BACKGROUND:The pathogenesis of moyamoya disease is unclear,and there is a lack of early diagnostic methods and effective medical treatments.OBJECTIVE:To identify biomarkers of moyamoya disease through machine learning,and analyze the therapeutic mechanism of Bu Huang Si Wu Tang in moyamoya disease.METHODS:Moyamoya disease gene dataset from gene expression omnibus database was retrieved.R language was used to screen differentially expressed genes and perform enrichment analysis on differentially expressed genes.Moyamoya disease biomarkers were screened using least absolute shrinkage and selection operator and support vector machine-recursive feature elimination machine learning algorithms.A diagnostic model was constructed by establishing a column chart,and its clinical utility and diagnostic value were evaluated and further validated through detecting clinical serum markers of patients with moyamoya disease.In vitro experiments were performed to observe the effect of Bu Huang Si Wu Tang on umbilical vein endothelial cells under oxygen glucose deprivation,and the main components of Bu Huang Si Wu Tang were selected for molecular docking and molecular dynamics simulation with the screened targets to explore its potential mechanism.RESULTS AND CONCLUSION:This study identified 76 differentially expressed genes,mainly enriched in immune and metabolic related pathways.Two potential biomarkers,complement factor D(CFD)and DKFZp434L192,were obtained through machine learning.The calibration curve,decision curve analysis,and clinical impact curve showed that the column chart had good predictive ability.qRT-PCR analysis showed that CFD and DKFZp434L192 expression levels were significantly upregulated in patients with moyamoya disease(P<0.001).In vitro experiments showed that Bu Huang Si Wu Tang significantly enhanced the activity and migration ability(P<0.01)of umbilical vein endothelial cells under oxygen glucose deprivation.Molecular docking results showed that all four active ingredients of Bu Huang Si Wu Tang could bind to the target site,and the dynamic simulation results further verified its binding stability.To conclude,CFD and DKFZp434L192 exhibit good diagnostic efficacy for moyamoya disease and can serve as potential diagnostic biomarkers and therapeutic targets for moyamoya disease.Bu Huang Si Wu Tang has a certain protective effect on vascular endothelial cells under ischemic conditions,which may be related to CFD.

BACKGROUND:The pathogenesis of moyamoya disease is unclear,and there is a lack of early diagnostic methods and effective medical treatments.OBJECTIVE:To identify biomarkers of moyamoya disease through machine learning,and analyze the therapeutic mechanism of Bu Huang Si Wu Tang in moyamoya disease.METHODS:Moyamoya disease gene dataset from gene expression omnibus database was retrieved.R language was used to screen differentially expressed genes and perform enrichment analysis on differentially expressed genes.Moyamoya disease biomarkers were screened using least absolute shrinkage and selection operator and support vector machine-recursive feature elimination machine learning algorithms.A diagnostic model was constructed by establishing a column chart,and its clinical utility and diagnostic value were evaluated and further validated through detecting clinical serum markers of patients with moyamoya disease.In vitro experiments were performed to observe the effect of Bu Huang Si Wu Tang on umbilical vein endothelial cells under oxygen glucose deprivation,and the main components of Bu Huang Si Wu Tang were selected for molecular docking and molecular dynamics simulation with the screened targets to explore its potential mechanism.RESULTS AND CONCLUSION:This study identified 76 differentially expressed genes,mainly enriched in immune and metabolic related pathways.Two potential biomarkers,complement factor D(CFD)and DKFZp434L192,were obtained through machine learning.The calibration curve,decision curve analysis,and clinical impact curve showed that the column chart had good predictive ability.qRT-PCR analysis showed that CFD and DKFZp434L192 expression levels were significantly upregulated in patients with moyamoya disease(P<0.001).In vitro experiments showed that Bu Huang Si Wu Tang significantly enhanced the activity and migration ability(P<0.01)of umbilical vein endothelial cells under oxygen glucose deprivation.Molecular docking results showed that all four active ingredients of Bu Huang Si Wu Tang could bind to the target site,and the dynamic simulation results further verified its binding stability.To conclude,CFD and DKFZp434L192 exhibit good diagnostic efficacy for moyamoya disease and can serve as potential diagnostic biomarkers and therapeutic targets for moyamoya disease.Bu Huang Si Wu Tang has a certain protective effect on vascular endothelial cells under ischemic conditions,which may be related to CFD.

