Feasibility of low-intensity ultrasound treatment with hydroxylamine to accelerate the initiation of partial nitrification and allow operation under intermittent aeration

Partial nitrification is a key aspect of efficient nitrogen removal, although practically it suffers from long start-up cycles and unstable long-term operational performance. To address these drawbacks, this study investigated the effect of low intensity ultrasound treatment combined with hydroxylamine (NH2OH) on the performance of partial nitrification. Results show that compared with the control group, low-intensity ultrasound treatment (0.10 W/mL, 15 min) combined with NH2OH (5 mg/L) reduced the time required for partial nitrification initiation by 6 days, increasing the nitrite accumulation rate (NAR) and ammonia nitrogen removal rate (NRR) by 20.4% and 6.7%, respectively, achieving 96.48% NRR. Mechanistic analysis showed that NH2OH enhanced ammonia oxidation, inhibited nitrite-oxidizing bacteria (NOB) activity and shortened the time required for partial nitrification initiation. Furthermore, ultrasonication combined with NH2OH dosing stimulated EPS (extracellular polymeric substances) secretion, increased carbonyl, hydroxyl and amine functional group abundances and enhanced mass transfer. In addition, 16S rRNA gene sequencing results showed that ultrasonication-sensitive Nitrospira disappeared from the ultrasound + NH2OH system, while Nitrosomonas gradually became the dominant group. Collectively, the results of this study provide valuable insight into the enhancement of partial nitrification start-up during the process of wastewater nitrogen removal.

In-situ generation of iron activated percarbonate for sustainable sludge dewatering

Effective dewatering of sewage sludge could potentially address the issues of high energy consumption and large carbon footprint inherent in the sludge treatment process, advancing toward carbon neutrality in environmental remediation. Yet, the surface hydrophilic characteristics and water-holding interfacial affinity in sludge led to dwindled sludge-water separation performance. Here, the integration of in-situ generation of iron from zero-valent scrap iron (ZVSI) and sodium percarbonate (SPC) was attempted to attenuate the water-retaining interfacial affinity within sludge, thus achieving superior sludge dewatering performance. Results showed that under the optimal conditions, the ZVSI + SPC system led to a remarkable decline of 76.09 % in the specific resistance to filtration of the sludge, accompanied by a notable decline of 34.96 % in the water content. Moreover, the utilization of ZVSI + SPC system could be a viable alternative to the traditional strategies in terms of enhanced sludge dewaterability, offering application potential with stable operating performance, economic feasibility, and reduced carbon emissions. Investigation into dewatering mechanism revealed that ZVSI could maintain the Fe3+/Fe2+ in a stable dynamic cycle and continuously in-situ generate Fe2+, thereby efficaciously fostering the SPC activation for the ceaseless yield of reactive oxygen species. The predominant •OH and 1O2 efficiently decomposed the hydrophilic biopolymers, therefore minimizing the hydrophilic protein secondary structures, along with the hydrogen and disulfide bonds within proteins. Subsequently, the water-holding interfacial affinity was profoundly diminished, leading to intensified hydrophobicity, self-flocculation, and dewaterability. These findings have important implications for the advancement of efficacious ZVSI + SPC conditioning techniques toward sustainable energy and low-carbon prospects.

Defluorination of perfluorooctanoic acid and perfluorooctane sulfonic acid by heterogeneous catalytic system of Fe-Al2O3/O3: Synergistic oxidation effects and defluorination mechanism

In this study, catalytic ozonation by Fe-Al2O3 was used to investigate the defluorination of PFOA and PFOS, assessing the effects of different experimental conditions on the defluorination efficiency of the system. The oxidation mechanism of the Fe-Al2O3/O3 system and the specific degradation and defluorination mechanisms for PFOA and PFOS were determined. Results showed that compared to the single O3 system, the defluorination rates of PFOA and PFOS increased by 2.32- and 5.92-fold using the Fe-Al2O3/O3 system under optimal experimental conditions. Mechanistic analysis indicated that in Fe-Al2O3, the variable valence iron (Fe) and functional groups containing C and O served as important reaction sites during the catalytic process. The co-existence of 1O2, OH, O2- and high-valence Fe(IV) constituted a synergistic oxidation system consisting of free radicals and non-radicals, promoting the degradation and defluorination of PFOA and PFOS. DFT theoretical calculations and the analysis of intermediate degradation products suggested that the degradation pathways of PFOA and PFOS involved Kolbe decarboxylation, desulfonation, alcoholization and intramolecular cyclization reactions. The degradation and defluorination pathways of PFOA and PFOS consisted of the stepwise removal of -CF2-, with PFOS exhibiting a higher defluorination rate than PFOA due to its susceptibility to electrophilic attack. This study provides a theoretical basis for the development of heterogeneous catalytic ozonation systems for PFOA and PFOS treatment.

