, specificity, and AUC were 66.67%, 87.32%, and 0.8, respectively. Correlation analysis showed that serum concentration of HMGB1 was moderately correlated with CRP in infectious diseases subgroup, and the serum concentration of anti-HMGB1 antibodies was strongly correlated with erythrocyte sedimentation rate in autoimmune disease subgroup. Our study had showed that serum HMGB1/anti-HMGB1 antibodies ratio can help clinicians identify FUO subtypes, thereby avoiding many unnecessary examinations and tests, and improving the effectiveness of clinical diagnosis and treatment of FUO.

Carbene modification and reversible crosslinking of silver nanoparticles for controlled antibacterial activity.

Silver nanoparticles (Ag NPs) system capable of exhibiting different particle size at different temperature was developed, which depended on the extent of Diels-Alder (DA) reaction of bismaleimide with furan. Thus, Ag NPs were functionalized on the surface by a furyl-substituted carbene through an insertion reaction. Subsequent reversible DA crosslinking achieved a controlled aggregation with different particle size, which gives a series of different antibacterial activity. These Ag NPs were characterized by Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM), X-ray Photoelectron Spectroscopy (XPS), and Nanoparticle Size Analyzer. The aggregation of the Ag NPs could be reliably adjusted by varying the temperature of DA/reverse-DA reaction. The antibacterial activity was assessed using the inhibition zone method against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus), which decreased first and then increased in agreement with the size evolution of Ag NPs. This approach opens a new horizon for the carbene chemistry to modify silver nanoparticles with variable size and give controlled antibacterial activity.

Neutrophil-lymphocyte ratio and plasma lactate predict 28-day mortality in patients with sepsis.

OBJECTIVE: The predictive potential of the neutrophil-to-lymphocyte ratio (NLR) and plasma lactate was investigated in regard to the prognosis of patients with sepsis. METHODS: Sixty-three nonsurgical and nontrauma adult patients with sepsis admitted to the intensive care unit (ICU) from September 2016 to October 2018 were consecutively included in the study. In addition, healthy subjects were assigned to a control group. Neutrophil and lymphocyte counts were evaluated via a complete blood count. Plasma lactate, procalcitonin (PCT), and C-reactive protein (CRP) levels were measured. The main outcome was 28-day mortality. RESULTS: Neutrophil-to-lymphocyte ratio and plasma lactate levels of the patients were significantly higher than those of control subjects: 19.44 (14.3-34.53) vs 14.09 (8.17-28.99), P = 0.049; and 3.7 (3-6.6) vs 2.72 (2.13-4.3) ng/mL, P = 0.008, respectively. There were no statistical differences in the concentrations of PCT and CRP between nonsurvivors and survivors: 6.1 (3.43-33.59) vs 9.43 (4.24-37.68) ng/mL, P = 0.44; and 108 (77.8-153) vs 114.5 (71.43-162) ng/mL, P = 0.672, respectively. With an optimal cutoff of 14.08, the sensitivity and specificity of NLR for prediction of 28-day mortality were 78.3% and 50%, respectively. And the sensitivity and specificity of plasma lactate level to predict 28-day mortality, at an optimal cutoff value of 2.99 mmol/L, were 82.6% and 55%, respectively. CONCLUSIONS: Neutrophil-to-lymphocyte ratio and plasma lactate were associated with poor outcomes in patients with sepsis and predicted mortality.

Clinical impact and reliability of carbonic anhydrase XII in the differentiation of malignant and tuberculous pleural effusions.

OBJECTIVE: To assess the practical utility of pleural fluid carbonic anhydrase XII (CAXII) quantification for differential diagnosis of effusions. MATERIALS AND METHODS: Fluid was collected prospectively from fifty patients presenting with lymphocytic pleural effusions for investigation and CAXII was quantified by ELISA. RESULTS: Pleural fluid CAXII concentrations were significantly higher in lung cancer patients (n=30) than in tuberculous controls (n=20). The sensitivity and specificity of this biomarker were 60%and 75%, respectively. CAXII measurement was not inferior to cytological examination in the diagnosis and exclusion of pleural effusions from lung cancer patients (sensitivity 60% vs. 57%; specificity 75% vs. 100%; positive predictive value 77%; negative predictive value 54%). In patients with negative cytology, it offered a sensitivity of 54%. CONCLUSIONS: Pleural fluid CAXII is elevated in pleural effusions from lung cancer patients. Measurement of CAXII may be used in the future as a valuable adjunct to cytology in the diagnostic assessment of patients with pleural effusions related to lung cancer, especially when cytological examination is inconclusive.