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Background Zika virus (ZIKV) is transmitted to humans primarily by Aedes aegypti. Previous studies on Ae. aegypti from Jiegao (JG) and Mengding (MD) in Yunnan province, China have shown that these mosquitoes are able to transmit ZIKV to their offspring through vertical transmission, indicating that these two Ae. aegypti strains pose a potential risk for ZIKV transmission. However, the vector competence of these two Ae. aegypti strains to ZIKV has not been evaluated and the molecular mechanisms influencing vector competence are still unclear. Methods Aedes aegypti mosquitoes from JG and MD were orally infected with ZIKV, and the infection rate (IR), dissemination rate (DR), transmission rate (TR) and transmission efficiency (TE) of these two mosquito strains were explored to evaluate their vector competence to ZIKV. On 2, 4 and 6 days post-infection (dpi), the small RNA profiles between ZIKV-infected and non-infected Ae. aegypti midgut and salivary gland tissues were compared to gain insights into the molecular interactions between ZIKV and Ae. aegypti. Results There were no significant differences in the IR, DR, TR and TE between the two Ae. aegypti strains (P > 0.05). However, ZIKV RNA appeared 2 days earlier in saliva of the JG strain, which indicated a higher competence of the JG strain to transmit ZIKV. Significant differences in the microRNA (miRNA) expression profiles between ZIKV-infected and non-infected Ae. aegypti were found in the 2-dpi libraries of both the midgut and salivary gland tissues from the two strains. In addition, 27 and 74 miRNAs (|log2 fold change| > 2) were selected from the miRNA expression profiles of ZIKV-infected and non-infected midgut and salivary gland tissues from the JG and MD strains, respectively. Conclusions Our results provide novel insights into the ZIKV–mosquito interactions and build a foundation for future research on how miRNAs regulate the vector competence of mosquitoes to this arbovirus. Graphical abstract

Objectives To report our single-center experience of the management of children with prostatic utricle cysts. Methods We retrospectively analyzed 15 children who were incidentally found to have a prostatic utricle cyst and were admitted to our department between October 2013 and August 2020. Clinical characteristics and management were collected and catalogued. Results Recurrent genitourinary tract infections were the most frequent complaint, and two-thirds of patients also had hypospadias. A connection between the posterior urethra and the prostatic utricle cyst was found in all cases. Two patients directly had their progressively enlarging prostatic utricle cyst resected laparoscopically. Endoscopic techniques were used in 13 patients, two of whom underwent laparoscopic excision for repeated symptoms. The mean (range) follow-up period was 34.9 (2-82) months. No recurrences were observed in four patients who underwent prostatic utricle cyst excision and eight patients who received endoscopic treatment. Three patients had recurrent symptoms after endoscopic treatment and were managed by nonsurgical treatment. Conclusions Prostatic utricle cyst is a rare disease which can cause recurrent genitourinary tract infections. Extra attention should be paid to evaluation for prostatic utricle cyst in children with external genital anomalies. Retrograde urethrogram and magnetic resonance imaging are useful tools with which to distinguish prostatic utricle cyst from other cystic lesions that are located in the midline pelvis in male patients. Individualized treatment is appropriate when considering fertility preservation, recurrences and malignancy. Laparoscopic excision is feasible for symptomatic and large prostatic utricle cyst. Regular long-term monitoring is recommended for all patients with prostatic utricle cyst.

Globally distributed mosquitoes play an important role in emerging and resurging infectious diseases in humans. The critical factor affecting vector competence is susceptibility of the vector to viruses, and the ability of midgut epithelial cells to resist viral infection is the main factor determining the susceptibility of mosquitoes to arbovirus infections and is a key index of vector competence. This study predicted the novel siRNA and piRNA sequences, and then attempted to identify the small RNAs derived from viruses through alignment with the DENV‐2 genome. Our results show that most of the novel piRNAs were down regulated post‐infection, but that the majority of novel siRNAs were upregulated after infection. Interestingly, there were no vsiRNA and vpiRNA sequences that had a high expression level and/or significant differential expression; moreover, all vpiRNAs and vsiRNAs were upregulated after infection. The novel_pirs, novel_sirs, vpiRNAs and vsiRNAs examined in this study play a role in resistance to viral infection.

The brain avatar of schizophrenic patients is different from the normal human brain avatar, and it is difficult to overcome the complex environmental effects of the brain through traditional magnetic resonance imaging (MRI). In order to improve the accuracy of MRI in detecting brain information in patients with schizophrenia, this study is based on the support vector machine classification algorithm and combined with multimodal MRI detection method to construct a detection model suitable for patients with schizophrenia. In addition, this study combines the existing test cases to divide the brain into regions and design a comparative experiment to study the accuracy of the model proposed in this study. Finally, the study draws the results by sub‐regional comparison. Studies have shown that the algorithm model of this study has certain effects on brain detection in patients with schizophrenia, and can be applied to practice, and can provide theoretical reference for subsequent related research.

Lung cancer is not only a serious disease but also a public problem threatening human health all over the world. Nonsmall cell lung cancer—which accounts for the majority of lung cancer—is mainly c...

The Japanese encephalitis virus (JEV), a mosquito-borne zoonotic pathogen, is the major cause of viral encephalitis worldwide. An investigation of mosquito species diversity, JEV infection rate, and seasonal population fluctuations of Culex tritaeniorhynchus in Huaihua County, Hunan Province, China, revealed the distribution of vector mosquito populations and genotypes and molecular characteristics of current, common JEV strains in this region. Research on mosquito species diversity in different habitats in Huaihua revealed that local community composition was relatively simple, including five species from four genera (two Culex spp., one Anopheles sp., one Aedes sp., and one Armigeres sp.). Cx. tritaeniorhynchus was clearly the dominant species comprising 94.2-98.6% of all specimens and was always the most common species captured in paddy fields, pigpens, and human dwellings. The seasonal abundance of Cx. tritaeniorhynchus was relatively even, with a single seasonal peak in late August. Two Huaihua JEV strains isolated from the mosquito and pig were highly congruent. The genetic affinities were determined by analyzing capsid/premembrane (C/PrM) and envelope (E) gene variation. The results showed that they were of genotype III and most closely related to the live, attenuated vaccine strains SAl4-14-2 and SA14 and JaGAr01. The Huaihua E protein shares high similarity (mosquito 98.8% and pig 97.6%) at the nucleotide level with the SA14-14-2 vaccine. Although we found that the E gene sequences of the Huaihua JEV mosquito strain and pig strain have 11 and 15 amino acid site substitutions compared with the SAl4-14-2 vaccine, key sites that associated with JEV's antigenic activity and neurovirulence were unchanged. The SA14-14-2 vaccine should therefore be effective in preventing JEV infection in the Huaihua region.