Objective:To investigate the molecular mechanism of antiglioma effect of curcumin.Methods:Cell experiment: (1) U251MG and SHG-44 cells at logarithmic growth phase were treated with 10 μmol/L curcumin (curcumin group) or same volume of dimethyl sulfoxide solution (control group); cells were transfected with negative control small interfering RNA (siRNA) and long non-coding RNA (lncRNA) H19 siRNA (negative control siRNA group and H19 siRNA group); cells were transfected with negative control siRNA and H19 siRNA, respectively, and then, they were treated with 10 μmol/L curcumin (negative control siRNA+curcumin group and H19 siRNA+curcumin group); the H19 siRNA was co-transfected with negative control miR inhibitor or miR-491-5p inhibitor into these cells (H19 siRNA+negative control inhibitor group and H19 siRNA+miR-4915p inhibitor group); H19 siRNA+negative control miR inhibitor or H19 siRNA+miR-491-5p inhibitor were co-transfected into the cells, and then, they were treated with 10 μmol/L curcumin (H19 siRNA+negative control inhibitor+curcumin group and H19 siRNA+miR-491-5p inhibitor+curcumin group); the cells were co-transfected with miR-491-5p mimic+blank plasmid or miR-491-5p mimic+HOXA9 overexpression plasmid, and then they were treated with 10 μmol/L curcumin (miR-491-5p mimic+blank plasmid+curcumin group and miR-491-5p mimic+HOXA9 overexpression plasmid+curcumin group); real-time fluorescent quantitative PCR (qRT-PCR) was used to detect the mRNA expressions of H19, miR-491-5p, and HOXA9; CCK-8 assay was used to detect the cell proliferation; flow cytometry was used to detect the cell apoptosis; plate cloning method was employed to detect the number of cell clone formation; Transwell assay was used to detect the cell migration; and the HOXA9 protein expression was measured by Western blotting. (2) The 293T cells at the logarithmic growth phase were chosen; the negative control miRNA mimics or miR-491-5p mimics combined with wild-type H19, wild-type HOXA9 3'-UTR plasmid vectors were co-transfected into the cells, respectively (negative control mimic+wild type H19 group and miR-491-5p mimic+wild type H19 group, negative control mimic+wild type HOXA9 3'-UTR group and miR-491-5p mimic+wild type HOXA9 3'-UTR group); the luciferase activity was detected by dual luciferase reporter experiment. (3) Thirty specimens from glioma patients (glioma group) underwent surgical resection and pathologically confirmed in our hospital from May 2017 to May 2019 and 30 normal brain tissue specimens obtained during decompression (normal group) at the same period were chosen; the mRNA expressions of H19, miR-491-5p, and HOXA9 were detected by qRT-PCR, and the HOXA9 protein expression level in these specimens was detected by Western blotting. (4) Twenty-four nude mice were randomly divided into negative control short hairpin RNA (shRNA) group, H19 shRNA group, negative control shRNA+curcumin group, and H19 shRNA+curcumin group ( n=6); U251MG cells stably transfected with negative control shRNA or H19 shRNA were intraperitoneally injected, respectively, into the mice; and 60 mg/kg curcumin was injected on the next d; the tumor volume was measured on the 7 th, 11 th, 15 th, 19 th, 23 rd, and 27 th d of rearing; and the H19, miR-491-5p and HOXA9 mRNA expressions in the tumor tissues were detected by qRT-PCR; the HOXA9 protein expression was detected by Western blotting. Results:(1) When curcumin group comparing with control group, and H19 siRNA group comparing with negative control siRNA group, U251MG and SHG-44 cells had significantly decreased miR-491-5p mRNA and protein expressions, and significantly increased miR-491-5p mRNA expression ( P<0.05); as compared with that in the H19 siRNA+negative control inhibitor group, the HOXA9 mRNA and protein expressions in U251MG and SHG-44 cells of H19 siRNA+miR-491-5p inhibitor group were significantly higher ( P<0.05). When curcumin group comparing with control group, H19 siRNA group comparing with negative control siRNA group, H19 siRNA+curcumin group comparing with negative control siRNA+curcumin group, the U251MG and SHG-44 cells after 72 h of culture had significantly decreased cell proliferation rate, significantly increased apoptosis rate, significantly reduced number of cell clone formation, and significantly reduced cell migration number ( P<0.05). When H19 siRNA+miR-491-5p inhibitor+curcumin group