The importance of analyzing the serum C3-epimer level for evaluating vitamin D storage in some special populations.

OBJECTIVE: The serum 25-hydroxyvitamin D [25(OH)D] is recommended by various management agencies for evaluating the nutritional status of vitamin D (VitD). However, 25(OH)D cannot reflect the actual composition and activity of VitD in vivo. This study used UPLC-MS/MS to detect the levels of serum VitD metabolites in some special populations, so as to clarify its importance in accurately evaluating VitD storage in vivo. SUBJECTS AND METHODS: A total of 2029 subjects were enrolled, including 1204 cases in minor health (MH), 467 in the minor disease (MD), 119 in the adult health (AH) and 239 in adult disease (AD). Serum VitD2 and VitD3 levels were measured by UPLC-MS/MS. Serum C3-epi concentrations were also measured in 144 subjects by a spot check method. RESULTS: There were significant differences in the levels of VitD2, VitD3 and 25(OH)D among groups (all p <0.001). According to serum level of 25(OH)D, percentage of subjects with sufficient VitD in the MH, MD, AH and AD group were 65.4%, 52.7%, 29.4% and 20.9%, respectively. After converting VitD2 activity to AVitD3, subjects with sufficient VitD in MH, MD, AH and AD group accounted for 53.2%, 40.9%, 17.7% and 11.3%, respectively. C3-epi levels in the MH (z = 7.49, p <0.001), MD (z = 7.03, p <0.001) and AD group (z = 4.68, p <0.001) were higher than that in the AH group. CONCLUSIONS: Not only the serum 25(OH)D level, but also the simultaneous detection of VitD2 and VitD3 levels will overestimate the VitD storage in some subjects. Accurate evaluation of VitD storage in these individuals also requires detection of C3-epi levels.

LncRNA HOXA11-AS promotes cell growth by sponging miR-24-3p to regulate JPT1 in prostate cancer.

OBJECTIVE: Long noncoding RNA (lncRNA) was found to play crucial roles in regulating cancer progression. HOXA11 antisense RNA (HOXA11-AS) was reported to serve an oncogenic lncRNA in cancers but its role in prostate cancer (PCa) remains to be explored. MATERIALS AND METHODS: Expression levels of HOXA11-AS in PCa tissues and cells were analyzed with quantitative Real-Time PCR method. MTT assay, colony formation assay, transwell invasion assay, and flow cytometry assay were conducted to explore the biological roles of HOXA11-AS in PCa. Rescue experiments were conducted to investigate mechanisms of HOXA11-AS in regulating PCa progression. RESULTS: We revealed that HOXA11-AS was upregulated in PCa. Silencing of HOXA11-AS significantly inhibited PCa cell proliferation, colony formation, invasion, and promoted apoptosis in vitro. On the contrary, forcing of HOXA11-AS expression caused opposite effects on cancer cell behaviors. Furthermore, we showed that HOXA11-AS1 serves as a competing endogenous RNA (ceRNA) to regulate Jupiter microtubule associated homolog 1 (JPT1) via sponging microRNA-24-3p (miR-24-3p). Functionally, the overexpression of miR-24-3p or knockdown of JPT1 could partially reverse the effects of HOXA11-AS overexpression on PCa cell behaviors. CONCLUSIONS: This newly identified HOXA11-AS/miR-24-3p/JPT1 axis may provide novel angle for the better control of PCa.

Developmental toxicity of cryptotanshinone on the early-life stage of zebrafish development.

Cryptotanshinone (Cry) has multiple potential functions in treating different diseases. Most studies on Cry focus on its pharmacological effects and mechanisms, but toxicological reports on Cry are rare. Zebrafish is used as a model organism in drug development as it saves costs and time. This work aimed to investigate the toxicity of Cry on zebrafish. Results showed that growth retardation, pericardial edema, and scoliosis occurred when zebrafish embryos were exposed to Cry, indicating its teratogenic effects. Cell apoptosis was observed in the brainstem area of embryos using acridine orange staining, and qPCR showed that caspase-3 was increased in Cry-exposed embryos. The results of locomotor activity and touched-evoke escape reaction experiments showed that Cry significantly reduced the swimming speed and escape reaction time of larvae.

