[Research progress in endoluminal treatment of urethral stricture]

Urethral stricture is regarded as a common disease in urology whose treatment modalities usually include open surgery and endoluminal treatment. Endoluminal techniques have gradually become one of the essential treatments in urethral stricture due to easier operation, less trauma, faster recovery, higher safety and fewer complications. The popularity of plasma knife and laser, and the application of new urethral stents and grafts, make endoscopic surgery easier and less invasive. However, due to its anatomical particularity and diverse etiologies of urethral stricture, the endoluminal treatment is still not satisfactory and a considerable number of patients still experience poor long-term treatment effect. Non-operative managements, such as intracavitary brachytherapy, intracavitary injection of drugs or stem cells and new urinary catheters are also being explored in treating urethral stricture, which would improve the effect of endoscopic surgery. This review summarizes the clinical application and new progress of various kinds of endoluminal treatments and pharmacotherapy in urethral stricture at home and abroad. More prospective randomized controlled studies are needed to confirm its feasibility, effectiveness and optimal time of operation.

Upregulation of miR-142-5p induced by lipopolysaccharide contributes to apoptosis of hepatocytes and hepatic failure

OBJECTIVE

This study was probed to uncover the mechanism of miR-142-5p in septic liver injury.

MATERIALS AND METHODS

In this study, in-vitro and in-vivo models of sepsis were used. For in-vitro sepsis model, hepatocyte cell line (L02 cells) was treated with LPS (lipopolysaccharide). Whereas for in-vivo sepsis model, cecal ligation and puncture were performed in mice. Mice were assigned into three groups: control, CLP (Cecal Ligation Puncture), CLP + miR-142-5p inhibitor group. Liver injury was assessed via H&E staining. IL-6, TNF-α, and IL-1β expressions were assayed through ELISA kits. C-caspase-9, C-caspase-3, ERK, p65, and IκBα expressions were determined via western blot and RT-qPCR. Apoptosis in LPS-induced L02 cells was detected by TUNEL staining.

RESULTS

Our results show that miR-142-5p exhibited perspicuous upregulation in CLP mice tissues and LPS-induced L02 cells. On the other hand, inhibition of miR-142-5p could promote LPS-induced L02 cell activity and reduce apoptosis and inflammation. In terms of molecular mechanism, downregulation of miR-142-5p could abate sepsis-mediated acute hepatic injury by targeting SOCS1, through ERK and NF-κB pathway.

CONCLUSIONS

Overall our results demonstrate that miR-142-5p inhibitors can mitigate septic liver injury by downregulating the inflammation and apoptosis via targeting SOCS1. Thus, miR-142-5p can serve a potential therapeutic target for sepsis mediated acute hepatic injury.

Treatment and outcome in deficiency of adenosine deaminase 2: a literature review

OBJECTIVES

Deficiency of adenosine deaminase 2 (DADA2) is a rare disease with varying phenotypes and disease outcomes. We aimed to summarize the treatments of DADA2 and to explore the factors associated with disease outcome.

MATERIAL AND METHODS

A systemic literature review of DADA2 was conducted. Cases were included if they had documented detailed genotypes, phenotypes, treatment protocols and outcomes. Patients were categorized into uncontrolled and controlled groups. Factors associated with disease outcome were analyzed with logistic regression models.

RESULTS

A total of 242 DADA2 patients with treatment protocols and responses were included, 17 of whom required no treatment. The general effective rate of TNFi was 78.6% (103/131). Hematological abnormalities and increased acute phase reactants are independently associated with TNFi effectiveness, OR=0.21 (95%CI 0.07-0.661, p=0.007) and 9.62 (95%CI 2.31-40.00, p=0.002), respectively. Among those 225 patients requiring active treatment, 157 (69.8%) patients were in the controlled group, and 68(30.2%) in the uncontrolled group. Neither age of disease onset nor genotype was associated with disease outcome. Increased acute phase reactants (APRs), constitutional symptoms, neurological symptoms, and treatment with TNF inhibitors (TNFi) were independently associated with disease control, while recurrent infections and severe vascular events were the main causes of mortality (10/21 and 6/21, respectively).

CONCLUSIONS

In patients requiring treatment, symptoms of systemic inflammation and vasculitis and TNFi treatment are associated with disease control; while recurrent infections and severe vascular events should be treated intensively as they are the main causes of death. Hematological abnormalities should be monitored as it would decrease TNFi effectiveness.

[Autologous stem cell transplantation improves outcomes of patients with multiple myeloma receiving proteasome inhibitors and lenalidomide treatment]

OBJECTIVE

To evaluate the effect of autologous stem cell transplantation (ASCT) on treatment response and survival outcomes in patients with newly diagnosed multiple myeloma (MM) receiving treatments with proteasome inhibitors and lenalidomide.

METHODS

We retrospectively collected the clinical data of newly diagnosed MM patients, who were eligible for ASCT and received proteasome inhibitors or lenalidomide-based treatment in our hospital from January, 2015 to December, 2019. The patients were divided into transplantation group and non-transplantation group, and in transplantation group, the patients received 4 to 6 courses of induction therapy with proteasome inhibitors or lenalidomide before ASCT, while those in the non-transplantation group received more than 8 courses of induction and consolidation therapy with proteasome inhibitors or lenalidomide-based regimens. The therapeutic efficacy and survival outcomes of the patinets were compared between the two groups.

RESULTS

A total of 105 patients were enrolled in the study, including 48 (45.7%) in transplantation group and 57 (54.3%) in non-transplantation group. The two groups were matched for gender, age and treatment response after 4 courses of induction therapy (P > 0.05). The rate of optimal response before relapse differed significantly between the two groups (P=0.000), and the patients receiving ASCT had significantly higher rates of complete response (85.4% vs 54.4%, P= 0.001) and very good partial response or better (95.8% vs 73.7%, P=0.002) than those without ASCT. At the end of follow-up, the median progression-free survival in the transplantation group was not reached, as compared with 29 months in the nontransplantation group (P=0.013). The median overall survival (OS) in the two groups was not reached, but the OS was better in the transplant group than in the non-transplant group (P=0.022).

CONCLUSION

ASCT can further improve the depth of remission and survival outcomes in patients with newly diagnosed MM receiving treatments with proteasome inhibitors and lenalidomide.

Observation of D_{s}^{±}/D^{0} Enhancement in Au+Au Collisions at sqrt[s_{NN}]=200 GeV

We report on the first measurement of charm-strange meson D_{s}^{±} production at midrapidity in Au+Au collisions at sqrt[s_{NN}]=200  GeV from the STAR experiment. The yield ratio between strange (D_{s}^{±}) and nonstrange (D^{0}) open-charm mesons is presented and compared to model calculations. A significant enhancement, relative to a pythia simulation of p+p collisions, is observed in the D_{s}^{±}/D^{0} yield ratio in Au+Au collisions over a large range of collision centralities. Model calculations incorporating abundant strange-quark production in the quark-gluon plasma and coalescence hadronization qualitatively reproduce the data. The transverse-momentum integrated yield ratio of D_{s}^{±}/D^{0} at midrapidity is consistent with a prediction from a statistical hadronization model with the parameters constrained by the yields of light and strange hadrons measured at the same collision energy. These results suggest that the coalescence of charm quarks with strange quarks in the quark-gluon plasma plays an important role in D_{s}^{±}-meson production in heavy-ion collisions.

