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A pan-cancer analysis of the oncogenic role of Holliday junction recognition protein in human tumors

  • Rong Su , Hechen Huang , Xingxing Gao , Yuan Zhou , Shengyong Yin , Haiyang Xie , Lin Zhou and Shusen Zheng EMAIL logo
Published/Copyright: February 16, 2022

Abstract

Although cell-based or animal-based research evidence support the association of Holliday junction recognition protein (HJURP) with cancers, no pan-cancer investigation has been reported. The datasets of Gene Expression Omnibus database along with The Cancer Genome Atlas project were used to evaluate the expression of HJURP in various types of tumors. HJURP is overexpressed in a considerable number of cancers, and some changes in DNA methylation and genetic alterations are discovered in some types of tumors, such as kidney-related and adrenal gland-related tumors. Based on PrognoScan and gene expression profiling interactive analysis (GEPIA), the elevated expression of HJURP worsened the survival time of individuals with cancer. The biological general repository for interaction datasets (BioGRID) and The database for annotation, visualization and integrated discovery (DAVID) were used to establish the functional molecular network. It revealed that the cell cycle and p53 signaling pathway are the key molecular mechanisms that HJURP promotes carcinogenesis. The nomograms between HJURP and clinical pathological factors based on the Cox proportional hazards model showed a good prognostic performance in kidney carcinoma, hepatocellular carcinoma, and lung adenocarcinoma. Our first pan-cancer study provides a relatively profound insights into the oncogenic roles of HJURP across different tumors.

1 Introduction

The pan-cancer analysis provides a unique and comprehensive understanding of how, where, and why cancers appear in humans. Due to the complexity of tumorigenesis, the pan-cancer expression analysis helps to assess the association between special genes and clinical outcome/potential molecular mechanism. The Cancer Genome Atlas (TCGA) project and the Gene Expression Omnibus (GEO) database, which contain public functional genomics data of different tumors, allow researchers to perform pan-cancer analysis [1,2].

Holliday junction recognition protein (HJURP) is a histone H3 chaperone that mediates centromere protein A (CENP-A) deposition at human centromeres during the early G1 phase. HJURP is required for cell cycle-specific targeting of CENP-A to centromeres participating in tumorigenesis [3,4]. Highly expressed HJURP gene expression and its transcriptional signature are reported in many cancer types, such as hepatocellular carcinoma, glioma, breast cancer, and bladder cancer [5,6,7]. Our earlier study has already demonstrated that active HJURP promoted cell proliferation through the ubiquitination and cytoplasmic localization of cyclin dependent kinase inhibitor 1A via the mitogen-activated protein kinases1/2 and AKT serine/threonine kinase 1/glycogen synthase kinase 3 beta pathways in hepatocellular carcinoma [8].

Herein, we (1) investigated the association between HJURP and clinical prognosis across TCGA cancers; (2) compared HJURP expression in cancer vs. normal tissues; (3) identified key genomic features such as DNA methylation, mutation, and copy number variation; and (4) described the integrated network and pathway of HJURP.

2 Materials and methods

The mRNA expression of HJURP in different types of cancers of microarray datasets was evaluated in the ONCOMINE data resource (www.oncomine.org). Moreover, the mRNA expression of HJURP in different types of cancers in TCGA datasets was evaluated in the tumor immune estimation resource (TIMER) data resource (cistrome.org/TIMER). The methylation, mutation, and copy number variation of HJURP were obtained from cBioPortal (www.cbioportal.org) [9,10,11].

2.1 Survival analysis performed in PrognoScan and GEPIA

The association of HJURP with survival in pan-cancer was evaluated in PrognoScan (http://dna00.bio.kyutech.ac.jp/PrognoScan/index.html), as well as GEPIA (http://gepia.cancer-pku.cn) data resources [12,13]. PrognoScan screens the connection linking gene expression to aspects of prognosis of patients, entailing disease-free survival (DFS) and overall survival (OS), over an extensive collection of publicly accessible cancer microarray datasets. The threshold was adjusted to Cox p-value <0.05.

2.2 Integrated network analysis of HJURP

Integrated network analysis of HJURP was obtained from BioGRID 4.2 (https://thebiogrid.org), consisting of physical and genetic interaction data [14]. Yellow means the line is based on physical interactions. Green means the line is generated from genetic interaction. Purple means colocalization. Node size stands for its weight in the network.

2.3 Pathway enrichment analysis

The 50 genes with the highest correlation with HJURP expression were obtained from GEPIA. Pathway enrichment analysis (gene ontology and kyoto encyclopedia of genes and genomes) of HJURP-related genes was performed using DAVID 6.8 [15]. Pathways with a p-value threshold of 0.05 were regarded to be significantly regulated.

2.4 Prognostic analysis

The multivariate prognostic analysis is expressed by nomogram, based on rms (R package).