Triclocarban transformation and removal in sludge conditioning using chalcopyrite-triggered percarbonate treatment

Herein, a facile combination approach of chalcopyrite and sodium percarbonate (CuFeS2+ SPC) was established to augment both TCC removal efficiency and sludge dewatering. Results showed that utilizing the CuFeS2 dosage of 600 mg/g total solids (TS) under the optimal condition, along with the SPC dosage of 12.5 mg/g TS, an initial pH of 4.0, and a reaction duration of 40 min, led to a substantial reduction of 53.9% in the TCC content within the sludge, accompanied by a notable decrease of 36.9% in the water content. Compared to well-studied iron-based advanced oxidation processes, CuFeS2 + SPC treatment proved to be more cost-effective and environmentally friendly. Mechanistic findings demonstrated that •OH oxidation played a significant role in TCC removal, with O2•- and 1O2 acting as secondary factors. During the CuFeS2 + SPC process, the received •OH, O2•-, and 1O2 destroyed the main binding sites of extracellular polymeric substances to TCC, including tryptophan-like protein, amide, CO stretch, and -COO- functional groups. As a result, approximately 50% of TCC was partially degraded within the solid sludge phase after the attack of radicals. Meanwhile, the decreased macromolecular organic compounds in solid sludge attenuated the binding efficacy of TCC, giving rise to the transfer of partial TCC to the liquid phase. Ultimately, the TCC in sludge was successfully removed, and five transformation products were identified. This study significantly contributes to our understanding regarding TCC transformation and removal in the sludge conditioning process.

A highly efficient process to enhance the bioleaching of spent lithium-ion batteries by bifunctional pyrite combined with elemental sulfur

Bioleaching technologies have been shown to be an environmentally friendly and economically beneficial tool for extracting metals from spent lithium-ion batteries (LIBs). However, conventional bioleaching methods have exhibited low efficiency in recovering metals from spent LIBs. Therefore, relied on the sustainability principle of using waste to treat waste, this study employed pyrite (FeS2) as an energy substance with reducing properties and investigated its effects in combination with elemental sulfur (S0) or FeSO4 on metals bioleaching from spent LIBs. Results demonstrated that the bioleaching efficiency was significantly higher in the leaching system constructed with FeS2 + S0, than in the FeS2 + FeSO4 or FeS2 system. When the pulp densities of FeS2, S0 and spent LIBs were 10 g L-1, 5 g L-1 and 10 g L-1, respectively, the leaching efficiency of Li, Ni, Co and Mn all reached 100%. Mechanistic analysis reveals that in the FeS2 + S0 system, the activity and acid-producing capabilities of iron-sulfur oxidizing bacteria were enhanced, promoting the generation of Fe (Ⅱ) and reducible sulfur compounds. Simultaneously, bio-acids were shown to disrupt the structure of the LIBs, thereby increasing the contact area between Fe (Ⅱ) and sulfur compounds containing high-valence metals. This effectively promoted the reduction of high-valence metals, thereby enhancing their leaching efficiency. Overall, the FeS2 + S0 bioleaching process constructed in this study, improved the leaching efficiency of LIBs while also effectively utilizing waste, providing technical support for the comprehensive and sustainable management of solid waste.

[Analysis of iodine nutritional status of children aged 8-10 years in Zhejiang Province from 2016 to 2021]

