GPCR-MAPK signaling pathways underpin fitness trade-offs in whitefly

Trade-offs between evolutionary gain and loss are prevalent in nature, yet their genetic basis is not well resolved. The evolution of insect resistance to insecticide is often associated with strong fitness costs; however, how the fitness trade-offs operates remains poorly understood. Here, we show that the mitogen-activated protein kinase (MAPK) pathway and its upstream and downstream actors underlie the fitness trade-offs associated with insecticide resistance in the whitefly Bemisia tabaci. Specifically, we find a key cytochrome P450 gene CYP6CM1, that confers neonicotinoids resistance to in B. tabaci, is regulated by the MAPKs p38 and ERK through their activation of the transcription factor cAMP-response element binding protein. However, phosphorylation of p38 and ERK also leads to the activation of the transcription repressor Cap "n" collar isoform C (CncC) that negatively regulates exuperantia (Ex), vasa (Va), and benign gonial cell neoplasm (Bg), key genes involved in oogenesis, leading to abnormal ovary growth and a reduction in female fecundity. We further demonstrate that the transmembrane G protein-coupled receptor (GPCR) neuropeptide FF receptor 2 (NPFF2) triggers the p38 and ERK pathways via phosphorylation. Additionally, a positive feedback loop between p38 and NPFF2 leads to the continuous activation of the MAPK pathways, thereby constitutively promoting neonicotinoids resistance but with a significant reproductive cost. Collectively, these findings provide fundamental insights into the role of cis-trans regulatory networks incurred by GPCR-MAPK signaling pathways in evolutionary trade-offs and applied knowledge that can inform the development of strategies for the sustainable pest control.

[The relationship between differentially expressed thyroid cancer genes and clinical characteristics in metastatic children and adolescents]

Objective: To investigate the relationship between genes and clinical characteristics in children and adolescents with metastatic differentiated thyroid cancer (caDTC). Methods: A cross sectional study. A total of 67 caDTC patients with lymph node metastasis or distant metastasis in Peking Union Medical College Hospital from December 2020 to December 2022 were included, according to the inclusion and exclusion criteria. Then the differences in clinicopathologic features and iodine intake were compared among different genomes, and the age subgroups divided by the age of 12 were further analyzed. Results: Among the 67 cases of caDTC, the diagnosed age [M(Q1, Q3)]was 13.2 (9.7, 16.9) years old, with 23 males and 44 females. There were 68.7% (46/67) of patients have distant metastasis (M1 stage). Pathogenic or potentially pathogenic gene variants were detected in 68.7% (46/67) of the patients, with RET or NTRK fusion (RET/NTRK) being the most common [43.3%(29/67)], BRAF V600E mutation followed [19.4%(13/67)].There was only 1 caDTC with NRAS Q61R mutation. The patients were divided into RET/NTRK fusion group (n=29), BRAF mutation group (n=12), other mutation group (n=4), and non-mutation group (n=21) (1 patient was not included in the gene mutation subgroup comparison due to the presence of NRAS Q61R mutation and BRAF V600E mutation). The comparison of gene feature groups showed that compared to the BRAF mutation group, caDTC with RET/NTRK fusion tended to have a lower age at diagnosis [12.6(9.3, 15.9) vs 17.2(15.5, 18.1) years old, P<0.001], the proportion of mutation load≥2 was higher (10.4% vs 8.3%, P=0.027), with statistically significant difference. Among 46 M1 stage patients, 71.7% (33/46) had initial iodine intake, and 30.4% (14/46) developed radioiodine-refractory (RAIR). In age group comparison, the<12 year old group had a higher proportion of male patients (51.9% vs 22.5%, P=0.013) and a lower incidence of BRAF V600E mutations (0 vs 32.5%, P<0.001) compared to the≥12 year old group, and the differences were statistically significant. Conclusions: The incidence of RET/NTRK fusion ranks first in metastatic caDTC, featured with younger age at diagnosis and higher rate of distant metastasis. Although most metastatic lesions initially consume iodine, they are prone to RAIR. Attention should be paid to the potential role of RET/NTRK fusion in the invasion and iodine resistance of young caDTC patients.

Glutathione S-transferase directly metabolizes imidacloprid in the whitefly, Bemisia tabaci

The whitefly Bemisia tabaci poses a significant threat to various crops and ornamental plants and causes severe damage to the agricultural industry. Over the past few decades, B. tabaci has developed resistance to several pesticides, including imidacloprid. Therefore, elucidating the mechanism that leads to insecticide detoxification is very important for controlling B. tabaci and managing whitefly resistance to neonicotinoid insecticides. Among insect detoxification enzymes, glutathione S-transferase (GST) is an important phase II detoxification enzyme that helps detoxify exogenous toxic substances. In this study, we cloned the BtGSTz1 gene and observed that its expression level was greater in imidacloprid-resistant populations than sensitive populations of B. tabaci. By silencing BtGSTz1 via RNA interference, we found a significant increase in the mortality of imidacloprid-resistant B. tabaci. Additionally, prokaryotic expression and in vitro metabolism studies revealed that the recombinant BtGSTz1 protein could metabolize 36.36% of the total imidacloprid, providing direct evidence that BtGSTz1 plays a crucial role in the detoxification of imidacloprid. Overall, our study elucidated the role of GSTs in physiological activities related to insecticide resistance, which helps clarify the resistance mechanisms conferred by GSTs and provides useful insights for sustainable integrated pest management.