Erratum: Azimuthal Anisotropy of K_{S}^{0} and Λ+Λ[over ¯] Production at Midrapidity from Au+Au Collisions at sqrt[s]_{NN}=130 GeV [Phys. Rev. Lett. 89, 132301 (2002)]

This corrects the article DOI: 10.1103/PhysRevLett.89.132301.

Erratum: Azimuthal Anisotropy at the Relativistic Heavy Ion Collider: The First and Fourth Harmonics [Phys. Rev. Lett. 92, 062301 (2004)]

This corrects the article DOI: 10.1103/PhysRevLett.92.062301.

Measurement of e^{+}e^{-} Momentum and Angular Distributions from Linearly Polarized Photon Collisions

The Breit-Wheeler process which produces matter and antimatter from photon collisions is experimentally investigated through the observation of 6085 exclusive electron-positron pairs in ultraperipheral Au+Au collisions at sqrt[s_{NN}]=200  GeV. The measurements reveal a large fourth-order angular modulation of cos4Δϕ=(16.8±2.5)% and smooth invariant mass distribution absent of vector mesons (ϕ, ω, and ρ) at the experimental limit of ≤0.2% of the observed yields. The differential cross section as a function of e^{+}e^{-} pair transverse momentum P_{⊥} peaks at low value with sqrt[⟨P_{⊥}^{2}⟩]=38.1±0.9  MeV and displays a significant centrality dependence. These features are consistent with QED calculations for the collision of linearly polarized photons quantized from the extremely strong electromagnetic fields generated by the highly charged Au nuclei at ultrarelativistic speed. The experimental results have implications for vacuum birefringence and for mapping the magnetic field which is important for emergent QCD phenomena.

[Predictive value of combination of MRI tumor regression grade and apparent diffusion coefficient for pathological complete remission after neoadjuvant treatment of locally advanced rectal cancer]

Objective: Pelvic high-resolution magnetic resonance imaging (MRI) has now become a standard method for evaluating the efficacy of neoadjuvant treatment for locally advanced rectal cancer (LARC). However, this traditional morphological qualitative assessment method based on T2-weighted imaging (T2WI) is not effective in predicting pathological complete remission (pCR). The purpose of this study is to investigate whether combining the magnetic resonance tumor regression grade (mrTRG) with apparent diffusion coefficient (ADC) can improve diagnostic value for pCR after preoperative neoadjuvant chemoradiotherapy (nCRT) of LARC. Methods: This was a diagnostic study. Clinicopathological data of 134 LARC patients who received nCRT and radical surgery in the First Affiliated Hospital of Kunming Medical University from January 2017 to December 2019 were retrospectively analyzed. All the patients underwent MRI which included T2WI and DWI sequences before and 8 weeks after nCRT. Two radiologists independently drew ROIs on T2WI and DWI to estimate mrTRG stage and calculate the mean ADC value. Receiver operating characteristics (ROC) method was applied to evaluate the predict value of mrTRG combined with mean ADC value for pCR. Results: Of 134 LARC patients, 85 were male and 49 were female with median age of 58 (28-82) years. After nCRT, MRI suggested 21 patients (15.7%) had clinical complete remission (cCR), e.g. mrTRG stage 1-2. Postoperative pathology revealed 31 (23.1%) patients had pCR. The evaluations of mrTRG and ADC value by the two readers were highly consistent, and the intra-group correlation coefficients were 0.83 (95% CI: 0.703-0.881) and 0.96 (95% CI: 0.989-0.996), respectively. There was a negative correlation between mrTRG and pCR (r(s)=-0.505, P<0.01), and a positive correlation between mean ADC value and pCR (r(s)=0.693, P<0.01). The ROC curve showed that mrTRG alone had a medium predictive value for pCR, with an area under the curve (AUC) of 0.832 (95% CI: 0.743-0.921); the mean ADC value had a higher predictive value for pCR, with AUC of 0.906 (95% CI: 0.869-0.962). The predictive value of the combined model of mrTRG and ADC value for pCR was significantly better than that of mrTRG alone (P=0.015), and the AUC was 0.908 (95% CI: 0.849-0.968). Conclusion: Both mrTRG and mean ADC value can be non-invasive methods to predict the efficacy of nCRT for LARC. Combining the mean ADC value with mrTRG can result in better pCR prediction.

Global Polarization of Ξ and Ω Hyperons in Au+Au Collisions at sqrt[s_{NN}]=200 GeV

Global polarization of Ξ and Ω hyperons has been measured for the first time in Au+Au collisions at sqrt[s_{NN}]=200  GeV. The measurements of the Ξ^{-} and Ξ[over ¯]^{+} hyperon polarization have been performed by two independent methods, via analysis of the angular distribution of the daughter particles in the parity violating weak decay Ξ→Λ+π, as well as by measuring the polarization of the daughter Λ hyperon, polarized via polarization transfer from its parent. The polarization, obtained by combining the results from the two methods and averaged over Ξ^{-} and Ξ[over ¯]^{+}, is measured to be ⟨P_{Ξ}⟩=0.47±0.10(stat)±0.23(syst)% for the collision centrality 20%-80%. The ⟨P_{Ξ}⟩ is found to be slightly larger than the inclusive Λ polarization and in reasonable agreement with a multiphase transport model. The ⟨P_{Ξ}⟩ is found to follow the centrality dependence of the vorticity predicted in the model, increasing toward more peripheral collisions. The global polarization of Ω, ⟨P_{Ω}⟩=1.11±0.87(stat)±1.97(syst)% was obtained by measuring the polarization of daughter Λ in the decay Ω→Λ+K, assuming the polarization transfer factor C_{ΩΛ}=1.

Nonmonotonic Energy Dependence of Net-Proton Number Fluctuations

Nonmonotonic variation with collision energy (sqrt[s_{NN}]) of the moments of the net-baryon number distribution in heavy-ion collisions, related to the correlation length and the susceptibilities of the system, is suggested as a signature for the quantum chromodynamics critical point. We report the first evidence of a nonmonotonic variation in the kurtosis times variance of the net-proton number (proxy for net-baryon number) distribution as a function of sqrt[s_{NN}] with 3.1  σ significance for head-on (central) gold-on-gold (Au+Au) collisions measured solenoidal tracker at Relativistic Heavy Ion Collider. Data in noncentral Au+Au collisions and models of heavy-ion collisions without a critical point show a monotonic variation as a function of sqrt[s_{NN}].

Effect of strontium ranelate on rabbits with steroid-induced osteonecrosis of femoral head through TGF-β1/BMP2 pathway

OBJECTIVE

To study the effect of strontium ranelate (SR) on steroid-induced osteonecrosis of the femoral head (SIONFH) in rabbits and its regulatory mechanism.

MATERIALS AND METHODS

The ONFH model was established in 30 rabbits using steroid and they were randomly divided into Control group, Model group, and SR group. After SR intervention, the rabbits were sacrificed and sampled. The pathological injury of the femoral head in each group was detected via hematoxylin-eosin (HE) staining, the level of vascular endothelial growth factor (VEGF) in the femoral head in each group was detected via enzyme-linked immunosorbent assay (ELISA). The messenger ribonucleic acid (mRNA) and protein expression levels of transforming growth factor-β1 (TGF-β1), as well as the bone morphogenetic protein 2 (BMP2) in the femoral head in each group, were determined using Reverse Transcription-Polymerase Chain Reaction (RT-PCR) and Western blotting.