The COVID-19 pandemic has been a tremendous global threat and challenge for human beings, and individuals need to be prepared for the next wave of the outbreak, especially in the educational setting. Limited research has focused on individual knowledge, awareness, and preparedness of COVID-19 in postsecondary institutions in the post-COVID-19 era so far. This study aimed to explore whether students’ perceived anti-epidemic campus signals had effects on their awareness of and preparedness for COVID-19. Leveraging the data collected from full-time college students in a province located in East China and building a structural regression model, we found that students’ perceived anti-epidemic campus signals were significantly associated with their awareness of and preparedness for COVID-19. With one perceived signal decrease, there were 0.099 unit and 0.051 unit decreases in students’ awareness and preparedness, respectively. In addition, we indeed found that female students had a higher awareness and better preparedness than their male peers. These findings provided important implications for postsecondary administrators and policymakers, as well as future research.

BACKGROUND: Correcting ventral curvature (VC) by lengthening the ventral corpora using a graft has been verified feasible, but still has been associated with the recurrence. The use of acellular dermal matrix (ADM) in the setting of tissue reconstruction has captured the attention of many surgeons. There are few reports on the use of ADM exclusively as correction of VC. Thus, we evaluate the safety and effectiveness of repairing the defect with ADM for straightening the VC in proximal hypospadias repair. METHODS: We retrospectively analyzed the records of patients with proximal hypospadias who underwent ventral corporal lengthening with graft in staged repair from January 2013 to December 2019. Those with curvature greater than 30° after urethral plate transection were enrolled. ADM was used for repairing the defect left by transversely transection of tunica albuginea. Patient outcomes were compared with the non-matched control group who underwent the same procedure with tunica vaginalis (TV) repair. Patient demographics, operative techniques, complications, reoperations were summarized and compared between 2 groups. RESULTS: Forty-three patients underwent ventral lengthening with ADM repair after transverse urethral plate transection and 35 patients with TV patching respectively. At a mean follow-up of 10 months in those with the first-stage ventral lengthening, 5 of 43 (11.6%) in ADM group was detected with recurrent VC, while 2 of 35 (5.7%) in TV group were observed with recurrent curvature contemporarily (P=0.363). At a mean follow-up of 46.8 and 45.3 months, persistent curvature in ADM group was not significantly different comparing to TV group (1/43, 2.3% vs. 1/35, 2.9%; P=0.883). CONCLUSIONS: Ventral corporal lengthening using ADM graft may facilitate correction of VC without increasing the risk of urethroplasty complications. It offers a promising material that can be safe, effective and simple to use and provides psychological and aesthetic benefits. Additional series assessment and further randomized controlled trials will elucidate the clinical impact of using ADM with ventral lengthening.

Asymptomatic recurrences of atrial fibrillation (AF) have been found to be common after ablation.A randomized controlled trial of AF screening using a handheld single-lead ECG monitor (BigThumb®) or a traditional follow-up strategy was conducted in patients with non-valvular AF after catheter ablation. Consecutive patients were randomized to either BigThumb Group (BT Group) or Traditional Follow-up Group (TF Group). The ECGs collected via BigThumb were compared using the automated AF detection algorithm, artificial intelligence (AI) algorithm, and cardiologists' manual review. Subsequent changes in adherence to oral anticoagulation of patients were also recorded. In this study, we examined 218 patients (109 in each group). After a follow-up of 345.4 ± 60.2 days, AF-free survival rate was 64.2% in BT Group and 78.9% in TF Group (P = 0.0163), with more adherence to oral anticoagulation in BT Group (P = 0.0052). The participants in the BT Group recorded 26133 ECGs, among which 3299 (12.6%) were diagnosed as AF by cardiologists' manual review. The sensitivity and specificity of the AI algorithm were 94.4% and 98.5% respectively, which are significantly higher than the automated AF detection algorithm (90.7% and 96.2%).As per our findings, it was determined that follow-up after AF ablation using BigThumb leads to a more frequent detection of AF recurrence and more adherence to oral anticoagulation. AI algorithm improves the accuracy of ECG diagnosis and has the potential to reduce the manual review.

Purpose: ADME genes are those involved in the absorption, distribution, metabolism, and excretion (ADME) of drugs. In the present study, a non-small-cell lung cancer (NSCLC) risk prediction model was established using prognosis-associated ADME genes, and the predictive performance of this model was evaluated and verified. In addition, multifaceted difference analysis was performed on groups with high and low risk scores. Methods: An NSCLC sample transcriptome and clinical data were obtained from public databases. The prognosis-associated ADME genes were obtained by univariate Cox and lasso regression analyses to build a risk model. Tumor samples were divided into high-risk and low-risk score groups according to the risk score. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses of the differentially expressed genes and the differences in the immune infiltration, mutation, and medication reactions in the two groups were studied in detail. Results: A risk prediction model was established with seven prognosis-associated ADME genes. Its good predictive ability was confirmed by studies of the model's effectiveness. Univariate and multivariate Cox regression analyses showed that the model’s risk score was an independent prognostic factor for patients with NSCLC. The study also showed that the risk score closely correlated with immune infiltration, mutations, and medication reactions. Conclusion: The risk prediction model established with seven ADME genes in the present study can predict the prognosis of patients with NSCLC. In addition, significant differences in immune infiltration, mutations, and therapeutic efficacy exist between the high- and low-risk score groups.

Sepsis-associated encephalopathy (SAE) is a common complication of sepsis. It is imperative to recognize, diagnose, and effectively manage SAE at the early stages. The aim of this study was to evaluate the potential of using the serum tau protein level in the diagnosis of SAE and the prediction of SAE outcomes. This was a retrospective and observational study. The patients included in this study were diagnosed with severe sepsis or septic shock. The serum tau protein level was measured using a commercial enzyme-linked immunosorbent assay. The association between the level of serum tau protein and SAE was assessed by multiple logistic regression analysis. One hundred nine patients with severe sepsis were enrolled during a period of two years. Of the 109 enrolled patients, 27 developed SAE. The serum tau protein level was significantly higher in the patients with SAE than that of the non-SAE group. The serum tau protein level and the sequential organ failure assessment (SOFA) score were independent factors that were associated with SAE. The combined use of the serum tau protein level with the SOFA score improved the accuracy in distinguishing SAE from non-SAE patients. A cutoff value serum tau protein level of 75.92 pg/mL had 81.1% sensitivity and 86.1% specificity in predicting the 28-day mortality in patients with severe sepsis. We identified a close association between the serum tau protein level with the appearance of SAE in patients with severe sepsis. The serum tau protein level can be useful in the prediction of poor outcomes in patients with sepsis.