Expression and significance of miR-223 in rats with pulmonary fibrosis.

OBJECTIVE: To explore the expression and significance of miR-223 in mice with pulmonary fibrosis. MATERIALS AND METHODS: The rats were separated into a control group (n=15), a sham operation group (n=15), and a model group (n=45) (which was then divided into a 3-day group, a 7-day group, and a 14-day group, with 15 rats in each group). The rat model of pulmonary fibrosis was established. The rats in the model group were injected with bleomycin solution, while those in the control group and sham operation group were given the same operation and injected with the same amount of normal saline. After observing the pulmonary function indexes of the rats on the 3rd, 7th and 14th days after modeling, the rats were sacrificed by cervical dislocation, the pulmonary inflammation and fibrosis of the rats were observed, and the HYP (hydroxyproline) content and miR-223 expression level were determined. Pearson correlation analysis was employed to analyze the correlation between miR-223 and HYP. RESULTS: The pulmonary inflammation score of the model group was significantly higher than that of the sham group and the control group, and the pulmonary inflammation of the model group significantly increased with the increase of time (p<0.05). The pulmonary fibrosis score in the model group was markedly higher than that in the rest two groups, and the pulmonary fibrosis in the model group elevated significantly with the passage of time (p<0.05). The relevant pulmonary function indexes of the model group rats were significantly lower than those of the other two groups, and the pulmonary function of the model group rats gradually decreased with time (p<0.05). As to the HYP, it presented notably higher content in the model group than in the remaining two groups, and its content in the model group rats increased significantly with time (p<0.05). The expression of miR-223 decreased with the increase of fibrosis (p<0.05), and the expression level of miR-223 was negatively correlated with the HYP content (p<0.05). CONCLUSIONS: MiR-572 targeted CDH1 to promote cell metastasis in WT by suppressing EMT.

Age distribution of human papillomavirus infection and neutralizing antibodies in healthy Chinese women aged 18-45 years enrolled in a clinical trial.

OBJECTIVES: Data from clinical trials of human papillomavirus (HPV) vaccines showed that women naïve (negative for both type-specific antibodies and DNA) to vaccine types would derive benefit from vaccination; therefore, an understanding of the proportion of naïve women in different age groups is important for developing HPV vaccination strategies. METHODS: From November 2012 to April 2013, a total of 7372 healthy women aged 18-45 years were recruited in five provinces in China. Cervical specimens and serum samples were collected for each woman at entry. Cervical specimens were first tested by the HPV DNA enzyme immunoassay method; if positive, the specimens were then tested by reverse hybridization line probe assay and HPV-16 and HPV-18 specific polymerase chain reactions. Neutralizing antibodies against HPV-16 or HPV-18 were tested with a pseudovirion-based neutralization assay. RESULTS: The overall prevalence of high-risk HPV DNA was 14.8% (1088/7367, 95% CI 14.0-15.6), and the seroprevalence of neutralizing antibodies against HPV-16 and HPV-18 was 12.6% (925/7367) and 4.9% (364/7367), respectively. In younger women (18-26 years) and middle-aged women (27-45 years), 83.8% (3116/3719) and 81.4% (2968/3648) were naïve to both HPV-16 and HPV-18 (both neutralizing antibodies and DNA were negative), respectively. In addition, 98.5% (3664/3719) and 98.0% (3575/3648) of the younger or middle-aged women were naïve to at least one HPV type (HPV-16 or HPV-18). DISCUSSION: This study revealed that the majority of Chinese women aged 18-26 years and 27-45 years were naïve to both HPV-16 and HPV-18 and would thus derive full benefit from bivalent HPV vaccination.

Simvastatin alleviates inflammation and oxidative stress in rats with cerebral hemorrhage through Nrf2-ARE signaling pathway.