Objective: To analyze the iodine nutrition status of children aged 8 to 10 years in Zhejiang Province from 2016 to 2021. Methods: A multi-stage stratified sampling method was used to select non-residential children aged 8 to 10 years from 90 counties in Zhejiang Province. A total of 114 103 children were included in the study from 2016 to 2021. Direct titration method and arsenic-cerium catalytic spectrophotometry were used to detect salt iodine content and urinary iodine level, respectively, to evaluate the iodine nutritional status of children. Ultrasound was used to detect thyroid volume and analyze the current prevalence of goiter in school-age children. Results: The age of 114 103 children was (9.04 ± 0.81) years old, with 50.0% of (57 083) boys. The median of iodine content M (Q1, Q3) in children's household salt was 23.00 (19.80, 25.20) mg/kg, including 17 242 non-iodized salt, 6 173 unqualified iodized salt, and 90 688 qualified iodized salt. The coverage rate of iodized salt was 84.89%, and the coverage rate of qualified iodized salt was 79.48%. The proportion of non-iodized salt increased from 11.85% in 2016 to 16.04% in 2021 (χ2trend=111.427, P<0.001). The median of urinary iodine concentration M (Q1, Q3) in children was 182.50 (121.00, 261.00) μg/L, among which the proportions of iodine deficiency, iodine suitability, iodine over suitability, and iodine excess were 17.25% (19 686 cases), 39.21% (44 745 cases), 26.85% (30 638 cases), and 16.68% (19 034 cases), respectively. The median of urinary iodine concentration in children in inland areas [M (Q1, Q3): 190.90 (128.80, 269.00) μg/L] was significantly higher than that in children in coastal areas [M (Q1, Q3): 173.00 (113.00, 250.30) μg/L] (P<0.001). From 2016 to 2021, a total of 39 134 ultrasound examinations were conducted, and 1 229 cases of thyroid enlargement were detected. The goiter rate was 3.14% (95%CI: 2.97%-3.32%). The incidence of goiter in children in coastal areas [3.45% (95%CI: 3.19%-3.72%), 641/18 604] was higher than that in children in inland areas [2.86% (95%CI: 2.64%-3.10%), 588/20 530] (P=0.001). Conclusion: From 2016 to 2021, the iodine nutrition level of children aged 8-10 years in Zhejiang Province is generally suitable, and the rate of goiter in children meets the limit of iodine deficiency disease elimination standards.

Identification and Automated Delineation of Radioresistant Biological Tumor Volume in Nasopharyngeal Carcinoma Based on Magnetic Resonance Imaging Radiomics

PURPOSE/OBJECTIVE(S)

Widespread use of intensity modulated radiotherapy (IMRT) has improved the tumor control rate of nasopharyngeal carcinoma (NPC). However, nearly 20% of the patients with local-advanced NPC would relapse after precise irradiation and 80% of the recurrent lesions occur within the high dose field, suggesting that there are radiation-resistant cancer cell subsets within the tumor. In this context, identification and contouring of radiation resistance region of NPC for dose escalation at primary IMRT could be advantageous. In this work, we proposed a two-step radiomics workflow to predict local relapse and the recurrent region of NPC before primary IMRT.

MATERIALS/METHODS

In this single-center, retrospective study, pre-treatment magnetic resonance (MR) sequences of T1-weighted imaging (T1-w) and contrast-enhanced T1-weighted imaging (CET1-w) were collected from 800 patients of newly diagnosed and non-metastatic NPC between April 2009 and December 2015. The primary gross tumor volume (GTVp) of all patients and the actual recurrent lesion (GTVr) of patients who suffered from local recurrence were manually contoured for further analysis. A two-step complete radiomics workflow was designed to predict tumor recurrence and segment the region. First, least absolute shrinkage and selection operator (LASSO) was utilized for radiomics features selection of GTVp and support vector machine (SVM) was adopted to predict the recurrence. If the model predicts a recurrence, then the workflow utilizes an improved 3D U-Net to segment the recurrent region. Area under receiver operating characteristic curve (ROC-AUC) was used to evaluate the performance of tumor recurrence prediction, and Dice similarity coefficient (DSC) was used to assess the consistence between the actual and predicted GTVr.

RESULTS

Of 800 NPC patients, 95 (11.9%) patients developed in-field local recurrence. For recurrence risk prediction, the SVM ensemble model (T1-w+CET1-w) was selected for further application with higher sensitivity. The average ROC-AUC, specificity, sensitivity of the SVM ensemble model in a 5-fold cross-validation and in the independent test set of 160 patients were 0.922, 0.922, 0.777 and 0.928, 0.915, 0.737, respectively. Moreover, for recurrent region segmentation, the multi-modality (T1-w+CET1-w) model was superior to the single-modality (T1-w or CET1-w) model. In an independent test set of 15 patients, the DSC, sensitivity and 95% Hausdorff Distance between actual and predicted GTVr was 0.549±0.176, 0.696±0.118 and 9.813±4.788 which was superior to 0.444±0.188, 0.497±0.218 and 12.047±5.361 of original 3D U-Net.

CONCLUSION

The proposed two-step radiomics workflow showed a good performance in predicting tumor recurrence of NPC. The predicted location of the recurrence lesion was all accurate, but there was still a certain difference between the volume of the automated delineated and actual GTVr, which needed to be further optimized to be used as biological tumor volume.