RESULTS

The rabbit model of SIONFH was successfully established. Compared with Control group, the Model group had a severer pathological injury of the femoral head, a lower level of VEGF in the femoral head, significantly decreased mRNA and protein levels of TGF-β1 and BMP2. Compared with Model group, the SR group had markedly improved pathological injury of the femoral head, a higher level of VEGF in the femoral head, significantly increased mRNA and protein levels of TGF-β1, as well as BMP2.

CONCLUSIONS

SR can remarkably improve the pathological injury of the femoral head and increase the expression of VEGF in SIONFH rabbits, whose potential mechanism may be related to the activation of the TGF-β1/BMP2 signaling pathway.

Influence of the Internet of Things management system on hand hygiene compliance in an emergency intensive care unit

BACKGROUND

Hand hygiene is a critical strategy for infection prevention in all healthcare settings. Automated electronic monitoring systems are expected to improve hand hygiene performance.

AIM

To investigate the impact of the Internet of Things (IoT) management system on hand hygiene compliance among medical staff in an emergency intensive care unit (EICU).

METHODS

This retrospective observational study was conducted between July 1^st, 2017 and February 28^th, 2018 in a 19-bed EICU. The changes in hand hygiene compliance among 54 members of medical staff and the incidence of hospital infections were compared, counted, and analysed before and after implementing the IoT management system in the EICU that was initiated on November 1^st, 2017.

FINDINGS

After the application of the IoT management system, the hand hygiene compliance rates among the members of the medical staff before (29.5% (3347/11,338) vs 57.9% (4690/8094), P < 0.001) and after (59.9% (9915/16,556) vs 73.8% (17,194/23 286), P < 0.001) the contact with patients and surrounding environment significantly improved. However, hand hygiene compliance among three cleaning staff did not significantly improve after the application. Moreover, there was no significant difference in healthcare-acquired infection rates (2.535% (9/355) vs 2.047% (7/342), P = 0.667) nor in the detection rates of the four major multidrug-resistant bacteria in the EICU before and after the application of the IoT management system (P > 0.05).

CONCLUSION

The IoT management system significantly improved hand hygiene compliance among medical staff, except cleaners, in the EICU of one provincial hospital; however, the rates of nosocomial infection did not significantly decrease. The quality of hand hygiene implementation needs to be improved.

PPARγ inhibits breast cancer progression by upregulating PTPRF expression

OBJECTIVE

Peroxisome proliferator-activated receptor γ (PPARγ) regulates fatty acid storage and glucose metabolism. Recently, PPARγ has been reported to be involved in cancer. The present study reported a PPARγ consensus binding site (AGGTCA) in the ptprf promoter and identified a strong association between PPARγ and PTPRF expression, as well as their tumor suppressor roles in a v-Ha-Ras-induced model of breast cancer.

MATERIALS AND METHODS

The prognostic potential of PPARγ was assessed with a KM analysis of raw data from 3,951 breast cancer patients. The expression of PPARγ and PTPRF in the rat breast cancer cell lines was detected by Western blot and qPCR. The impact of PPARγ on cancer cell migration, invasion, and growth was confirmed using cell migration assay, transwell cell invasion assay, tri-dimensional soft agar culture, respectively. The binding of PPARγ with the ptprf promoter was then examined using electrophoretic mobility shift assay. The inhibitory effect of PPARγ on tumor growth was then examined in mouse tumor model in vivo.

RESULTS

It was identified that PPARγ expression is lost in the aggressive v-Ha-Ras-induced breast cancer cell line FE1.2 but highly expressed in less malignant FE1.3 cells. Exogenous expression of PPARγ in FE1.2 cells (FE1.2-PPARγhi) resulted in a marked inhibition of proliferation compared with that in FE1.2-Vector control group. FE1.2-PPARγhi cells also exhibited reduced migration, invasion, and colony formation abilities compared with those of the controls. The PPARγ agonist rosiglitazone also suppressed the malignant properties of FE1.2 cells. Protein tyrosine phosphatase receptor F (PTPRF), a downstream target of PPARγ, was markedly induced in FE1.2-PPARγhi cells. A PPARγ consensus binding site (AGGTCA) was identified in the ptprf promoter, and an electrophoretic mobility shift assay confirmed that PPARγ bind to this promoter. Similar to the effect of vector-mediated overexpression of PPARγ, ectopic overexpression of PTPRF in FE1.2 cells led to reduced proliferation. Furthermore, a PPARγ antagonist (GW9662) and PTP inhibitor (NSC87877) abrogated the suppressive function of PPARγ and PTPRF in FE1.2 cells, respectively. PPARγ overexpression or activation suppressed the progression and distant organ metastasis of breast cancer cells in a NOD/SCID mouse model.

CONCLUSIONS

These results suggest that PPARγ inhibits tumor cell proliferation, at least in part, through direct regulation of the ptprf gene and that PPARγ is a potential target for breast cancer treatment.

[Study on the relationships between precollege sexual abuse experiences at different stages and adult attachment in college students]

Objective: To explore the association between precollege sexual abuse experiences at different periods and adult attachment in college students. Methods: In October 2018,a total of 4 034 college students were selected from 4 colleges in Hefei City by using the stratified cluster sampling method. A self-designed questionnaire was used to investigate the demographic characteristics, sexual abuse experience, and attachment style of participants. Multivariate linear regression analysis was performed to analyze the association between different periods, types of precollege sexual abuse experiences and attachment style in college students. Results: The rate of total precollege sexual abuse, noncontact sexual abuse, and contact sexual abuse was 14.1% (569), 12.7% (512) and 5.4% (219), respectively. Multivariate linear regression analysis showed that secure attachment [β(95%CI)=-0.205 (-0.292, -0.117)] was negatively correlated with total precollege sexual abuse experiences, whereas anxiety attachment [β(95%CI)=0.211 (0.110, 0.310)], avoidant attachment [β(95%CI)=0.117 (0.020, 0.216)] were positively correlated with total precollege sexual abuse experiences. The number of periods of precollege noncontact sexual abuse was negatively correlated with secure attachment [β(95%CI)=-0.106(-0.171, -0.041)]and positively correlated with anxiety attachment [β(95%CI)=0.158 (0.084, 0.231)]and avoidant attachment [β(95%CI)=0.080 (0.008, 0.152)]. The noncontact [β(95%CI)=0.427 (0.018, 0.775)] and contact sexual abuse [β(95%CI)=0.468 (0.251, 0.687)] in high school were positively correlated with anxiety attachment (P<0.05). Conclusion: Different periods, types of precollege sexual abuse experiences were all associated with adult attachment in college students.

LncRNA TATDN1 induces the progression of hepatocellular carcinoma via targeting miRNA-6089

OBJECTIVE

To clarify the potential effect of long non-coding RNA (lncRNA) TATDN1 on accelerating the proliferative rate and cell cycle progression of hepatocellular carcinoma (HCC) via sponging miRNA-6089, thus participating in the progression of HCC.

PATIENTS AND METHODS

TATDN1 expression in HCC tissues and normal tissues was first determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The correlation between TATDN1 expression to metastasis and overall survival of HCC was analyzed. The cellular level of TATDN1 in HCC cell lines was examined as well. Regulatory effects of TATDN1 on cell cycle progression and viability of HepG2 and SMMC7721 cells were evaluated. Subsequently, a potential target of TATDN1 was screened out and verified by Dual-Luciferase reporter gene assay. The expression pattern and biological function of the target gene miRNA-6089 in HCC were also determined. In a similar way, LIX1L was verified to be the target of miRNA-6089 and tested for its biological function in HCC.