Cytochrome P450 CYP6EM1 Underpins Dinotefuran Resistance in the Whitefly Bemisia tabaci

Being a destructive pest worldwide, the whitefly Bemisia tabaci has evolved resistance to neonicotinoid insecticides. The third-generation neonicotinoid dinotefuran has commonly been applied to the control of the whitefly, but its underlying mechanism is currently unknown. On the base of our transcriptome data, here we aim to investigate whether the cytochrome P450 CYP6EM1 underlies dinotefuran resistance in the whitefly. Compared to the susceptible strain, the CYP6EM1 gene was found to be highly expressed in both laboratory and field dinotefuran-resistant populations. Upon exposure to dinotefuran, the mRNA levels of CYP6EM1 were increased. These results demonstrate the involvement of this gene in dinotefuran resistance. Loss and gain of functional studies in vivo were conducted through RNAi and transgenic Drosophila melanogaster assays, confirming the role of CYP6EM1 in conferring such resistance. In a metabolism assay in vitro, the CYP6EM1 protein could metabolize 28.11% of dinotefuran with a possible dinotefuran-dm-NNO metabolite via UPLC-QTOF/MS. Docking of dinotefuran to the CYP6EM1 protein showed a good binding affinity, with an energy of less than -6.0 kcal/mol. Overall, these results provide compelling evidence that CYP6EM1 plays a crucial role in the metabolic resistance of B. tabaci to dinotefuran. Our work provides new insights into the mechanism underlying neonicotinoid resistance and applied knowledge that can contribute to sustainable control of a global pest such as whitefly.

Decline in Cancer Diagnoses during the 'Zero COVID' Policy in Hong Kong: Indirect Spillover Impact of the COVID-19 Pandemic

AIMS

Despite a largely successful 'zero COVID' policy in 2020, the COVID-19 pandemic disrupted routine cancer services in the city of Hong Kong. The aims of this study were to examine the trends in cancer incidence before and during the COVID-19 pandemic and estimate missed cancer diagnoses.

MATERIALS AND METHODS

We used population-based data from the Hong Kong Cancer Registry 1983-2020 to examine the trends of age- and sex-standardised cancer incidence before and during the COVID-19 pandemic. We applied: (i) the annual average percentage change (AAPC) calculated using the Joinpoint regression model and (ii) the autoregressive integrated moving average (ARIMA) model to forecast cancer incidence rates in 2020. Missed cancer diagnoses in 2020 were estimated by comparing forecasted incidence rates to reported rates. A subgroup analysis was conducted by sex, age and cancer site.

RESULTS

The cancer incidence in Hong Kong declined by 4.4% from 2019 to 2020 (male 8.1%; female 1.1%) compared with the long-term AAPC of 0.5% from 2005 to 2019 (95% confidence interval 0.3, 0.7). The gap between the reported and forecasted incidence for 2020 ranged from 5.1 to 5.7% (male 8.5%, 9.8%; female 2.3%, 3.5%). We estimated 1525-1596 missed cancer diagnoses (ARIMA estimate -98, 3148; AAPC 514, 1729) in 2020. Most missed diagnoses were in males (ARIMA 1361 [327, 2394]; AAPC 1401 [1353, 1460]), with an estimated 479-557 missed cases of colorectal cancer (ARIMA 112, 837; AAPC 518, 597) and 256-352 missed cases of prostate cancer (AAPC 231, 280; ARIMA 110, 594).

CONCLUSION

The incidence of new cancer diagnoses declined in 2020 contrary to the long-term increase over the previous decades. Significantly lower diagnoses than expected were observed in males, particularly for colorectal and prostate cancers. Fewer reported cancer cases indicate missed diagnoses and could lead to delayed treatment that could impact future health outcomes.

CYP4CS5-mediated thiamethoxam and clothianidin resistance is accompanied by fitness cost in the whitefly Bemisia tabaci

BACKGROUND

Understanding the trade-offs between insecticide resistance and the associated fitness is of particular importance to sustainable pest control. One of the most devastating pest worldwide, the whitefly Bemisia tabaci, has developed resistance to various insecticides, especially the neonicotinoid group. Although neonicotinoid resistance often is conferred by P450s-mediated metabolic resistance, the relationship between such resistance and the associated fitness phenotype remains largely elusive. By gene cloning, quantitative reverse transcription (qRT)-PCR, RNA interference (RNAi), transgenic Drosophila melanogaster, metabolism capacity in vitro and 'two sex-age stage' life table study, this study aims to explore the molecular role of a P450 gene CYP4CS5 in neonicotinoid resistance and to investigate whether such resistance mechanism carries fitness costs in the whitefly.