  1. Ethics approval and consent to participate: Not applicable.

3 Results

3.1 The mRNA expression and genomic features

As many studies have suggested that HJURP is highly expressed in cancer, it may constitute a pivotal novel target or a biomarker for diagnosis. In the ONCOMINE database, we evaluated 20 kinds of tumors with adjacent normal tissues, showing that 62 out of 383 data sources of microarray included significantly high expression levels of HJURP (Figure 1a). RNA sequencing data in TCGA examined by TIMER showed that the levels of HJURP expression were remarkably higher in tumor tissues in contrast with normal tissues, among BLCA, BRCA, CESC, CHOL, COAD, ESCA, GBM, HNSC, KICH, KIRC, KIRP, LIHC, LUAD, LUSC, PCPG, PRAD, READ, STAD, THCA, and UCEC (Figure 1b). Figure 1c indicates the DNA methylation levels among 29 kinds of tumors, demonstrating the lowest DNA methylation level of HJURP in the kidney-related and adrenal gland-related tumors. Low DNA methylation level may be one of the possible mechanisms that promote the high expression biological effects of the oncogene. To find out the genomic features of HJURP, we checked the genetic alterations in the cBioPortal database. The deep deletion of HJURP was the most accumulated factor in sarcoma, cervical adenocarcinoma, diffuse glioma, and esophageal squamous cell carcinoma. Besides, the mutation frequencies of HJURP are the highest in endometrial carcinoma, melanoma, esophagogastric adenocarcinoma, cervical squamous cell carcinoma, and bladder urothelial carcinoma (Figure 1d).

Figure 1 
                  HJURP expression and mutation landscape: (a) In the ONCOMINE database, the expression of HJURP in tumor tissues compared with normal tissues. The number in each unit is the number of data sets. Red means that the tumor is significantly high in tumor tissues; blue is the opposite. (b) The expression level of HJURP of different tumor types in the TIMER database. (c) Boxplot of the methylation levels. (d) HJURP (single mutation) mutation and copy number aberrations in all TCGA cohorts.
Figure 1

HJURP expression and mutation landscape: (a) In the ONCOMINE database, the expression of HJURP in tumor tissues compared with normal tissues. The number in each unit is the number of data sets. Red means that the tumor is significantly high in tumor tissues; blue is the opposite. (b) The expression level of HJURP of different tumor types in the TIMER database. (c) Boxplot of the methylation levels. (d) HJURP (single mutation) mutation and copy number aberrations in all TCGA cohorts.

3.2 Multifaceted clinical prognosis of HJURP in cancers

Next, we explored the clinical prognosis of HJURP for pan-cancer in two data resources. In PrognoScan, HJURP expression was remarkably linked to five kinds of cancers, consisting of blood, brain, breast, soft tissue, and lung cancer (Figure 2). HJURP played an oncogenic role in multiple myeloma (GSE2658: DSS, n = 559, HR = 1.55, Cox p = 0.000223), in brain cancer (GSE4271: OS, n = 74, HR = 1.56, Cox p = 0.001901; GSE4412: OS, HR = 1.56, Cox p = 0.001901), in soft tissue cancer (GSE30929: DRFS, n = 140, HR = 2.61, Cox p = 0.000136), and in lung cancer (GSE31210: OS, n = 74, HR = 1.56, Cox p = 0.001901; RFS, HR = 1.94, Cox p = 0.000003). HJURP had a very detrimental role in breast cancer (GSE1456: OS, n = 159, HR = 1.77, Cox p = 0.001678; GSE2034: DMFS, n = 286, HR = 1.51, Cox p = 0.011628; GSE9195: RFS, n = 77, HR = 4.63, Cox p = 0.002148; GSE11121: DMFS, n = 200, HR = 2.24, Cox p = 0.001154; GSE12276: RFS, HR = 1.39, Cox p = 0.001701).

Figure 2 
                  Kaplan–Meier survival curves comparing high and low expression of HJURP in different cancer types in PrognoScan: (a) DSS (n = 562) in multiple myeloma cohort GSE2658, (b) OS (n = 77) in brain cancer cohort GSE4271, (c) OS (n = 74) in brain cancer cohort GSE4412, (d) OS (n = 159) in breast cancer cohort GSE1456, (e) DMFS (n = 286) in breast cancer cohort GSE2034, (f) RFS (n = 78) in breast cancer cohort GSE9195, (g) DMFS (n = 200) in breast cancer cohort GSE11121, (h) RFS (n = 204) in breast cancer cohort GSE12276, (i) DRFS (n = 140) in soft tissue cancer cohort GSE30929, and (j and k) OS and RFS (n = 204) in lung cancer cohort GSE31210.
Figure 2

Kaplan–Meier survival curves comparing high and low expression of HJURP in different cancer types in PrognoScan: (a) DSS (n = 562) in multiple myeloma cohort GSE2658, (b) OS (n = 77) in brain cancer cohort GSE4271, (c) OS (n = 74) in brain cancer cohort GSE4412, (d) OS (n = 159) in breast cancer cohort GSE1456, (e) DMFS (n = 286) in breast cancer cohort GSE2034, (f) RFS (n = 78) in breast cancer cohort GSE9195, (g) DMFS (n = 200) in breast cancer cohort GSE11121, (h) RFS (n = 204) in breast cancer cohort GSE12276, (i) DRFS (n = 140) in soft tissue cancer cohort GSE30929, and (j and k) OS and RFS (n = 204) in lung cancer cohort GSE31210.

