The use of vaccines for cancer therapy is a promising immunotherapeutic strategy that has been shown to be effective against various cancers. Vaccines directly target tumors but their efficacy against glioblastoma multiforme (GBM) remains unclear. Immunotyping that classifies tumor samples is considered to be a biomarker for immunotherapy. This study aimed to identify potential GBM antigens suitable for vaccine development and develop a tool to predict the response of GBM patients to vaccination based on the immunotype. Gene Expression Profiling Interactive Analysis (GEPIA) was applied to evaluate the expression profile of GBM antigens and their influence on clinical prognosis, while the cBioPortal program was utilized to integrate and analyze genetic alterations. The correlation between antigens and antigen processing cells was assessed using TIMER. RNA-seq data of GBM samples and their corresponding clinical data were downloaded from the Cancer Genome Atlas (TCGA) and the Chinese Glioma Genome Atlas (CGGA) for further clustering analysis. Six overexpressed and mutated tumor antigens (ARHGAP9, ARHGAP30, CLEC7A, MAN2B1, ARPC1B and PLB1) were highly correlated with the survival rate of GBM patients and the infiltration of antigen presenting cells in GBMs. With distinct cellular and molecular characteristics, three immune subtypes (IS1-IS3) of GBMs were identified and GBMs from IS3 subtype were more likely to benefit from vaccination. Through graph learning-based dimensional reduction, immune landscape was depicted and revealed the existence of heterogeneity among individual GBM patients. Finally, WGCNA can identify potential vaccination biomarkers by clustering immune related genes. In summary, the six tumor antigens are potential targets for developing anti-GBMs mRNA vaccine, and the immunotypes can be used for evaluating vaccination response.

Synapse and synapse associated proteins (SAPs) play critical roles in various neurodegeneration diseases and brain tumors. However, in lower-grade gliomas (LGG), SAPs have not been explored systematically. Herein, we are going to explore SAPs expression profile and its clinicopathological significance in LGG which can offer new insights to glioma therapy. In this study, we integrate a list of SAPs that covered 231 proteins with synaptogenesis activity and post synapse formation. The LGG RNA-seq data were downloaded from GEO, TCGA and CGGA database. The prognosis associated SAPs in key modules of PPI (protein-protein interaction networks) was regarded as hub SAPs. Western blot, quantitative reverse transcription PCR (qRT-PCR) and immunochemistry results from HPA database were used to verify the expression of hub SAPs. There were 68 upregulated SAPs and 44 downregulated SAPs in LGG tissue compared with normal brain tissue. Data from function enrichment analysis revealed functions of differentially expressed SAPs in synapse organization and glutamatergic receptor pathway in LGGs. Survival analysis revealed that four SAPs, GRIK2, GABRD, GRID2 and ARC were correlate with the prognosis of LGG patients. Interestingly, we found that GABRD were upregulated in LGG patients with seizures, indicating that SAPs may link to the pathogenesis of seizures in glioma patients. The four-SAPs signature was revealed as an independent prognostic factor in gliomas. Our study presented a novel strategy to assess the prognostic risks of LGGs, based on the expression of SAPs.

Background: Vascular endothelial growth factors (VEGFs) are important for glioblastoma multiforme (GBM) growth and development. However, the effects of VEGF-targeting drugs in primary GBM remain poorly understood. Aim: We aimed to explore the key genes correlated with VEGF expression and prognosis and elucidate their potential implications in GBM anti-VEGF therapy. Materials and Methods: RNA-seq data with the corresponding clinicopathological information was retrieved from The Cancer Genome Atlas and the Chinese Glioma Genome Atlas. Weighted gene coexpression network analyses was performed on differentially expressed genes to construct coexpression modules and investigate their correlation with VEGFs. Functional enrichment analyses were performed based on the coexpressed genes from the most promising modules. CytoHubba and Kaplan-Meier analyses were implemented to identify the key genes in the modules of interest. The oncomine database, quantitative reverse transcription PCR, and the Human Protein Atlas were used to investigate the expression characteristics of the identified key genes. Results: Four modules (cyan, green, purple, and tan) correlated significantly with VEGF expression. Enrichment analyses suggested that extracellular matrix-receptor interaction, growth factor binding, and the PI3K-Akt pathways were involved in VEGF expression. Four hub genes (COL6A1, SNRPG, COL3A1, and AHI1) associated with VEGF were identified. Among them, COL6A1 was regarded as the key gene associated with anti-VEGF therapy. Further, COL6A1 was upregulated in GBM compared to that in normal brain tissues. COL6A1 overexpression was associated with a poor prognosis. Conclusion: COL6A1 was identified as the key gene associated with anti-VEGF therapy and may provide novel insight into GBM targeted therapy.

Background: Synapse and synapse associated proteins (SAPs) play critical roles in various neurodegeneration diseases and brain tumors. However, in lower-grade gliomas (LGG), SAPs have not been explored systematically. Herein, we are going to explore SAPs expression profile and its clinicopathological significance in LGG which can offer new insights to glioma therapy. Method: In this study, we used five sources including, Venkatesh, Shen, Colón, Jüttner R, Gene Ontology (GO) project to integrate a list of SAPs that covered 231 proteins with synaptogenesis activity and post synapse formation. The LGG RNA-seq data were downloaded from gene expression omnibus (GEO) database, The Cancer Genome Atlas (TCGA), and Chinese Glioma Genome Atlas (CGGA). The differentially expressed SAPs were filtered out and constructed PPI to search for key modules and SAPs. Then, using Kaplan–Meier survival analysis, least absolute shrinkage and selection operator (LASSO), and multicox regression analysis, the prognostic significance of these key SAPs was evaluated. CGGA database, Human Protein Altas (HPA) and quantitative real-time PCR were used to verify our findings. Result: Data from function enrichment analysis revealed functions of differentially expressed SAPs in synapse organization and glutamatergic receptor pathway in LGGs. Survival analysis revealed four SAPs, GRIK2, GABRD, GRID2, ARC that were correlate with the prognosis of LGG patients and used to construct the prognostic models. Among them, the expression of GABRD was lower in glioma tissue than normal brain tissue, but higher in seizure LGG patients than non-seizure patients. The four-SAPs signature was revealed as an independent prognostic factor in gliomas.Conclusion: Our study presented a novel strategy to assess the prognostic risks of LGGs, based on the expression of SAPs. Also, we revealed that several SAPs upregulated in patients with seizures, indicating that they are linked to the pathogenesis of seizures in glioma patients.