OBJECTIVE: To investigate the regulatory effects of simvastatin on the inflammation and oxidative stress in rats with cerebral hemorrhage through the nuclear factor E2-related factor 2-antioxidant response element (Nrf2-ARE) signaling pathway. MATERIALS AND METHODS: A total of 120 healthy male rats weighing 280-300 g and 7-8 weeks old were selected to establish the traumatic brain injury (TBI) model. Rats were divided into group A (trauma operation, n=30), group B (no treatment, n=30), group C (drug administration after trauma operation, n=30), and group D (no trauma operation, drug administration, n=30). Cerebral edema content in brain tissues was measured by calculating the dry and wet weight. Neurological dysfunction was scored using the Garcia method. Positive levels of the Toll-like receptor 4 (TLR4) and interleukin-1ß (IL-1ß) were qualitatively analyzed via immunohistochemistry. Protein levels of TLR4 and IL-1ß were quantitatively analyzed via Western blotting. Moreover, the brain injury volume and neuronal apoptosis were evaluated via Nissl staining and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining, respectively. At 48 h after injury, activities of superoxide dismutase (SOD), reduced glutathione (GSH), and oxidized glutathione (GSSG) in brain tissues were detected, and levels of malondialdehyde (MDA) and nitric oxide (NO) were detected using the enzyme activity assay kits. Finally, relative levels of the Nrf2-ARE signaling pathway and its downstream molecules heme oxygenase-1 (HO-1) and NAD (P)H dehydrogenase, quinone 1 (NQO1) were detected via reverse Transcription-Polymerase Chain Reaction (RT-PCR) and Western blotting. RESULTS: Compared with those in group B, cerebral edema content in brain tissues significantly increased (p<0.05), the neurological dysfunction score significantly declined (p<0.05), and protein levels of TLR4 and IL-1ß were significantly upregulated in group A (p<0.05). In group C, relative levels of TLR4 and IL-1ß were down-regulated, cerebral edema content decreased, and the neurological dysfunction score significantly increased (p<0.05). After 48 h, activities of SOD, reduced GSH and GSSG and levels of MDA and NO all increased, and levels of MDA and NO declined in group C (p<0.05). Western blotting and RT-PCR showed that simvastatin could increase the transcriptional level of Nrf2. After simvastatin intervention, expression levels of downstream molecules HO-1 and NQO1 were upregulated. CONCLUSIONS: Simvastatin alleviates TLR4-mediated inflammatory injury, promotes neurological recovery and resists oxidative stress through the Nrf2-ARE signaling pathway, thus exerting a neuroprotective effect in TBI.

MicroRNA-23b suppresses cervical cancer biological progression by directly targeting six1 and affecting epithelial-to-mesenchymal transition and AKT/mTOR signaling pathway.

OBJECTIVE: To elucidate the effects and mechanism of microRNA-23b (miR-23b) in cervical cancer (CC) progression. PATIENTS AND METHODS: Fifty-six pairs of CC tissue samples and matched para-carcinoma tissue samples were collected. Meanwhile, human normal cervical epithelial cell and CC cell lines were cultured. The abilities of cell proliferation and migration were detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assays and transwell assays. The correlation between sine oculis homeobox 1 (six1) and miR-23b was clarified by dual-luciferase reporter assay. The relative protein and mRNA expression were detected by quantitative real-time polymerase chain reaction (qRT-PCR), immunohistochemistry (IHC) and Western blot. In addition, Xenograft tumor formation assay was performed in this study. RESULTS: MiR-23b was remarkably down-regulated in CC and the low miR-23b expressions were associated with the poor prognosis and worse OS of CC patients. Additionally, the functional assays demonstrated that miR-23b overexpression obviously repressed CC cell proliferation, invasion and migration abilities through the regulation of the AKT/mTOR pathway and the epithelial-to-mesenchymal transition (EMT) progress. Moreover, the luciferase reporter assay indicated that six1 was one functional target for miR-23b in CC cells, indicating that the inhibitory functions of miR-23b in CC cells were partially regulated by six1. Moreover, miR-23b restoration could prominently repress tumor growth in vivo. CONCLUSIONS: MiR-23b suppressed CC progression via directly targeting six1 and affecting AKT/mTOR signaling pathway as well as EMT progress. Therefore, miR-23b/six1 may be promising biomarkers for CC diagnosis and therapy.

