Platelets are reprogrammed by cancer via a process called education, which favors cancer development. The transcriptional profile of tumor-educated platelets (TEPs) is skewed and therefore practicable for cancer detection. This intercontinental, hospital-based, diagnostic study included 761 treatment-naïve inpatients with histologically confirmed adnexal masses and 167 healthy controls from nine medical centers (China, n = 3; Netherlands, n = 5; Poland, n = 1) between September 2016 and May 2019. The main outcomes were the performance of TEPs and their combination with CA125 in two Chinese (VC1 and VC2) and the European (VC3) validation cohorts collectively and independently. Exploratory outcome was the value of TEPs in public pan-cancer platelet transcriptome datasets. The AUCs for TEPs in the combined validation cohort, VC1, VC2, and VC3 were 0.918 (95% CI 0.889-0.948), 0.923 (0.855-0.990), 0.918 (0.872-0.963), and 0.887 (0.813-0.960), respectively. Combination of TEPs and CA125 demonstrated an AUC of 0.922 (0.889-0.955) in the combined validation cohort; 0.955 (0.912-0.997) in VC1; 0.939 (0.901-0.977) in VC2; 0.917 (0.824-1.000) in VC3. For subgroup analysis, TEPs exhibited an AUC of 0.858, 0.859, and 0.920 to detect early-stage, borderline, non-epithelial diseases and 0.899 to discriminate ovarian cancer from endometriosis. TEPs had robustness, compatibility, and universality for preoperative diagnosis of ovarian cancer since it withstood validations in populations of different ethnicities, heterogeneous histological subtypes, and early-stage ovarian cancer. However, these observations warrant prospective validations in a larger population before clinical utilities.
Humans ; Female ; Blood Platelets/pathology* ; Biomarkers, Tumor/genetics* ; Ovarian Neoplasms/pathology* ; China

Pregnane X receptor (PXR) is key transcription factors which mainly regulate the expression of CYP3A genes. At the molecular level, PXR has been revealed the protection mechanism of the body against xenochemicals and a major mode of the drug-drug interactions. Besides playing an important role in drug metabolism and interactions, PXR and its target genes also play an important role in maintaining normal physiological function and homeostasis. Therefore, it is necessary to study the regulation of PXR and its related pharmacological effects of TCM and natural products, and to provide new clues for the new pharmacological pathway.
Animals ; Drug Evaluation, Preclinical ; Drugs, Chinese Herbal ; pharmacology ; Gene Expression ; drug effects ; Humans ; Receptors, Steroid ; antagonists & inhibitors ; genetics ; metabolism

OBJECTIVETo optimize the synthetic pathway and fermentation process of yeast cell factories for production of oleanoic acid.

METHODUsing the DNA assembler method, one copy of Glycyrrhiza glabra beta-amyrin synthase (GgbAS), Medicago truncatula oleanolic acid synthase (MtOAS) and Arabidopsis thaliana cytochrome P450 reductase 1 (AtCPR1) genes were introduced into Saccharomyces cerevisiae strain BY-OA, resulting in strain BY-20A. YPD medium with different glucose concentration were then used to cultivate strain BY-2OA.

RESULTIncreasing gene copies of GgbAS, MtOAS and AtCPR1 resulted in increased beta-amyrin and oleanolic acid production. The strain BY-2OA produced 136.5 mg x L(-1) beta-amyrin and 92.5 mg x L(-1) oleanolic acid, which were 54% and 30% higher than the parent strain BY-OA. Finally, the titer of oleanolic acid increased to 165.7 mg x L(-1) when cultivated in YPD medium with 40 mg x L(-1) glucose.

CONCLUSIONProduction of oleanoic acid increased significantly in the yeast strain BY-2OA, which can provide the basis for creating an alternative way for production of oleanoic acid in place of extraction from plant sources.

Biomass ; Biotechnology ; methods ; Dose-Response Relationship, Drug ; Fermentation ; Glucose ; pharmacology ; Oleanolic Acid ; biosynthesis ; Saccharomyces cerevisiae ; cytology ; drug effects ; metabolism

BACKGROUNDThe chronic obstructive pulmonary disease assessment test (CAT) is an easy to use health-related quality of life questionnaire, the modified Medical Research Council (mMRC) dyspnea scale is a classic dyspnea scale which is widely used, while the correlation between them is still not clear. This study investigated the use of the Chinese translation of CAT in chronic obstructive pulmonary disease patients and its correlation with the mMRC dyspnea scale.