This study was aimed at evaluating the application effect of pulmonary rehabilitation training under 5A nursing mode based on X-ray in elderly patients with chronic obstructive pulmonary disease (COPD). Then, 84 elderly patients with chronic obstructive emphysema were selected as the research subjects. COPD knowledge level questionnaire, caregiver self-efficacy scale (CSES), COPD assessment test (CAT), and 6-minute walking experiment (6MWD) were adopted, and the clinical application effect of pulmonary rehabilitation training and conventional nursing under 5A nursing mode was comprehensively compared. The results show that after two and four months of intervention, the average score of COPD knowledge level questionnaire in the test group was 27.43 points and 30.08 points, respectively, higher than that in the control group ( P < 0.05 ). After two and four months of intervention, the number of patients with good compliance in the test group was remarkably improved, and the severity of airflow restriction in the test group was slower than that in the control group. In short, pulmonary rehabilitation training under 5A nursing mode based on X-ray can effectively improve the disease knowledge level, self-efficacy, and pulmonary rehabilitation training compliance of elderly COPD patients, which played an important role in improving the quality of life of patients and alleviating the degree of dyspnea of patients.

BackgroundSynapse and synapse associated proteins (SAPs) play critical roles in various neurodegeneration diseases and brain tumors. However, in lower-grade gliomas (LGG), SAPs have not been explored systematically. Herein, we are going to explore SAPs expression profile and its clinicopathological significance in LGG which can offer new insights to glioma therapy. MethodIn this study, we used five sources including, Venkatesh, Shen, Colón, Jüttner R, Gene Ontology (GO) project to integrate a list of SAPs that covered 231 proteins with synaptogenesis activity and post synapse formation. The LGG RNA-seq data were downloaded from gene expression omnibus (GEO) database, The Cancer Genome Atlas (TCGA), and Chinese Glioma Genome Atlas (CGGA). The differentially expressed SAPs were filtered out and constructed PPI to search for key modules and SAPs. Then, using Kaplan–Meier survival analysis, least absolute shrinkage and selection operator (LASSO), and multicox regression analysis, the prognostic significance of these key SAPs was evaluated. CGGA database, Human Protein Altas (HPA) and quantitative real-time PCR were used to verify our findings. ResultData from function enrichment analysis revealed functions of differentially expressed SAPs in synapse organization and glutamatergic receptor pathway in LGGs. Survival analysis revealed four SAPs, GRIK2, GABRD, GRID2, ARC that were correlate with the prognosis of LGG patients and used to construct the prognostic models. Among them, the expression of GABRD was lower in glioma tissue than normal brain tissue, but higher in seizure LGG patients than non-seizure patients. The four-SAPs signature was revealed as an independent prognostic factor in gliomas. ConclusionOur study presented a novel strategy to assess the prognostic risks of LGGs, based on the expression of SAPs. Also, we revealed that several SAPs upregulated in patients with seizures, indicating that they are linked to the pathogenesis of seizures in glioma patients.

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Objectives Chronic obstructive pulmonary disease (COPD) patients have higher laryngopharyngeal reflux (LPR)‐related symptom incidence. But LPR treatment is empirical. We aimed to determine the frequency of LPR, diagnosed by 24‐hour Dx‐pH monitoring, among acute exacerbations of COPD (AECOPD) patients with Reflux Symptom Index (RSI) ≥13 and investigate proton pump inhibitor (PPI) treatment effect on LPR, COPD symptoms, and pulmonary function. Methods From January 2016 to September 2017, 102 AECOPD patients with RSI ≥13 were enrolled. COPD assessment test (CAT), mMRC dyspnea scale, pulmonary function tests, and 24‐hour Dx‐pH monitoring were performed. The Ryan score was evaluated by using the Dx‐pH DataView Lite software, which identifies patients with abnormal pharyngeal pH environments. Associations among RSI, pulmonary function test results, and Ryan score parameters were evaluated. The abovementioned assessments were reperformed after treatment, and pre‐ and posttreatment data were compared. Results Of the 102 eligible patients, 49 (48.04%) were diagnosed with LPR based on Ryan score. Percentage of the forced expiratory volume at 1 second (FEV1%) was significantly worse in Ryan‐positive than in Ryan‐negative AECOPD patients. There were significant negative correlations between FEV1% and Ryan score (r = −0.394, P < 0.001), FEV1% and % time below pH threshold (r = −0.371, P < 0.001) in upright position but not in supine position. There was no significant correlation between RSI and Ryan score parameters. There were significant improvements in RSI, mMRC, CAT, and FEV1% in Ryan‐positive AECOPD patients after PPI and basic treatments. Conclusion Study results indicate unreliability of RSI threshold for LPR diagnosis. Combination of symptoms, endoscopic findings, and 24‐hour Dx‐pH monitoring is recommended for LPR diagnosis and PPI treatment decisions, especially in difficult‐to‐control or severe COPD patients.