[Reliability and validity of the Chinese version on Comprehensive Scores for Financial Toxicity based on the patient-reported outcome measures]

Objective: To evaluate the reliability and validity of the Chinese version on comprehensive scores for financial toxicity (COST), based on the patient-reported outcome measures. Methods: A total of 118 cancer patients were face-to-face interviewed by well-trained investigators. Cronbach's α and Pearson correlation coefficient were used to evaluate reliability. Content validity index (CVI) and exploratory factor analysis (EFA) were used to evaluate the content validity and construct validity, respectively. Results: The Cronbach's α coefficient appeared as 0.889 for the whole questionnaire, with the results of test-retest were between 0.77 and 0.98. Scale-content validity index (S-CVI) appeared as 0.82, with item-content validity index (I-CVI) between 0.83 and 1.00. Two components were extracted from the Exploratory factor analysis, with cumulative rate as 68.04% and loading>0.60 on every item. Conclusion: The Chinese version of COST scale showed high reliability and good validity, thus can be applied to assess the financial situation in cancer patients.

[Correlation of 41 loci of single nucleotide polymorphisms with testicular germ cell tumor]

OBJECTIVE

To identify genetic susceptibility genes and the loci of their single nucleotide polymorphisms (SNPs) in patients with testicular germ cell tumor (TGCT) and provide some new ideas for the prediction, diagnosis and treatment of TGCT.

METHODS

We identified 41 SNP loci of TGCT-related genetic susceptibility genes from the literature published abroad. Using the iMLDRTM genotyping technique, we examined the SNP loci of the genetic susceptibility genes in the blood samples from 76 TGCT patients (aged 16－68 years) and 148 healthy men (aged 22－61 years) in China and analyzed their correlation with TGCT.

RESULTS

In China, TGCT was found to be correlated with the SNP loci rs2978381, rs10146204, rs12435857 and rs1256063 of the ESR2 gene, rs9397080 of the ESR1 gene, rs11202586 of the PTEN gene, rs2606345 and rs4646903 of the CYP1A1 gene, and rs1456432 of the CYP19A1 gene.

CONCLUSIONS

The results of our study indicated some difference in the positive SNP loci of the TGCT patients between Chinese and foreign cohorts as well as in different groups in China.

CCAAT enhancer binding protein β promotes tumor growth and inhibits apoptosis in prostate cancer by methylating estrogen receptor β

The CCAAT enhancer binding protein β (C/EBPβ) is overexpressed at late stages in carcinogenesis of prostate cancer (PCa), suggesting that it could potentially contribute to progression of PCa. Estrogen receptor beta (ERβ) is a tumor suppressor gene in PCa. However, whether C/EBPβ could regulate ERβ by promoter methylation is still poorly understood.In this study, expression levels of C/EBPβ and ERβ in two PC lines (LNCap and PC-3), prostatic epithelial cell line (RWPE-1), forty-eight paired non-cancerous and cancerous peripheral blood samples were examined via qRT-PCR, western blotting and methylation-specific PCR. In addition, PCa cell line was infected with pCDH-C/EBPβ and pLKO.1-C/EBPβ and expression levels of C/EBPβ, ERβ and DNA methyltransferases were detected. Finally, the role of C/EBPβ in proliferation and apoptosis of PCa cell lines was examined by MTT and flow cytometer assay. Our results show a higher frequency of promoter methylation of ERβ levels in blood samples from PCa patients (16 of 48 cases) compared with that from healthy controls (3 of 48). Besides, elevated expression levels of C/EBPβ were found in PCa patients and two PCa lines (LNCap and PC-3) compared to non-cancerous cases or prostatic epithelial cell line (RWPE-1), while opposite expression levels of ERβ were found. Overexpression of C/EBPβ could regulate ERβ expression, DNA methyltransferases expression, cell proliferation and apoptosis. Our results support the conclusion that C/EBPβ down-regulated ERβ expression through increasing its promoter methylation, and then regulated proliferation and apoptosis in PCa.