METHODSThe multicenter cross-sectional study was conducted in 329 hospitals throughout China from March 1 to April 30, 2010. Chronic obstructive pulmonary disease patients completed both the assessment test and the dyspnea scale during a single study visit.

RESULTSSix thousand, four hundred and thirty-seven patients were evaluated; 74.9% were male and the mean age was (64.9 ± 10.0) years. Median test scores in dyspnea grades 0 to 4 were 14, 16, 22, 26 and 32, respectively; these differences were statistically significant. The CAT score was moderately correlated with mMRC dyspnea grade (r = 0.579, P < 0.001). There was no significant difference in mean CAT score between males and females, and patients of high and low socioeconomic status. Primary analysis suggested that CAT scores were higher in older patients (>65 years) than in younger patients (≤ 65 years) and increased with duration of formal education, but these findings were repudiated by further analysis of subgroups according to mMRC dyspnea grade.

CONCLUSIONSThere was no obvious confounding factor influencing use of the CAT in Chinese patients. CAT scores were moderately correlated with the mMRC dyspnea scale.

Adult ; Aged ; Cross-Sectional Studies ; Dyspnea ; psychology ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; psychology ; Quality of Life ; Severity of Illness Index ; Surveys and Questionnaires

With the growing threat of malignancy to health, it is necessary to analyze cancer incidence and patient survival rates among the residents in Pudong New Area of Shanghai to formulate better cancer prevention strategies. A total of 43,613 cancer patients diagnosed between 2002 and 2006 were recruited from the Pudong New Area Cancer Registry. The incidence, observed survival rate, and relative survival rate of patients grouped by sex, age, geographic area, and TNM stage were calculated using the Kaplan-Meier, life table, and Ederer II methods, respectively. Between 2002 and 2006, cancer incidence in Pudong New Area was 349.99 per 100,000 person-years, and the 10 most frequently diseased sites were the lung, stomach, colon and rectum, liver, breast, esophagus, pancreas, brain and central nervous system, thyroid, and bladder. For patients with cancers of the colon and rectum, breast, thyroid, brain and central nervous system, and bladder, the 5-year relative survival rate was greater than 40%, whereas patients with cancers of the liver and pancreas had a 5-year relative survival rate of less than 10%. The 1-year to 5-year survival rates for patients grouped by sex, age, geographic area, and TNM stage differed significantly (all P < 0.001). Our results indicate that cancer incidence and patient survival in Pudong New Area vary by tumor type, sex, age, geographic area, and TNM stage.
Adult ; Age Factors ; Aged ; Breast Neoplasms ; epidemiology ; pathology ; China ; epidemiology ; Colorectal Neoplasms ; epidemiology ; pathology ; Female ; Humans ; Incidence ; Liver Neoplasms ; epidemiology ; pathology ; Lung Neoplasms ; epidemiology ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Neoplasms ; epidemiology ; pathology ; Pancreatic Neoplasms ; epidemiology ; pathology ; Rural Population ; Sex Factors ; Stomach Neoplasms ; epidemiology ; pathology ; Survival Rate ; Urban Population

Background The chronic obstructive pulmonary disease assessment test (CAT) is an easy to use health-related quality of life questionnaire,the modified Medical Research Council (mMRC) dyspnea scale is a classic dyspnea scale which is widely used,while the correlation between them is still not clear.This study investigated the use of the Chinese translation of CAT in chronic obstructive pulmonary disease patients and its correlation with the mMRC dyspnea scale.Methods The multicenter cross-sectional study was conducted in 329 hospitals throughout China from March 1 to April 30,2010.Chronic obstructive pulmonary disease patients completed both the assessment test and the dyspnea scale during a single study visit.Results Six thousand,four hundred and thirty-seven patients were evaluated; 74.9％ were male and the mean age was (64.9±10.0) years.Median test scores in dyspnea grades 0 to 4 were 14,16,22,26 and 32,respectively; these differences were statistically significant.The CAT score was moderately correlated with mMRC dyspnea grade (r=0.579,P ＜0.001).There was no significant difference in mean CAT score between males and females,and patients of high and low socioeconomic status.Pdmary analysis suggested that CAT scores were higher in older patients (＞65 years) than in younger patients (≤65 years) and increased with duration of formal education,but these findings were repudiated by further analysis of subgroups according to mMRC dyspnea grade.Conclusions There was no obvious confounding factor influencing use of the CAT in Chinese patients.CAT scores were moderately correlated with the mMRC dyspnea scale.