RESULTS

TATDN1 was upregulated in HCC tissues and cell lines. The overexpression of TATDN1 accelerated the proliferative rate and cell cycle progression of HCC. MiRNA-6089, the target gene of TATDN1, was lowly expressed in HCC. The overexpression of miRNA-6089 partially reversed the promotive role of TATDN1 in regulating the proliferation and cell cycle of HCC cells. Subsequently, LIX1L was verified to be the target of miRNA-6089. The overexpression of LIX1L partially reversed the regulatory effect of miRNA-6089 on the proliferative rate and cell cycle progression of HCC.

CONCLUSIONS

TATDN1 accelerates the proliferative rate and cell cycle progression of HCC by degrading miRNA-6089 to upregulate LIX1L.

[Analysis of gene mutations and clinic features in 108 patients with myeloproliferative neoplasm]

Objective: To analyze the genetic mutations and clinical features of the subtypes of classical BCR-ABL-negative myeloproliferative neoplasm (MPN) . Methods: Mutations of 108 newly diagnosed BCR-ABL-negative MPN patients [including 55 patients with essential thrombocytopenia (ET) , 24 with polycythemia vera (PV) , and 29 with primary myelofibrosis (PMF) ] were identified using next-generation sequencing with 127-gene panel, and the relationship between gene mutations and clinical features were analyzed. Results: Total 211 mutations in 32 genes were detected in 100 MPN patients (92.59% ) , per capita carried (1.96±1.32) mutations. 85.19% (92/108) patients carried the driver gene (JAK2, CALR, MPL) mutations, 69.56% (64/92) of these patients carried at least 1 additional gene mutation. In descending order of mutation frequency, the highest frequency was for activation signaling pathway genes (42.2% , 89/211) , methylation genes (17.6% , 36/211) , and chromatin-modified genes (16.1% , 34/211) . There was a significant difference in the number of mutations in the activation signaling pathway genes, epigenetic regulatory genes, spliceosomes, and RNA metabolism genes among the three MPN subgroups. The average number of additional mutations in PMF patients was higher than that in ET and PV patients (1.69±1.39, 0.67±0.70, 0.87±1.22, χ(2)=13.445, P=0.001) . MPN-SAF-TSS (MPN 10 score) (P=0.006) and myelofibrosis level (P=0.015) in patients with ≥ 3 mutant genes were higher and the HGB level (P=0.002) was lower than in those with<3 mutations. Twenty-six patients (24.1% ) carried high-risk mutation (HMR) , and patients with HMR had lower PLT (P=0.017) , HGB levels (P<0.001) , and higher myelofibrosis level (P=0.010) and MPN10 score (P<0.001) . The frequency of ASXL1 mutations was higher in PMF than in PV patients (34.5% vs. 4.2% , P=0.005) . PMF patients with ASXL1 had lower levels of PLT and HGB (P=0.029 and 0.019) . Conclusion: 69.56% of MPN patients carry at least one additional mutation, and 24.1% patients had HMR. Each subgroup had different mutation patterns. PMF patients had a higher average number of additional gene mutations, especially a higher frequency of ASXL1 mutation; PLT and HGB levels were lower in ASXL1 mutation PMF patients.

[Clinical observation of three-dimensional printing donor tooth model in peri-operative period of autotransplantation of tooth]

Objective: To prepare a three-dimensional (3D) printing donor tooth model and to observe its application in the peri-operative period. Methods: In part one, 192 cases (2017.9-2019.8) from Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University ［107 males and 85 females, age (34.2±10.7) years］ which need autotransplantation of teeth (ATT) were collected. Whether the donor teeth can be completely extracted was predicted through clinical and imaging examination (first prediction). The second prediction was supplemented by the three-dimensional printing model of the donor teeth. Each of the prediction was compared with the actual results and the coincidence rate was calculated. In part two, 64 cases (2017.9-2019.8) from Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University ［28 males, 36 females, age (30.2±8.3) years］ which need ATT were randomly divided into the model group and the donor group. The time of alveolar fossa preparation, time of donor tooth in vitro, times of trial implantation and time of pulptomy and root canal location were recorded respectively. Results: In part one, the coincidence rate between the second prediction and the actual results ［97.4%(187/192)］ was significantly higher than that of the first prediction ［93.2%(179/192)］ (P<0.05). In part two, the preparation time of the alveolar fossa in the maxillary and mandibular were (18.8±4.6) and (22.7±3.4) min, the time of the teeth in vitro were (3.0±0.6) and (2.1±0.6) min, the times of trial implantation were (1.3±0.8) and (1.0±0.9), and the time of pulpotomy and root canal location were (4.3±0.6) and (4.0±0.5) min. All values in the model groups were better than those in the donor group (P<0.05). Conclusions: The 3D printing model is accurate. It can be used in autogenous tooth transplantation to shorten the preparation time of alveolar fossa and time of donor tooth in vitro, and reduce the times of trial implantation of donor teeth, and to help to improve the prediction accuracy of complete extraction of donor teeth and the time of pulpotomy and root canal location.

Efficacy of laparoscopic gastric bypass vs laparoscopic sleeve gastrectomy in treating obesity combined with type-2 diabetes

OBJECTIVE

This prospective study compared the efficacy and safety of laparoscopic gastric bypass and laparoscopic sleeve gastrectomy in treating overweight and obese patients with BMI>28 kg/m² and type-2 diabetes.

METHODS

Patients were randomized into a gastric bypass group (n = 77) or a gastrectomy group (n = 80). The surgery time, intraoperative blood loss, recovery time, and hospitalization time were collected. BMI, waistline, hipline, C-peptide level, insulin resistance index (HOMA-IR), and their blood and lipid profile were also measured.

RESULTS

Surgery time and blood loss were significantly higher in the gastrectomy group, when compared to the gastric bypass group (P < 0.05). In both groups, the levels of BMI, waist circumference and hip circumference (but not their ratio) gradually and significantly decreased after surgery compared with baseline (P < 0.05), and no significant difference was found between these two groups. The C-peptide level, HOMA-IR, fasting blood glucose, 2-hour postprandial blood glucose and glycosylated haemoglobin gradually and significantly decreased after surgery compared with the values before treatment (P < 0.05). The levels of total cholesterol, triglyceride, LDL, and monocyte chemoattractant protein-1 were also lower after surgery in both groups, while HDL and glucagon-like peptide-1 were significantly higher after surgery compared with the values before treatment (P < 0.05). However, no significant difference was found between these two groups of patients.

CONCLUSION

Both laparoscopic gastric bypass and laparoscopic sleeve gastrectomy improved the BMI and diabetic conditions of overweight/obese diabetics, while laparoscopic sleeve gastrectomy had a shorter surgical time and less blood loss.

Tear inflammatory cytokines and ocular surface changes in patients with active thyroid eye disease treated with high-dose intravenous glucocorticoids

PURPOSE

To evaluate high-dose intravenous glucocorticoid treatment on tear inflammatory cytokines and ocular surface parameters in patients with active TED. Correlations between tear inflammatory cytokines and clinical parameters were also investigated.