RESULTS

Our bioassay tests showed that a total of 13 field-collected populations of B. tabaci MED biotype displayed low-to-moderate resistance to thiamethoxam and clothianidin. Compared to the laboratory susceptible strain, we then found that an important P450 CYP4CS5 was remarkably upregulated in the field resistant populations. Such overexpression of CYP4CS5 had a good match with the resistance level among the whitefly samples. Further exposure to the two neonicotinoids resulted in an increase in CYP4CS5 expression. These results implicate that overexpression of CYP4CS5 is closely correlated with thiamethoxam and clothianidin resistance. RNAi knockdown of CYP4CS5 increased mortality of the resistant and susceptible populations after treatment with thiamethoxam and clothianidin in bioassay, but obtained an opposite result when using a transgenic line of D. melanogaster expressing CYP4CS5. Metabolic assays in vitro revealed that CYP4CS5 exhibited certain capacity of metabolizing thiamethoxam and clothianidin. These in vivo and in vitro assays indicate an essential role of CYP4CS5 in conferring thiamethoxam and clothianidin resistance in whitefly. Additionally, our life-table analysis demonstrate that the field resistant whitefly exhibited a prolonged development time, shortened longevity and reduced fecundity compared to the susceptible, suggesting an existing fitness cost as a result of the resistance.

CONCLUSION

Collectively, in addition to the important role of CYP4CS5 in conferring thiamethoxam and clothianidin resistance, this resistance mechanism is associated with fitness costs in the whitefly. These findings not only contribute to the development of neonicotinoids resistance management strategies, but also provide a new target for sustainable whitefly control. © 2023 Society of Chemical Industry.

Dynamic monitoring of the insecticide resistance status of Bemisia tabaci across China from 2019-2021

BACKGROUND

Bemisia tabaci (Gennadius) (Hemiptera: Aleyrodidae) is a major agricultural insect pest that causes severe economic losses worldwide. Several insecticides have been applied to effectively control this key pest. However, owing to the indiscriminate use of chemical insecticides, B. tabaci has developed resistance against these chemical compounds over the past several years.

RESULTS

From 2019 to 2021, 23 field samples of B. tabaci were collected across China. Twenty species were identified as the Mediterranean 'Q' type (MED) and three were identified as MED/ Middle East-Asia Minor 1 mixtures. Subsequently, resistance of the selected populations to different insecticides was evaluated. The results showed that 13 populations developed low levels of resistance to abamectin. An overall upward trend in B. tabaci resistance toward spirotetramat, cyantraniliprole and pyriproxyfen was observed. In addition, resistance to thiamethoxam remained low-to-moderate in the 23 field populations.

CONCLUSION

These findings suggest that the overall resistance of the field-collected B. tabaci populations has shown an upward trend over the years in China. We believe our study can provide basic data to support integrated pest management and insecticide resistance management of field B. tabaci in China. © 2023 Society of Chemical Industry.

[Research advances of collagen-based biomaterials in wound repair]

Acute or chronic wounds are common clinical problems. Collagen, with advantages including rich sources, impeccable biocompatibility, and inherent biodegradability, has been widely used in fundamental research and clinical treatment of wound repair with broad prospects of clinical applications. This article provided a brief overview of the role of collagen in various biological processes related to wound healing and also outlined the sources of collagen. Furthermore, the article summarized the application and recent research advancements of collagen-based wound dressings in the field of wound repair.

[Strategies and advances in laboratory tests for primary liver cancer]

Primary liver cancer is one of the leading causes of cancer-related deaths worldwide, its early diagnosis and early treatment are of great clinical importance. The main detection tools for liver cancer include serological indicators, imaging tests and risk assessment models. With the advancement of technology and research, the sensitivity and specificity of laboratory tests for liver cancer have been substantially improved, but there are still false negatives and low rates of early diagnosis. For different causes and prevalence regions, each country has developed its clinical practice guidelines to guide risk groups for effective prevention, early diagnosis and standardized treatment. It is important to establish a liver cancer diagnosis strategy that is suitable for China's national conditions, concerning the guidelines for the vigilance and prevention of liver cancer. In this article, the advantages and disadvantages of liver cancer-related tests and the impact of future development trends on laboratory strategies are explained from the perspective of laboratory testing strategies, to provide theoretical support for the practical application of liver cancer diagnostic strategies.

