Low microRNA-139 expression associates with poor prognosis in patients with tumors: A meta-analysis

Background:microRNA-139(miR-139)is dysregulated in various types of tumors and plays a key role in carcinogenesis.miR-139 may be used as a diagnostic and prognostic biomarker of cancers.However,the data from the literature are not consistent.The present study aimed to verify the prognostic and diagnostic values of miR-139 in solid tumors.Data sources:PubMed,Web of Science and Embase databases were searched and publications from January 2011 to August 2017 were included.We used Gene Expression Omnibus(GEO)and The Cancer Genome Atlas(TCGA)database to further validate this meta-analysis.Results:Eight individual studies from seven articles were included.Pooled analyses showed that low miR-139 expression was related to worse overall survival(OS)[hazard ratio(HR)=2.27;95%confidence intervals(CI):1.74–2.95;P<0.001]in solid tumors,including hepatocellular carcinoma(HCC)and glioblastoma multiforme(GBM),consisting with the results of TCGA.However,our results of CRC showed that low miR-139 expression was associated with poor OS which was contradictory with the results in TCGA database and need larger samples to validate the phenomenon;whereas for CRC patients,high miR-139 expression predicted poor RFS,which was in good accordance with TCGA results.The results of 27 microarrays from GEO database showed that miR-139 expression levels were lower in tumor tissues compared to adjacent non-tumor tissues or healthy tissues.Decreased miR-139 expression was also significantly correlated with poor differentiation grade(OR=3.57;95%CI:1.44–8.85;P=0.006).However,the combined data indicated that no associations between miR-139 expression and the following parameters such as age(pooled OR=1.50;95%CI:0.69–3.24;P=0.304),gender(pooled OR=0.92;95%CI:0.56–1.51;P=0.738),tumor size(pooled OR=1.51;95%CI:0.69–3.31;P=0.298),late tumor-node-metastasis stage(pooled OR=1.63;95%CI:0.99–2.68;P=0.057)and lymph-node-metastasis(pooled OR=0.66;95%CI:0.34–1.28;P=0.222).Conclusions:Low miR-139 expression was related to poor prognosis in HCC and GBM,which could be regarded as a potential prognostic biomarker.However,its precise functional role in CRC still need to be further investigated through larger samples and multicenter studies.

Hypereosinophilic syndrome presenting as acute ischemic stroke,myocardial infarction,and arterial involvement:A case report

BACKGROUND Simultaneous cerebral and myocardial infarction with arterial involvement has not been reported in hypereosinophilic syndrome(HES).Here,we report a patient with HES that was also associated with acute ischemic stroke,myocardial infarction,and arterial involvement of the left common carotid artery,vertebral arteries,posterior cerebral artery,and coronary artery.CASE SUMMARY A 64-year-old male patient was admitted with headache and right lower extremity weakness.Laboratory tests indicated eosinophilia.Brain magnetic resonance imaging(MRI)showed bilateral and multiple acute infarcts in the border zones.Electrocardiography revealed that T wave was inverted and that the concentration of troponin I was significantly elevated above normal levels.Cardiac echocardiography showed an ejection fraction of 69%with mitral and tricuspid mild regurgitation.Computed tomography angiography detected multiple and localized instances of mild stenosis in the left common carotid artery bifurcation,bilateral vertebral arteries(V5 segment),and the posterior cerebral artery(P2 segment).These were observed together with multiple non-calcified and mixed plaques as well as luminal stenosis in the left circumflex artery,left anterior descending artery,and right coronary artery.The patient was treated with oral methylprednisolone and clopidogrel,after which the absolute eosinophil count fell rapidly to a normal level.After one month,a second brain MRI showed a partial reduction in the size and number of the lesions.CONCLUSION HES can masquerade as ischemic stroke,myocardial infarction,and arterial vascular involvement.The patient reported here recovered very quickly when his eosinophil blood count returned to normal.Early diagnosis and rapid reduction of eosinophils may lead to a good prognosis.

Systemic non-albicans infections presented as meningitis in chronic hepatitis B patient:a case report

Non-albicans candida meningitis is a relatively rare disease,with nonspecific clinical manifestation,which makes the misdiagnosis occur sometimes,especially in the early stage of the disease.Abuse of broad-spectrum antibiotics,corticosteroids,central vein cannulas,senility,big operation,malignancy,and total parenteral alimentation were all the susceptible factors of non-albicans candida infection.We present a case of this type of non-albicans infection in a 42-year-old woman who was early misdiagnosed as tuberculous meningitis and was treated with antibiotics and antituberculosis agents.The diagnosis of non-albicans infection was confirmed by fungus culture of the cerebrospinal fluid(CSF)with a low detectable rate.This case reminds us that the non-albicans candida meningitis had a nonspecific clinical presentations and laboratory data,and was difficult to differentiate from tuberculosis meningitis.Hence,we should highly suspect this disease if central nervous system infections with uncertain pathogens.Test cell counts;protein and fungus culture of CSF should be used to confirm the diagnosis.Once the diagnosis was established,the patients should receive antifungal treatment based on drug sensitivity tests as early as possible.