The aim of this study is to investigate the effects of long-chain noncoding RNA plasmacytoma variant translocation 1 (PVT1) on the activation of astrocytes and the expression of brain-derived neurotrophic factor (BDNF) in hippocampus tissues of epileptic rats. The epilepsy rat model was induced by intraperitoneal injection of lithium chloride-pilocarpine. Successfully modeled rats were grouped, and their spatial learning and memory, neuronal loss, number of TdT-mediated dUTP nick labeling (TUNEL)-positive cells, and the expression of cleaved-caspase-3, pro-caspase-3, Bax, Bcl-2, GFAP, BDNF, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6, axin, and cyclin D1 in hippocampus tissues were evaluated. Increased expression of PVT1 was found in hippocampus tissues of epileptic rats. Silencing of PVT1 improved spatial learning and memory, decreased neuronal loss, decreased the number of TUNEL-positive cell, decreased the expression of cleaved-caspase-3 and Bax while increased pro-caspase-3 and Bcl-2 expression, decreased the expression of GFAP, increased the expression of BDNF, decreased the expression of TNF-α, IL-1β, and IL-6, and decreased the expression of axin and cyclin D1 in hippocampus tissues in epileptic rats. Our study provides evidence that the inhibition of PVT1 may decrease the loss of neurons, inhibit the activation of astrocytes, and increase the expression of BDNF in hippocampus by downregulating the Wnt signaling pathway.

BACKGROUND Parathyroid carcinoma (PC) is a rare malignancy that is difficult to eradicate completely after recurrence. We assessed the efficiency of extended en bloc resection (EEBR) in the management of recurrent or persistent PC. METHODS In this observational cohort study, 31 patients who underwent reoperations for recurrent or persistent PC were enrolled after 2-9 surgeries by other medical teams. EEBRs, which provided the oncologic resection by removing all possible tumor-bearing scar tissues, were adopted in 25 patients. The other 6 with gross infiltration into the upper aerodigestive tract (UAT) underwent less radical procedures for unwillingness to sacrifice laryngeal function. RESULTS The 5-year overall survival (OS) rate after EEBR was 59.6% compared with 16.7% after less radical procedures, with an improved median expected survival time of 90.0 months compared with 13.0 months after local excision. EEBR exhibited a favorable local control of relapses in 84.0% of patients after a median follow-up period of 27.0 months, 40.0% even achieved disease-free survival, although 56.0% had subsequent distant metastases (DMs) and suffered a worse 5-year OS of 36.7% in contrast with 100.0% in the absence of DM (p = 0.011). UAT invasion, rather than age, number of previous operations, or preoperative PTH levels, was the unique independent factor associated with both DM (HR = 5.466, p = 0.006) and mortality (HR = 7.606, p = 0.011). CONCLUSION EEBRs provide better outcomes than other conventional surgical approaches and might offer a second chance of cure for patients with recurrent or persistent PC in the absence of DM.

Purpose: The host’s immune response to malignant tumor is fundamental to tumorigenesis and tumor development. The immune score is currently used to assess prognosis and to guide immunotherapy; however, its association with lung cancer prognosis is not clear. Methods: Clinical features and immune score data of lung cancer patients from The Cancer Genome Atlas were obtained to build a clinical prognosis nomogram. The model’s accuracy was verified by calibration curves. Results: In total, 1005 patients with lung cancer were included. Patients were divided into three groups according to low, medium, and high immune scores. Compared with patients in the low immune score group, the disease-free survival (DFS) of patients in medium and high immune score groups was significantly longer; the hazard ratio (HR) and 95% confidence interval (95% CI) were 0.77 [0.60–0.99] and 0.74 [0.60–0.91], respectively. The overall survival (OS) of patients in the medium and high immune score groups was significantly longer than in the low immune score group; the HR and 95% CI were 0.74 [0.57–0.96] and 0.69 [0.55–0.88], respectively. A clinical prediction model was established to predict the survival prognosis. As verified by calibration curves, the model showed good predictive ability, especially for predicting 3-/5-year DFS and OS. Conclusion: Patients with lung cancer with medium and high immune scores had longer DFS and OS than those in low immune score group. Patient prognosis can be effectively predicted by the clinical prediction model combining clinical features and immune score and was consistent with actual clinical outcomes.

We wished to construct a prognostic model based on ferroptosis-related genes and to simultaneously evaluate the performance of the prognostic model and analyze differences between high-risk and low-risk groups at all levels. The gene-expression profiles and relevant clinical data of patients with non-small-cell lung cancer (NSCLC) were downloaded from public databases. Differentially expressed genes (DEGs) were obtained by analyzing differences between cancer tissues and paracancerous tissues, and common genes between DEGs and ferroptosis-related genes were identified as candidate ferroptosis-related genes. Next, a risk-score model was constructed using univariate Cox analysis and least absolute shrinkage and selection operator (Lasso) analysis. According to the median risk score, samples were divided into high-risk and low-risk groups, and a series of bioinformatics analyses were conducted to verify the predictive ability of the model. Single-sample gene set enrichment analysis (ssGSEA) was used to investigate differences in immune status between high-risk and low-risk groups, and differences in gene mutations between the two groups were investigated. A risk-score model was constructed based on 21 ferroptosis-related genes. A Kaplan–Meier curve and receiver operating characteristic curve showed that the model had good prediction ability. Univariate and multivariate Cox analyses revealed that ferroptosis-related genes associated with the prognosis may be used as independent prognostic factors for the overall survival time of NSCLC patients. The pathways enriched with DEGs in low-risk and high-risk groups were analyzed, and the enriched pathways were correlated significantly with immunosuppressive status.

Highlights • Non-invasive detection of copy number variations (CNVs) was firstly reported in patients with biliary tract cancer. • Biliary tract cancer harbors rich information of CNVs based on plasma cell-free DNA analyses. • The sensitivity and specificity of CNVs for diagnosing biliary tract cancer were 89.7% and 88.9%, respectively. The diagnostic performance of CNVs significantly outperformed CA 19-9 and CEA., Background The diagnosis of biliary tract cancer (BTC) is challenging in clinical practice. We performed a prospective study to evaluate the value of plasma copy number variation (CNV) assays in diagnosing BTC. Methods 47 treatment-naïve patients with suspicious biliary lesions were recruited. Plasma samples were collected at admission. Cell-free DNA was analyzed by low coverage whole genome sequencing, followed by CNV analyses via a customized bioinformatics workflow, namely the ultrasensitive chromosomal aneuploidy detector. Results 29 patients were pathologically diagnosed as BTC, including 8 gallbladder cancers (GBCs) and 21 cholangiocarcinomas (CCs). Cancer patients had more CNV signals as compared with benign patients (26/29 vs. 2/18, P < 0.001). The most frequent copy number gains were chr3q (7/29) and chr8q (6/29). The most frequent copy number losses were chr7p (6/29), chr17p (6/29), and chr19p (6/29). The sensitivity and specificity of plasma CNV assays in diagnosing BTC were 89.7% and 88.9%, respectively. For CA 19-9 (cutoff: 37 U/ml), the sensitivity was 58.6% and the specificity was 72.2%. The diagnostic accuracy of CNV assays significantly outperformed CA 19-9 (AUC 0.91 vs. 0.62, P = 0.004). Compared with CA 19-9 alone, the adding of CNV profiles to CA 19-9 increased the sensitivity in diagnosing GBC (75.0% vs. 25.0%) and CC (100% vs. 52.4%). Higher CNV burden was also associated with decreased overall survival (Hazard ratio = 4.32, 95% CI 2.06–9.08, P = 0.033). Discussion Our results suggest that BTC harbors rich plasma CNV signals, and their assays might be useful for diagnosing BTC.