Fabrication of PEDOT:PSS-based solution gated organic electrochemical transistor array for cancer cells detection

Organic electrochemical transistor (OECT) was applied in chemical and biological sensing. In this work, we developed a simple and repeatable method to fabricate OECT array, which had been successfully used to detect cancer cells. PEDPT:PSS conductive film between source and drain electrodes were patterned through photolithography, which can achieve uniform devices with same electrical characterization. When MCF-7 cancer cells are captured on the PEDOT:PSS surface via specifical antibody, the transfer characteristic of OECT shifts to higher gate electrode voltage due to the electrostatic interaction between cancer cells and device. The effective gate voltage shift can reach about 63 mV when the concentration of cancer cells increased to 5000. The shift of effective gate voltage is related to the cancer cell morphology, which is increased in the first 1 h and decreased when the capture time was larger than 1 h. The device of OECT array can increase the sample flux and make the detection result more accurate. It is expected that OECT array will have promising practical applications in single cancer cell detection in the future.

Network pharmacological and molecular docking verification of the mechanism of Osteoking in preventing deep vein thrombosis of lower limb

OBJECTIVE

The aim of this study was to predict the mechanism of Osteoking in preventing deep vein thrombosis (DVT) of the lower limb by network pharmacology and molecular docking.

MATERIALS AND METHODS

The relevant active components and targets of Osteoking were collected through the TCMSP database, and the relevant disease targets of DVT were collected through the GeneCards, OMIM, and DisGeNET databases. The intersecting gene targets of Osteoking and DVT were obtained using Venny 2.1.0 software. PPI network construction and core target selection using Cytoscape 3.9.0 software. The Metascape database was used for GO and KEGG enrichment analysis of relevant targets. Finally, the molecular docking of the main active components and key targets was carried out.

RESULTS

There are 361 potential targets and 71 core targets of Osteoking in preventing deep vein thrombosis of the lower limb. Signal pathways are involved in various diseases such as cancer, diabetic complications, atherosclerosis, and more. Some of the most common pathways include AGE-RAGE signaling pathway and Calcium signaling pathway. Molecular docking results showed that the main active components of Osteoking had relatively stable binding activities with the key targets.

CONCLUSIONS

Osteoking can play a role through multiple targets and multiple signal pathways to prevent the formation of deep venous thrombosis of the lower limb after fracture.

Temporal Structures in Positron Spectra and Charge-Sign Effects in Galactic Cosmic Rays

We present the precision measurements of 11 years of daily cosmic positron fluxes in the rigidity range from 1.00 to 41.9 GV based on 3.4×10^{6} positrons collected with the Alpha Magnetic Spectrometer (AMS) aboard the International Space Station. The positron fluxes show distinctly different time variations from the electron fluxes at short and long timescales. A hysteresis between the electron fluxes and the positron fluxes is observed with a significance greater than 5σ at rigidities below 8.5 GV. On the contrary, the positron fluxes and the proton fluxes show similar time variation. Remarkably, we found that positron fluxes are modulated more than proton fluxes with a significance greater than 5σ for rigidities below 7 GV. These continuous daily positron fluxes, together with AMS daily electron, proton, and helium fluxes over an 11-year solar cycle, provide unique input to the understanding of both the charge-sign and mass dependencies of cosmic rays in the heliosphere.

Efficacy of Postoperative Radiotherapy for Patients with New N2 Descriptors of Subclassification in Completely Resected Non-Small Cell Lung Cancer: A Real-World Study

PURPOSE/OBJECTIVE(S)

Patients with N2 non-small cell lung cancer (NSCLC) were heterogeneous groups and required further stratification. The International Society for the Study of Lung Cancer (IASLC) added new descriptors of three sub-stages for stage N2 NSCLC: N2 at a single station without N1 involvement (N2a1), N2 at a single station with N1 involvement (N2a2), and N2 at multiple stations (N2b). This study aimed to investigate the efficacy of postoperative radiotherapy (PORT) for patients with these N2 descriptors.

MATERIALS/METHODS

Patients with histologically confirmed NSCLC after complete resection and divided into PORT group and non-PORT group. The primary endpoint was DFS. The second endpoints were overall survival (OS) and locoregional recurrence-free survival (LRFS). Propensity-score matching (PSM) of baseline characteristics between the PORT and non-PORT groups was used for validation.

RESULTS

Totally 1832 patients were enrolled, including 308 N2a1 patients, 682 N2a2 patients, and 842 N2b patients. The median follow-up time was 50.1 months. The survival outcomes of the PORT and non-PORT groups before PSM were shown in Table 1. For patients with N2a1, PORT could not improve the DFS (median DFS of the PORT group and the non-PORT group: not reached vs. 46.8 months, P = 0.41), OS (P = 0.85), or LRFS (P = 0.32), which were consistent with the multivariate analysis and data after the PSM. For patients with N2a2, PORT significantly improved the DFS (median DFS 29.7 vs. 22.2 months, P = 0.02), OS (P = 0.03), and LRFS (P = 0.01). The multivariate analysis and data after the PSM confirmed the benefits in DFS and LRFS, but no benefit was observed in OS (multivariate analysis: HR 0.79, P = 0.18; median OS after PSM: 103.7 vs. 63.1 months, P = 0.34). For patients with N2b, PORT could not improve the DFS (median DFS 20.6 vs. 21.2 months, P = 0.39) but significantly improved the OS (P<0.001) and LRFS (P<0.001). However, the multivariate analysis showed that PORT significantly improved DFS (HR 0.81, P = 0.03), consistent with the data after the PSM (median DFS 20.6 and 17.6 months, P = 0.04).