Effect of miR-130a on neuronal injury in rats with intracranial hemorrhage through PTEN/PI3K/AKT signaling pathway.

OBJECTIVE: The aim of this study was to investigate the effect of micro-ribonucleic acid (miR)-130a on neuronal injury in rats with intracerebral hemorrhage (ICH) through the phosphatase and tensin homolog deleted on chromosome ten/phosphatidylinositol 3-hydroxy kinase/protein kinase B (PTEN/PI3K/AKT) signaling pathway. MATERIALS AND METHODS: A total of 30 healthy male rats were randomly divided into three groups, including the blank control group, ICH model group (ICH group) and ICH model + miR-130a treatment group (miR-130a treatment group). The differences in neurological injury, the number of apoptotic cells in brain tissues, the activity of Caspase-9 and protein expressions of PTEN/PI3K/AKT were analyzed among the three groups, respectively. RESULTS: Neurological function was normal without injury in the control group. However, the neurological injury was severe in the ICH group and mild in the miR-130a treatment group. There were statistically significant differences in neurological function in the control group relative to those of the ICH group and miR-130a treatment group (p<0.05). Meanwhile, the neurological injury was markedly milder in the miR-130a treatment group than that of the ICH group, showing a statistically significant difference (p<0.05). The number of apoptotic cells was remarkably smaller in the control group when compared with the ICH group and miR-130a treatment group. However, it was markedly larger in the ICH group than that of the miR-130a treatment group, showing significant differences (p<0.05). The activity of Caspase-9 was significantly lower in the control group than ICH group and miR-130a treatment group (p<0.05). However, it increased remarkably in the ICH group compared with that of the miR-130a treatment group (p<0.05). Moreover, the protein level of PTEN in the ICH group was significantly higher than control group and miR-130a treatment group, displaying statistically significant differences (p<0.05). However, no marked difference in the protein level of PTEN was observed between the control group and miR-130a treatment group (p>0.05). The protein levels of the phosphorylated 3-hydroxy kinase (p-PI3K) and phosphorylated protein kinase B (p-AKT) were remarkably lower in the ICH group than those of the control group and miR-130a treatment group, displaying statistically significant differences (p<0.05). However, they were remarkably higher in the miR-130a treatment group than that of the control group (p<0.05). CONCLUSIONS: MiR-130a promotes neuronal growth in brain tissues in ICH rats and alleviates neuronal injury after ICH through the PTEN/PI3K/AKT signaling pathway. Our findings suggest that miR-130a exerts important clinical significance in the treatment of ICH.

Correlations of insulin resistance and HbA1c with cytokines IGF-1, bFGF and IL-6 in the aqueous humor of patients with diabetic cataract.

OBJECTIVE: The study aimed to investigate the correlations of insulin resistance and hemoglobin A1c (HbA1c) with cytokines [insulin-like growth factor 1 (IGF-1), basic fibroblast growth factor (bFGF) and interleukin-6 (IL-6)] in the aqueous humor of patients with diabetic cataract. PATIENTS AND METHODS: 59 patients with diabetic cataract and 58 patients with simple cataract treated in Jining No. 1 People´s Hospital (Jining, China) from January 2017 to February 2018, were selected randomly. The levels of homeostasis model assessment of insulin resistance (HOMA-IR) and HbAlc, as well as IGF-1, bFGF and IL-6 in the aqueous humor were compared between the two groups. The correlations of HOMA-IR and HbAlc with IGF-1, bFGF and IL-6 were analyzed. In control group, the levels of HOMA-IR and HbAlc, as well as IGF-1, bFGF and IL-6 in the aqueous humor were significantly lower than those in observation group (p<0.05). RESULTS: Compared with the group with HbAlc ≤ 7%, the groups with HbAlc ≥ 9% and 7%

MicroRNA-495 inhibits the progression of non-small-cell lung cancer by targeting TCF4 and inactivating Wnt/ß-catenin pathway.

