Small hepatocellular carcinoma: using MRI to predict histological grade and Ki-67 expression

AIMS

To investigate the predictive indicators of small aggressive hepatocellular carcinomas by examining the association between preoperative magnetic resonance imaging (MRI) parameters and Ki-67 expression and histological grade.

MATERIALS AND METHODS

Sixty patients with small hepatocellular carcinomas (tumour diameter: ≤3 cm, tumour numbers: ≤2) who underwent curative resection or biopsy after contrast-enhanced and diffusion-weighted MRI were evaluated retrospectively. Signal intensity (SI) of the whole lesion and erector spinae muscle was measured quantitatively. Tumour-to-muscle SI ratio was calculated. The association between these MRI parameters and histological grade and Ki-67 level was then investigated.

RESULTS

There was a significant correlation between tumour-to-muscle SI ratio and histological grade in tissues captured during the non-enhanced T1-weighted (p=0.001), arterial phase (p=0.001), and portal venous phase (p=0.036) of dynamic contrast-enhanced MRI and apparent diffusion coefficient (p=0.027). Arterial inhomogeneous enhancement was also correlated with high-Ki-67 expression (p=0.032).

CONCLUSIONS

Preoperative MRI may serve as a non-invasive tool for prediction of small, aggressive hepatocellular carcinomas, which may otherwise be treated conservatively.

Electrical detection of current generated spin in topological insulator surface states: Role of interface resistance

Current generated spin polarization in topological insulator (TI) surface states due to spin-momentum locking has been detected recently using ferromagnet/tunnel barrier contacts, where the projection of the TI spin onto the magnetization of the ferromagnet is measured as a voltage. However, opposing signs of the spin voltage have been reported, which had been tentatively attributed to the coexistence of trivial two-dimensional electron gas states on the TI surface which may exhibit opposite current-induced polarization than that of the TI Dirac surface states. Models based on electrochemical potential have been presented to determine the sign of the spin voltage expected for the TI surface states. However, these models neglect critical experimental parameters which also affect the sign measured. Here we present a Mott two-spin current resistor model which takes into account these parameters such as spin-dependent interface resistances, and show that such inclusion can lead to a crossing of the voltage potential profiles for the spin-up and spin-down electrons within the channel, which can lead to measured spin voltages of either sign. These findings offer a resolution of the ongoing controversy regarding opposite signs of spin signal reported in the literature, and highlight the importance of including realistic experimental parameters in the model.

Exosomal Wnt-induced dedifferentiation of colorectal cancer cells contributes to chemotherapy resistance

Cancer stem cells (CSCs) are inherently resistant to chemotherapy, and CSCs in chemotherapy-failed recurrent tumors are enriched; however, the cellular origin of chemotherapy-induced CSC enrichment remains unclear. Communication with stromal fibroblasts may induce cancer cell dedifferentiation into CSCs through secreted factors. We recently demonstrated that fibroblast-derived exosomes promote chemoresistance in colorectal cancer (CRC). Here, we report that fibroblasts confer CRC chemoresistance via exosome-induced reprogramming (dedifferentiation) of bulk CRC cells to phenotypic and functional CSCs. At the molecular level, we provided evidence that the major reprogramming regulators in fibroblast-exosomes are Wnts. Exosomal Wnts were found to increase Wnt activity and drug resistance in differentiated CRC cells, and inhibiting Wnt release diminished this effect in vitro and in vivo. Together, our results indicate that exosomal Wnts derived from fibroblasts could induce the dedifferentiation of cancer cells to promote chemoresistance in CRC, and suggest that interfering with exosomal Wnt signaling may help to improve chemosensitivity and the therapeutic window.