We further investigated the prognostic value (OS and RFS) of HJURP for pan-cancer in TCGA. In general, HJURP was a harmful index for cancer outcome in most cancer types (Figure 3 and Figure A1). High levels of HJURP expression were harmful for kidney-related cancer (Figure 3a and b). In addition, we indicated that the level of HJURP expression had a forceful positive relationship with patient pathological stages (p < 0.001). We also found some similar effects in LIHC and LUAD (Figure 3c and d).

Figure 3 
                  The relationship between the expression of HJURP and clinical prognosis/tumor stage. Kaplan–Meier survival curves and boxplot showed the association between expression of HJURP and OS, RFS and clinical stage of (a) kidney renal clear cell carcinoma, (b) kidney renal papillary cell carcinoma, (c) liver hepatocellular carcinoma, and (d) lung adenocarcinoma. Boxplot “boxes” indicate the first, second, and third quartiles of the data.
Figure 3

The relationship between the expression of HJURP and clinical prognosis/tumor stage. Kaplan–Meier survival curves and boxplot showed the association between expression of HJURP and OS, RFS and clinical stage of (a) kidney renal clear cell carcinoma, (b) kidney renal papillary cell carcinoma, (c) liver hepatocellular carcinoma, and (d) lung adenocarcinoma. Boxplot “boxes” indicate the first, second, and third quartiles of the data.

3.3 Integrated network and pathway analysis of HJURP

To obtain more functional insights for HJURP, an integrative network was built on coexpression, physical interaction, genetic interaction, where we found that the most related protein is CENPA, and the linkage is supported by an earlier study (Figure 4a) [16]. HJURP is the molecular chaperone of CENP-A, which is considered as an epigenetic mark of the centromere [17]. Integrated network analysis revealed that HJURP may associate with cell cycle, further affecting carcinogenesis. Based on the GEPIA database, we calculated the Pearson correlation coefficient between HJURP and all other genes among KIRC, KIRP, LIHC, and LUAD, and obtained the top 50 genes with the largest correlation coefficient. Pathway analysis was conducted based on the top 50 genes to demonstrate their molecular function and biological process by DAVID. Pathway analysis revealed that these genes converged on cell cycle and p53 signaling pathway, which are components of carcinogenesis. The top ten most related pathways are shown in Figure 4b–e.

Figure 4 
                  Integrated network and pathway analysis of HJURP: (a) The integrated network of HJURP. Yellow means the line is based on physical interactions. Green means the line is generated from genetic interaction. Purple means colocalization. Node size stands for its weight in the network. (b–e) Pathway enrichment of top 50 genes with the highest expression similarity to HJURP in different tumor types.
Figure 4

Integrated network and pathway analysis of HJURP: (a) The integrated network of HJURP. Yellow means the line is based on physical interactions. Green means the line is generated from genetic interaction. Purple means colocalization. Node size stands for its weight in the network. (b–e) Pathway enrichment of top 50 genes with the highest expression similarity to HJURP in different tumor types.

3.4 Nomogram construction for HJURP based on TCGA

To predict the probability of cancer recurrence, we built some nomograms that combined both HJURP and clinicopathological factors (Figure 5). Researchers can use our nomograms to predict the clinical prognosis of specific individuals based on the age, gender, pathological tumor stage, and the absolute expression of HJURP (transcripts per kilobase of per million mapped reads). These nomograms of KIRC, KIRP, LIHC, and LUAD showed a good predictive power, especially for 2 year survival. The calibration plots demonstrated that the developed nomogram performed well.

Figure 5 
                  Nomogram construction and validation: (a) Nomogram for predicting 2, 3, and 5 year OS for different cancer patients based on expression of HJURP and clinicopathological parameters. (b) Calibration curves of nomograms in terms of agreement between predicted and observed 2, 3, and 5 year outcomes in TCGA cohort. The dashed line of 45° represents perfect prediction, and the actual performances of our nomogram are shown by green, red, and blue lines.
Figure 5

Nomogram construction and validation: (a) Nomogram for predicting 2, 3, and 5 year OS for different cancer patients based on expression of HJURP and clinicopathological parameters. (b) Calibration curves of nomograms in terms of agreement between predicted and observed 2, 3, and 5 year outcomes in TCGA cohort. The dashed line of 45° represents perfect prediction, and the actual performances of our nomogram are shown by green, red, and blue lines.

