Abstract Objective: transarterial chemoembolization (TACE) is one of the common treatments for hepatocellular carcinoma (HCC). Predicting prognosis for HCC patients who received TACE is challenging because of huge differences in outcome. At present, the Nutritional Risk Screening 2002 (NRS-2002) is widely used to screen nutritional risk in hospitalized patients, which has been confirmed to be related to prognosis. Here, the objective of this research is to construct a prognostic nomogram using the NRS-2002 score for HCC patients receiving TACE. Methods: we enrolled 359 HCC patients who received TACE at the Xingtai People's Hospital between January 2015 and December 2020. According to the preoperative NRS-2002 score, patients were divided into an NRS ≥ 3 group (n = 190; 52.9 %) and an NRS < 3 group (n = 167, 47.1 %). Meanwhile, variables associated with survival were analyzed by univariate and multivariate Cox regression. Beyond that, a nomogram incorporating independent variables was established. The concordance index (C-index) and calibration curves were used to assess the prediction performance of the nomogram. Results: the median survival of the NRS ≥ 3 group was significantly lower than that of the NRS < 3 group. As shown by multivariate analysis, in the Barcelona Clinic Liver Cancer stage an NRS-2002 score ≥ 3, γ-glutamyl transpeptidase, and alpha-fetoprotein were significantly associated with survival in HCC patients after TACE. In addition, the C-index was 0.708 (95 % confidence interval: 0.672-0.743), and the calibration curves showed a good consistency between the observed and predicted survivals at 1, 2, and 3 years, respectively. Conclusions: NRS-2002 ≥ 3 could identify high-risk patients with HCC who received TACE. The NRS-2002-based nomogram model had good prognostic prediction accuracy.

Resumen Objetivo: la quimioembolización transarterial (TACE) es uno de los tratamientos comúnmente utilizados para el carcinoma hepatocelular (CHC). La predicción pronóstica en pacientes con CHC sometidos a TACE es un desafío debido a la gran variabilidad del resultado. La “Detección del riesgo nutricional 2002” (NRS-2002) se utiliza ampliamente en la actualidad para evaluar el riesgo nutricional de los pacientes hospitalizados y se ha demostrado que está relacionada con el pronóstico. Aquí, nuestro objetivo fue construir un nomograma pronóstico, utilizando la puntuación NRS-2002, para pacientes con HCC que reciben TACE. Métodos: reclutamos a 359 pacientes con CHC tratados con TACE en el Hospital Popular de Xingtai desde enero de 2015 hasta diciembre de 2020. Los pacientes se dividieron en un grupo NRS ≥ 3 (n = 190; 52,9 %) y un grupo NRS < 3 (n = 167, 47,1 %) según la puntuación NRS-2002 preoperatoria. Las variables asociadas con la supervivencia se analizaron mediante la regresión de Cox univariante y multivariante. Se estableció un nomograma que incorpora variables independientes. El rendimiento predictivo del nomograma se evaluó mediante el índice de concordancia (índice C) y la curva de calibración. Resultados: la mediana de supervivencia del grupo NRS ≥ 3 fue significativamente menor que la del grupo NRS < 3. El análisis multivariante mostró que el estadio del grupo de Clínica de Cáncer de Hígado de Barcelona, una puntuación NRS-2002 ≥ 3, la γ-glutamil transpeptidasa y la alfa-fetoproteína se asociaron significativamente con la supervivencia de los pacientes con CHC después de la TACE. El índice C fue de 0,708 (intervalo de confianza del 95 %: 0,672-0,743) y las curvas de calibración mostraron una buena concordancia entre las supervivencias observadas y las predichas a 1, 2 y 3 años. Conclusiones: la puntuación NRS-2002 ≥ 3 podría identificar a los pacientes con HCC de alto riesgo sometidos a TACE. El modelo de nomograma basado en la NRS-2002 tuvo una buena precisión de predicción pronóstica.

Severe pneumonia related to human adenoviruses (HAdVs) has a high lethality rate in children and its early diagnosis and treatment remain a major challenge. Circular RNAs (circRNAs) are novel long noncoding RNAs that play important roles in gene regulation and disease pathogenesis. To investigate the roles of circRNAs in HAdV pneumonia, we analyzed the circRNA profiles of healthy children and children with HAdV pneumonia, including both mild and severe cases, and identified 139 significantly upregulated circRNAs in children with HAdV pneumonia vs healthy controls and 18 significantly upregulated circRNAs in children with severe HAdV pneumonia vs mild HAdV pneumonia. In particular, hsa_circ_0002171 was differentially expressed in both groups and might thus be useful as a diagnostic biomarker of HAdV pneumonia and severe HAdV pneumonia. To identify the underlying mechanisms of circRNAs in HAdV pneumonia, we analyzed the transcriptome of children with HAdV pneumonia and established a circRNA-mRNA regulatory network. Enrichment analysis of differentially expressed target mRNAs demonstrated that the differentially expressed genes between healthy controls and HAdV pneumonia patients were mainly involved in RNA splicing while the differentially expressed genes between children with mild and severe HAdV pneumonia were mainly involved in regulating lymphocyte activation. Receiver operating characteristic (ROC) curve analysis suggested that hsa_circ_0002171 had a significant value in the diagnosis of HAdV pneumonia and of severe HAdV pneumonia. Taken together, the circRNA expression profile was altered in children with HAdV pneumonia. These results demonstrated that hsa_circ_0002171 is a potential diagnostic biomarker of HAdV pneumonia.

ABSTRACT Objective This study aimed to present the impact of age and gender on thyroid hormone levels in a large Chinese population with sufficient iodine intake. Subjects and methods A total of 83643 individuals were included and were stratified by age and gender. The median, 2.5th and 97.5th of thyrotropin (TSH), free triiodothyronine (FT3), free thyroxine (FT4) and FT3/FT4 ratio were calculated for both genders for every decade from 18 to over 80 years. TSH, FT3, FT4, FT3/FT4 distribution in each age group was evaluated for females and males using smoothing splines in the generalized additive models (GAM). TSH concentrations were compared in the different age groups in gender. Results In the over 80s age group, the TSH level (median: 2.57 mIU/L, 2.5th-97.5th: 0.86-7.56 mIU/L) was significantly higher than other age groups, irrespective to gender (P<0.001). Females had a higher TSH value than males in all age groups (P<0.001). Results of the smoothing curves showed that TSH increased with age, FT3 concentration was higher in males than in females and the tendency of the FT3/FT4 ratio was basically similar to that of FT3. TSH concentration in the 50s age group (median 2.48 mIU/L for females versus 2.00 mIU/L for males) was significantly higher than that in the 30s age group (median 2.18 mIU/L for females versus median 1.85 mIU/L for males). Conclusions In accord with increasing TSH values during aging, females and older adults have lower FT3 values and lower FT3/FT4 ratios, while the FT4 values remain stable.