Objective: Atorvastatin and aspirin have been used in treating different forms of epilepsy. However, their effect on post-stroke epilepsy (PSE) still needs to be validated by large-scale clinical studies. In addition, their impact on the use of the antiepileptic drug levetiracetam for post-stroke epilepsy remains to be explored. Thus, the aim of this study was to further evaluate the effect of atorvastatin and aspirin on PSE and their effect on the usage of the antiepileptic drug levetiracetam in PSE patients. Methods: Patients, aged 65 to 85 years, with newly diagnosed post-ischemic stroke epilepsy from August 30, 2014 to August 30, 2018 were included in the study, with the exclusion of those with coexisting conditions. Results: Initially, 1321 patients were included, and 780 remained in the study at the 1-year follow-up. During the study, atorvastatin treatment with or without aspirin reduced the number of clinical epileptic episodes in PSE patients. It also reduced the dosage of levetiracetam and achieved better control of epilepsy compared to levetiracetam mono-treatment. Aspirin co-treatment with levetiracetam did not result in a significant improvement. However, the combination of aspirin with atorvastatin significantly reduced the number of seizures compared to atorvastatin treatment alone. Conclusion: Atorvastatin and aspirin co-treatment with levetiracetam can reduce epilepsy in PSE patients and reduce the dosage of levetiracetam required for effective control of PSE.

Background Investigations have revealed the association between inflammation and post-stroke depression (PSD). However, whether the C-reactive protein (CRP) level, a biomarker of inflammation, would affect the development of PSD is still controversial. Methods A systematic search of databases was performed for eligible studies. Standardized Mean Difference (SMD) with 95 % Confidence Interval (CI) was used to assess the association between the CRP level in the acute phase of stroke and the risk of PSD. Results 13 cohort studies that involved 3536 participants were included. Combined results showed that compared with non-PSD patients, the CRP level of PSD patients was significantly higher on admission (SMD = 0.19, 95 % CI: 0.12−0.27). A subgroup analysis by classifying the assessment time of depression showed obvious differences of the CRP levels between the PSD patients who were diagnosed more than 1 month after stroke and the non-PSD (1−3 months: SMD = 0.16, 95 % CI: 0.06−0.25; >3months: SMD = 0.34, 95 % CI: 0.18−0.51). Conclusion A higher level of CRP in the acute phase of stroke suggests an increased risk for PSD.

Based on the anti-ulcerative colitis (UC) effect of total saponins of Pulsatilla (PTS), a pH dependent colonic targeting particle design powder of PTS was prepared. The core-shell composite particle design powder of PTS was prepared with pH sensitive polymer material Eudragit S100 superfine powder as shell and the drug as core. The release of PTS composite particle design powder was increased in the artificial colon fluid and decreased in the artificial stomach and small intestine fluid. In this paper, the release performance of Pulsatilla saponin D in PTS and the ulcerative colitis model induced by TNBS in rats were used to evaluate the targeting of PTS composite particle design powder in colon. The results showed that the content of Pulsatilla saponin D in colon tissue was significantly higher than that of the original drug group after oral administration of PTS composite particle design powder. The solubility of Pulsatilla saponin D in colon tissue was also higher than that in the stomach and small intestine. The peak time and retention time in vivo were prolonged, and the maximum blood concentration was decreased (Cmax). The effect of colonic targeting powder of PTS (50 mg/kg)on anti-ulcerative colitis induced by TNBS in SD rats was better than the original drug (200 mg/kg). Therefore, it is a great significance to make the PTS into colon targeted preparation for improving bioavailability, efficacy and reducing gastrointestinal stimulation.

Purpose Our aims were to determine (1) whether the marriage rate was different between the sexes and (2) whether the influencing factors of marital status varied by sexes. Methods A cross-sectional study was performed among 475 people with epilepsy (PWE) in Northeast China. The demographic information and clinical data were gathered and recorded. Sex differences in the marriage rate of PWE and the related influencing factors were analyzed. Multivariate logistic regression analyses were used to investigate the independent factors influencing marital status in men and women, respectively. Results Among 475 participants, 219 (79.6%) men with epilepsy (MWE) were married, and 140 (70%) women with epilepsy (WWE) were married. In MWE, age, educational level, age at seizure onset, and disease duration were significantly different between the married men and the single men. In WWE, age, educational level, occupation and age at seizure onset showed significant differences between the married women and the single women. In the multiple logistic regression model, age and age at first seizure onset had an independent effect on the marital status in men with epilepsy. Multiple logistic regression analysis also revealed that age and age at first seizure onset were independent factors that influenced marital status in WWE. Conclusion Men with epilepsy were more likely to marry than WWE. Age and the age of seizure onset independently affected the marital status of men and women.

Background: Asymptomatic recurrences of atrial fibrillation (AF) are common after ablation of AF. Objective: We aimed to analyze the performance of the mobile ECG device using artificial intelligence (AI) algorithm in detection of AF after ablation. Method: A randomized controlled trial of AF screening using a handheld single-lead ECG monitor (BigThumb®) or a traditional follow-up strategy was conducted in patients with non-valvular AF after catheter ablation. Consecutive patients were randomized to either BigThumb Group (BT Group) or Traditional Follow-up Group (TF Group). Monitoring data was collected and analyzed. The ECGs collected by BigThumb were compared using the automated AF detection algorithm, AI algorithm and cardiologists’ manual review. Subsequent changes in adherence on oral anticoagulation of patients were also recorded. Result: We studied 218 patients (109 in BT Group, 109 in TF Group). After a follow-up of 345.4±60.2 days, AF-free survival rate was 64.2% in BT Group and 78.9% in TF Group (P=0.0163), with more adherence on oral anticoagulation in BT Group (P=0.0052). The participants in the BT Group recorded 26133 ECGs during the follow-up, among which 3299 (12.6%) were diagnosed as AF by cardiologists’ manual review. The sensitivity and specificity of the AI algorithm were 94.4% and 98.5% respectively, which are significantly higher than the automated AF detection algorithm (90.7% and 96.2%). Conclusion: We found that follow-up after AF ablation using BigThumb leads to a more frequent detection of AF recurrence and more adherence on oral anticoagulation. Artificial intelligence algorithm improves the accuracy of ECG diagnosis.