Prediction of Response to Neoadjuvant Chemoradiotherapy Combined with Pembrolizumab in Esophageal Squamous Cell Carcinoma with CT/FDG PET Radiomic Signatures Based on Machine Learning Classification

PURPOSE/OBJECTIVE(S)

PALACE-1 trial has confirm that the addition of pembrolizumab to neoadjuvant chemoradiotherapy (NCRT) improves the pathological complete response(pCR) for esophageal squamous cell carcinoma (ESCC), which might be a novel treatment strategy for ESCC. In the present study, we aim to establish a machine learning model to predict the local response to NCRT+ pembrolizumab for ESCC by using pretreatment 18-fluorodeoxyglucose positron emission tomography (FDG PET) and contrast-enhanced plan CT images.

MATERIALS/METHODS

A total of 65 cases treated with NCRT+ pembrolizumab followed by surgery were prospectively enrolled for analysis from 2019-2022. Each patient contains a contrast-enhanced plan CT and FDG PET images. 52 patients were randomly divided into training set and 13 patients were used as test set. The Extraction of radiomics features was performed using an open-source Python library PyRadiomics automatically. Features were computed according to the radiologist-drawn ROIs on both CT and PET images. In the feature selection stage least absolute shrinkage and selection operator (LASSO) was utilized on CT features and PET features separately. Four different machine learning models were implemented: Support Vector Machine (SVM), Logistic Regression (LR), Random Forest (RF) and XGBoost (XGB). The features selected by LASSO regression were used as model input and the output of the model is "pCR" or "non-pCR". To find the optimal parameter, the 5-fold cross-validation method was used in the training stage. In this study, we use accuracy, sensitivity and specificity as the metrics to evaluate the performance of the model on the testing cohort. The predictive performance of the model was assessed using the area under curve (AUC) of the receiver operating characteristics curve (ROC).

RESULTS

Of the 65 cases treated with NCRT+pembrolizumab, 35 patients archived pCR (53.8%), and 30 archived non-pCR. 1684 radiomics features were extracted from each case, and half of them (842 features) were from CT and others were from PET. Among the machine learning models mentioned above SVM achieves the most promising performance on the evaluation metrics. Accuracy, sensitivity, specificity and AUC score on test set were 0.692, 0.833, 0.571 and 0.786 for CT features and 0.615, 0.667, 0.571 and 0.762 for PET features, respectively. For CT+FDG PET fused features accuracy, sensitivity, specificity and AUC score on test set were 0.769, 0.667, 0.857 and 0.833.

CONCLUSION

In this study, we performed several different machine learning models to predict the response to NCRT+ pembrolizumab among ESCC based on the extracted radiomics features from CT and FDG PET images. The best-performing model based on radiomics features of CT and PET images could identify non-pCR to NCRT + pembrolizumab in EC patients.

Comprehensive insights into the gallic acid assisted bioleaching process for spent LIBs: Relationships among bacterial functional genes, Co(III) reduction and metal dissolution behavior

Despite the growing demand for resource recovery from spent lithium-ion batteries (LIBs) by bioleaching, low Co leaching efficiency has hindered the development and application of this technology. Therefore, a novel process was designed, combining gallic acid (GA) and mixed culture bioleaching (MCB), to enhance the removal of metals from spent LIBs. Results indicated that the GA + MCB process achieved 98.03% Co and 98.02% Li leaching from spent LIBs, simultaneously reducing the biotoxicity, phytotoxicity and leaching toxicity of spent LIBs under optimal conditions. The results of mechanism analysis demonstrated that functional microorganisms adapted to the leaching system through various strategies, including oxidative stress reduction, DNA damage repair, heavy metal resistance and biofilm formation, maintaining normal physiological activities and the continuous production of biological acid. The biological acid erodes the surface of waste LIBs, causing some Co and a large amount of Li to be released, while also increasing the contact area between GA and Co(III). Therefore, GA is beneficial for reducing insoluble Co(III), forming soluble Co(II). Finally, biological acid can effectively promote Co(II) leaching. Collectively, the results of this study provide valuable insight into the simultaneous enhancement of metal extraction and the mitigation of environmental pollution from spent LIBs.