4 Discussion

It has been reported that HJURP played an important role in human neoplasms [18]. HJURP has been demonstrated to participate in a number of biological processes including cell cycle across different cancers [19]. Moreover, HJURP exhibits some oncogenic activities in various cancer types such as breast cancer and liver cancer. Through a literature search, no reference was found with the pan-cancer assessment of HJURP of overall tumors. Thus, in this study, we examined the HJURP gene in 20 kinds of tumors based on TCGA and GEO databases and identified that the cell cycle and p53 signaling pathway triggered by HJURP are the key factors for tumor growth.

Two studies have reported that HJURP mRNA contents remained an independent prognostic factor for DFS and OS [20,21]. Based on Kaplan–Meier analysis containing datasets (GSE1456, GSE2034, GSE9195, GSE11121, and GSE12276), high expression of HJURP was related to poor clinical outcomes, such as OS, distant metastasis-free survival, and relapse-free survival. Among these breast cancer cohorts, GSE1456 contained breast tumors of different molecular classifications, GSE2034 was a dataset from breast tissues from lymph node-negative patients, and the GSE12276 dataset evaluated breast cancer samples from patients who have had brain metastasis. The significant association between the expression of HJURP and the prognosis of patients revealed that HJURP was a general biomarker for breast cancer. Although we did not find a significant association between expression of HJURP and total survival in the TCGA-BRCA cohort, there was a significant association between HJURP and 5 year survival and 2 year progression-free survival (Figure A2).

For kidney-related tumors, Xu and his colleagues indicated HJURP, ISG20, and FOXM1 as hub genes via weighted gene coexpression network analysis [22]. We here gave more evidence about the molecular mechanism of HJURP-inducing kidney-related tumors and the associations between HJURP and the prognosis of kidney-related tumors.

Even though we integrated information from different databases, there were still some limitations in this study. We did not confirm that the high level of HJURP is a byproduct of dysregulated signaling or a starting factor. The changes in DNA methylation and genetic alterations seem to suggest more hidden mechanisms of epigenetics, and biological experiments in vitro/vivo are needed to verify these findings and promote clinical utility. More research should be conducted to explore further the prospective role of HJURP in cell cycle modulation of tumorigenesis. All of the microarray and sequencing data were collected by bulk tumor tissue; thus, the nontumor cells could have introduced systematic bias. In the future, some researches with a higher resolution, such as single-cell RNA sequencing, should be performed.

Altogether, our data show a new understanding of the nature of HJURP in cancer. We demonstrate that HJURP has an oncogenic influence on pan-cancer, and high HJURP expression worsens the survival of cancer patients. Collectively, HJURP is not only a biomarker of carcinogenesis, but also a marker of poor prognosis.

Abbreviations

ACC

adrenocortical carcinoma

BLCA

bladder urothelial carcinoma

BRCA

breast invasive carcinoma

CESC

cervical squamous cell carcinoma and endocervical adenocarcinoma

CHOL

cholangiocarcinoma

COAD

colon adenocarcinoma

DLBC

diffuse large B-cell lymphoma

ESCA

esophageal carcinoma

GBM

glioblastoma multiforme

HNSC

head and neck squamous cell carcinoma

KICH

kidney chromophobe

KIRC

kidney renal clear cell carcinoma

KIRP

kidney renal papillary cell carcinoma

LAML

acute myeloid leukemia

LGG

lower grade glioma

LIHC

liver hepatocellular carcinoma

LUAD

lung adenocarcinoma

LUSC

lung squamous cell carcinoma

MESO

mesothelioma

OV

ovarian serous cystadenocarcinoma

PADD

pancreatic adenocarcinoma

PCPG

pheochromocytoma and paraganglioma

PRAD

prostate adenocarcinoma

READ

rectum adenocarcinoma

SARC

sarcoma

SKCM

skin cutaneous melanoma

STAD

stomach adenocarcinoma

TGCT

testicular germ cell tumors

THCA

thyroid carcinoma

THYM

thymoma

UCEC

uterine corpus endometrial carcinoma

UCS

uterine carcinosarcoma

UVM

uveal melanoma

OS

overall survival

DMFS

distant metastasis-free survival

DRFS

distant recurrence free survival

DSS

disease-specific survival

RFS

relapse-free survival


Rong Su and Hechen Huang contributed equally.

tel: +86-571-87236466, fax: +86-571-87236466

Acknowledgments

Not applicable.

  1. Funding information: This study was supported by Research Unit Project of Chinese Academy of Medical Sciences [Zhejiang University] (2019-I2M-5-030) and Grant from Health Commission of Zhejiang Province [Zhejiang University] (JBZX-202004).

  2. Author contributions: RS, HX, LZ, and SZ conceived and designed the experiments. SY and XG performed data acquisition. XG, HH, and YZ analyzed the data. RS and HH wrote and edited the manuscript. All authors read and approval the final manuscript.

  3. Conflict of interest: The authors declare that they have no competing interests.

  4. Data availability statement: The datasets analyzed during the current study are available in the ONCOMINE (www.oncomine.org), TIMER (cistrome.org/TIMER), cBioPortal (www.cbioportal.org), PrognoScan (dna00.bio.kyutech.ac.jp/PrognoScan/index.html), GEPIA (gepia.cancer-pku.cn), and BioGRID 4.2 (https://thebiogrid.org).