[The protective effect of human umbilical cord mesenchymal stem cells-induced neural stem cells in the vitreous on the blood-retinal barrier in diabetic rats]

Objective: To investigate the effect of intravitreal injection of neural stem cells (NSC) induced from human umbilical cord mesenchymal stem cells, and to provide a theoretical basis for the clinical treatment of blood-retinal barrier damage due to diabetic retinopathy (DR). Methods: Experimental study. Sixty male Sprague-Dawley rats were randomly divided into control group, DR group and NSC group. Diabetic rats were induced by injection of streptozotocin, and the control rats were injected with an equal volume of solvent. Three months after the establishment of diabetic models, the NSC group was injected with 2 μl of NSC in the right vitreous, and the DR group was injected with 2 μl of phosphate-buffered saline. One month later, all the rats were sacrificed. The retinal vessels and leakage were examined with flat-mounted retinas. Vascular permeability was quantified by analyzing albumin leakage using the Evans blue (EB) method. Retina was examined by hematoxylin and eosin staining. Results: Retinal blood vessels of the control rats were normal, with no EB leakage outside the vessels. The background fluorescence was enhanced and focal leakage and focal dilated vessels were detected in the DR group. In the NSC group, background fluorescence was enhanced slightly and EB leakage area decreased significantly compared with the DR group. The average EB in control group, DR group and NSC group were (9.91±1.53), (24.67±2.26) and (12.85±2.58)μg/g, The EB leakage in the NSC group decreased significantly compared with the DR group (q=9.748, P<0.05). Pathological hematoxylin and eosin staining showed that the retinal layer structure was normal and clear in the control group, the retina was thin, the cell arrangement was in disorder and the nucleus was swelling in the DR group, the status of the NSC group was between the other two groups. Conclusions: Transferring human umbilical cord mesenchymal stem cells-induced NSC in vitro to diabetic rat models by intravitreal injection could reduce leakage of blood vessels and attenuate blood-retinal barrier breakdown induced by diabetes. (Chin J Ophthalmol, 2017, 53: 53-58).

Clinical comparison of patients with benign urachal masses versus urachal carcinomas

The clinical features of 17 patients with benign urachal masses and 30 patients with urachal carcinoma treated at Sun Yat-sen University Cancer Center were analyzed retrospectively. Univariate analysis indicated that seven parameters differed significantly between the two groups. Binary logistic regression analyses showed that the rate of gross hematuria was significantly higher (P = 0.042, Exp[B] = 7.889) and the rate of fatty infiltration of the Retzius space was significantly lower (P = 0.006, Exp[B] = 0.028) in patients with urachal carcinoma than in those with benign urachal masses. Gross hematuria and fatty infiltration of the Retzius space may be indications of malignant and benign urachal masses, respectively.

Bilateral pelvic lymph node dissection for Chinese patients with penile cancer: a multicenter collaboration study

BACKGROUND

Current guidelines recommend pelvic lymphadenectomy (PLND) for patients with pelvic lymph node metastasis and special state. However, these data and recommendations do not distinguish the role of PLND in different patient groups and confirm the final benefits. The aim of this study was to confirm the efficacy of pelvic lymphadenectomy (PLND) for the different groups of patients.

METHODS

Data obtained from 7 centers were retrospectively analyzed. Of the patients, 190 pN2-3 penile carcinoma patients confirmed by bilateral inguinal lymph node excision were included in this study. Sixty-nine and 121 of these patients did and did not undergo bilateral PLND, respectively. The baseline differences from the patients were matched by propensity score analysis.

RESULTS

In this study, the Kaplan-Meier estimated disease-specific survival (DSS) was not significantly different between the PLND and no-PLND groups (P = 0.796). According to the propensity score matching for T stage, N stage, grade, adjuvant therapies, and lymph node stage (number of inguinal lymph node metastasis and extranodal extension), 48 patients were selected for each group. Among the pN2 patients, the PLND group showed higher DSS rates than the no-surgery group (P = 0.030). However, even after matching, survival did not differ between the PLND and no-PLND patients among all patients (P = 0.609) and pN3 patients (P = 0.417) with comparable DSS.

CONCLUSION

Bilateral PLND may improve survival in pN2 patients. Men with pN3 may not benefit from bilateral PLND.