Iron-rich digestate biochar toward sustainable peroxymonosulfate activation for efficient anaerobic digestate dewaterability

In this study, a suite of Fe-rich biochars derived from Fenton-like treated digestate (Fe-BC) were fabricated under different pyrolysis temperatures (300, 500, and 800 °C), which were firstly utilized as peroxymonosulfate (PMS) activators for promoting digestate dewaterability with wide applicability. Results showed that compared to the Fe-BC₃₀₀/Fe-BC₅₀₀ + PMS treatments, Fe-BC₈₀₀ + PMS process performed superior digestate dewaterability in which specific resistance to filtration reduction and water content reduction improved by > 12.5% and > 130%, respectively, under the optimal conditions. Mechanistic results demonstrated that in Fe-BC₈₀₀ + PMS system, HO• and SO₄^•- oxidation played a pivotal role on promoted digestate dewaterability, while HO• and ¹O₂ oxidation was dominated in Fe-BC₃₀₀/Fe-BC₅₀₀ + PMS treatments. Fe-BC₈₀₀ containing higher Fe and CO contents could efficiently interact with PMS to generate numerous HO• and SO₄^•- via iron cycle. These highly reactive oxygen species proficiently reduced the hydrophilic biopolymers, protein molecules, and amino acids in extracellular polymeric substances, leading to remarkable decrease in particle size, hydrophilicity, adhesion, network strength, and bound water of digestate. Consequently, the flowability and dewaterability of digestate could be significantly enhanced. The cost-benefit result indicated the Fe-BC + PMS treatment possessed desirable reusability, applicability, and economic viability. Collectively, the Fe-BC + PMS is a high-performance and eco-friendly technique for digestate dewatering, which opens a new horizon towards a closed-loop of digestate reutilization.

[VIPR1 promoter methylation promotes transcription factor AP-2α binding to inhibit VIPR1 expression and promote hepatocellular carcinoma cell growth in vitro]

OBJECTIVE

To explore the transcriptional regulation mechanism and biological function of low expression of vasoactive intestinal peptide receptor 1 (VIPR1) in hepatocellular carcinoma (HCC).

METHODS

We constructed plasmids carrying wild-type VIPR1 promoter or two mutant VIPR1 promoter sequences for transfection of the HCC cell lines Hep3B and Huh7, and examined the effect of AP-2α expression on VIPR1 promoter activity using dual-luciferase reporter assay. Pyrosequencing was performed to detect the changes in VIPR1 promoter methylation level in HCC cells treated with a DNA methyltransferase inhibitor (DAC). Chromatin immunoprecipitation was used to evaluate the binding ability of AP-2α to VIPR1 promoter. Western blotting was used to assess the effect of AP-2α knockdown on VIPR1 expression and examine the differential expression of VIPR1 in the two cell lines. The effects of VIPR1 overexpression and knockdown on the proliferation, cell cycle and apoptosis of HCC cells were analyzed using CCK8 assay and flow cytometry. We also observed the growth of HCC xenograft with lentivirus-mediated over-expression of VIPR1 in nude mice.

RESULTS

Compared with the wild-type VIPR1 promoter group, co-transfection with the vector carrying two promoter mutations and the AP-2α-over-expressing plasmid obviously restored the luciferase activity in HCC cells (P < 0.05). DAC treatment of the cells significantly decreased the methylation level of VIPR1 promoter and inhibited the binding of AP-2α to VIPR1 promoter (P < 0.01). The HCC cells with AP-2α knockdown showed increased VIPR1 expression, which was lower in Huh7 cells than in Hep3B cells. VIPR1 overexpression in HCC cells caused significant cell cycle arrest in G2/M phase (P < 0.01), promoted cell apoptosis (P < 0.001), and inhibited cell proliferation (P < 0.001), while VIPR1 knockdown produced the opposite effects. In the tumor-bearing nude mice, VIPR1 overexpression in the HCC cells significantly suppressed the increase of tumor volume (P < 0.001) and weight (P < 0.05).

CONCLUSION

VIPR1 promoter methylation in HCC promotes the binding of AP-2α and inhibits VIPR1 expression, while VIPR1 overexpression causes cell cycle arrest, promotes cell apoptosis, and inhibits cell proliferation and tumor growth.