CONCLUSION

PORT significantly improved the DFS and LRFS in patients with N2a2 and significantly improved the DFS, LRFS, and OS in patients with N2b. Patients with N2a1 could not benefit from PORT.

Effect of PD-L1 Expression for the PD-1/L1 Inhibitors on Non-small Cell Lung Cancer: A Meta-analysis Based on Randomised Controlled Trials

AIMS

As PD-L1 expression has been proposed as one of the cancer biomarkers for non-small cell lung cancer (NSCLC), the predictive value of tumour proportional score (TPS) in the effect of immunotherapy [programmed death protein-1/ligand 1 (PD-1/L1) inhibitors] for NSCLC is worth exploring further. Here, we aimed to summarise the outcomes of current NSCLC randomised controlled trials (RCTs) and explore the predictive value of TPS in clinical immunotherapy, including immune checkpoint inhibitors (ICIs) with or without chemotherapy.

MATERIALS AND METHODS

RCTs published by PubMed, Medline, Embase and Scopus before February 2023 comparing immunotherapy (PD-1/L1 with or without other therapy) versus a control group in advanced or metastatic NSCLC were included to assess the prognosis according to the patients' TPS with 1% and 50% as the thresholds. The primary endpoints were overall survival and progression-free survival.

RESULTS

In total, 28 RCTs containing 17 266 participants with advanced or metastatic NSCLC were included in this meta-analysis. Statistical results showed that compared with TPS <1%, ≥1% or within 1-49%, patients with TPS ≥50% benefited more significantly from the immunotherapy. A subgroup analysis showed that when TPS was <1%, ≥1% or within 1-49%, ICIs + chemotherapy had better efficacy than ICIs alone; PD-1 (such as pembrolizumab) inhibitors had better efficacy than PD-L1 inhibitors (such as atezolizumab).

CONCLUSION

The efficacy of immunotherapy (PD-1/L1 inhibitors) for advanced or metastatic NSCLC is influenced by TPS.

Role and Modality of Combining Radiotherapy with Immunotherapy in Stage III-IV Unresectable Small Cell Lung Cancer

PURPOSE/OBJECTIVE(S)

The combination of radiotherapy and immunotherapy was rarely reported in the management of small cell lung cancer (SCLC). We retrospectively assessed the role and modality of this combination in Stage III-IV unresectable SCLC.

MATERIALS/METHODS

Patients with stage III and IV SCLC were enrolled according to AJCC 8th edition. Both efficacy and safety of immunotherapy combined with radiotherapy were evaluated. Thereinto, patients received first-line chemo-immunotherapy and sequential thoracic consolidation radiotherapy (TCRT) were further evaluated. Survival and descriptive analyses were performed.

RESULTS

Between January 1, 2019 and December 31, 2021, 51 patients were included in our analysis. Median follow-up was 28.0 months (95% CI 22.8-33.2). Patients received radiotherapy in treatment course had a prolonged 2-year overall survival (OS). And in the first-line immunotherapy cohort of 27 patients, the addition of TCRT significantly improved 2y-OS (72.22% vs. 13.89%, p = 0.0048), 2y-locoregional recurrence free survival (LRRFS) (90.00% vs 48.00%, p = 0.011), and 2y-distance progression free survival (DPFS) (66.67% vs. 16.67%, p = 0.039). Subgroup analyses showed that TCRT rendered superior outcomes regardless of brain metastases. Dose-escalation (45 Gy/15f) and earlier radiotherapy seemed to improve the benefit. Of 70.37% (19/27) patients experienced disease progression in the TCRT evaluation cohort, 63.16% (12/19) patients failed in brain. A tendency toward better OS and superior brain metastases free survival (BMFS) were observed after receiving prophylactic cranial irradiation (PCI). Finally, the most common grade 2 or higher toxic effects were pneumonitis in all patients (11.76% of immune-related vs. 7.84% of radiation related).

CONCLUSION

Earlier addition of TCRT to immunotherapy could significantly improve survival and extracranial control for stage IIIA-IVB unresectable SCLC patients, with no increased risk of adverse events. In the era of immunotherapy, PCI may still be a recommended strategy. Further investigation is warranted.

Dosimetric Analysis of Proton Beam Therapy vs. Photon Radiotherapy for Cardiac Tumors with or without Deep Inspiratory Breath Holding: A Case Report

PURPOSE/OBJECTIVE(S)

Proton beam therapy (PBT) has been demonstrated to deliver equivalent dosimetric radiation with the benefit of improved sparing of organs at risk (OAR). Deep inspiration breath holding (DIBH) is a commonly used method for reducing the radiation dose to the heart and lungs. However, few studies have ever reported the usage of DIBH combined with proton beam therapy in cardiac tumors. The purpose of this case report is to compare the dosimetric differences between photon radiotherapy and proton radiation therapy (PBT) with or without deep inspiration breath holding.