The expression pattern of exosomal miRNAs derived from parathyroid tumor is still unknown. In the present work, we aimed to examine the differences on microRNA (miRNA) expression, present in serum exosomes, by comparing parathyroid carcinoma (PC) and parathyroid adenoma (PA). MiRNA expression profile of serum exosomes, derived from 4 PC patients and 4 PA patients, were analyzed by next-generation sequencing technology. The differential expressions of target miRNAs were further verified in both serum exosomes and tissues of PC/PA patients by quantitative reverse transcription polymerase chain reaction (qRT-PCR). Lastly, receiver operating characteristic (ROC) curves were plotted to investigate the efficiency of target exosomal miRNAs in distinguishing PC patients from PA controls. Multiple differentially expressed miRNAs of serum exosomes were screened out by sequencing. Based on this screening, hsa-miR-146b-5p (p = 0.0846), hsa-miR-27a-5p (p = 0.0412), hsa-miR-93-5p (p = 0.73), hsa-miR-381-3p (p = 0.1239) and hsa-miR-134-5p (p = 0.0694) were upregulated in the serum exosomes of PC patients. These results were validated by qPCR, where the trend on differential miRNA expression was consistent with the sequencing results. Specifically, the expression of exosomal hsa-miR-27a-5p was able to clearly distinguish PC patients from PA controls, and related analysis indicated that the area under the ROC curve was 0.8594 (p = 0.0157). Here we present, for the first time, the miRNA expression profile of serum exosomes derived from PC patients. Based on this result, we presently suggest that the exosomal hsa-miR-27a-5p may serve as a putative tumor marker for preoperative identification of PC and PA subjects.

Immunoglobulin G4 (IgG4)-related disease is a systemic disease characterized by sclerosing lesions and an increased serum IgG4 level. This condition can involve any organ, but IgG4-related spinal pachymeningitis is relatively rare. In the current study, we report a case of spinal cord compression caused by IgG4-related spinal pachymeningitis. A 39-year-old man presented to us with a 15-day history of back pain and a 3-day history of dysuresia, exacerbated by weakness in the lower extremities for 2 days. Cervical magnetic resonance imaging (MRI) showed strip-shaped abnormal signals along the anterior and posterior borders of the spinal cord at the C5-T4 levels. The IgG level in cerebrospinal fluid was 718.0 mg/L. Thoracic MRI revealed strip-shaped abnormal signals with remarkable enhancement along the anterior and posterior borders of the dural sac at the T1-T6 levels. Histopathological examination confirmed IgG4-related spinal pachymeningitis. The symptoms worsened rapidly, and surgical resection of the space-occupying lesion in the vertebral canal was performed for spinal decompression. Corticosteroid therapy was administered, and the patient's motor functions were mildly improved. IgG4-related disease can manifest as spinal pachymeningitis and cause spinal cord compression. Clinicians should be aware of this rare condition, and early diagnosis, timely surgical decompression, and appropriate corticosteroid therapy should be highlighted.

BACKGROUND: The zinc finger of the cerebellum 2 (ZIC2) has been reported to function as an oncogenic transcription factor. However, the level and prognostic value of ZIC2 in patients with clear cell renal cell carcinoma (ccRCC) remain unclear. METHODS: UALCAN was employed to analyze the level of ZIC2 mRNA in ccRCC samples compared to normal kidney tissues and to explore the impacts of ZIC2 expression according to tumor-node-metastasis (TNM) stages and histologic grades. The correlations between ZIC2 expression and clinicopathological parameters were investigated by bioinformatic analysis using UCSC Xena Browser in the light of data from The Cancer Genome Atlas. We used Kaplan–Meier analysis to assess the association between the level of ZIC2 and overall survival (OS), disease-free survival (DFS) in ccRCC patients. Moreover, Cox analyses were adopted to evaluate its prognostic value in ccRCC patients. RESULTS: ZIC2 expression was much higher in ccRCC samples than that in normal ones and increased with the escalation of TNM stages and histologic grades. In addition, the high ZIC2 expression group had significantly advanced age (age >65), T, N, M, TNM stage, histologic grade and lower 5-years OS (19.40% vs. 31.74%, P=0.006) than the low one. High ZIC2 expression was related to remarkably worse OS (P

Ectopic parathyroid glands are thought to be the cause of a significant portion of failed primary surgery for hyperparathyroidism. Parathyroid carcinoma (PTCA) is a rare malignant tumor, and ectopic PTCA is a particularly unusual situation. Here, we describe, for the first time, a case of intrapericardial PTCA. We describe the case of a 53-year-old female presented with 1-year history of backache, multiple fractures, nephrolithiasis, nausea, vomiting, fatigue, and unexplained myocardial ischemia-like symptoms. Physical examination revealed a barrel chest and sternal tenderness with stable vital signs. Blood tests confirmed hypercalcemia (3.70 mmol/L) and hyperparathyroidism (>1900 pg/ml). 99mTc-sestamibi scan indicated ectopic findings in the mediastinum highly suggestive of parathyroid adenoma. After more tests, cardiac magnetic resonance imaging (MRI) revealed a mass closely related to the great vessels of the heart. The ectopic tumor in the pericardium was successfully resected through sternotomy, with subsequent histopathological confirmation of PTCA. The metabolism of calcium and phosphorus and the level of PTH returned to normal after surgery. This unique case reinforces the tremendous variety of possible ectopic locations of parathyroid glands. Although most patients with primary hyperparathyroidism (PHPT) carry a high suspicion of a benign course, the entity of ectopic PTCA also needs to be considered. Accurate preoperative locating diagnosis as well as en bloc tumor resection offers the highest chance of cure in patients with PHPT.

We conducted a 3-year longitudinal serologic survey on an open cohort of poultry workers, swine workers, and general population controls to assess avian influenza A virus (AIV) seroprevalence and seroincidence and virologic diversity at live poultry markets (LPMs) in Wuxi City, Jiangsu Province, China. Of 964 poultry workers, 9 (0.93%) were seropositive for subtype H7N9 virus, 18 (1.87%) for H9N2, and 18 (1.87%) for H5N1. Of 468 poultry workers followed longitudinally, 2 (0.43%), 13 (2.78%), and 7 (1.5%) seroconverted, respectively; incidence was 1.27, 8.28, and 4.46/1,000 person-years for H7N9, H9N2, and H5N1 viruses, respectively. Longitudinal surveillance of AIVs at 9 LPMs revealed high co-circulation of H9, H7, and H5 subtypes. We detected AIVs in 726 (23.3%) of 3,121 samples and identified a high diversity (10 subtypes) of new genetic constellations and reassortant viruses. These data suggest that stronger surveillance for AIVs within LPMs and high-risk populations is imperative.