High-efficiency treatment of electroless nickel plating effluent using core-shell MnFe2O4-C@Al2O3 combined with ozonation: Performance and mechanism

Heterogeneous catalytic ozonation (HCO) has been widely applied for the treatment of wastewater. In order to maintain the structural stability and surface catalytic activity of heterogeneous catalysts during the HCO treatment of electroless nickel plating effluent (ENPE), a MnFe₂O₄-C@Al₂O₃ catalyst with a core-shell structure was synthesized. MnFe₂O₄-C@Al₂O₃ was characterized and applied in the removal of total nickel (T_Ni) and organic contaminants from actual ENPE, using a coupled system of HCO combined with a magnetic dithiocarbamate chelating resin (MnFe₂O₄-C@Al₂O₃/O₃-MDCR). Results show that embedding Al₂O₃ with C and MnFe₂O₄ significantly increased the T_Ni removal efficiency (99.3%), enhanced the O₃-utilization efficiency and improved the generation of reactive oxygen species (ROS). The reaction rate (k = 0.7641 min^-1) and O₃-utilization efficiency established for T_Ni removal (ΔT_Ni/ΔO₃ =0.221) by the MnFe₂O₄-C@Al₂O₃/O₃-MDCR system, were 220% and 140% higher than the Al₂O₃/O₃-MDCR system, respectively. Catalytic mechanism analysis demonstrated that surface hydroxyl groups, oxygen vacancy, metals, the carbon surface and its functional groups, can all potentially serve as catalytic active sites, with ¹O₂ and •OH considered to the predominant ROS. Overall, these findings verify that the synthesized MnFe₂O₄-C@Al₂O₃ catalyst possesses excellent catalytic capabilities and outstanding structural stability, making it suitable for practical application in the treatment of wastewater effluent.

Dewaterability improvement and environmental risk mitigation of waste activated sludge using peroxymonosulfate activated by zero-valent metals: Fe0 vs. Al0

The stabilization and dewaterability of waste activated sludge (WAS) are essential factors for downstream disposal or reuse. Herein, two types of zero-valent metals, zero-valent iron (Fe⁰) and zero-valent aluminum (Al⁰), were compared for their ability to activate peroxymonosulfate (PMS) during the WAS conditioning process, with the effects of PMS activation by these two metals on WAS dewaterability and the potential environmental risks evaluated. Results showed that compared to Al⁰/PMS treatment, Fe⁰/PMS treatment achieved superior WAS dewaterability and reduced operational costs. Using PMS combined with Fe⁰ and Al⁰ treatments under optimal conditions, the water content (Wc) of dewatered sludge decreased to 55.7 ± 2.7 wt% and 59.4 ± 1.3 wt%, respectively. Meanwhile, application of the Fe⁰/PMS treatment system reduced the total annual cost by approximately 33.1%, compared to the Al⁰/PMS treatment. Analysis of the dewatering mechanism demonstrated that in the Fe⁰/PMS treatment, Fe³⁺/Fe²⁺ flocculation played an important role in the enhancement of WAS dewatering, while sulfate radical (SO₄^•-) oxidation was the dominant factor for WAS dewaterability improvement in Al⁰/PMS treatment. The greater enhancement of WAS dewaterability by Fe⁰/PMS treatment, was mainly attributed to more efficient reduction of hydrophilic extracellular polymeric substances (EPS) and an increase in surface charge neutralization. Environmental risk evaluation results indicated that Fe⁰/PMS and Al⁰/PMS treatments both effectively alleviated the environmental risks of heavy metals and faecal coliforms in dewatered sludge. Overall, this study proposes a novel perspective for the selection of an optimal PMS activator in sludge treatment.

Cell wall thickness and the molecular mechanism of heterogeneous vancomycin-intermediate Staphylococcus aureus

Methicillin‐resistant Staphylococcus aureus (MRSA) with reduced sensitivity to vancomycin (VAN) has caused many clinical cases of VAN treatment failure, but the molecular mechanism underlying the reduced sensitivity to VAN is still unclear. We isolated a heterogeneous VAN‐intermediate Staphylococcus aureus (hVISA), which was also a MRSA strain with reduced sensitivity to VAN. To investigate the molecular mechanism underlying the reduced sensitivity to VAN exhibited by the hVISA strain, we compared the hVISA strain with a VAN‐sensitive MRSA strain, known as the N315 strain. The images captured by transmission electron microscopy showed that the cell wall of the hVISA strain was significantly thicker than that of the N315 strain (36·72 ± 1·04 nm vs 28·15 ± 1·25 nm, P < 0·05), and the results of real‐time quantitative PCR analysis suggested that the expression levels of the cell wall thickness related genes (glmS, vraR/S, sgtB, murZ and PBP4) of the hVISA strain were significantly higher than those of the N315 strain (P < 0·05). In conclusion, this study indicated that the upregulation of the expression of the genes related to cell wall synthesis might be the molecular mechanism underlying the cell wall thickening of the hVISA strain and might be related to its resistance to VAN.