OBJECTIVE: Different effects of microRNA-495 (miR-495) on human cancers have been exhibited in recent years. However, the specific function of miR-495 remains uncertain in non-small-cell lung cancer (NSCLC). Thus, we aim to explore the role of miR-495 in NSCLC. PATIENTS AND METHODS: The expressions of miR-495 and transcription factor 4 (TCF4) were detected through quantitative Real-time polymerase chain reaction (qRT-PCR) assay. Western blot was used to measure the protein expression of relative genes. The relationship between miR-495 and TCF4 was testified by the dual-luciferase reporter gene assay. The function of miR-495 was investigated through cell counting kit-8 (CCK-8) assay and transwell assay. RESULTS: MiR-495 was downregulated in NSCLC tissues. Overexpression of miR-495 inhibited the migration, invasion and proliferation of NSCLC cells. Further, TCF4 was a direct target gene of miR-495. TCF4 was highly expressed in NSCLC tissues. In addition, miR-495 inhibited the progression of NSCLC through targeting TCF4. Furthermore, miR-495 inhibited EMT and Wnt/ß-catenin pathway in NSCLC. CONCLUSIONS: MiR-495 inhibited the progression of NSCLC by targeting TCF4 and inactivating Wnt/ß-catenin pathway.

Effects of normal lymphatic fluid on rats with sepsis complicated with lung injury.

OBJECTIVE: Infection can be caused by severe burnt, trauma and hypoxia, further causing systemic inflammatory syndrome or sepsis. The sepsis occurs in about 2% of all hospitalizations and ranges from 6% to 30% in intensive care unit (ICU) in developed countries This study aimed to investigate the effects of normal lymph fluid on sepsis complicated with pulmonary injury. MATERIALS AND METHODS: Wistar rats were prepared for sepsis complicated with acute pulmonary model via cecal ligation and puncture, and received normal lymph fluid injection 60 min later. Artery blood-gas index, wet/dry weight (W/D) ratio of lung, Myeloperoxidase (MPO) and superoxide dismutase (SOD) activity of lung tissues were measured, along with protein content and cell count in bronchoalveolar lavage fluid (BALF). Real-time PCR (RT-PCR) and Western blot were employed to measure expression of nuclear factor κB (NF-κB) in lung tissues, whilst enzyme linked immunosorbent assay (ELISA) was used to analyze serum expression of tumor necrosis factor α (TNF-α) and interleukin 2 (IL-2). RESULTS: Model group had significantly depressed PaO2 and pH value, higher W/D ratio, and MPO activity, lower SOD activity, higher protein and cell count of BALF, and up-regulation of TNF-α, IL-2 and NF-κB (p < 0.05 compared to sham group). Infusion of lymph fluid effectively improved blood-gas function, decreased W/D ratio, MPO activity, elevated SOD activity, and lowered TNF-α, IL-2 and NF-κB expression (p < 0.05 compared to model group). CONCLUSIONS: Normal lymph fluid can inhibit NF-κB expression, suppress inflammation, and improve blood-gas exchange in lung tissues. Therefore, the normal lymph fluid could effectively relieve the sepsis complicated with pulmonary injury.

A Multiple-Cell Microenvironment in a 3-Dimensional System Enhances Direct Cellular Reprogramming Into Hepatic Organoids.

OBJECTIVES: The difficulty in proliferation and availability and the rapid loss functions of primary human hepatocytes highlight the need to develop an alternative, preferably renewable source of human induced hepatocytes in regenerative medicine. Liver organoids generated on a multiple-cell microenvironment in a 3-dimensional (3D) system can provide a highly efficient solution to this issue. METHODS: Human hepatocytes were induced from fibroblasts by the lentiviral expression of FOXA3, HNF1A, and HNF4A. Together with these induced hepatocytes, human umbilical vein endothelial cells and mesenchymal stem cells in a 3D system were used to produce liver organoids. Liver-related gene and protein expression of liver organoids and induced hepatocytes were tested using a 2-dimensional (2D) system. RESULTS: Liver organoids notably increased the expression of hepatic transcription factors, marker genes, transporter genes, and liver metabolism enzyme genes, while it decreased the specific gene expression of fibroblasts. Liver organoids expressed comparable liver-specific proteins, such as ALB, AAT, and HNF4A in the 3D system. CONCLUSION: Direct reprogramming in multiple-cell microenvironments in 3D systems is more controllable and efficient than cell reprogramming in 2D systems. Liver organoids have the potential for use in disease modeling, pharmaceutical applications, and cellular transplantation.