Appendix

Figure A1 
                  The relationship between the expression of HJURP and clinical prognosis in TCGA.
Figure A1

The relationship between the expression of HJURP and clinical prognosis in TCGA.

Figure A2 
                  The relationship between the expression of HJURP and 5-year overall survival and 2-year progression free survival in TCGA-BRCA datasets.
Figure A2

The relationship between the expression of HJURP and 5-year overall survival and 2-year progression free survival in TCGA-BRCA datasets.

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Received: 2021-05-26
Revised: 2021-11-30
Accepted: 2021-12-14
Published Online: 2022-02-16

© 2022 Rong Su et al., published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  43. miR-223-3p alleviates TGF-β-induced epithelial-mesenchymal transition and extracellular matrix deposition by targeting SP3 in endometrial epithelial cells
  44. Clinical value of SIRT1 as a prognostic biomarker in esophageal squamous cell carcinoma, a systematic meta-analysis
  45. circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8
  46. miR-22-5p regulates the self-renewal of spermatogonial stem cells by targeting EZH2
  47. hsa-miR-340-5p inhibits epithelial–mesenchymal transition in endometriosis by targeting MAP3K2 and inactivating MAPK/ERK signaling
  48. circ_0085296 inhibits the biological functions of trophoblast cells to promote the progression of preeclampsia via the miR-942-5p/THBS2 network
  49. TCD hemodynamics findings in the subacute phase of anterior circulation stroke patients treated with mechanical thrombectomy
  50. Development of a risk-stratification scoring system for predicting risk of breast cancer based on non-alcoholic fatty liver disease, non-alcoholic fatty pancreas disease, and uric acid
  51. Tollip promotes hepatocellular carcinoma progression via PI3K/AKT pathway
  52. circ_0062491 alleviates periodontitis via the miR-142-5p/IGF1 axis
  53. Human amniotic fluid as a source of stem cells
  54. lncRNA NONRATT013819.2 promotes transforming growth factor-β1-induced myofibroblastic transition of hepatic stellate cells by miR24-3p/lox
  55. NORAD modulates miR-30c-5p-LDHA to protect lung endothelial cells damage
  56. Idiopathic pulmonary fibrosis telemedicine management during COVID-19 outbreak
  57. Risk factors for adverse drug reactions associated with clopidogrel therapy
  58. Serum zinc associated with immunity and inflammatory markers in Covid-19
  59. The relationship between night shift work and breast cancer incidence: A systematic review and meta-analysis of observational studies
  60. LncRNA expression in idiopathic achalasia: New insight and preliminary exploration into pathogenesis
  61. Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway
  62. Moscatilin suppresses the inflammation from macrophages and T cells
  63. Zoledronate promotes ECM degradation and apoptosis via Wnt/β-catenin
  64. Epithelial-mesenchymal transition-related genes in coronary artery disease
  65. The effect evaluation of traditional vaginal surgery and transvaginal mesh surgery for severe pelvic organ prolapse: 5 years follow-up
  66. Repeated partial splenic artery embolization for hypersplenism improves platelet count
  67. Low expression of miR-27b in serum exosomes of non-small cell lung cancer facilitates its progression by affecting EGFR
  68. Exosomal hsa_circ_0000519 modulates the NSCLC cell growth and metastasis via miR-1258/RHOV axis
  69. miR-455-5p enhances 5-fluorouracil sensitivity in colorectal cancer cells by targeting PIK3R1 and DEPDC1
  70. The effect of tranexamic acid on the reduction of intraoperative and postoperative blood loss and thromboembolic risk in patients with hip fracture
  71. Isocitrate dehydrogenase 1 mutation in cholangiocarcinoma impairs tumor progression by sensitizing cells to ferroptosis
  72. Artemisinin protects against cerebral ischemia and reperfusion injury via inhibiting the NF-κB pathway
  73. A 16-gene signature associated with homologous recombination deficiency for prognosis prediction in patients with triple-negative breast cancer
  74. Lidocaine ameliorates chronic constriction injury-induced neuropathic pain through regulating M1/M2 microglia polarization
  75. MicroRNA 322-5p reduced neuronal inflammation via the TLR4/TRAF6/NF-κB axis in a rat epilepsy model
  76. miR-1273h-5p suppresses CXCL12 expression and inhibits gastric cancer cell invasion and metastasis
  77. Clinical characteristics of pneumonia patients of long course of illness infected with SARS-CoV-2
  78. circRNF20 aggravates the malignancy of retinoblastoma depending on the regulation of miR-132-3p/PAX6 axis
  79. Linezolid for resistant Gram-positive bacterial infections in children under 12 years: A meta-analysis
  80. Rack1 regulates pro-inflammatory cytokines by NF-κB in diabetic nephropathy
  81. Comprehensive analysis of molecular mechanism and a novel prognostic signature based on small nuclear RNA biomarkers in gastric cancer patients