Avian influenza A(H7N9) virus has caused 5 epidemic waves in China since its emergence in 2013. We investigated the dynamic changes of antibody response to this virus over 1 year postinfection in 25 patients in Suzhou City, Jiangsu Province, China, who had laboratory-confirmed infections during the fifth epidemic wave, October 1, 2016–February 14, 2017. Most survivors had relatively robust antibody responses that decreased but remained detectable at 1 year. Antibody response was variable; several survivors had low or undetectable antibody titers. Hemagglutination inhibition titer was >1:40 for

According to the American Thyroid Association guidelines in 2015, both an unstimulated thyroglobulin (u-Tg) below 0.2 ng/ml and a stimulated thyroglobulin (s-Tg) below 1.0 ng/ml were required along with negative imaging findings to define an excellent response. This study aimed to investigate whether a u-Tg below 0.2 ng/ml coincides with a s-Tg below 1 ng/ml.A total of 290 patients with nonmetastatic differentiated thyroid cancer were retrospectively evaluated with a median follow-up of 36 months. The levels of s-Tg were observed in patients whose u-Tg levels were below 0.2 ng/ml after radioiodine therapy, and risk factors associated with the increase of s-Tg to above 1 ng/ml from below 0.2 ng/ml were analyzed.In total, 52.8% (153/290) of the patients achieved a u-Tg below 0.2 ng/ml 3 months after remnant ablation, most of whom (83.7%, 128/153) also achieved a s-Tg below 1 ng/ml. A total of 25 (16.3%) patients had an increased s-Tg above 1 ng/ml. A comparative analysis showed no significant difference between patients who showed an increase in thyroglobulin from below 0.2 ng/ml to above 1 ng/ml and those who did not. In a subgroup analysis assessing the influence of thyrotropin (thyroxin-stimulating hormone) on s-Tg, we enrolled 43 patients with at least two s-Tg measurements. We found that a higher level of thyroxin-stimulating hormone (118.23±30.72 vs. 59.99±26.12 µIU/ml) increased the s-Tg in 88.4% patients (P=0.00), which led to more patients (18.6-30.2%) with an increased s-Tg (to above 1 ng/ml) after thyroxin withdrawal.Assessment of the level of u-Tg might be a better parameter to use for defining excellent response as u-Tg is more stable, convenient, economical, and is not associated with hypothyroidism as a side effect.

Epilepsy is a brain and neurological disorder with high prevalence. It was reported that more than 70% of epileptic seizures were controlled by anti-epileptic medications, whereas the lack of evidence with respect to head-to-head comparisons motivated researchers to seek alternative approaches that are able to provide deep insights into the profile of anti-epileptic medications. In this study, we performed a network meta-analysis (NMA) to evaluate the efficacy and safety of anti-epileptic medications for partial seizures of epilepsy. Publications were retrieved from PubMed, Embase, and Cochrane Library. Then, studies were screened and selected based on the inclusion criteria. Data were extracted and a NMA was performed to combine both direct and indirect evidence. Surface under the cumulative ranking curve (SUCRA) was obtained for ranking purposes. Consistency between direct and indirect evidence was assessed by using the node-splitting method. Seventeen anti-epileptic medications from 90 publications were enrolled. Fifty percent responder and state of seizure freedom were studied as outcomes for efficacy; treatment emergent adverse effect (TEAE), including dizziness, somnolence, headache, fatigue, and nausea were evaluated as safety outcomes. Topiramate, levetiracetam, pregabalin, and oxcarbazepine were recommended for their relatively high efficacy and low-risk of adverse events for partial seizures. Rufinamide was the least preferable medication due to its low efficacy and high-risk of adverse effects. J. Cell. Biochem. 118: 2850-2864, 2017. © 2017 Wiley Periodicals, Inc.

Objective Preablative stimulated thyroglobulin (ps-Tg) has the potential to be used in identifying distant metastatic differentiated thyroid carcinoma (DM-DTC), but its single level can be affected by remnant thyroid tissue and thyrotropin (TSH). The objective of this retrospective study was to evaluate the value of serial ps-Tg measurements in identifying DM-DTC specifically. Methods A total of 317 DTC patients with serial measurements of ps-Tg, TSH and anti-Tg antibody were divided into M1 (n=72) and M0 (n=245) according to the presence of distant metastasis (DM) or not. The initial ps-Tg measurement, with a corresponding TSH exceeding 30 μIU/mL, was marked as Tg1, and ps-Tg measured right before radioactive iodine (RAI) therapy was defined as Tg2, with a median interval of 8 days. ΔTg denotes Tg2-Tg1, and ΔTSH denotes TSH2-TSH1. Tg1, Tg2, ΔTg, and ΔTg/ΔTSH were tested for efficacy in identifying DM-DTC using receiver operating characteristic (ROC) curve analysis, and further compared with chest computed tomography (CT) and posttreatment whole-body RAI scan (RxWBS). Results Compared with single ps-Tg measurement (Tg1 or Tg2), both ΔTg and ΔTg/ΔTSH were more narrowly distributed around zero in the M0 group, which made their distribution in the M1 group more distinguished in a relatively dispersed way. ΔTg/ΔTSH manifested a higher accuracy (88.64%) and specificity (90.20%) in identifying DM-DTC than Tg1 or Tg2 measurements, with a much higher specificity than chest CT (90.20% vs. 66.00%) and a much higher sensitivity than RxWBS (83.33% vs. 61.11%). Conclusions Serial ps-Tg measurements even over as short an interval as 8 days hold incremental value in identifying DM-DTC. ΔTg/ΔTSH is a specific early biochemical marker for DM-DTC.

Ectopic parathyroid adenomas (PAs) can occur in numerous locations and are thought to be the cause of a significant portion of failed primary surgery for hyperparathyroidism. PA is a rare cause of hoarseness, which may be harbingers of a malignant process. Here, we describe an unusual case of an ectopic PA in the carotid sheath presenting as unilateral vocal cord paralysis (VCP). A 49-year-old lady presented with a 1-week history of hoarseness, irritating cough and shortness of breath. Fibreoptic laryngoscopy revealed left VCP. Ultrasound and computed tomography of the neck demonstrated a mass in the carotid sheath. Laboratory investigations revealed hypercalcemia (3.10 mmol/L), hypophosphatemia (0.81 mmol/L) and elevated intact parathyroid hormone (iPTH) level (381.6 pg/mL), despite of a negative 99mTc-sestamibi scan. After more rigorous tests, the ectopic tumor adjacent to the left vagus nerve was successfully resected, with subsequent histopathological confirmation of PA. The patient eventually got a normal iPTH level and serum calcium postoperatively, and regular voice function was also regained 4 months after surgery. This case emphasizes the importance of broad differential diagnosis and thorough workup. Although most patients with PA present with hypercalcemia, this disease entity also need to be considered in the differentials of neck masses and VCP.