Development of Individualized Induced Pluripotent Stem Cells From Fibroblasts of Keloid Lesions in Patients.

OBJECTIVE: Presently, interesting research related to induced pluripotent stem cells (iPSCs) is emerging. However, the development of new therapies and techniques for treatment of refractory diseases is still required in dermatology. We are exploring novel methods to provide stem cell therapy and elucidate research mechanisms underlying troublesome diseases by reprogramming iPSCs from the fibroblasts of keloid lesions from patients in vitro. METHOD: Here, we identified the expression of fibroblastic genes in the fibroblast derived from diseased individuals. Corresponding iPSCs were then produced by transfecting patient fibroblasts with non-modified RNA cocktails, expressing OCT4, SOX2, KLF4, cMYC, NANOG, and LIN28 reprogramming factors. The pluripotency of these patient-derived iPSCs was identified by immunocytochemistry, real-time quantitative polymerase chain reaction, and teratoma formation in vivo in non-obese diabetic/severe combined immunodeficiency mice. RESULTS: All iPSCs derived from patients significantly expressed the pluripotent transcription factors and could be expanded in vitro. Furthermore, induction of terminal differentiation in long-term culture and the capability of forming embryonic bodies to differentiate into all 3 germ layers in vivo were confirmed in immune-deficient mice. CONCLUSION: Fibroblasts from a keloid patient were successfully reprogrammed to iPSCs in vitro. This reprogramming may provide a basis for the production of individualized modified artificial skin to prevent rejections after xenogeneic skin transplantation and trauma through autologous skin transplantation. These cells can also offer a new platform for research on mechanisms underlying skin diseases and personal medical applications.

Correlations of glucose metabolism, insulin resistance and inflammatory factors with symptom score of patients with benign prostatic hyperplasia.

OBJECTIVE: To investigate the effects of glucose metabolism, insulin resistance, and inflammatory factors on International Prostatic Symptom Score (IPSS) of patients with benign prostatic hyperplasia (BPH), to explore their correlations and evaluate the clinical significance. PATIENTS AND METHODS: 90 patients with BPH were selected and divided into normal blood glucose group and abnormal blood glucose group. The changes of indexes related to prostate function, prostate volume (PV), prostate-specific antigen (PSA), and IPSS in two groups were evaluated. The fasting blood glucose (FBS), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR) index and inflammatory factors interleukin-8 (IL-8) and cyclooxygenase 2 (COX-2) levels in expressed prostatic secretion (EPS) were compared. The correlations of glucose metabolism, insulin resistance and inflammatory factors with IPSS were analyzed by Logistic regression. The changes of these indexes after treatment of BPH were observed. RESULTS: The FBS, FINS, HOMA-IR, and inflammatory factors IL-8 and COX-2 levels were significantly different between high IPSS group and low IPSS group of patients with BPH. Moreover, the PV and PSA were higher in high IPSS group than those in low IPSS group. The FBS, FINS and inflammatory factors IL-8 and COX-2 levels were positively correlated with IPSS (p<0.05). All the indexes above of BPH patients were decreased after treatment. CONCLUSIONS: The FBS, FINS, and inflammatory factors IL-8 and COX-2 levels are closely correlated with IPSS, which can reflect the severity and prognosis of BPH. It can effectively postpone the progression of BPH by lowering blood glucose, improving insulin resistance, and controlling the expressions of inflammatory factors in serum through a healthy lifestyle and clinical comprehensive treatment.

Predictive value of cell cycle arrest biomarkers for cardiac surgery-associated acute kidney injury: a meta-analysis.