Genotype frequencies of human neutrophil antigen-3 in the Chinese Zhuang and Dong populations

Individuals with the human neutrophil antigen (HNA)-3b/3b type can produce HNA-3a antibodies, which have been reported to cause severe, sometimes fatal transfusion-related acute lung injury (TRALI). Our study aimed to determine the genotype frequency of HNA-3a/3b which will be helpful to estimate the potential risk for forming anti-HNA-3a, the clinically relevant antibody linked to TRALI in two different ethnic groups of southern China. Five hundred unrelated and healthy blood donors (284 male, 216 female; 300 Zhuangs, 200 Dongs) from the Guangxi Zhuang Autonomous Region were simultaneously typed for the HNA-3 allele using a polymerase chain reaction sequence-based typing (PCR-SBT) method. Genotype frequencies of HNA-3a/3a, HNA-3a/3b and HNA-3b/3b were 51.7%, 39.7% and 8.6% in the Zhuang population, and 44.0%, 49.0% and 7.0% in the Dong population, respectively. Homozygous HNA-3b/3b genotype frequency among the Zhuang population (8.6%) was significantly higher than previously reported in African Americans (0.4%), Brazilians (3.6%) and English Caucasians (2.9%) (p < .05). And the HNA-3b/3b genotype frequency among the Dong population was higher than African Americans (0.4%) (p < .05). This study showed Chinese Zhuang and Dong populations possessed a higher frequency of HNA-3b/3b genotype, suggesting that they may be at greater risk for developing anti-HNA-3a alloantibodies that may cause severe cases of TRALI. A molecular-based identification of the HNA-3b/3b genotype in all multiparous female blood donors was suggested to reduce the risk of TRALI following plasma and whole blood allogeneic transfusions.

The prevalence of and risk factors for prostatitis-like symptoms and its relation to erectile dysfunction in Chinese men

The aim of this study was to describe the prevalence of and risk factors for prostatitis-like symptoms and its relation to erectile dysfunction (ED) among southern Chinese men. Data were collected from 2790 men attending the Fangchenggang Area Male Healthy and Examination Survey from September 2009 to December 2009. The prostatitis-like symptoms were assessed by the NIH Chronic Prostatitis Symptom Index and ED was assessed using the 5-item International Index of Erectile Function. Lifestyle and demographic characteristics were obtained through a questionnaire. Prevalence of prostatitis-like symptoms was 12.4% among 2790 Chinese men aged 20-84 years. In smokers who smoked ≥20 cigarettes per day (age-adjusted OR = 1.29; 95% CI = 1.00-1.66; p = 0.04), physical inactivity (age-adjusted OR = 1.31; 95% CI = 1.03-1.66; p = 0.02) was a significant risk factor for prostatitis-like symptoms. Alcohol consumption (daily drinking) also was a risk factor for prostatitis-like symptoms, although the differences were not statistically significant (age-adjusted OR = 1.36; 95% CI = 0.96-1.92; p = 0.07). Those with diabetes may also be at higher risk for prostatitis-like symptoms (age-adjusted OR = 1.37; 95% CI = 0.85-2.21; p = 0.19). In addition, men with ED were more likely to have had prostatitis-like symptoms (age-adjusted OR = 1.86; 95% CI = 0.47-2.36; p < 0.0001), and the ORs increased with increasing severity of ED status (mild ED, mild to moderate ED, and moderate to severe ED were 1.57, 2.62, and 3.24, respectively. Test for trend, p = 0.0001). Our results show that prostatitis-like symptoms are prevalent in Southern China affecting men of all ages. Smoking, drinking, lack of physical activity, and elevated plasma glucose level were associated with an increased risk of prostatitis-like symptoms. In addition, our results reveal that ED accounted for a large proportion (61.5%) among men with prostatitis-like symptoms; we also confirm the magnitude of ED associated with prostatitis-like symptoms. Thus, interventions to evaluate and improve ED might help ameliorate prostatitis-like symptoms and vice versa.