Plant growth promotion and suppression of bacterial leaf blight in rice by Paenibacillus polymyxa Sx3

The effects and mechanisms of Paenibacillus polymyxa Sx3 on growth promotion and the suppression of bacterial leaf blight in rice were evaluated in this study. The results from a plate assay indicated that Sx3 inhibited the growth of 20 strains of Xanthomonas oryzae pv. oryzae (Xoo). Rice seedling experiments indicated that Sx3 promoted plant growth and suppressed bacterial leaf blight. In addition, bacteriological tests showed that Sx3 was able to fix nitrogen, solubilize phosphate and produce indole acetic acid, indicating that various mechanisms may be involved in the growth promotion by Sx3. The culture filtrate of P. polymyxa Sx3 reduced bacterial growth, biofilm formation and disrupted the cell morphology of Xoo strain GZ 0005, as indicated by the transmission and scanning electron microscopic observations. In addition, MALDI-TOF MS analysis revealed that Sx3 could biosynthesize two types of secondary metabolites fusaricidins and polymyxin P. In summary, this study clearly indicated that P. polymyxa Sx3 has strong in vitro and in vivo antagonistic activity against Xoo, which may be at least partially attributed to its production of secondary metabolites. SIGNIFICANCE AND IMPACT OF THE STUDY: Antagonistic bacteria can grow well in their originating environment. However, it is unclear whether antagonistic bacteria were able to survive in different ecological environments. This study revealed that Paenibacillus polymyxa Sx3 isolated from rhizosphere soil of cotton significantly promoted the plant growth and suppressed bacterial leaf blight in rice. Therefore, it could be inferred that P. polymyxa Sx3 has the potential to be used as biocontrol agents in plants grown in different ecological environments.

Theoretical investigation on the optical and EPR spectra for Cu2+ -doped ZnO-CdS nanocomposites

The three optical absorption bands and EPR parameters of the [CuO6 ]10- center in the ZnO-CdS composite nanopowders are theoretically studied from the perturbation formulas based on the cluster approach. In the formulas, the contributions to EPR parameters arising from the ligand orbital and spin-orbit coupling interactions via covalence effect are considered. For the studied [CuO6 ]10- cluster, the Cu-O bond lengths are suggested to show a relative elongation ratio ρ (≈ 4.1%) along the z-axis due to Jahn-Teller effect. The defect models suggested in this work are different from the previous assumption that the impurity Cu2+ can replace the host Zn2+ site when it enters the lattices of the ΖnO and ΖnS nanocrystals, forming the tetrahedral [CuΧ4 ]6- clusters (Χ = O, S). The validity of the proposed model is discussed. The differences between the present calculations and the previous ones for the interstitial Cu2+ center in ZnO nanocrystals are analyzed in view of the dissimilar impurity behaviors due to the new composition CdS and distinct preparation conditions.

Electrical Detection of Charge-to-spin and Spin-to-Charge Conversion in a Topological Insulator Bi2Te3 Using BN/Al2O3 Hybrid Tunnel Barrier

One of the most striking properties of three-dimensional topological insulators (TIs) is spin-momentum locking, where the spin is locked at right angles to momentum and hence an unpolarized charge current creates a net spin polarization. Alternatively, if a net spin is injected into the TI surface state system, it is distinctively associated with a unique carrier momentum and hence should generate a charge accumulation, as in the so-called inverse Edelstein effect. Here using a Fe/Al₂O₃/BN tunnel barrier, we demonstrate both effects in a single device in Bi₂Te₃: the electrical detection of the spin accumulation generated by an unpolarized current flowing through the surface states, and that of the charge accumulation generated by spins injected into the surface state system. This work is the first to utilize BN as part of a hybrid tunnel barrier on TI, where we observed a high spin polarization of 93% for the TI surfaces states. The reverse spin-to-charge measurement is an independent confirmation that spin and momentum are locked in the surface states of TI, and offers additional avenues for spin manipulation. It further demonstrates the robustness and versatility of electrical access to the spin system within TI surface states, an important step towards its utilization in TI-based spintronics devices.

Engineering the spin polarization of one-dimensional electrons

We present results of magneto-focusing on the controlled monitoring of spin polarization within a one-dimensional (1D) channel, and its subsequent effect on modulating the spin-orbit interaction (SOI) in a 2D GaAs electron gas. We demonstrate that electrons within a 1D channel can be partially spin polarized as the effective length of the 1D channel is varied in agreement with the theoretical prediction. Such polarized 1D electrons when injected into a 2D region result in a split in the odd-focusing peaks, whereas the even peaks remain unaffected (single peak). On the other hand, the unpolarized electrons do not affect the focusing spectrum and the odd and even peaks remain as single peaks, respectively. The split in odd-focusing peaks is evidence of direct measurement of spin polarization within a 1D channel, where each sub-peak represents the population of a particular spin state. Confirmation of the spin splitting is determined by a selective modulation of the focusing peaks due to the Zeeman energy in the presence of an in-plane magnetic field. We suggest that the SOI in the 2D regime is enhanced by a stream of polarized 1D electrons. The spatial control of spin states of injected 1D electrons and the possibility of tuning the SOI may open up a new regime of spin-engineering with application in future quantum information schemes.