METHODS

This prospective pilot study included 15 moderate-to-severe and active TED patients. Control group consist of 15 sex and age-matched healthy subjects. All TED patients were treated with high-dose intravenous methylprednisolone with cumulative dose of 4.5 g during the therapy subdivided into 12 weekly infusions. Tear concentrations of interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-17A, tumor necrosis factor (TNF)-α, and vascular endothelial growth factor (VEGF) were measured by multiplex bead analysis in TED patients at baseline and 12 weeks after treatment. Ocular surface disease index (OSDI), tear break-up time (TBUT), corneal fluorescent staining, and Schirmer's test were obtained from TED and controls.

RESULTS

All baseline cytokine levels except for IL-17A were significantly elevated in active TED patients compared with controls. Concentrations of IL-1β, IL-6, IL-8, TNF-α, and VEGF were significantly decreased at 12 weeks compared with baseline. OSDI and TBUT showed significant improvement at 6 and 12 weeks. There were significant positive correlations between IL-6, IL-8, and CAS, and negative correlation was found between IL-6 level and TED duration before methylprednisolone treatment. The reduction of IL-6, IL-8, and VEGF were positive correlated with the reduction in CAS at 12 weeks.

CONCLUSIONS

High-dose glucocorticoids treatment improved ocular surface symptom, increased the tear film stability, and decreased tear inflammatory cytokines in active TED. The reduction of the inflammatory cytokines is consistent with the improvement of clinical parameters.

A systems genomics approach identifies SIGLEC15 as a susceptibility factor in recurrent vulvovaginal candidiasis

Candida vaginitis is a frequent clinical diagnosis with up to 8% of women experiencing recurrent vulvovaginal candidiasis (RVVC) globally. RVVC is characterized by at least three episodes per year. Most patients with RVVC lack known risk factors, suggesting a role for genetic risk factors in this condition. Through integration of genomic approaches and immunological studies in two independent cohorts of patients with RVVC and healthy individuals, we identified genes and cellular processes that contribute to the pathogenesis of RVVC, including cellular morphogenesis and metabolism, and cellular adhesion. We further identified SIGLEC15, a lectin expressed by various immune cells that binds sialic acid-containing structures, as a candidate gene involved in RVVC susceptibility. Candida stimulation induced SIGLEC15 expression in human peripheral blood mononuclear cells (PBMCs) and a polymorphism in the SIGLEC15 gene that was associated with RVVC in the patient cohorts led to an altered cytokine profile after PBMC stimulation. The same polymorphism led to an increase in IL1B and NLRP3 expression after Candida stimulation in HeLa cells in vitro. Last, Siglec15 expression was induced by Candida at the vaginal surface of mice, where in vivo silencing of Siglec15 led to an increase in the fungal burden. Siglec15 silencing was additionally accompanied by an increase in polymorphonuclear leukocytes during the course of infection. Identification of these pathways and cellular processes contributes to a better understanding of RVVC and may open new therapeutic avenues.

FAIRLANE, a double-blind placebo-controlled randomized phase II trial of neoadjuvant ipatasertib plus paclitaxel for early triple-negative breast cancer

BACKGROUND

This hypothesis-generating trial evaluated neoadjuvant ipatasertib-paclitaxel for early triple-negative breast cancer (TNBC).

PATIENTS AND METHODS

In this randomized phase II trial, patients with early TNBC (T ≥ 1.5 cm, N0-2) were randomized 1 : 1 to receive weekly paclitaxel 80 mg/m2 with ipatasertib 400 mg or placebo (days 1-21 every 28 days) for 12 weeks before surgery. Co-primary end points were pathologic complete response (pCR) rate (ypT0/TisN0) in the intention-to-treat (ITT) and immunohistochemistry phosphatase and tensin homolog (PTEN)-low populations. Secondary end points included pCR rate in patients with PIK3CA/AKT1/PTEN-altered tumors and pre-surgery response rates by magnetic resonance imaging (MRI).

RESULTS

pCR rates with ipatasertib versus placebo were 17% versus 13%, respectively, in the ITT population (N = 151), 16% versus 13% in the immunohistochemistry PTEN-low population (N = 35), and 18% versus 12% in the PIK3CA/AKT1/PTEN-altered subgroup (N = 62). Rates of overall and complete response (CR) by MRI favored ipatasertib in all three populations (CR rate 39% versus 9% in the PIK3CA/AKT1/PTEN-altered subgroup). Ipatasertib was associated with more grade ≥3 adverse events (32% versus 16% with placebo), especially diarrhea (17% versus 1%). Higher cycle 1 day 8 (C1D8) immune score was significantly associated with better response only in placebo-treated patients. All ipatasertib-treated patients with low immune scores and a CR had PIK3CA/AKT1/PTEN-altered tumors.

CONCLUSIONS

Adding ipatasertib to 12 weeks of paclitaxel for early TNBC did not clinically or statistically significantly increase pCR rate, although overall response rate by MRI was numerically higher with ipatasertib. The antitumor effect of ipatasertib was most pronounced in biomarker-selected patients. Safety was consistent with prior experience of ipatasertib-paclitaxel. A T-cell-rich environment at C1D8 had a stronger association with improved outcomes in paclitaxel-treated patients than seen for baseline tumor-infiltrating lymphocytes. This dependency may be overcome with the addition of AKT inhibition, especially in patients with PIK3CA/AKT1/PTEN-altered tumors.

CLINICALTRIALS.GOV

NCT02301988.

Negative Correlation Between Serum Levels of Homocysteine and Apolipoprotein M

BACKGROUND

Homocysteine (Hcy) has been suggested as an independent risk factor for atherosclerosis. Apolipoprotein M (apoM) is a constituent of the HDL particles. The goal of this study was to examine the serum levels of homocysteine and apoM and to determine whether homocysteine influences apoM synthesis.

METHODS

Serum levels of apoM and Hcy in 17 hyperhomocysteinemia (HHcy) patients and 19 controls were measured and their correlations were analyzed. Different concentrations of homocysteine (Hcy) and LY294002, a specific phosphoinositide 3- kinase (PI3K) inhibitor, were used to treat HepG2 cells. The mRNA levels were determined by RT-PCR and the apoM protein mass was measured by western blot.

RESULTS

We found that decreased serum apoM levels corresponded with serum HDL levels in HHcy patients, while the serum apoM levels showed a statistically significant negative correlation with the serum Hcy levels. Moreover, apoM mRNA and protein levels were significantly decreased after the administration of Hcy in HepG2 cells, and this effect could be abolished by addition of LY294002.

CONCLUSIONS

Present study demonstrates that Hcy downregulates the expression of apoM by mechanisms involving the PI3K signal pathway.

Characterization of carbapenem-resistant Klebsiella pneumoniae in a tertiary hospital in Fuzhou, China

Aims

The emergence of carbapenem‐resistant Klebsiella pneumoniae (CRKP) strains has led to increased mortality and morbidity rates. Tigecycline, a new class of broad‐spectrum glycyl‐tetracycline antibiotics, has been used to target multi‐ and pan‐drug‐resistant bacterial infections. This study aimed to assess the molecular characteristics of CRKP in a tertiary hospital, and its susceptibility to tigecycline, to create a reference for hospital infection control and clinical drug use.