Interleukin-17 promotes prostate cancer via MMP7-induced epithelial-to-mesenchymal transition

Chronic inflammation has been associated with a variety of human cancers including prostate cancer. Interleukin-17 (IL-17) is a critical pro-inflammatory cytokine, which has been demonstrated to promote development of prostate cancer, colon cancer, skin cancer, breast cancer, lung cancer, and pancreas cancer. IL-17 promotes prostate adenocarcinoma with a concurrent increase of matrix metalloproteinase 7 (MMP7) expression in mouse prostate. Whether MMP7 mediates IL-17’s action and the underlying mechanisms remain unknown. We generated Mmp7 and Pten double knockout (Mmp7^−/− in abbreviation) mouse model and demonstrated that MMP7 promotes prostate adenocarcinoma through induction of epithelial-to-mesenchymal transition (EMT) in Pten-null mice. MMP7 disrupted E-cadherin/β-catenin complex to up-regulate EMT transcription factors in mouse prostate tumors. IL-17 receptor C and Pten double knockout mice recapitulated the weak EMT characteristics observed in Mmp7^−/− mice. IL-17 induced MMP7 and EMT in human prostate cancer LNCaP, C4-2B, and PC-3 cell lines, while siRNA knockdown of MMP7 inhibited IL-17-induced EMT. Compound III, a selective MMP7 inhibitor, decreased development of invasive prostate cancer in Pten single knockout mice. In human normal prostates and prostate tumors, IL-17 mRNA levels were positively correlated with MMP7 mRNA levels. These findings demonstrate that MMP7 mediates IL-17’s function in promoting prostate carcinogenesis through induction of EMT, indicating IL-17-MMP7-EMT axis as potential targets for developing new strategies in the prevention and treatment of prostate cancer.

Formononetin-induced apoptosis of human prostate cancer cells through ERK1/2 mitogen-activated protein kinase inactivation

Formononetin is a main active component of red clover plants (Trifolium pratense L.), and is considered as a phytoestrogen. Our previous studies demonstrated that formononetin caused cell cycle arrest at the G0/G1 phase by inactivating insulin-like growth factor 1(IGF1)/IGF1R-phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) pathway in MCF-7 cells. In the present study, we investigated the molecular mechanisms involved in the effect of formononetin on prostate cancer cells. Our results suggested that higher concentrations of formononetin inhibited the proliferation of prostate cancer cells (LNCaP and PC-3), while the most striking effect was observed in LNCaP cells. We further found that formononetin inactivated extracellular signal-regulated kinase1/2 (ERK1/2) mitogen-activated protein kinase (MAPK) signaling pathway in a dose-dependent manner, which resulted in increased the expression levels of BCL2-associated X (Bax) mRNA and protein, and induced apoptosis in LNCaP cells. Thus, we concluded that the induced apoptosis effect of formononetin on human prostate cancer cells was related to ERK1/2 MAPK-Bax pathway. Considering that red clover plants were widely used clinically, our results provided the foundation for future development of different concentrations formononetin for treatment of prostate cancer.

Cetuximab-based therapy vs noncetuximab therapy in advanced or metastatic colorectal cancer: a meta-analysis of seven randomized controlled trials

PURPOSE

A meta-analysis was performed to assess the efficacy and safety of cetuximab-based therapy vs noncetuximab therapy in advanced or metastatic colorectal cancer.

METHOD

A total of 4617 patients from seven randomized controlled trials were available for analysis, with 2305 patients in the cetuximab group and 2312 patients in the noncetuximab group. The efficacy data included progression-free survival (PFS), overall survival (OS) and overall response rate (ORR). The safety data that contained overall grade 3 and 4 adverse events (AEs), specific grade 3 and 4 toxicity such as acneiform rash, cetuximab-related skin toxicity, diarrhoea, fatigue, neutropenia, hypertension, nausea and hand-foot skin reaction are evaluated.

RESULT

There was a significant PFS benefit in favour of cetuximab-based therapy (HR = 0.68, 95%CI: 0.63 to 0.73) and OS benefit (HR = 0.90, 95%CI: 0.81 to 1.00). The ORR was significantly higher in the cetuximab-based arm (OR = 2.19, 95% CI: 1.30 to 3.68). The incidence of overall grade 3-4 toxicity was significantly higher in the cetuximab arm compared with the noncetuximab arm (61.2%vs 43.0%, OR = 2.32, 95%CI: 1.59-3.39). This difference was mainly attributed to cetuximab-related skin toxicity (OR = 5.86, 95%CI: 1.38-24.88), especially acneiform rash (OR = 51.37, 95%CI: 22.75-116.02). In addition, cetuximab resulted in a significant increase in grade 3 and 4 diarrhoea, fatigue and neutropenia, except for hypertension, nausea and hand-foot skin reaction.

CONCLUSION

Cetuximab-based therapy improves PFS and OS resulting in better ORR vs noncetuximab therapy. Its most common and severe AE is skin toxicity that should be predictable and manageable.