MATERIALS/METHODS

A 66-year-old female patient with cardiac tumors was recruited, and the prescribed dose of radiotherapy for cardiac tumors was 95%PGTV 50Gy/2.5Gy/20f. Two simulation CT scans were collected during free breath (FB) and DIBH. And the target area was delineated on deep inspiratory breath holding image (DIBH-CT) and free breathing image (FB-CT). The target area of FB-CT was modified by referring to the ten-time phases of 4D-CT. Finally, IMRT, VMAT and PBT plans (DIBH-IMRT, DIBH-VAMT, DIBH-PBT, FB-IMRT, FB-VAMT, FB-PBT) were generated on the above images, and the organs at risk were limited as follows: lungs V20 ≤20%, lungs mean ≤11 Gy, heart V30 ≤40%, coronary artery mean ≤26 Gy, spinal cord ≤30 Gy, and left breast mean ≤5 Gy.

RESULTS

All of the six plans satisfied most of the treatment planning goals. DIBH resulted in a dose reduction in all organs at risk including the heart, lungs, coronary artery (CA), spinal cord and breasts, when compared with FB using IMRT, VMAT, or PBT. Compared with the FB, DIBH provided a significant reduction in the mean dose of coronary artery (CA mean for DIBH-IMRT vs FB-IMRT = 28.32 Gy vs 42.66 Gy, CA mean for DIBH-VMAT vs FB-VAMT = 26.44Gy vs 40.85Gy, CA mean for DIBH-PBT vs FB-PBT = 27.71Gy vs 39.51Gy). Similarly, when compared with IMRT or VMAT in either FB or DIBH, PBT reduced radiation doses for all of the OAR. In comparison, the difference was less significant between IMRT and VMAT technique. Pitmen compared with IMRT and VMAT, reduced significantly the max dose of spinal cord, lungs V5, breast-L/R mean. Totally, DIBH-PBT was observed sufficient dose coverage and better sparing of organs at risk.

CONCLUSION

PBT combined with DIBH technique gained an advantage in the sparing of OAR for cardiac tumors, especially in coronary protection. The possibility of broader application of PBT with DIBH in clinical practice is currently being evaluated and further studies are needed.

20E biosynthesis gene CYP306A1 confers resistance to imidacloprid in the nymph stage of Bemisia tabaci by detoxification metabolism

BACKGROUND

Difference in physiology level between the immature and mature stages of insects likely contribute to different mechanisms of insecticide resistance. It is well acknowledged that insect 20-hydroxyecdysone (20E) plays an important role in many biological processes in the immature stage, whether 20E confers insecticide resistance at this specific stage is still poorly understood. By gene cloning, reverse transcription quantitative real-time PCR, RNA interference (RNAi) and in vitro metabolism experiments, this study aimed to investigate the potential role of 20E-related genes in conferring imidacloprid (IMD) resistance in the immature stage of the whitefly Bemisia tabaci Mediterranean.

RESULTS

After identification of low to moderate IMD resistance in the whitefly, we found CYP306A1 of the six 20E-related genes was overexpressed in the nymph stage of the three resistant strains compared to a laboratory reference susceptible strain, but not in the adult stage. Further exposure to IMD resulted in an increase in CYP306A1 expression in the nymph stage. These results together imply that CYP306A1 may be implicated in IMD resistance in the nymph stage of the whitefly. RNAi knockdown of CYP306A1 increased the mortality of nymphs after treatment with IMD in bioassay, suggesting a pivotal role of CYP306A1 in conferring IMD resistance in the nymph stage. Additionally, our metabolism experiments in vivo showed that the content of IMD reduced by 20% along with cytochrome P450 reductase and heterologously expressed CYP306A1, which provides additional evidence for the important function of CYP306A1 in metabolizing IMD that leads to the resistance.

CONCLUSION

This study uncovers a novel function of the 20E biosynthesis gene CYP306A1 in metabolizing imidacloprid, thus contributing to such resistance in the immature stage of the insect. These findings not only advance our understanding of 20E-mediated insecticide resistance, but also provide a new target for sustainable pest control of global insect pests such as whitefly. © 2023 Society of Chemical Industry.

The Causes of Death and Conditional Survival for Long-Term Survivors of Thymoma

PURPOSE/OBJECTIVE(S)

Data on the morality cause for long-time survival of thymoma is limited. The previous study hinted that thymoma may be a chronic disease rather than a curable cancer. we performed a large-scale retrospective analysis to assess long-term cause of death in patients with thymoma.

MATERIALS/METHODS

This study reviewed thymoma patients from the Surveillance, Epidemiology, and End Results (SEER) database between January1975 and December 2016.Conditional survival and annual hazard rates was calculated with Kaplan-Meier, and cause-specific mortality was performed using Fine-Gray competing risks analysis.

