Background: Programmed cell death ligand 1 (PD-L1) expression has been shown to correlate with poor prognosis in diverse human cancers. However, limited data exist on the prognostic and clinicopathologic significance of PD-L1 expression in prostate cancers (PCa), and the curative effect of anti-PD-1/PD-L1 therapy remains controversial. In this systematic review and meta-analysis, we aimed to evaluate the prognostic and clinicopathologic value of PD-L1 in PCa.Methods: We performed a systematic literature search in the PubMed, Cochrane Library, EMBASE, Web of Science, and SCOPUS databases up to July 21st, 2018. Pooled prevalence of PD-L1 in PCa was calculated using Freeman-Tukey double arcsine transformation by R software version 3.5.0. The data from the studies were examined by a meta-analysis using Review Manager software 5.3 to calculate pooled hazard ratios (HRs) and pooled odds ratios (ORs) with 95% confidence intervals (CIs) to estimate the prognostic and clinicopathologic value of PD-L1 in PCa. Heterogeneity was tested by the Chi-squared test and I2 statistic.Results: Five studies with 2,272 patients were included in this meta-analysis. The pooled prevalence of PD-L1 in PCa was 35% (95% CI 0.32 to 0.37). Both PD-L1 expression (HR = 1.78; 95% CI 1.39 to 2.27; p < 0.00001) and PD-L1 DNA methylation (HR = 2.23; 95% CI 1.51 to 3.29; p < 0.0001) were significantly associated with poor biochemical recurrence-free survival (BCR-FS). PD-L1 tended to have high expression levels in high Gleason score cases (OR = 1.54; 95% CI, 1.17 to 2.03; P = 0.002) and androgen receptor-positive cases (OR = 2.42, 95% CI 1.31 to 4.50; P = 0.005). However, PD-L1 had relatively weak correlation with age, pathologic stage, lymph node metastasis and preoperative PSA level.Conclusions: This meta-analysis confirms the negative prognostic significance of PD-L1 expression and mPD-L1 in PCa patients. Additionally, PD-L1 has a statistically significant correlation with Gleason score and androgen receptor status, while the correlations with age, pathologic stage, lymph node metastasis, and preoperative PSA level were not statistically significant. However, the number of included studies is too small to make the conclusions more convincing, so more retrospective large-cohort studies are expected for the further confirmation of these findings.
BackgroundSupport from healthcare professionals has been identified as an important variable affecting successful breastfeeding in preterm infants. This study aimed to explore the knowledge of healthcare providers regarding breastfeeding preterm infants in mainland China.MethodsAn online cross-sectional survey of healthcare providers from 9 tertiary level neonatal intensive care units across 4 districts in mainland China was conducted from May–November, 2017. A total of 187 healthcare providers responded to the survey. Data included demographic information and current and desired knowledge about breastfeeding preterm infants. Breastfeeding knowledge was evaluated using a researcher-developed questionnaire with six domains based on breastfeeding preterm infant guidelines.ResultsThe average percent of correctly answered questions was 53.73%. The domain with the highest mean percent was ‘indications and methods of breastfeeding’ (64.41%). The lowest scoring domain was ‘characteristics of premature human milk’ (38.83%). Knowledge score was related to the following factors: age, profession, professional title, education background and offspring amount by univariate analysis (p < 0.05). Multiple linear regression analysis found that healthcare provider breastfeeding knowledge was associated with profession (physician or nurse), professional title, sex and total offspring. In terms of training needs, 86.7% of healthcare providers reported insufficient knowledge about breastfeeding in the preterm infant population; 82.2% wanted more knowledge about indications and contraindications related to breastfeeding premature infant; and 71.7% considered expert lectures as the most effective way of acquiring additional breastfeeding knowledge.ConclusionThe knowledge about breastfeeding in the preterm infant population among NICU healthcare professionals in mainland China was limited. More targeted training is needed to improve NICU healthcare provider knowledge regarding breastfeeding preterm infants.
Cadmium (Cd) pollution is one of the major threats in agricultural production, and can cause oxidative damage and growth limitation in plants. MicroRNA398 (miR398) is involved in plant resistance to different stresses, and the post-transcriptional regulation of miR398 on CSDs plays a key role. Here, we report that miR398 was down-regulated in tomato in response to Cd stress. Simultaneously, CSD1 and SOD were up-regulated, with CSD2 unchanged, suggesting CSD1 is involved in miR398-induced regulation under Cd stress. In addition, the role of miR398 in Cd tolerance in tomato was evaluated using a transgenic line overexpressing MIR398 (miR398#OE) in which the down-expression of miR398 was disrupted. The results showed that Cd stress induced more significant growth inhibition, oxidative damage, and antioxidant enzymes disorder in miR398#OE than that in wild type (WT). Moreover, higher Cd concentration in the shoot and xylem sap, and net Cd influx rate, were observed in miR398#OE, which could be due to the increased Cd uptake genes (IRT1, IRT2, and NRAMP2) and decreased Cd compartmentalization gene HMA3. Overall, our results indicate that down-regulated miR398 plays a protective role in tomato against Cd stress by modulating the activity of antioxidant enzymes and Cd uptake and translocation.
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