Background China is thought to be a hotspot for zoonotic influenza virus emergence, yet there have been few prospective studies examining the occupational risks of such infections. Methods We present the first 2 years of data collected from a 5-year, prospective, cohort study of swine-exposed and -unexposed participants at 6 swine farms in China. We conducted serological and virological surveillance to examine evidence for swine influenza A virus infection in humans. Results Of the 658 participants (521 swine-exposed and 137 swine-unexposed), 207 (31.5%) seroconverted against at least 1 swine influenza virus subtype (swine H1N1 or H3N2). Swine-exposed participants’ microneutralization titers, especially those enrolled at confined animal feeding operations (CAFOs), were higher against the swine H1N1 virus than were other participants at 12 and 24 months. Despite elevated titers, among the 187 study subjects for whom we had complete follow-up, participants working at swine CAFOs had significantly greater odds of seroconverting against both the swine H1N1 (odds ratio [OR] 19.16, 95% confidence interval [CI] 3.55–358.65) and swine H3N2 (OR 2.97, 95% CI 1.16–8.01) viruses, compared to unexposed and non-CAFO swine workers with less intense swine exposure. Conclusions While some of the observed increased risk against swine viruses may have been explained by exposure to human influenza strains, study data suggest that even with elevated preexisting antibodies, swine-exposed workers were at high risk of infection with enzootic swine influenza A viruses., A 2-year (2015–2017) prospective cohort study of 187 swine workers in China revealed that swine workers were at increased risk of infection with the endemic swine influenza A viruses, despite having preexisting elevated neutralizing antibodies against these viruses.

The trans-Golgi network (TGN) and endosomes are essential protein sorting stations in the secretory transport pathway. Protein sorting is fundamentally a process of spatial segregation, but the spatial relationships among the proteins that constitute the sorting machinery have not been systematically analyzed at high resolution in mammalian cells. Here, using two-color STORM imaging, we show that the TGN/endosome-localized cargo adaptors, AP-1, GGA2 and epsinR, form elongated structures of over 250 nm in length at the juxta-nuclear Golgi area. Many of these structures are associated with clathrin. We found that AP-1 is spatially segregated from AP-3 and GGA2, whereas a fraction of AP-1 and GGA2 punctae are associated with epsinR. Moreover, we observed that the planar cell polarity cargo proteins, Vangl2 and Frizzled6 associate with different cargo adaptors-AP-1 and GGA2 or epsinR, respectively-when exiting the TGN. Knockdown analysis confirms the functional significance of this segregation. Our data indicates that TGN/endosome-localized cargo adaptors have distinct spatial relationships. The spatially segregated cargo adaptors GGA2 and AP-1 regulate sorting of Frizzled6 and Vangl2, respectively and spatially associated cargo adaptors can cooperatively regulate a specific sorting process.

Objective: This research aimed to validate the therapeutic effect of losmapimod and explore the underlying mechanism in its treatment of epilepsy. Methods: A rat model of epilepsy was constructed with an injection of pilocarpine. Microarray analysis was performed to screen aberrantly expressed mRNAs and activated signaling pathways between epileptic rats and normal controls. A TdT-mediated dUTP nick-end labeling (TUNEL) assay was used to identify cell apoptosis. Hippocampal cytoarchitecture was visualized with Nissl staining. The secretion of inflammatory factors as well as the marker proteins in the mitogen-activated protein kinase (MAPK) pathway were detected by Western blot. A Morris water maze navigation test evaluated the rats’ cognitive functions. Results: Activation of the MAPK signaling pathway was observed in epilepsy rats. A decrease in the MAPK phosphorylation level by application of losmapimod protected against epilepsy by reducing neuron loss. Losmapimod effectively improved memory, reduced the frequency of seizures, protected the neuron from damage, and limited the apoptosis of neurons in epilepsy rats. Conclusion: The application of losmapimod could partly reverse the development of epilepsy.

An anti-CD30 antibody-drug conjugate incorporating the antimitotic agent DM1 and a stable SMCC linker, anti-CD30-MCC-DM1, was generated as a new antitumor drug candidate for CD30-positive hematological malignancies. Here, the in vitro and in vivo pharmacologic activities of anti-CD30-MCC-DM1 (also known as F0002-ADC) were evaluated and compared with ADCETRIS (brentuximab vedotin). Pharmacokinetics (PK) and the safety profiles in cynomolgus monkeys were assessed. Anti-CD30-MCC-DM1 was effective in in vitro cell death assays using CD30-positive lymphoma cell lines. We studied the properties of anti-CD30-MCC-DM1, including binding, internalization, drug release and actions. Unlike ADCETRIS, anti-CD30-MCC-DM1 did not cause a bystander effect in this study. In vivo, anti-CD30-MCC-DM1 was found to be capable of inducing tumor regression in subcutaneous inoculation of Karpas 299 (anaplastic large cell lymphoma), HH (cutaneous T-cell lymphoma) and L428 (Hodgkin’s disease) cell models. The half-lives of 4 mg/kg and 12 mg/kg anti-CD30-MCC-DM1 were about 5 days in cynomolgus monkeys, and the tolerated dose was 30 mg/kg in non-human primates, supporting the tolerance of anti-CD30-MCC-DM1 in humans. These results suggest that anti-CD30-MCC-DM1 presents efficacy, safety and PK profiles that support its use as a valuable treatment for CD30-positive hematological malignancies.

Tissue sampling of biliary tract carcinomas (BTCs) for molecular characterization is challenging. The aim of this study was to investigate the possibility of identifying individual actionable mutations derived from bile cell-free DNA (cfDNA) using targeted deep sequencing. Ten BTC patients, four with gallbladder carcinomas and six with cholangiocarcinomas, were enrolled in the present study. Using targeted deep sequencing with a panel of 150 tumor-related genes, paired bile cfDNA and tumor DNA were analyzed for mutational variants individually and then compared. The present study, to the best of our knowledge, is the first to reveal that bile cfDNA is predominantly comprised of long DNA fragments, which is not the case for plasma cfDNA. Herein, paired bile cfDNA and tumors from ten BTC patients were examined using targeted deep sequencing. When comparing bile cfDNA and tumor DNA for single nucleotide variation (SNV)/insertion and deletion (Indel), the results using targeted deep sequencing revealed high sensitivity (94.7%) and specificity (99.9%). Additionally, the sensitivity of detecting a copy number variation (CNV) was 75.0%, with a specificity of 98.9%. When comparing two bile extraction methods, including percutaneous transhepatic cholangial drainage and operation, no significant difference in SNV/Indel or CNV detection sensitivity was noted. Moreover, when examining the tumor stage and incidence site, AJCC stage II and the distal bile duct both had significantly decreased CNV detection sensitivities. The present study revealed that targeted deep sequencing can reliably detect mutational variants within bile cfDNA obtained from BTC patients. These preliminary results may shed light on bile cfDNA as a promising liquid biopsy for BTC patients.