RESULTS

Of 3105 patients were identified (median [range] age,58 (18-93), years), 1615 (52.0%) were male,1028(33.1%) were 65 years or older and 1360(43.8%)patients was at locally advanced (IIB-III) disease. The 10-year overall survival (OS) and cancer-specific survival (CSS) rates were 55.5% (95% CI, 53.4-57.6%) and 74.4% (95% CI, 72.4-76.3%) respectively. Smoothed hazard showed that the annual overall death hazard of death increased steadily, but the hazard of thymoma-related death began to decline at about 4 years and is exceeded by other causes at death. However, the annual risk of death by thymoma remain about 1-2% at 5-25 years. Similarly, the conditional OS increased slowly with increased survival time however the cancer-specific survival based decreased slowly. The cumulative incidence of the most common causes of death was 23.1% for thymoma, 5.4% for heart of disease, and 3.9% for the second cancer in 10 years, 28.5%,8.3 and 7.0% in 15 years, and 31.8%,11.8% and 10.8% in 25 years. After 5 years of survival, the death of heart was the main cause of non-thymoma death. The 10-years survivors' older patients (≥65 years) or with radiotherapy suffered more heart specific death (adjust P< 0.001, P = 0.015, respectively).

CONCLUSION

The risk of cancer-specific death and other causes of death shift over time for patients with thymoma. The non-cancer cause, especially heart diseases which may be the vital competing cause of death, increased with prolongation of survival time.

Study of the ^{22}Mg Waiting Point Relevant for X-Ray Burst Nucleosynthesis via the ^{22}Mg(α,p)^{25}Al Reaction

The ^{22}Mg(α,p)^{25}Al reaction rate has been identified as a major source of uncertainty for understanding the nucleosynthesis flow in Type-I x-ray bursts. We report a direct measurement of the energy- and angle-integrated cross sections of this reaction in a 3.3-6.9 MeV center-of-mass energy range using the MUlti-Sampling Ionization Chamber (MUSIC). The new ^{22}Mg(α,p)^{25}Al reaction rate is a factor of ∼4 higher than the previous direct measurement of this reaction within temperatures relevant for x-ray bursts, resulting in the ^{22}Mg waiting point of x-ray burst nucleosynthesis flow to be significantly bypassed via the (α,p) reaction.

CYP6CX2 and CYP6CX3 mediate thiamethoxam resistance in field whitefly, Bemisia tabaci (Hemiptera:Aleyrodidae)

Cytochrome P450 monooxygenases (P450s) are well-known for their crucial roles in the detoxification of xenobiotics. However, whether CYP6CX2 and CYP6CX3, 2 genes from our Bemisia tabaci (B. tabaci) MED/Q genome data were associated with detoxification metabolism and confer resistance to thiamethoxam is unclear. In this study, we investigated the role of CYP6CX2 and CYP6CX3 in mediating whitefly thiamethoxam resistance. Our results showed that mRNA levels of CYP6CX2 and CYP6CX3 were up-regulated after exposure to thiamethoxam. Transcriptional levels of 2 genes were overexpressed in laboratory and field thiamethoxam resistant strains by RT-qPCR. These results indicate that the enhanced expression of CYP6CX2 and CYP6CX3 appears to confer thiamethoxam resistance in B. tabaci. Moreover, linear regression analysis showed that the expression levels of CYP6CX2 and CYP6CX3 were positively correlated with thiamethoxam resistance levels among populations. The susceptibility of whitefly adults was markedly increased after silencing 2 genes by RNA interference (RNAi) which further confirming their major role in thiamethoxam resistance. Our findings provide information to better understand the roles of P450s in resistance to neonicotinoids and suggest that these genes may be applied to develop target genes for sustainable management tactic of agricultural pests such as B. tabaci.

[The application value of shear wave dispersion and shear wave elastography combined with serological indicators in the evaluation of liver fibrosis]