[The normative values of vestibular evoked myogenic potentialin different age-groups]

Objective:To obtain the normative values of vestibular evoked myogenic potential(VEMP),i.e.the threshold,latency,latency-interval,amplitude of healthy population in Tianjin medical university General hospital.These values will help clinical diagnosis.Method:Seventy-five healthy individuals (39 males and 36 females,age from 21 to 70 years)were enrolled in this study.They were divided into 3 groups according to age:group 1(21-30 years),group 2(>30-50 years),group 3(>50-70 years).oVEMP and cVEMP were performed and the normative values were obtained.SPSS 19.0 was used to analyze the data.Result:The response rate was 77.3% and 85.3% of oVEMP and cVEMP respectively in all subjects.The values of oVEMP:in group 1 response rate was 100%,amplitude was(8.29±1.25)μV and threshold value was(83.65±4.10) dBnHL.In group 2 response rate was 85.4%,amplitude was(6.32±1.21)μV and threshold value was(89.24±4.18) dBnHL.In group 3 response rate was 46%,amplitude was(4.26±1.20) μV,threshold value was(95.13±4.21) dBnHL.The values of cVEMP: in group 1 response rate was 100%,amplitude was(108.87±19.10)μV and threshold value was(84.54±4.35) dBnHL.In group 2 response rate was 83.3%,amplitude was(84.10±20.02)μV and threshold value was (90.33±4.29)dBnHL.In group 3 response rate was 72.0%,amplitude was(64.18±19.22)μV and threshold value was (95.19±4.30)dBnHL.The statistical analysis show significant difference in oVEMP/cVEMP response rate,threshold and amplitude among different age-groups(P<0.05).No significant difference was found in N1,P1 latency and latency-interval among different age-groups(P>0.05).Conclusion:The normative values of VEMP of healthy population in Tianjin medical university General hospital were obtained in this research.These VEMP data were used for the diagnosis of related diseases.

Association of FokⅠ polymorphism in vitamin D receptor gene with risk of gastric cancer in a Xinjiang Uygur population

AIM: To investigate whether the FokⅠ polymorphism in the vitamin D receptor gene is associated with risk of gastric cancer.

METHODS: A total of 147 Uygur patients with gastric cancer (group A) were randomly selected from March 2013 to May 2015 in the Tumor Hospital of Xinjiang Medical University, and 151 healthy Uygur people (group B) were used as controls. The FokⅠ polymorphism in the vitamin D receptor gene was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method, followed by an intergroup comparison. By PCR-RFLP test, all the patients with gastric cancer were divided into an FF group (a) and an Ff + ff group (b) according to whether the patient carried the allele f. The D-dimer level of the two groups was then compared.

RESULTS: The frequency of the allele f in gastric cancer patients was higher than that in the control group (57.8% vs 47.4%, P < 0.05). Multivariate logistic regression analysis showed that the study subjects carrying the allele f (Ff + ff) had a higher gastric cancer risk than those without (FF) (OR = 2.85). The D-dimer level in the Ff + ff group was significantly elevated compared with the FF group (2.79 ± 1.21 vs 1.09 ± 0.65, P < 0.05). As the differentiation of gastric cancer worsened, the percentage of patients only carrying the allele F (FF) decreased gradually (P < 0.05).

CONCLUSION: The FokⅠ polymorphism in the vitamin D receptor gene is associated with susceptibility to gastric cancer. The allele f may be one of the risk factors for gastric cancer, whereas the allele F may be a protective factor. Moreover, the levels of D-dimer in patients with gastric cancer carrying the allele f (Ff, ff) are significantly higher than those only carrying the allele F (FF), suggesting that the allele f may be a regulator of D-dimer and thus influences the onset or prognosis of gastric cancer in Uygur people.

Evaluation of Vitronectin Expression in Prostate Cancer and the Clinical Significance of the Association of Vitronectin Expression with Prostate Specific Antigen in Detecting Prostate Cancer

PURPOSE

To detect the expression of vitronectin (VTN) in the tissues and blood serum of prostate cancer (PCa) patients, and evaluate its clinical significance and to evaluate the significance of the combined assay of VTN and prostate specific antigens (PSA) in PCa diagnosis.

MATERIALS AND METHODS

To detect the expression of VTN as a potential marker for PCa diagnosis and prognosis, immunohistochemistry was performed on the tissues of 32 patients with metastatic PCa (PCaM), 34 patients with PCa without metastasis (PCa), and 41 patients with benign prostatic hyperplasia (BPH). The sera were then subjected to Western blot analysis. All cases were subsequently examined to determine the concentrations of PSA and VTN in the sera. The collected data were collated and analyzed.