Methods and Results

We retrieved patient clinical information and CRKP characterization from medical records and detected the MIC of tigecycline using the micro‐broth dilution method. Multi‐locus sequence typing was performed, and antibiotic resistance genes associated with CRKP were detected by qPCR. A total of 166 CRKP strains were detected in the sputum, urine and blood among intensive care unit patients (average age, 69·6 years). The most infrequently observed resistance genes were amikacin resistance genes, followed by tobramycin resistance genes. KPC‐2, CTX‐M9 and CTX‐M1 were the most frequently detected resistance genes.

Conclusions

No strain was resistant to tigecycline (MIC ≥ 8 µg ml⁻¹). Twenty‐four sequence types were identified, with ST11 being the most common type.

Significance and Impact of the Study

Clinicians and infection control experts should be aware of CRKP prevalence to facilitate clinical treatment and improve nosocomial infection control.

Outcomes of occipitocervical fixation using a spinous process screw in C2 as a third anchor point for occipitocervical fixation: a case presentation

BACKGROUND

Posterior occipitocervical fixation and fusion are often required to address occipitocervical instability. Safe, stable internal fixation with screws is vital for the success of such surgery. Thus, poor selection of an internal fixation technique may cause fixation and fusion failure, possibly leading to neurovascular injury. Hence, in certain cases, such as in patients with severe instability of an occipitocervical deformity or osteoporosis, we hypothesized that having a third anchor point (a screw in C2) could enhance the stability of the occipitocervical fixation.

CASE PRESENTATION

A 31-year-old man with occipitocervical deformity and spinal cord edema underwent a traditional occipitocervical fixation procedure but with the addition of a spinous process screw in C2 as a third anchor point. The procedure included posterior internal fixation and fusion. The occipitocervical fixation was completed by inserting occipital screws, bilateral C2 pedicle screws, C3 lateral mass screws, and a spinous process screw in C2 as a third anchor point. There were no neurovascular complications or incision-site infections. Postoperatively, radiography and computed tomography showed that the occipitocervical reduction and internal fixation had resulted in good spinal alignment, and magnetic resonance imaging showed no obvious spinal cord compression. At 4 months after the surgery, fusion was observed, and the occipitocervical screws remained well positioned. The patient continued to be monitored for 24 months postoperatively. At the 24-month follow-up visit, the muscle strength of the limbs was grade 5, and the patient's sensation function had improved over his preoperative condition.

CONCLUSIONS

Use of a C2 spinous process screw as a third anchor point may enhance the stability of occipitocervical fixation. Further biomechanical and clinical studies are needed to validate this result.

First Measurement of Λ_{c} Baryon Production in Au+Au Collisions at sqrt[s_{NN}]=200 GeV

We report on the first measurement of the charmed baryon Λ_{c}^{±} production at midrapidity (|y|<1) in Au+Au collisions at sqrt[s_{NN}]=200  GeV collected by the STAR experiment at the Relativistic Heavy Ion Collider. The Λ_{c}/D^{0} [denoting (Λ_{c}^{+}+Λ_{c}^{-})/(D^{0}+D[over ¯]^{0})] yield ratio is measured to be 1.08±0.16  (stat)±0.26  (sys) in the 0%-20% most central Au+Au collisions for the transverse momentum (p_{T}) range 3<p_{T}<6  GeV/c. This is significantly larger than the pythia model calculations for p+p collisions. The measured Λ_{c}/D^{0} ratio, as a function of p_{T} and collision centrality, is comparable to the baryon-to-meson ratios for light and strange hadrons in Au+Au collisions. Model calculations including coalescence hadronization for charmed baryon and meson formation reproduce the features of our measured Λ_{c}/D^{0} ratio.

The temporal-spatial patterns, polymorphisms and association analysis with meat quality traits of FABP1 gene in domestic pigeons (Columba livia)

1. Fatty acid-binding proteins (FABP) are members of lipid-binding proteins, which participate in the metabolism and intracellular transportation of lipids. This study was designed to investigate the expression patterns, polymorphisms and associations with meat quality traits of the FABP1 gene in pigeons. 2. The temporal-spatial expression patterns showed FABP1 was widely expressed in all eleven tissues from 0-4 weeks of age, the expression level in the liver was the highest, followed by the small intestine and subcutaneous fat. 3. Five novel SNPs were found; all of them were synonymous and in Hardy-Weinberg equilibrium. Association analysis revealed that for the SNP of G161C, the AB and BB genotypes had higher (P ≤ 0.01) inosinic acid concentrations in breast muscle than the AA genotype. The BB genotype showed the highest (P < 0.01) intramuscular fat among the three genotypes, and significantly greater FABP1 mRNA levels were observed in the breast muscle of the BB genotype than in the AA and AB genotypes (P < 0.01). In the SNP C1376T, the AB and BB genotypes showed higher (P < 0.01) intramuscular fat than the AA genotype, and the relative mRNA expression level of the BB (P < 0.01) and AB (P < 0.05) genotypes was higher than that of the AA genotype in breast muscle. Correlation analysis implied that the FABP1 mRNA expression level was closely related to the inosinic acid (P < 0.05) and intramuscular fat content (P < 0.01). Oil red O staining of frozen sections of breast muscle on d 28 for SNPs G161C and C1376T also indicated that the BB genotype had the highest intramuscular fat content in both SNPs. In addition, correlation analysis implied the FABP1 mRNA expression level was closely related to inosinic acid (P < 0.05) and intramuscular fat content (P < 0.01). 4. The results suggested that FABP1 could be a potential candidate gene in marker-assisted selection for breeding pigeons with high-quality meat.

Directional massless Dirac fermions in a layered van der Waals material with one-dimensional long-range order

One or a few layers of van der Waals (vdW) materials are promising for applications in nanoscale electronics. Established properties include high mobility in graphene, a large direct gap in monolayer MoS₂, the quantum spin Hall effect in monolayer WTe₂ and so on. These exciting properties arise from electron quantum confinement in the two-dimensional limit. Here, we use angle-resolved photoemission spectroscopy to reveal directional massless Dirac fermions due to one-dimensional confinement of carriers in the layered vdW material NbSi_0.45Te₂. The one-dimensional directional massless Dirac fermions are protected by non-symmorphic symmetry, and emerge from a stripe-like structural modulation with long-range translational symmetry only along the stripe direction as we show using scanning tunnelling microscopy. Our work not only provides a playground for investigating further the properties of directional massless Dirac fermions, but also introduces a unique component with one-dimensional long-range order for engineering nano-electronic devices based on heterostructures of vdW materials.

[Analysis of influencing factors of ureteral anastomotic stenosis following urinary diversion after laparoscopic radical cystectomy]

Objective: To investigate the influencing factors of ureteroenteric strictures (UES) in patients undergoing laparoscopic radical cystectomy plus urinary diversion (UD). Method: A total of 412 patients who underwent UD after radical prostatectomy from January 2008 to December 2016 were retrospectively included in this study. Age, gender, body mass index (BMI), diversion type, time to diagnosis of UES, duration of ureteral stent, postoperative complications, including urinary tract infections, ureteroenteric leakage and UES were collected. Kaplan-Meier curves were used to describe time to developing UES. Prognostic factors of UES were analyzed using COX proportional hazard regression model. Result: Median follow-up time was 37 (IQR 17-120) months. A total of 59 patients (70 sides) developed UES, including 34 cases on the left side, 14 cases on the right side and 11 cases on both sides, following UD after radical cystectomy. The median time to diagnosis of UES was 7 (IQR 4-11) months. The total incidence of UES was 14.3%. The incidence of UES was 10.9%, 13.3% and 14.1% at 1, 3 and 5 years after UD, respectively. Cox proportional hazard regression model analysis demonstrated that BMI≥25kg·m(-2) (P=0.008), ureteroenteric leakage (P=0.001) and urinary tract infections (P=0.037) were the independent risk factors associated with UES following UD after radical cystectomy. Conclusion: The incidence rate of UES following UD after radical cystectomy was relatively high, which occurs more common on the left side. Obese patients, combined with ureteroenteric leakage, urinary tract infection after UD, are more likely to develop into UES.