BACKGROUNDThe nocturnal nondipping and elevated morning blood pressure (BP) in patients with obstructive sleep apnea syndrome (OSAS) have not yet been well investigated in Chinese patients. This study aimed to describe the BP profile, and to elucidate the relationships between daytime BP and nighttime BP, and between evening BP and morning BP in patients with OSAS.

METHODSTwenty teaching hospital sleep centers in China were organized by the Chinese Medical Association to participate in this study and 2297 patients were recruited between January 2004 and April 2006. BP assessments were made at four time points (daytime, evening, nighttime and morning) and polysomnography (PSG) was performed and subjects were classified into four groups by their apnea-hypopnea index (AHI): control, n = 213 with AHI < 5; mild, n = 420 with AHI ≥ 5 and < 15; moderate, n = 460 with AHI ≥ 15 and < 30; and severe, n = 1204 with AHI ≥ 30. SPSS 11.5 software package was used for statistical analysis and figure drawing.

RESULTSAll the average daytime, nighttime, evening and morning BPs were positively correlated with AHI and negatively correlated with nadir nocturnal oxygen saturation. The ratios of nighttime/daytime and morning/evening average BP were positively correlated with AHI. The ratio of nighttime/daytime systolic BP became a "reversed BP dipping" pattern until the classification reached severe, while the ratio of nighttime/daytime diastolic BP became reversed at moderate. Similarly, the ratio of morning/evening diastolic BP becomes reversed even at mild.

CONCLUSIONSOSAS may result in higher BP levels at all four time points. The ratios of nighttime/daytime and morning/evening BP increase with increased AHI. The increasing of diastolic BP, which is inclined to rise more quickly, is not parallel with increasing systolic BP.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anthropometry ; Blood Pressure ; physiology ; Female ; Humans ; Hypertension ; physiopathology ; Male ; Middle Aged ; Sleep Apnea, Obstructive ; physiopathology ; Young Adult

Objective To analyze the incidence and survival rates of primary liver cancer (PLC) among residents in Pudong district of Shanghai.Methods Permanent residents of Pudong district,Shanghai were recruited in the study between 2002 and 2011,among whom 7981 PLC cases were diagnosed and 7233 death cases were certified.Both morbidity and mortality of PLC were calculated and standardized (ASR) by the world population of 1966,in order to analyze the survival condition of PLC patients on gender or address,to explore the prognosis of surgical excision treatment.Results Among the incident cases of PLC between 2002 and 2011,5754 cases were males,with an average age of 60.27; while 2227 cases were females,with an average age of 68.26.The crude incidence rate for both sexes was 30.73 per 100 000 person-year,and was 44.30 per 100 000 person-year for males,higher than that in females,17.16 per 100 000 person-year.The difference showed statistical significance (u=3.46,P＜0.01).The ASR for incidence rates were 25.72 per 100 000 person-year in males and 8.22 per 100 000 person-year in females,respectively,with difference statistically significant (u=3.00,P＜0.01).There were 7233 PLC death cases in total,including 5151 males and 2082 females,with the crude mortality rate as 27.85 per 100 000 person-year.Rate for males was 39.65 per 100 000 person-year,significantly different from 16.04 per 100 000 person-year in females,statistically (u=3.16,P＜0.01).The ASRs for mortality were 22.77 per 100 000 person-year in males and 7.39 per 100 000 person-year in females,with statistically significant difference (u=2.80,P＜0.01).Both incidence and mortality rates increased apparently for males aged over 35 and females aged over 45.The 1-to 5-year survival rates of PLC were 19.88％,14.91％,12.19％,10.29％ and 8.56％,respectively.There were statistically significant differences among urban,town and rural areas in the over-all survival rates(x2=8.711,P=0.013) ;The differences in 1-to 5-year survival rates between surgical and non-surgical groups showed statistically significant differences (u=10.8,6.93,4.75,3.3 and 2.61,respectively,P＜0.01).Conclusion The incidence and mortality rates in males were significantly higher than in females and the over-all survival in rural area was significantly lower than in other areas of Pudong district,suggesting that surgical treatment could improve the prognosis of PLC.