RESULTS

The positive expression rates of VTN in the tissues of the BPH and PCa groups (including PCa and PCaM groups) were 75.61% and 45.45%, respectively (P = .005). VTN was more highly expressed in the sera of the BPH patients (0.83 &plusmn; 0.07) than in the sera of the PCa patients (0.65 &plusmn; 0.06) (P &lt; .05). It was also more highly expressed in the sera of the PCa patients than in the sera of the PCaM patients (0.35 &plusmn; 0.08) (P &lt; .05). In the diagnosis of BPH and PCa, the Youden indexes of PSA detection, VTN detection, and combined detection were 0.2620, 0.3468, and 0.5635; the kappa values were 0.338, 0.304, and 0.448, respectively, and the areas under the receiver operating characteristic curve were 0.625, 0.673, and 0.703 (P &lt; .05), respectively.

CONCLUSION

VTN levels in sera may be used as a potential marker of PCa for the diagnosis and assessment of disease progression and metastasis. The combined detection of VTN and PSA in sera can be clinically applied in PCa diagnosis.&nbsp.

Effect and clinical significance of fast-track surgery combined with laparoscopic radical gastrectomy on the plasma level of vascular endothelial growth factor in gastric antrum cancer

This study discusses the effect and clinical significance of fast-track surgery (FTS) combined with laparoscopic radical surgery on the plasma level of vascular endothelial growth factor (VEGF) in locally advanced gastric antrum cancer. Plasma VEGF levels were detected in 63 cases of locally advanced gastric antrum cancer by using double-antibody sandwich Avidinbiotincomplex-ELISA before and after operation. The pure laparoscopic surgery group (group A) comprised 30 cases, and the combined FTS group (group B) consisted of 33 cases. Results of the two groups were obtained at similar time points and then compared. The VEGF levels were not significantly different between the two groups on the first day before the operation and on the first day, third day, and sixth month after the operation (P > 0.05). However, the differences were significant on the seventh day and first month after the operation (P < 0.05). The postoperative eating time, anal exhaust time, and hospital stay of the patients were statistically significantly different between the two groups (P < 0.05). Nevertheless, no significant differences were detected in terms of wound healing time and complications (P > 0.05). The 3-year survival rate significantly differed between the two groups (P < 0.05). FTS combined with laparoscopic surgery can decrease the postoperative VEGF level compared with pure laparoscopic surgery. The combined approach improved postoperative recovery without prolonging the wound healing time or increasing the incidence of postoperative complications. The 3-year survival rate also increased. Thus, FTS combined with laparoscopic surgery can improve the prognosis in gastric antrum cancer.

Effect of different luteal support schemes on clinical outcome in frozen-thawed embryos transfer cycles

OBJECTIVE

To evaluate the clinical outcome of frozen-thawed embryo transfer (FET) when using different luteal support schemes.

STUDY DESIGN

Retrospective analysis of FET cycles was performed from June 2013 and December 2013. Infertile women, who underwent FET cycles utilizing embryos cryopreserved on day 3 post-insemination following an initial fresh IVF cycle. Patients were divided into three groups according to the luteal support scheme. Grade A (oral administration of progesterone, n=156), Group B (vaginal administration of progesterone, n=345), Group C (dissolved progesterone in oil with intramuscular infection, n=885), and group C was divided into two subgroups according to with (subgroup Cl, n=521) or without (subgroup C2 ,n=364) human chorionic gonadotrophi (hCG) injected intramuscularly. The authors compared patients' characteristics and the pregnancy outcomes of each group.

RESULTS

There was no difference in the patient characteristics of each group. There was no difference in the implantation rate or clinical and ongoing pregnancy rate among oral, vaginal, and intramuscular progesterone groups. The abortion and ectopic pregnancy rates were not significantly different among the three groups.

CONCLUSION

Oral progesterone in the FET cycles is convenient and has similar pregnancy outcomes compared with intramuscular or vaginal administration.