The MTase15 regulates reproduction in the wing-dimorphic planthopper, Nilaparvata lugens (Hemiptera: Delphacidae)

S-Adenosyl-l-methionine-dependent methyltransferases (SAMMTases) modulate important cellular and metabolic activities in both prokaryotes and eukaryotes. Here, we functionally characterized an SAMMTase gene (MTase15) in the migratory brown planthopper (BPH), Nilaparvata lugens, which is the most notorious rice pest in Asia. The cDNA sequence of MTase15 is 2764 nt in length with an open reading frame of 1218 nt encoding 405 amino acid residues. Quantitative real-time PCR analysis showed that MTase15 was readily detected from egg to adult stages and extensively distributed in various body parts of adult females and males, with slightly high levels in ovary and testis, respectively. In addition, MTase15 was transcriptionally regulated by the insulin signalling pathway in BPH. RNA-interference-mediated knockdown of MTase15 (dsMtase15) resulted in deficiencies in vitellogenin synthesis and oogenesis, and female infertility. Males with Mtase15 knockdown retained the capability of producing sperms with normal viability, but less sperm was transferred to wild-type (wt) females during copulation, and eggs laid by these wt females arrested embryogenesis. These findings not only assign a functional role to MTase15, but also provide a link between the insulin signalling pathway and epigenetic regulation in BPH reproduction.

Increased expression of long noncoding RNA LINC00961 suppresses glioma metastasis and correlates with favorable prognosis

OBJECTIVE

Long non-coding RNA LINC00961 (LINC00961) has been reported to play an important role in tumor development and metastasis of lung cancer. However, the expression and role of LINC00961 in glioma remains unclear. The present study aimed to investigate the expression of LINC00961 in patients with glioma and to investigate its effect on glioma cells.

PATIENTS AND METHODS

Quantitative Real-Time PCR (qRT-PCR) was performed to detect the expression of LINC00961 in glioma tissues and cell lines. Then, the association between LINC00961 expression and clinical pathological parameters and prognosis of glioma patients were further evaluated. Gain of function studies were performed to determine the effects of LINC00961 on proliferation and metastasis of glioma cells. Western blotting assay was used to explore the regulation mechanism.

RESULTS

We found that LINC00961 was significantly downregulated in glioma tissues and cell lines compared with that of adjacent normal brain tissues and normal human astrocytes. Low expression of LINC00961 was significantly correlated with WHO grade and KPS score. Clinical analysis indicated that patients with low LINC00961 expression had a shorter overall survival than those with high expression. Univariate and multivariable Cox regression analyses further identified that down-regulated LINC00961 might act as an independent prognostic factor for glioma patients. Functionally, overexpression of LINC00961 significantly suppressed glioma cells proliferation, migration, and invasion. Mechanistically, we found that overexpression of LINC00961 inhibited glioma cell EMT.

CONCLUSIONS

LINC00961 might be considered as a novel molecule involved in glioma development, which provides an independent prognostic indicator and a potential therapeutic target for glioma patients.

[Clinical and prognostic analysis of single-center multidisciplinary treatment for rhabdomyosarcoma in children]

Objective: To summarize the clinical characteristics, treatment response and prognostic factors of rhabdomyosarcoma (RMS) in children. Methods: The clinical characteristics such as age at diagnosis, primary tumor site, tumor size, pathological type, clinical stage, and risk grouping of 213 RMS patients (140 males and 73 females) treated in Hematology Oncology Center of Beijing Children's Hospital, Capital Medical University, from May 2006 to June 2018 were analyzed retrospectively. The clinical characteristics, overall survival (OS), event free survival (EFS) and prognostic factors of children treated with the Beijing Children's Hospital-Rhabdomyosarcoma (BCH-RMS) regimen were analyzed. Survival data were analyzed by Kaplan-Meier survival analysis, and single factor analysis was performed by Log-Rank test. Results: The diagnostic age of 213 cases was 48.0 months (ranged 3.0-187.5 months), of which 136 cases (63.8%) were younger than 10 years old. The head and neck region was the most common primary site of tumor (30%, 64 cases), followed by the genitourinary tract (26.8%, 57 cases). Among pathological subtypes, embryonal RMS accounted for 71.4% (152 cases), while alveolar RMS and anaplastic RMS accounted for only 26.8% (57 cases) and 1.9% (4 cases), respectively. According to the Intergroup Rhabdomyosarcoma Study Group (IRS), IRS-Ⅲ and Ⅳ accounted for 85.0% (181 cases) of all RMS patients. In all patients, 9.4% (20 cases) patients were divided in to low-risk group, 52.1% (111 cases) patients in to intermediate -risk group, 25.8% (55 cases) patients in to high-risk group, and 12.7% (27 cases) patients in to the central nervous system invasion group, respectively. All patients with RMS received chemotherapy. The cycles of chemotherapy were 13.5 (ranged 5.0-18.0) for patients without event occurrence, while 14.2 (ranged 3.0-30.0) for patients with event occurrence. Among the 213 patients, 200 patients had surgical operation, of whom 103 patients underwent surgery before chemotherapy and 97 patients at the end of chemotherapy, 21 patients had secondary surgical resection. Radiotherapy was performed in 114 patients. The follow-up time was 23.0 months (ranged 0.5-151.0 months) . There were 98 patients with relapsed or progressed disease and 67 patients with death. The median time to progression was 10 months, of which 67 (68.4%) relapse occurred within 1 year and no recurrence occurred after follow-up for more than 5 years. The 3-year EFS and 5-year EFS were (52±4) % and (48±4) %, while the 3-year OS and 5-year OS were (65±4) % and (64±4) % by survival analysis. The 5-year OS of the low-risk, intermediate-risk, the high-risk were 100%, (74±5) %, (48±8) %, and the 2-year OS of the central nervous system invasion group was (36±11) % (χ(2)=33.52, P<0.01). The 5-year EFS of the low-risk, intermediate-risk, the high-risk were (93±6) %, (51±5) %, (36±7) % and the 2-year EFS of the central nervous system invasion group was (31±10) % (χ(2)=24.73, P<0.01) . Survival factor analysis suggested that the OS of children was correlated with age(χ(2)=4.16, P=0.038), tumor TNM stage (χ(2)=22.02, P=0.001), IRS group (χ(2)=4.49, P<0.01) and the risk group (χ(2)=33.52, P<0.01). Conclusions: This study showed that the median age of newly diagnosed RMS patients was 4 years. The head and neck and the genitourinary tract were the most common primary origin of RMS. The OS was low in single-center RMS children. The median time to recurrence was 10 months, and recurrence was rare 3 years later.