  82. Smog and risk of maternal and fetal birth outcomes: A retrospective study in Baoding, China
  83. Let-7i-3p inhibits the cell cycle, proliferation, invasion, and migration of colorectal cancer cells via downregulating CCND1
  84. β2-Adrenergic receptor expression in subchondral bone of patients with varus knee osteoarthritis
  85. Possible impact of COVID-19 pandemic and lockdown on suicide behavior among patients in Southeast Serbia
  86. In vitro antimicrobial activity of ozonated oil in liposome eyedrop against multidrug-resistant bacteria
  87. Potential biomarkers for inflammatory response in acute lung injury
  88. A low serum uric acid concentration predicts a poor prognosis in adult patients with candidemia
  89. Antitumor activity of recombinant oncolytic vaccinia virus with human IL2
  90. ALKBH5 inhibits TNF-α-induced apoptosis of HUVECs through Bcl-2 pathway
  91. Risk prediction of cardiovascular disease using machine learning classifiers
  92. Value of ultrasonography parameters in diagnosing polycystic ovary syndrome
  93. Bioinformatics analysis reveals three key genes and four survival genes associated with youth-onset NSCLC
  94. Identification of autophagy-related biomarkers in patients with pulmonary arterial hypertension based on bioinformatics analysis
  95. Protective effects of glaucocalyxin A on the airway of asthmatic mice
  96. Overexpression of miR-100-5p inhibits papillary thyroid cancer progression via targeting FZD8
  97. Bioinformatics-based analysis of SUMOylation-related genes in hepatocellular carcinoma reveals a role of upregulated SAE1 in promoting cell proliferation
  98. Effectiveness and clinical benefits of new anti-diabetic drugs: A real life experience
  99. Identification of osteoporosis based on gene biomarkers using support vector machine
  100. Tanshinone IIA reverses oxaliplatin resistance in colorectal cancer through microRNA-30b-5p/AVEN axis
  101. miR-212-5p inhibits nasopharyngeal carcinoma progression by targeting METTL3
  102. Association of ST-T changes with all-cause mortality among patients with peripheral T-cell lymphomas
  103. LINC00665/miRNAs axis-mediated collagen type XI alpha 1 correlates with immune infiltration and malignant phenotypes in lung adenocarcinoma
  104. The perinatal factors that influence the excretion of fecal calprotectin in premature-born children
  105. Effect of femoral head necrosis cystic area on femoral head collapse and stress distribution in femoral head: A clinical and finite element study
  106. Does the use of 3D-printed cones give a chance to postpone the use of megaprostheses in patients with large bone defects in the knee joint?
  107. lncRNA HAGLR modulates myocardial ischemia–reperfusion injury in mice through regulating miR-133a-3p/MAPK1 axis
  108. Protective effect of ghrelin on intestinal I/R injury in rats
  109. In vivo knee kinematics of an innovative prosthesis design
  110. Relationship between the height of fibular head and the incidence and severity of knee osteoarthritis
  111. lncRNA WT1-AS attenuates hypoxia/ischemia-induced neuronal injury during cerebral ischemic stroke via miR-186-5p/XIAP axis
  112. Correlation of cardiac troponin T and APACHE III score with all-cause in-hospital mortality in critically ill patients with acute pulmonary embolism
  113. LncRNA LINC01857 reduces metastasis and angiogenesis in breast cancer cells via regulating miR-2052/CENPQ axis
  114. Endothelial cell-specific molecule 1 (ESM1) promoted by transcription factor SPI1 acts as an oncogene to modulate the malignant phenotype of endometrial cancer
  115. SELENBP1 inhibits progression of colorectal cancer by suppressing epithelial–mesenchymal transition
  116. Visfatin is negatively associated with coronary artery lesions in subjects with impaired fasting glucose
  117. Treatment and outcomes of mechanical complications of acute myocardial infarction during the Covid-19 era: A comparison with the pre-Covid-19 period. A systematic review and meta-analysis
  118. Neonatal stroke surveillance study protocol in the United Kingdom and Republic of Ireland
  119. Oncogenic role of TWF2 in human tumors: A pan-cancer analysis
  120. Mean corpuscular hemoglobin predicts the length of hospital stay independent of severity classification in patients with acute pancreatitis
  121. Association of gallstone and polymorphisms of UGT1A1*27 and UGT1A1*28 in patients with hepatitis B virus-related liver failure
  122. TGF-β1 upregulates Sar1a expression and induces procollagen-I secretion in hypertrophic scarring fibroblasts
  123. Antisense lncRNA PCNA-AS1 promotes esophageal squamous cell carcinoma progression through the miR-2467-3p/PCNA axis
  124. NK-cell dysfunction of acute myeloid leukemia in relation to the renin–angiotensin system and neurotransmitter genes
  125. The effect of dilution with glucose and prolonged injection time on dexamethasone-induced perineal irritation – A randomized controlled trial
  126. miR-146-5p restrains calcification of vascular smooth muscle cells by suppressing TRAF6