comparing with H19 siRNA+negative control inhibitor+curcumin group, miR-491-5p mimic+HOXA9 overexpression plasmid+curcumin group comparing with miR-491-5p mimic+blank plasmid+curcumin group, the U251MG and SHG-44 cells after 72 h of culture had significantly increased cell proliferation rate, significantly reduced apoptosis rate, significantly increased number of cell clone formation, and significantly increased cell migration number ( P<0.05). (2) When miR-491-5p mimic+wild-type H19 group comparing with negative control mimic+wild-type H19 group, miR-491-5p mimic+wild-type HOXA9 3'-UTR group comparing with negative control mimic+wild-type HOXA9 3'-UTR group, the cell luciferase activity was significantly reduced ( P<0.05). (3) As compared with those in the normal group, the H19 and HOXA9 mRNA expressions and HOXA9 protein expression in the glioma group were significantly increased, and the miR-491-5p mRNA expression was significantly reduced ( P<0.05). (4) On the 27 th d of rearing, when H19 shRNA group comparing with negative control shRNA group, and H19 shRNA+curcumin group comparing with negative control shRNA+curcumin group, the tumor volume was significantly reduced, the miR-491-5p mRNA expression in the tumor tissues was significantly increased, and the H19 mRNA, HOXA9 mRNA and protein expressions were significantly reduced ( P<0.05). Conclusion:Curcumin may inhibit the cell proliferation and migration and promote the apoptosis of glioma cells through lncRNA H19/miR-491-5p/HOXA9 axis.

【Objective】 To explore the value of thromboelastogram (TEG) in evaluating coagulation function of patients with liver cancer. 【Methods】 102 patients with liver cancer and 48 with hepatic hemangioma from Department of Hepatobiliary Surgery, Nanyang Central Hospital from August 2017 to September 2020 were retrospectively analyzed. TEG indicators (R, K, Angle, MA, CI, and G value) and routine coagulation indicators (Plt, PT, INR, APTT, FIB, and TT) of those patients and basic clinical data of liver cancer patients were collected, and the difference of detection parameters between the liver cancer group and liver hemangioma group was compared; The difference of TEG parameters in liver cancer patient subgroups was compared, and the correlation between TEG and routine coagulation tests in liver cancer patients was analyzed using Spearman rank correlation analysis. The sensitivity of the two detection methods in detecting the coagulation status of patients with liver cancer was compared. 【Results】 1) Compared with patients with hepatic hemangioma, Plts decreased significantly (166.6±108.824 vs 224.10±54.933, P<0.001), while PT, INR and APTT values increased significantly (13.12±2.052 vs 11.421±0.884, 1.156±0.191 vs 1.00±0.074, 29.977±5.333 vs 26.954±5.269, all P<0.05) in patients with liver cancer; MA and G values in patients with liver cancer were lower (56.991±11.574 vs 60.069±5.094, 7.667±4.682 vs 7.725±1.709, P<0.05); 2) Compared with newly diagnosed liver cancer patients, the Plt of re-diagnosed liver cancer patients decreased significantly(125.78±79.673 vs 188.86±116.437, P<0.05); the R and K value increased significantly (7.594±2.601 vs 6.058±1.739, 3.453±2.402 vs 2.438±1.990, all P<0.05), while the Angle, MA, CI and G value decreased significantly (53.897±12.288 vs 61.495±9.949, 53.556±11.407 vs 58.865±11.313, -3.494±4.253vs -0.836±3.180, 6.311±3.209 vs 8.406±5.191, all P<0.05); 3) There were significant differences in TEG parameters (R value excluded) between liver resection, transhepatic arterial chemoembolization and conservative treatment (P<0.05); 4) The R, K value of patients with liver cancer were negatively correlated with the Plt value, while the Angle, MA, CI, and G value were positively correlated with Plt value (P<0.001); the K value was negatively correlated with the Fib value, while the Angle, MA, CI, G value were positively correlated with Fib value (P<0.001); the R and K value were positively correlated with TT value, while the Angle and CI were negatively correlated with TT value (P<0.05); 5) The detection rate of hypocoagulability by TEG and routine coagulation testing was 18.63% (19/102) and 7.84%. 【Conclusion】 Compared with the newly diagnosed liver cancer patients, re-diagnosed liver cancer patients showed hypercoagulability. TEG can diagnose the coagulation abnormalties more sensitively, and help reduce the risk of bleeding.