Shear stress regulates endothelial cell autophagy via redox regulation and Sirt1 expression

Disturbed cell autophagy is found in various cardiovascular disease conditions. Biomechanical stimuli induced by laminar blood flow have important protective actions against the development of various vascular diseases. However, the impacts and underlying mechanisms of shear stress on the autophagic process in vascular endothelial cells (ECs) are not entirely understood. Here we investigated the impacts of shear stress on autophagy in human vascular ECs. We found that shear stress induced by laminar flow, but not that by oscillatory or low-magnitude flow, promoted autophagy. Time-course analysis and flow cessation experiments confirmed that this effect was not a transient adaptive stress response but appeared to be a sustained physiological action. Flow had no effect on the mammalian target of rapamycin-ULK pathway, whereas it significantly upregulated Sirt1 expression. Inhibition of Sirt1 blunted shear stress-induced autophagy. Overexpression of wild-type Sirt1, but not the deacetylase-dead mutant, was sufficient to induce autophagy in ECs. Using both of gain- and loss-of-function experiments, we showed that Sirt1-dependent activation of FoxO1 was critical in mediating shear stress-induced autophagy. Shear stress also induced deacetylation of Atg5 and Atg7. Moreover, shear stress-induced Sirt1 expression and autophagy were redox dependent, whereas Sirt1 might act as a redox-sensitive transducer mediating reactive oxygen species-elicited autophagy. Functionally, we demonstrated that flow-conditioned cells are more resistant to oxidant-induced cell injury, and this cytoprotective effect was abolished after inhibition of autophagy. In summary, these results suggest that Sirt1-mediated autophagy in ECs may be a novel mechanism by which laminar flow produces its vascular-protective actions.

Parallel enzyme-linked immunosorbent assay screening for human immunodeficiency virus among blood donors in five Chinese blood centres: a retrospective analysis

AIMS

To evaluate the strategy of parallel screening with different enzyme-linked immunosorbent assays (ELISA) among Chinese blood donors.

BACKGROUND

Parallel screening with ELISA has been the main strategy to detect human immunodeficiency virus (HIV) in blood donations in China for more than a decade. The performance of the strategy should be analysed.

METHODS

A total of 821,927 donations collected from five Chinese blood centres in 2008-2010 were tested using two third-generation ELISAs by different manufacturers licenced and confirmed by the Western blot (WB) in this study. The confirmatory positive predictive values (PPV), false positive rates (FPR), false negative rates (FNR) and potential risks for transfusion resulting from single or sequential ELISA screening were evaluated.

RESULTS

A total of 5318 (0·647%) of donations screened HIV reactive and were discarded. WB confirmatory results on 1668 available samples suggested that PPVs for dual ELISA, one round ELISA reactive and grey zone samples were 75·1, 0·7 and 0·5%, respectively. Eight out of 1124 one round ELISA reactive and 1 out of 195 grey zone samples were WB confirmed positive. All but one ELISA assay displayed comparable PPVs but variable FPRs and FNRs that differed by blood centre.

CONCLUSIONS

In the absence of nucleic acid testing (NAT), parallel ELISA screening prevented a substantial number of HIV infected donations from entering the Chinese blood supply. However, the loss of false positive donors should be re-evaluated especially given the frequently reported blood supply shortage in China.

Two-year outcome of first-line antiretroviral therapy among HIV-1 vertically-infected children in Hanoi, Vietnam

A retrospective analysis of 86 HIV-1 vertically-infected Vietnamese children with a follow-up period >24 months after initiating antiretroviral therapy (ART) was performed from 2008 to 2012, to assess the outcome of first-line ART in resource-limited settings. Of the 86 children, 68 (79.1%) were treated successfully (plasma HIV-1 viral load [VL] <1000 copies/ml), and 63 (73.3%) had full viral suppression (VL <400 copies/ml) after 24 months of ART. No significant difference between successfully treated patients and failure groups was observed in VL, CD4(+) T-cell count or clinical stage at baseline; age at ART start; or ART regimen. All 14 children with VL >5000 copies/ml, one of four children with VL 1000-5000 copies/ml and none with VL <1000 copies/ml developed reverse transcriptase inhibitor (RTI)-resistance mutations by 24 months of ART. Y181C and M184V/I were the most dominant non-nucleoside and nucleoside RTI-resistance mutations, respectively (13/15, 86.7%). These findings suggest that VL testing after 24 months of ART can be used to efficiently differentiate ART failures among HIV-1 vertically-infected children in resource-limited settings.