Objective: To explore the application value of shear wave dispersion (SWD) and shear wave elastography (SWE) combined with serological indicators in the evaluation of liver fibrosis. Methods: A total of 219 patients with liver disorders who underwent liver biopsy were prospectively collected in Huashan Hospital, Fudan University from January 2021 to September 2022, including 130 males and 89 females, aged from 18 to 76 (42±12) years. All patients underwent SWD and SWE examinations before liver biopsy. Serological indicators including alanine aminotransferase(ALT), aspartate aminotransferase(AST), alkaline phosphatase(ALP)) and γ-glutamyl transpeptadase (GGT) were also collected. Based on pathological diagnosis of liver fibrosis stage (from S0 to S4), the distribution of dispersion slope and liver elastic modulus at different fibrosis stages were analyzed in all patients. All patients were divided 7: 3 into training set (156 cases) and validation set (63 cases) in chronological order. In training set, factors influencing liver fibrosis≥S2 stage and S4 stage were analysed using binary logistic regression. The predictive models were established for diagnosing liver fibrosis≥S2 stage and S4 stage by using R language, and the models were evaluated by the area under curve (AUC) and calibrated for validation. Results: The dispersion slope and elastic modulus increased with the severity of fibrosis, with statistically significant differences in different fibrosis stages (both P<0.001). In training set, dispersion slope, elastic modulus, ALT, AST, and GGT were influential factors in liver fibrosis≥S2 stage and S4 stage(both P<0.05), and prediction models were constructed based on these indicators. In training set, the AUCs of the predictive model, SWD and SWE for diagnosingliver fibrosis≥S2 stage were 0.743 (95%CI: 0.665-0.821), 0.709 (95%CI: 0.628-0.790) and 0.725 (95%CI: 0.647-0.804), respectively; for diagnosing liver fibrosis S4 stage, the AUCs were 0.988 (95%CI: 0.968-1.000), 0.908 (95%CI: 0.852-0.963) and 0.974 (95%CI: 0.945-1.000), respectively. In validation set, the AUC of the predictive model, SWD and SWE for diagnosing liver fibrosis≥S2 stage were 08.735 (95%CI: 0.612-0.859), 0.658 (95%CI:0.522-0.793) and 0.699 (95%CI:0.570-0.828), respectively; for diagnosing liver fibrosis S4 stage, the AUC were 0.976 (95%CI: 0.937-1.000), 0.872 (95%CI: 0.757-0.988) and 0.948 (95%CI: 0.889-1.000), respectively. The calibration curves of the prediction models were consistent in the training and validation sets. Conclusion: The predictive model of SWD and SWE combined with serological indicators is helpful in the diagnosis of stage of liver fibrosis non-invasively.

Cytochrome P450 CYP6DB3 was involved in thiamethoxam and imidacloprid resistance in Bemisia tabaci Q (Hemiptera: Aleyrodidae)

High level resistance for a variety of insecticides has emerged in Bemisia tabaci, a globally notorious insect. Neonicotinoid insecticides have been applied widely to control B. tabaci. Whether a differentially expressed gene CYP6DB3 discovered from transcriptome data of B. tabaci is involved in the resistance to neonicotinoid insecticides remains unclear. In the study, CYP6DB3 expression was significantly up-regulated in both thiamethoxam- and imidacloprid-resistant strains relative to the susceptive strains. We also found that CYP6DB3 expression was up-regulated after B. tabaci adults were exposed to thiamethoxam and imidacloprid. Moreover, knocking down CYP6DB3 expression via feeding corresponding dsRNA significantly reduced CYP6DB3 mRNA levels by 34.1%. Silencing CYP6DB3 expression increased the sensitivity of B. tabaci Q adults against both thiamethoxam and imidacloprid. Overexpression of CYP6DB3 gene reduced the toxicity of imidacloprid and thiamethoxam to transgenic D. melanogaster. In addition, metabolic studies showed that CYP6DB3 can metabolize 24.41% imidacloprid in vitro. Collectively, these results strongly support that CYP6DB3 plays an important role in the resistance of B. tabaci Q to imidacloprid and thiamethoxam. This work will facilitate a deeper insight into the part of cytochrome P450s in the evolution of insecticide resistance and provide a theoretical basis for the development of new integrated pest resistance management.

[Epidemiological characteristics of imported malaria cases after malaria elimination in Yixing City of Jiangsu Province]

OBJECTIVE

To analyse the epidemiological characteristics of imported malaria cases after malaria elimination in Yixing City, Jiangsu Province, so as to provide reference for malaria prevention and control in grassroots healthcare institutions.

METHODS

All data pertaining to malaria cases reported in Yixing City from 2016 to 2022 were retrieved from Chinese Disease Control and Prevention Information System, and the data pertaining to vector monitoring and human malaria parasite infections from 2016 to 2022 were collected for a descriptive statistical analysis.

RESULTS

A total of 14 imported malaria cases were reported in Yixing City from 2016 to 2022, including 12 cases with Plasmodium falciparum malaria, one case with P. vivax malaria and one case with P. ovale malaria, and all cases acquired infections in Africa and then returned to Yixing City. Malaria cases were reported across 2016 to 2022 except in 2020 and 2021. Malaria cases were predominantly reported during the period between December and February of the next year, and workers were the predominant occupation. The institutions where malaria was initially diagnosed included county-level general hospitals, county-level disease prevention and control institutions and grassroots healthcare centers, and there were 10 cases with definitive diagnosis of malaria on the day of initial diagnosis, with a 64.29% (9/14) correct rate of initial diagnosis. There were 5 cases diagnosed with severe malaria, and the standardized response rate was 100.00% following the "1-3-7" surveillance and response strategy. Of all malaria vectors, only Anopheles sinensis was monitored in Yixing City from 2016 to 2022, and all humans were tested negative for blood smears exceptimportedmalariacases.

CONCLUSIONS

The correct rate of initial malaria diagnosis was not high in healthcare institutions in Yixing City from 2016 to 2022, and there are still multiple challenges for prevention of re-establishment of imported malaria.