BACKGROUND: A biomarker test based on a combination of urine tissue inhibitor of metalloproteinases 2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP7) has been used as a potential biomarker of acute kidney injury (AKI). This meta-analysis aimed to evaluate the predictive value of this biomarker for cardiac surgery-associated acute kidney injury (CSA-AKI). METHODS: We searched MEDLINE, PubMed, Cochrane, and EMBASE for studies. We evaluated the methodological quality of each included study using the Quality Assessment of Diagnostic Accuracy Studies 2 criteria. Meta-DiSc and STATA were used for statistical analyses. RESULTS: A total of 10 studies (747 patients) were included in this meta-analysis. Pooled sensitivity and specificity with corresponding 95% confidence intervals (CI) were 0.77 (95% CI: 0.70-0.83, I2=40.7%) and 0.76 (95% CI: 0.72-0.79, I2=69.1%), respectively. Pooled positive likelihood ratio (LR), negative LR, and diagnostic odds ratio were 3.26 (95% CI: 2.51-4.23, I2=50.7%), 0.32 (95% CI: 0.24-0.41, I2=6.7%), and 10.08 (95% CI: 6.85-14.84, I2=6.7%), respectively. The area under the curve estimated by summary receiver operating characteristics was 0.83 [standard error (SE) 0.023] with a Q* value of 0.759 (se 0.021). There was no heterogeneity amongst the 10 studies from both threshold and non-threshold effects. Subgroup analysis showed that the diagnostic value was related to the severity of AKI and time measurement. CONCLUSIONS: Urinary [TIMP-2]·[IGFBP7] is an effective predictive test for cardiac surgery associated acute kidney injury with good diagnostic accuracy within 24 h. Studies examining use of biomarker-guided care bundles are indicated.

Mental health literacy: A cross-cultural study of American and Chinese bachelor of nursing students.

WHAT IS KNOWN ON THE SUBJECT?: Many nursing students have inadequate preparation for practice in mental health nursing in the United States and China. The concept of mental illness has different connotations in different cultures. Studies differ from country to country concerning the influence of nursing education on students' knowledge about and attitudes towards mental disorders. There is a lack of cross-cultural research that takes a broad perspective to explore how nursing students' knowledge and beliefs about mental disorders are influenced by the culture within education and healthcare systems. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Nursing students in the United States and China shared similar views on a broad range of intervention options including professional help, psychotropic medications and activity interventions for managing depression and schizophrenia. The major difference between the two nursing student groups was that the Chinese students showed more preference to occasional alcohol consumption and specialized therapies including cognitive-behavioural therapy and electroconvulsive therapy and the US students held less skepticism towards traditional and religious practices as possible treatment options for depression and schizophrenia. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The Chinese nursing students need to be educated about safe alcohol consumption guidelines adopted by the National Health and Family Planning Commission. The US nursing students need to increase their awareness of national practice guidelines for managing mental disorders, particularly with respect to the use of specialized therapies such as cognitive-behavioural therapy and electroconvulsive therapy. We support professional and psychosocial interventions in caring for patients with mental disorders. ABSTRACT: INTRODUCTION Nursing students in the United States and China have reported inadequate preparedness for practice in mental health nursing. It is important to investigate nursing students' mental health literacy levels for a better understanding of their practice readiness in mental health field upon completion of their education. Aim This study was aimed at developing an understanding of American and Chinese nursing students' mental health literacy regarding the effectiveness of specific interventions for managing depression and schizophrenia. Method The "Australian National Mental Health Literacy Survey" was completed by a group of 310 nursing students including 152 Americans and 158 Chinese between April 2016 and April 2017 to compare students' rated intervention options on two provided vignettes. Results The two student groups reached consensus on many intervention options. However, the Chinese students showed more preference to occasional alcohol consumption and specialized therapies and the US students held less skepticism towards traditional practices as treatment options for depression and schizophrenia. Discussion and implications for practice The findings support professional and psychosocial interventions in caring for patients with mental disorders. There is a significant need for specific education on safe alcohol consumption guidelines for Chinese nursing students and clinical practice guidelines for managing mental disorders for American nursing students.

High expression of long non-coding RNA XIST in osteosarcoma is associated with cell proliferation and poor prognosis.