Background The nocturnal nondipping and elevated morning blood pressure (BP) in patients with obstructive sleep apnea syndrome (OSAS) have not yet been well investigated in Chinese patients.This study aimed to describe the BP profile,and to elucidate the relationships between daytime BP and nighttime BP,and between evening BP and morning BP in patients with OSAS.Methods Twenty teaching hospital sleep centers in China were organized by the Chinese Medical Association to participate in this study and 2297 patients were recruited between January 2004 and April 2006.BP assessments were made at four time points (daytime,evening,nighttime and morning) and polysomnography (PSG) was performed and subjects were classified into four groups by their apnea-hypopnea index (AHI):control,n=213 with AHI＜5; mild,n=420 with AHI ≥5 and＜15; moderate,n=460 with AHI≥15 and＜30; and severe,n=1204 with AHI ＞30.SPSS 11.5 software package was used for statistical analysis and figure drawing.Results All the average daytime,nighttime,evening and morning BPs were positively correlated with AHI and negatively correlated with nadir nocturnal oxygen saturation.The ralios of nighttime/daytime and morning/evening average BP were positively correlated with AHI.The ratio of nighttime/daytime systolic BP became a “reversed BP dipping” pattern until the classification reached severe,while the ratio of nighttime/daytime diastolic BP became reversed at moderate.Similarly,the ratio of morning/evening diastolic BP becomes reversed even at mild.Conclusions OSAS may result in higher BP levels at all four time points.The ratios of nighttime/daytime and morning/evening BP increase with increased AHI.The increasing of diastolic BP,which is inclined to rise more quickly,is not parallel with increasing systolic BP.

BACKGROUNDEpidemiologic studies have shown an independent and definite association between obstructive sleep apnea (OSA) and hypertension. This study aimed to define the association between daytime blood pressure and severity of OSA in Chinese population in mainland of China.

METHODSTwenty university hospital sleep centers in mainland of China were invited by the Chinese Medical Association (CMA) to participate in this epidemiologic study and 2297 consecutive patients (aged 18 - 85 years; 1981 males and 316 females) referred to these twenty sleep centers for evaluation of OSA between January 2004 and April 2006 were prospectively enrolled. Nocturnal polysomnography was performed in each patient, and disease severity was assessed based on the apneahypopnea index (AHI). These patients were classfied into four groups: nonapneic control (control, n = 257) with AHI < or = 5 episodes/hour; mild sleep apnea (mild, n = 402) with AHI > 5 and < or = 15 episodes/hour; moderate sleep apnea (moderate, n = 460) with AHI > 15 and < or = 30 episodes/hour and severe sleep apnea (severe, n = 1178) with AHI > 30 episodes/hour. Daytime blood pressure measurements were performed under standardized conditions in each patient at 10 a.m. in office on the day of referring to sleep centers for getting average value. All the patients were requested to quit medications related to blood pressure for three days before the day of assessing.

RESULTSBoth daytime systolic blood pressure and diastolic blood pressure values were significantly related to AHI positively (r = 0.201 and 0.276, respectively; both P values < 0.001) and to nadir nocturnal oxygen saturation negatively (r = -0.215 and -0.277, respectively; both P values < 0.001), which were the parameters of OSA severity. In two special designed mean plots, means of daytime systolic and diastolic blood pressure increased gradually with increasing AHI. Beyond AHI of 61 - 65, this increasing trend reached a plateau.

CONCLUSIONSThe results showed that OSA severity was associated with daytime blood pressure until AHI of 61 - 65, providing evidence for early OSA management, especially in OSA patients with concomitant hypertension.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Blood Pressure ; physiology ; China ; Female ; Humans ; Male ; Middle Aged ; Sleep Apnea, Obstructive ; pathology ; Young Adult