Electroconvulsive therapy (ECT), has become a widely applied potent treatment in clinical practice for major depressive disorder (MDD) over decades. However, due to its nonspecific and spatially unfocused nature, the underlying mechanisms of ECT remain unclear. In this longitudinal study, 11 patients with MDD underwent magnetic resonance imaging (MRI) before and after ECT at three different time points. A longitudinal voxel-based morphology approach was performed to characterize dynamic changes in brain gray matter volume (GMV). Twelve age- and sex-matched healthy controls were recruited to identify structural brain changes of patients with MDD before and after ECT. The brain GMV was globally found to increase shortly after a series of ECT, and then decrease 1 month after ECT treatment exposure. This fluctuating tendency was localized to the bilateral inferior parietal lobes, bilateral insula, and right superior temporal cortex. After the global GMV was corrected, there were only significant global effect increases in GMV in the left anterior hippocampus and right caudate, which were both significantly correlated with the improvement of depression symptoms. However, 1 month after ECT treatments, there was still significantly reduced GMV following patients with MDD compared to healthy controls in the left putamen, right anterior cingulate, and left inferior temporal cortex, which was observed before ECT. These findings indicate that ECT in patients with MDD is closely associated with dissociative structural changes. The locally enhanced GMV in limbic areas may reflect that the ECT-related brain compensatory mechanisms contribute to brain structure recovery in MDD.

BACKGROUND This study investigated the clinical effect of interventional therapy in ischemic cerebrovascular disease (ICD). MATERIAL AND METHODS A retrospective analysis was performed on 260 ICD patients who were divided into a control group (122 patients, conventional drug treatment) and an observation group (138 patients, interventional therapy plus conventional drug treatment). Enzyme-linked immunosorbent assay was used to examine the expression of IL-1β, IL-6, and NLR. Furthermore, neurological deficit scores and Barthel index scores as well as the correlation of IL-1β, IL-6 and NLR were examined in these 2 groups. RESULTS The expression of IL-1β, IL-6, and NLR significantly decreased in both groups after 1 week or 4 weeks of treatment compared with before treatment (P

Post-Golgi protein sorting and trafficking to the plasma membrane (PM) is generally believed to occur via the trans-Golgi network (TGN). In this study using Nicotiana tabacum pectin methylesterase (NtPPME1) as a marker, we have identified a TGN-independent polar exocytosis pathway that mediates cell wall formation during cell expansion and cytokinesis. Confocal immunofluorescence and immunogold electron microscopy studies demonstrated that Golgi-derived secretory vesicles (GDSVs) labeled by NtPPME1-GFP are distinct from those organelles belonging to the conventional post-Golgi exocytosis pathway. In addition, pharmaceutical treatments, superresolution imaging, and dynamic studies suggest that NtPPME1 follows a polar exocytic process from Golgi-GDSV-PM/cell plate (CP), which is distinct from the conventional Golgi-TGN-PM/CP secretion pathway. Further studies show that ROP1 regulates this specific polar exocytic pathway. Taken together, we have demonstrated an alternative TGN-independent Golgi-to-PM polar exocytic route, which mediates secretion of NtPPME1 for cell wall formation during cell expansion and cytokinesis and is ROP1-dependent.

Studies suggested a potential value of preablative stimulated thyroglobulin (ps-Tg) on predicting the recurrent and persistent diseases of differentiated thyroid cancer, whereas its correlations with therapeutic response remain uncertain.To establish the correlation between ps-Tg and therapeutic response proposed in 2015 American Thyroid Association guidelines, and calculate a cutoff ps-Tg threshold for predicting a poor response.Patients who underwent total thyroidectomy and radioactive iodine therapy in a university hospital participated in this retrospective study.Totally, 452 patients with differentiated thyroid cancer were followed for a median of 38 months and were divided into three groups in terms of ps-Tg level: group 1, less than 1 ng/ml (n = 82); group 2, 1-10 ng/ml (n = 173); and group 3, at least 10 ng/ml (n = 197).Clinical outcomes were assessed based on response to therapy restaging system, dividing responses into excellent, indeterminate, biomedical incomplete, and structural incomplete (SIR).Therapeutic responses could be obviously distinguished by different ps-Tg strata. SIR was identified in none of group 1, 1.73% of group 2, and 42.74% of group 3, respectively (χ(2) = 123.037, P.001). A cutoff value of ps-Tg at 26.75 ng/ml was obtained by receiver operating characteristic curve for differentiating SIR from either excellent, indeterminate, or biomedical incomplete responses. The area under curve was 0.947 and negative predictive value was 96.99%. Ps-Tg was an independent predictive variable of SIR (odds ratio, 42.312; P.001).Ps-Tg has a great performance in predicting therapeutic response and providing incremental value for decision making of radioactive iodine therapy, especially for patients with high ps-Tg level.

Preablative-stimulated thyroglobulin (ps-Tg) has manifested its potential for predicting prognosis in patients with differentiated thyroid carcinoma (DTC), but its level can be affected by thyrotropin (TSH). The objective of this study was to evaluate the utility of ps-Tg in predicting individual response after radioactive iodine (RAI) therapy, and further explore the appropriate TSH level for ps-Tg to serve as a prognostic marker in DTC without initial distant metastasis (DM).A total of 208 consecutive non-DM DTC patients with serial ps-Tg, TSH, and anti-Tg antibody (TgAb) measured simultaneously were enrolled. The initial and last measurements of ps-Tg were marked as Tg1 and Tg2, respectively, with a median interval of 8 days, so does TSH. Clinical response was retrospectively evaluated as excellent, indeterminate, biochemical incomplete, or structural incomplete response (ER, IDR, BIR, or SIR) after a mean follow-up of 21.5 months. Tg1 and Tg2 were tested and compared for their performances in predicting ER and incomplete response (IR, including BIR and SIR) by receiver operating characteristic (ROC) curve analysis. The 416 ps-Tg levels (Tg1 and Tg2) were then categorized by their corresponding TSH grouping of 30-60 (n = 100), 60-90 (n = 131), 90-120 (n = 99), and ≥120 μIU/mL (n = 86), and the predictive performances were further compared among TSH groups.Tg2, with a higher corresponding TSH level than Tg1 (median: 104.763 vs. 65.046 μIU/mL), presented higher area under the ROC curve (AUC) in predicting both ER and IR (ER: 0.889 vs. 0.836, P = 0.003; IR: 0.925 vs. 0.869, P = 0.046). The performances of ps-Tg in predicting ER and IR were both improved significantly as TSH rose from 30-60 to 60-90 μIU/mL, with an increase in AUC from 0.810 to 0.888 in predicting ER (P = 0.006) and from 0811 to 0.937 in predicting IR (P = 0.014), respectively. However, this kind of benefit was not further enlarged as TSH rose from 60-90 to 90-120 μIU/mL (both P 0.05).In comparison with the TSH context of 30 μIU/mL, a higher preablative TSH level of 60-90 μIU/mL might be more appropriate for ps-Tg to serve as a prognostic marker for DTC.