  127. Role of lncRNA MIAT/miR-361-3p/CCAR2 in prostate cancer cells
  128. lncRNA NORAD promotes lung cancer progression by competitively binding to miR-28-3p with E2F2
  129. Noninvasive diagnosis of AIH/PBC overlap syndrome based on prediction models
  130. lncRNA FAM230B is highly expressed in colorectal cancer and suppresses the maturation of miR-1182 to increase cell proliferation
  131. circ-LIMK1 regulates cisplatin resistance in lung adenocarcinoma by targeting miR-512-5p/HMGA1 axis
  132. LncRNA SNHG3 promoted cell proliferation, migration, and metastasis of esophageal squamous cell carcinoma via regulating miR-151a-3p/PFN2 axis
  133. Risk perception and affective state on work exhaustion in obstetrics during the COVID-19 pandemic
  134. lncRNA-AC130710/miR-129-5p/mGluR1 axis promote migration and invasion by activating PKCα-MAPK signal pathway in melanoma
  135. SNRPB promotes cell cycle progression in thyroid carcinoma via inhibiting p53
  136. Xylooligosaccharides and aerobic training regulate metabolism and behavior in rats with streptozotocin-induced type 1 diabetes
  137. Serpin family A member 1 is an oncogene in glioma and its translation is enhanced by NAD(P)H quinone dehydrogenase 1 through RNA-binding activity
  138. Silencing of CPSF7 inhibits the proliferation, migration, and invasion of lung adenocarcinoma cells by blocking the AKT/mTOR signaling pathway
  139. Ultrasound-guided lumbar plexus block versus transversus abdominis plane block for analgesia in children with hip dislocation: A double-blind, randomized trial
  140. Relationship of plasma MBP and 8-oxo-dG with brain damage in preterm
  141. Identification of a novel necroptosis-associated miRNA signature for predicting the prognosis in head and neck squamous cell carcinoma
  142. Delayed femoral vein ligation reduces operative time and blood loss during hip disarticulation in patients with extremity tumors
  143. The expression of ASAP3 and NOTCH3 and the clinicopathological characteristics of adult glioma patients
  144. Longitudinal analysis of factors related to Helicobacter pylori infection in Chinese adults
  145. HOXA10 enhances cell proliferation and suppresses apoptosis in esophageal cancer via activating p38/ERK signaling pathway
  146. Meta-analysis of early-life antibiotic use and allergic rhinitis
  147. Marital status and its correlation with age, race, and gender in prognosis of tonsil squamous cell carcinomas
  148. HPV16 E6E7 up-regulates KIF2A expression by activating JNK/c-Jun signal, is beneficial to migration and invasion of cervical cancer cells
  149. Amino acid profiles in the tissue and serum of patients with liver cancer
  150. Pain in critically ill COVID-19 patients: An Italian retrospective study
  151. Immunohistochemical distribution of Bcl-2 and p53 apoptotic markers in acetamiprid-induced nephrotoxicity
  152. Estradiol pretreatment in GnRH antagonist protocol for IVF/ICSI treatment
  153. Long non-coding RNAs LINC00689 inhibits the apoptosis of human nucleus pulposus cells via miR-3127-5p/ATG7 axis-mediated autophagy
  154. The relationship between oxygen therapy, drug therapy, and COVID-19 mortality
  155. Monitoring hypertensive disorders in pregnancy to prevent preeclampsia in pregnant women of advanced maternal age: Trial mimicking with retrospective data
  156. SETD1A promotes the proliferation and glycolysis of nasopharyngeal carcinoma cells by activating the PI3K/Akt pathway
  157. The role of Shunaoxin pills in the treatment of chronic cerebral hypoperfusion and its main pharmacodynamic components
  158. TET3 governs malignant behaviors and unfavorable prognosis of esophageal squamous cell carcinoma by activating the PI3K/AKT/GSK3β/β-catenin pathway
  159. Associations between morphokinetic parameters of temporary-arrest embryos and the clinical prognosis in FET cycles
  160. Long noncoding RNA WT1-AS regulates trophoblast proliferation, migration, and invasion via the microRNA-186-5p/CADM2 axis
  161. The incidence of bronchiectasis in chronic obstructive pulmonary disease
  162. Integrated bioinformatics analysis shows integrin alpha 3 is a prognostic biomarker for pancreatic cancer
  163. Inhibition of miR-21 improves pulmonary vascular responses in bronchopulmonary dysplasia by targeting the DDAH1/ADMA/NO pathway
  164. Comparison of hospitalized patients with severe pneumonia caused by COVID-19 and influenza A (H7N9 and H1N1): A retrospective study from a designated hospital
  165. lncRNA ZFAS1 promotes intervertebral disc degeneration by upregulating AAK1
  166. Pathological characteristics of liver injury induced by N,N-dimethylformamide: From humans to animal models
  167. lncRNA ELFN1-AS1 enhances the progression of colon cancer by targeting miR-4270 to upregulate AURKB
  168. DARS-AS1 modulates cell proliferation and migration of gastric cancer cells by regulating miR-330-3p/NAT10 axis
  169. Dezocine inhibits cell proliferation, migration, and invasion by targeting CRABP2 in ovarian cancer