First Observation of the Directed Flow of D^{0} and D^{0}[over ¯] in Au+Au Collisions at sqrt[s_{NN}]=200 GeV

We report the first measurement of rapidity-odd directed flow (v_{1}) for D^{0} and D^{0}[over ¯] mesons at midrapidity (|y|<0.8) in Au+Au collisions at sqrt[s_{NN}]=200  GeV using the STAR detector at the Relativistic Heavy Ion Collider. In 10-80% Au+Au collisions, the slope of the v_{1} rapidity dependence (dv_{1}/dy), averaged over D^{0} and D^{0}[over ¯] mesons, is -0.080±0.017(stat)±0.016(syst) for transverse momentum p_{T} above 1.5  GeV/c. The absolute value of D^{0} meson dv_{1}/dy is about 25 times larger than that for charged kaons, with 3.4σ significance. These data give a unique insight into the initial tilt of the produced matter, and offer constraints on the geometric and transport parameters of the hot QCD medium created in relativistic heavy-ion collisions.

[The Research of Present Situation and Influencing Factors of Inflammatory Bowel Disease Nursing Competence in Gastroenterology Department of Grade A of level Ⅲ Hospital in Shandong Province]

Objective: The research is to study the present situation and influencing factors of inflammatory bowel disease (IBD) nursing competency in grade A of level Ⅲ hospital in Shandong province. and provided reference for further training and education of IBD nurses. Methods: From October, 2018 to May, 2019, the research is a cross-sectional study including 17 cities, 327 IBD nurses (qualified group n=197, unqualified group n=130) based on the IBD nursing competency questionnaire. The questionnaire is self-designed on the reference of registered nurse core competence scale and the reliability and validity have been tested very well. Results: The IBD nursing competence questionnaire has 8 categories and 68 entries. The content validity index (CVI) is 0.90, while the Cronbach index is 0.992. The median score of IBD nursing competency is 70.59 and each category vary from 55.00 to 84.38. Among them, the critical thinking skills or research ability (55.00) and continuing nursing (58.33) behave not very well. According to the single factor analysis, the hierarchy (P=0.031) and the follow-up numbers of IBD patients (P=0.001) are two significant factors for the IBD nursing competency. In the Logistic multiple factors analysis, the hierarchy (N(1) and N(2)) and the follow-up numbers of IBD patients (21-50 patients) are also important factors. Conclusion: The present situation of IBD nursing competency of Shandong province is acceptable. But there is still a long way to go in the aspect of critical thinking skills, research ability, and continuing nursing. Nurse hierarchy level and follow-up of IBD patients affect nursing competence and we should reinforce the training and education of IBD nurses.

Polarization of Λ (Λ[over ¯]) Hyperons along the Beam Direction in Au+Au Collisions at sqrt[s_{NN}]=200 GeV

The Λ (Λ[over ¯]) hyperon polarization along the beam direction has been measured in Au+Au collisions at sqrt[s_{NN}]=200  GeV, for the first time in heavy-ion collisions. The polarization dependence on the hyperons' emission angle relative to the elliptic flow plane exhibits a second harmonic sine modulation, indicating a quadrupole pattern of the vorticity component along the beam direction, expected due to elliptic flow. The polarization is found to increase in more peripheral collisions, and shows no strong transverse momentum (p_{T}) dependence at p_{T} greater than 1  GeV/c. The magnitude of the signal is about 5 times smaller than those predicted by hydrodynamic and multiphase transport models; the observed phase of the emission angle dependence is also opposite to these model predictions. In contrast, the kinematic vorticity calculations in the blast-wave model tuned to reproduce particle spectra, elliptic flow, and the azimuthal dependence of the Gaussian source radii measured with the Hanbury Brown-Twiss intensity interferometry technique reproduce well the modulation phase measured in the data and capture the centrality and transverse momentum dependence of the polarization signal.

Observation of Excess J/ψ Yield at Very Low Transverse Momenta in Au+Au Collisions at sqrt[s_{NN}]=200 GeV and U+U Collisions at sqrt[s_{NN}]=193 GeV

We report on the first measurements of J/ψ production at very low transverse momentum (p_{T}<0.2  GeV/c) in hadronic Au+Au collisions at sqrt[s_{NN}]=200  GeV and U+U collisions at sqrt[s_{NN}]=193  GeV. Remarkably, the inferred nuclear modification factor of J/ψ at midrapidity in Au+Au (U+U) collisions reaches about 24 (52) for p_{T}<0.05  GeV/c in the 60%-80% collision centrality class. This noteworthy enhancement cannot be explained by hadronic production accompanied by cold and hot medium effects. In addition, the dN/dt distribution of J/ψ for the very low p_{T} range is presented for the first time. The distribution is consistent with that expected from the Au nucleus and shows a hint of interference. Comparison of the measurements to theoretical calculations of coherent production shows that the excess yield can be described reasonably well and reveals a partial disruption of coherent production in semicentral collisions, perhaps due to the violent hadronic interactions. Incorporating theoretical calculations, the results strongly suggest that the dramatic enhancement of J/ψ yield observed at extremely low p_{T} originates from coherent photon-nucleus interactions. In particular, coherently produced J/ψ's in violent hadronic collisions may provide a novel probe of the quark-gluon plasma.

Safety, efficacy and tumor mutational burden as a biomarker of overall survival benefit in chemo-refractory gastric cancer treated with toripalimab, a PD-1 antibody in phase Ib/II clinical trial NCT02915432

BACKGROUND

High tumor mutational burden (TMB-H) is correlated with enhanced objective response rate (ORR) and progression-free survival (PFS) for certain cancers receiving immunotherapy. This study aimed to investigate the safety and efficacy of toripalimab, a humanized programmed death-1 (PD-1) antibody, in advanced gastric cancer (AGC), and the predictive survival benefit of TMB and PD-L1.

PATIENTS AND METHODS

We reported on the AGC cohort of phase Ib/II trial evaluating the safety and activity of toripalimab in patients with AGC, oesophageal squamous cell carcinoma, nasopharyngeal carcinoma and head and neck squamous cell carcinoma. In cohort 1, 58 chemo-refractory AGC patients received toripalimab (3 mg/kg d1, Q2W) as a monotherapy. In cohort 2, 18 chemotherapy-naive AGC patients received toripalimab (360 mg d1, Q3W) with oxaliplatin 130 mg/m2 qd, d1, capecitabine 1000 mg/m2 b.i.d., d1-d14, Q3W as first-line treatment. Primary end point was ORR. Biomarkers such as PD-L1 and TMB were evaluated for correlation with clinical efficacy.

RESULTS

In cohort 1, the ORR was 12.1% and the disease control rate (DCR) was 39.7%. Median PFS was 1.9 months and median OS was 4.8 months. The TMB-H group showed significant superior OS than the TMB-L group [14.6 versus 4.0 months, HR = 0.48 (96% CI 0.24-0.96), P = 0.038], while PD-L1 overexpression did not correlate with significant survival benefit. A 77.6% of patients experienced at least one treatment-related adverse event (TRAE), and 22.4% of patients experienced a grade 3 or higher TRAE. In cohort 2, the ORR was 66.7% and the DCR was 88.9%. A 94.4% of patients experienced at least one TRAE and 38.9% of patients experienced grade 3 or higher TRAEs.

CONCLUSIONS

Toripalimab has demonstrated a manageable safety profile and promising antitumor activity in AGC patients, especially in combination with XELOX. High TMB may be a predictive marker for OS of AGC patients receiving toripalimab as a single agent.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02915432.