Combined skin and muscle vaccination differentially impact the quality of effector T cell functions: the CUTHIVAC-001 randomized trial

Targeting of different tissues via transcutaneous (TC), intradermal (ID) and intramuscular (IM) injection has the potential to tailor the immune response to DNA vaccination. In this Phase I randomised controlled clinical trial in HIV-1 negative volunteers we investigate whether the site and mode of DNA vaccination influences the quality of the cellular immune responses. We adopted a strategy of concurrent immunization combining IM injection with either ID or TC administration. As a third arm we assessed the response to IM injection administered with electroporation (EP). The DNA plasmid encoded a MultiHIV B clade fusion protein designed to induce cellular immunity. The vaccine and regimens were well tolerated. We observed differential shaping of vaccine induced virus-specific CD4 + and CD8 + cell-mediated immune responses. DNA given by IM + EP promoted strong IFN-γ responses and potent viral inhibition. ID + IM without EP resulted in a similar pattern of response but of lower magnitude. By contrast TC + IM (without EP) shifted responses towards a more Th-17 dominated phenotype, associated with mucosal and epidermal protection. Whilst preliminary, these results offer new perspectives for differential shaping of desired cellular immunity required to fight the wide range of complex and diverse infectious diseases and cancers.

Atf3 deficiency promotes genome instability and spontaneous tumorigenesis in mice

Mice lacking genes involving in the DNA damage response (DDR) are often tumor prone owing to genome instability caused by oncogenic challenges. Previous studies demonstrate that activating transcription factor 3 (ATF3), a common stress sensor, can activate the tumor suppressor p53 and regulate expression of p53 target genes upon DNA damage. However, whether ATF3 contributes to the maintenance of genome stability and tumor suppression remains unknown. Here we report that Atf3-deficient (Atf3^-/-) mice developed spontaneous tumors, and died significantly earlier than wild-type (Atf3^+/+) mice. Consistent with these results, Atf3^-/- mouse embryonic fibroblasts (MEFs) had more aberrant chromosomes and micronuclei, and were genetically unstable. Whereas we demonstrated that ATF3 activated p53 and promoted its pro-apoptotic activity in mouse thymi and small intestines, the chromosomal instability caused by Atf3 deficiency was largely dependent on the regulation of p53 by ATF3. Interestingly, loss of Atf3 also promoted spontaneous tumorigenesis in Trp53^+/- mice, but did not affect tumor formation in Trp53^-/- mice. Our results thus provide the first genetic evidence linking ATF3 to the suppression of the early development of cancer, and underscore the importance of ATF3 in the maintenance of genome integrity.

[Clinical efficacy of acute intraoperative encephalocele prevention strategy for severe traumatic brain injury]

Objective: To explore the clinical efficacy of prevention strategy for acute intraoperative encephalocele of patients with severe traumatic brain injury (sTBI). Methods: A total of 173 patients with sTBI, who treated in Emergency Neurosurgery Department of Shandong University Qilu Hospital from January, 2011 to September, 2015 were collected and divided into research group and control group, according to their therapeutic strategy.The clinical data during hospitalization and prognosis 1 year after injury was analyzed retrospectively to clarify the effect of acute encephalocele prevention strategy. Results: There were no statistically significant differences in sex, age, preoperative Glasgow coma scale score and imaging type of lesion between patients from the two groups.The highest intraoperative intracranial pressure in the research group and control group were (35.71±4.13) mmHg and(34.85±3.81) mmHg, respectively.The acute encephalocele incidence of the research group (7 cases, 6.5%) was significantly lower than that of the control group (13 cases, 19.7%) (P<0.01). Subgroup analysis showed that the incidence of acute encephalocele in patients with only unilateral lesions was low (1.3%), while higher (19.4%) in patients with both unilateral lesions and other secondary lesions or diffuse brain swelling.The prognosis of the patients was evaluated by Glasgow Outcome Scale according to the follow-up 1 year after injury, and it was suggested that the percentage of patients with good outcome in the research group (62 cases, 57.9%) was remarkably higher than that in the control group (26 cases, 39.4%) (P=0.018). Conclusions: For sTBI patients with high risk of acute encephalocele, prevention strategy was found to be able to retard the progression of delayed hematoma and diffuse brain swelling, prevent the acute encephalocele during operation, and then significantly improve the prognosis.