  170. MGST1 alleviates the oxidative stress of trophoblast cells induced by hypoxia/reoxygenation and promotes cell proliferation, migration, and invasion by activating the PI3K/AKT/mTOR pathway
  171. Bifidobacterium lactis Probio-M8 ameliorated the symptoms of type 2 diabetes mellitus mice by changing ileum FXR-CYP7A1
  172. circRNA DENND1B inhibits tumorigenicity of clear cell renal cell carcinoma via miR-122-5p/TIMP2 axis
  173. EphA3 targeted by miR-3666 contributes to melanoma malignancy via activating ERK1/2 and p38 MAPK pathways
  174. Pacemakers and methylprednisolone pulse therapy in immune-related myocarditis concomitant with complete heart block
  175. miRNA-130a-3p targets sphingosine-1-phosphate receptor 1 to activate the microglial and astrocytes and to promote neural injury under the high glucose condition
  176. Review Articles
  177. Current management of cancer pain in Italy: Expert opinion paper
  178. Hearing loss and brain disorders: A review of multiple pathologies
  179. The rationale for using low-molecular weight heparin in the therapy of symptomatic COVID-19 patients
  180. Amyotrophic lateral sclerosis and delayed onset muscle soreness in light of the impaired blink and stretch reflexes – watch out for Piezo2
  181. Interleukin-35 in autoimmune dermatoses: Current concepts
  182. Recent discoveries in microbiota dysbiosis, cholangiocytic factors, and models for studying the pathogenesis of primary sclerosing cholangitis
  183. Advantages of ketamine in pediatric anesthesia
  184. Congenital adrenal hyperplasia. Role of dentist in early diagnosis
  185. Migraine management: Non-pharmacological points for patients and health care professionals
  186. Atherogenic index of plasma and coronary artery disease: A systematic review
  187. Physiological and modulatory role of thioredoxins in the cellular function
  188. Case Reports
  189. Intrauterine Bakri balloon tamponade plus cervical cerclage for the prevention and treatment of postpartum haemorrhage in late pregnancy complicated with acute aortic dissection: Case series
  190. A case of successful pembrolizumab monotherapy in a patient with advanced lung adenocarcinoma: Use of multiple biomarkers in combination for clinical practice
  191. Unusual neurological manifestations of bilateral medial medullary infarction: A case report
  192. Atypical symptoms of malignant hyperthermia: A rare causative mutation in the RYR1 gene
  193. A case report of dermatomyositis with the missed diagnosis of non-small cell lung cancer and concurrence of pulmonary tuberculosis
  194. A rare case of endometrial polyp complicated with uterine inversion: A case report and clinical management
  195. Spontaneous rupturing of splenic artery aneurysm: Another reason for fatal syncope and shock (Case report and literature review)
  196. Fungal infection mimicking COVID-19 infection – A case report
  197. Concurrent aspergillosis and cystic pulmonary metastases in a patient with tongue squamous cell carcinoma
  198. Paraganglioma-induced inverted takotsubo-like cardiomyopathy leading to cardiogenic shock successfully treated with extracorporeal membrane oxygenation
  199. Lineage switch from lymphoma to myeloid neoplasms: First case series from a single institution
  200. Trismus during tracheal extubation as a complication of general anaesthesia – A case report
  201. Simultaneous treatment of a pubovesical fistula and lymph node metastasis secondary to multimodal treatment for prostate cancer: Case report and review of the literature
  202. Two case reports of skin vasculitis following the COVID-19 immunization
  203. Ureteroiliac fistula after oncological surgery: Case report and review of the literature
  204. Synchronous triple primary malignant tumours in the bladder, prostate, and lung harbouring TP53 and MEK1 mutations accompanied with severe cardiovascular diseases: A case report
  205. Huge mucinous cystic neoplasms with adhesion to the left colon: A case report and literature review
  206. Commentary
  207. Commentary on “Clinicopathological features of programmed cell death-ligand 1 expression in patients with oral squamous cell carcinoma”
  208. Rapid Communication
  209. COVID-19 fear, post-traumatic stress, growth, and the role of resilience
  210. Erratum
  211. Erratum to “Tollip promotes hepatocellular carcinoma progression via PI3K/AKT pathway”
  212. Erratum to “Effect of femoral head necrosis cystic area on femoral head collapse and stress distribution in femoral head: A clinical and finite element study”
  213. Erratum to “lncRNA NORAD promotes lung cancer progression by competitively binding to miR-28-3p with E2F2”
  214. Retraction
  215. Expression and role of ABIN1 in sepsis: In vitro and in vivo studies
  216. Retraction to “miR-519d downregulates LEP expression to inhibit preeclampsia development”
  217. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part II
  218. Usefulness of close surveillance for rectal cancer patients after neoadjuvant chemoradiotherapy
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