OBJECTIVE: Osteosarcoma is one of the most common primary bone malignancies. Long non-coding RNAs (lncRNAs) have recently emerged as key regulators of osteosarcoma. The aim of present study was to explore the prognostic value of long non-coding RNA XIST (XIST) in osteosarcoma and XIST's relation to the cell proliferation in osteosarcoma in vitro. PATIENTS AND METHODS: The XIST expressions were detected in osteosarcoma tissues and their paired adjacent normal tissues from 145 osteosarcoma patients by using qRT-PCR. The association between XIST expression and clinicopathological factors, as well as survival rates, was analyzed. The possibility of XIST as a prognostic biomarker for osteosarcoma was examined by Cox proportional hazard regression model. MTT assays were conducted to explore the impact of XIST overexpression on the proliferation of osteosarcoma cells. RESULTS: The results showed that XIST was significantly up-regulated in osteosarcoma tissues and cell lines, and high XIST expression was significantly associated with advanced tumor size (p=0.009), advanced clinical stage (p=0.001) and present distant metastasis (p=0.009). Kaplan-Meier analysis showed that increased XIST expression was associated with poor overall survival of patients. Univariate and multivariate analysis suggested that XIST expression was an independent prognostic factor for the survival of patients with osteosarcoma. Furthermore, we found that knockdown of XIST significantly suppressed the proliferation of osteosarcoma cells in vitro. CONCLUSIONS: XIST was suggested to have a tumor promoter effect, and thus, to be a predictor of outcome in patients with osteosarcoma.

Dynamic and contrast enhanced CT imaging of lung carcinoma, pulmonary tuberculoma, and inflammatory pseudotumor.

OBJECTIVE: Our main aim was to investigate the effect of dynamic and contrast enhanced CT imaging on differential diagnosis of lung carcinoma, pulmonary tuberculoma, inflammatory pseudotumor, and coexisting pulmonary tuberculosis and lung cancer. PATIENTS AND METHODS: About, 144 patients with pulmonary sarcoidosis as the study subjects were chosen which included: 36 patients with lung carcinoma, 36 patients with pulmonary tuberculoma, 36 patients with inflammatory pseudotumor, 36 patients with coexisting pulmonary tuberculosis and lung cancer. CT imaging scan was carried out on all of these 144 patients. RESULTS: CT scan value of lung carcinoma was different from other conditions such as pulmonary tuberculoma, inflammatory pseudotumor, and coexisting pulmonary tuberculosis and lung cancer (p < 0.01). Similarly, the peak of enhancement of lung carcinoma was different from others including inflammatory pseudotumor, and coexisting pulmonary tuberculosis and lung cancer (p < 0.01). Both, the intensive added values and S/A values of lung carcinoma, inflammatory pseudotumor, and coexisting pulmonary tuberculosis and lung cancer differed between them (p < 0.01). CONCLUSIONS: Helical incremental dynamic CT is helpful in differential diagnoses of lung carcinoma, pulmonary tuberculoma, inflammatory pseudotumor, and coexisting pulmonary tuberculosis and lung cancer.

Circulating microRNA-137 is a potential biomarker for human glioblastoma.

OBJECTIVE: In this study, we investigated whether circulating microRNA-137 (miR-137) could be a potential biomarker for patients with glioblastoma (GBM). PATIENTS AND METHODS: Serum samples were collected from 64 GBM patients and 64 healthy controls. The expression level of circulating miR-137 was compared by quantitative RT-PCR. Among GBM patients, circulating miR-137 was compared between patients at early stages and those at advanced stages. Also, the correlations of serum miR-137 expression with clinicopathological features and overall survival of GBM patients were statistically examined. Furthermore, whether circulating miR-137 could serve as an independent predicting biomarker GBM patients' survival was assessed. RESULTS: Serum miR-137 was downregulated in GBM patients than in healthy controls. It was further downregulated in GBM patients at advanced stages than in patients at early stages. Statistical analysis demonstrated that low serum miR-137 level was strongly correlated with patients' clinical grades (p = 0.003) and KFS (p = 0.002). Low serum miR-137 was also found to be significantly correlated with, and may predict poor survival in GBM patients. CONCLUSIONS: Downregulated serum miR-137 may be a potential non-invasive prognostic biomarker for poor prognosis in GBM patients.