Butyrate and retinoic acid imprint mucosal-like dendritic cell development synergistically from bone marrow cells

Accumulating data show that the phenotypes and functions of distinctive mucosal dendritic cells (DCs) in the gut are regulated by retinoic acid (RA). Unfortunately, the exact role of butyrate in RA-mediated mucosal DC differentiation has not been elucidated thoroughly to date. Mucosal-like dendritic cell differentiation was completed in vitro by culturing bone marrow cells with growth factors [granulocyte-macrophage colony-stimulating factor (GM-CSF/interleukin (IL)-4], RA and/or butyrate. The phenotypes, cytokine secretion, immune functions and levels of retinal dehydrogenase of different DCs were detected using quantitative polymerase chain reaction (qPCR), enzyme-linked immunosorbent assay (ELISA) and flow cytometry, respectively. The results showed that RA-induced DCs (RA-DCs) showed mucosal DC properties, including expression of CD103 and gut homing receptor α₄ β₇ , low proinflammatory cytokine secretion and low priming capability to antigen-specific CD4⁺ T cells. Butyrate-treated RA-DCs (Bu-RA-DCs) decreased CD11c, but increased CD103 and α₄ β₇ expression. Moreover, the CD4⁺ T priming capability and the levels of retinal dehydrogenase of RA-DCs were suppressed significantly by butyrate. Thus, butyrate and retinoic acid have different but synergistic regulatory functions on mucosal DC differentiation, indicating that immune homeostasis in the gut depends largely upon RA and butyrate to imprint different mucosal DC subsets, both individually and collectively.

Surfactant reduced the mortality of neonates with birth weight ⩾1500 g and hypoxemic respiratory failure: a survey from an emerging NICU network

OBJECTIVE

We evaluated the efficacy of surfactant therapy and assisted ventilation on morbidity and mortality of neonates with birth weight (BW) ⩾1500 g and hypoxemic respiratory failure (HRF).

STUDY DESIGN

We retrospectively analyzed 5650 patients with BW ⩾1500 g for incidence, management and outcome of HRF, defined as acute hypoxemia requiring mechanical ventilation and/or nasal continuous positive airway pressure ⩾24 h. The patients were allocated into groups of moderate preterm (1735, 30.7%), late preterm (1431, 25.4%), early term (ETM, 986, 17.5%), full term (1390, 24.6%) and post term (79, 1.4%), with gestational age ⩽33, 34 to 36, 37 to 38, 39 to 41 and ⩾42 weeks, respectively.

RESULTS

In the five groups, 66.9, 42, 21.6, 12.8 and 5.1% had respiratory distress syndrome (RDS). For pneumonia/sepsis and meconium aspiration syndrome (MAS), the proportion was 13.8%, 25.4%, 38.0%, 52.5% and 76.0%, respectively. Surfactant was given to 21.9% (n=1238) of HRF and 51.2% (n=1108) of RDS. Survival rates of RDS were 82.2%, 87.8%, 84.5%, 77.1% and 75.0%, respectively (numbers needed to treat was 8 to 11 for surfactant benefit). Overall mortality rate of HRF was 21%, or 17.9%, 14.7%, 25.6%, 28.9% and 39.2%, respectively. Mortalities of MAS and pneumonia/sepsis were 29.4 and 27.6%. Relative risk of death was associated with initial disease severity, female gender, mechanical ventilation and congenital anomalies by multivariate logistic regression analysis.

CONCLUSION

Surfactant was effective for infants with RDS and BW ⩾1500 g, and different incidences and outcome of HRF among GA groups reflected standard of perinatal and respiratory care in emerging neonatal intensive care unit network.