[Study on safety of adjuvant radiotherapy concurrent with weekly chemotherapy for stage ⅡB-ⅣA esophageal carcinoma after radical resection]

Objective: To evaluate the tolerability and short-term efficacy of chemo-radiotherapy in 125 patients with stage ⅡB-ⅣA esophageal carcinoma after radical resection. Methods: We retrospectively evaluated the rate of completion, toxicity and survival of patients undergoing adjuvant concurrent chemo-radiotherapy after radical resection of esophageal carcinoma from January 2004 to December 2014 in our institution. The survival rate was determined by the Kaplan-Meier method and analyzed using the log-rank test. Multivariate prognostic analysis was performed using the Cox proportional hazard model. Results: 122 patients received more than 50 Gy dose (97.6%). A total of 52 patients received more than 5 weeks chemo-radiotherapy (41.6%), while 73 patients underwent only 1-4 weeks (58.4%). The median following up was 48.4 months. 8 patients lost follow up (6.4%). The 1-year and 3-year overall survival rate were 91.6% and 57.0%, respectively, with a median survival time of 64.4 months. The 1-year and 3-year disease free survival rate were 73.2% and 54.3%, respectively, with a median disease free survival time of 59.1 months. The most common acute complications associated with chemo-radiotherapy were myelosuppression, radiation esophagitis and radiation dermatitis, the majority of which were Grade 1-2. Of the 125 patients, there were 59 cases of recurrence, including 23 cases with local regional recurrence, 26 cases with hematogenous metastasis, and 8 cases with mixed recurrence. Univariate analysis showed that the numbers of concurrent chemotherapy was associated with the overall survival (P=0.006). But receiving more than 5 weeks was not the prognostic factor compared to 1 to 4 weeks chemotherapy (P=0.231). Multivariate analysis showed that only the numbers of concurrent chemotherapy was an independent prognostic factor (P=0.010). Conclusions: Postoperative radiotherapy concurrent with weekly chemotherapy could improve the overall survival and decrease the recurrence for stage ⅡB-ⅣA esophageal carcinoma after radical resection. However, the completion rate of chemotherapy was low, so it was necessary to explore reasonable regimens to improve the completion rate and carry out prospective randomized controlled trial.

[The value of the planned neoadjuvant radiotherapy or chemoradiotherapy for the non-radical resection of esophageal squamous cell carcinoma]

Objective: The role of planned neoadjuvant radiotherapy or chemoradiotherapy in the non-radical resection of esophageal squamous cell carcinoma was unclear. The study aimed to evaluate their therapeutic effect and analyze the prognostic factors. Methods: We retrospectively analyzed the clinical data of locally advanced esophageal squamous cell carcinoma who received neoadjuvant radio therapy (33 patients) and concurrent chemoradiotherapy (119 patients) from January 2004 to December 2016 in our single-institution database.The survival rates were calculated by Kaplan-Meier method. The prognostic factors were analyzed by using Log rank test and Cox proportional hazards model. Results: The median follow-up was 29.8 months. One hundred and one patients survived more than 3 years. The rates of overall survival (OS) and disease-free survival (DFS) at 3 years were 63.9% and 55.6%, respectively.The rates of complete, partial and minimal pathological response of the primary tumor were 50.3%, 38.4%, 11.3%, the corresponding 3-year OS were 75.5%, 57.4%, 27.3% (P<0.001) and 3-year DFS were 72.0%, 44.7%, 17.6% (P<0.001), respectively.The postoperative lymph node metastasis rate was 27.0%. The 3-year OS and DFS of the lymph node positive group was 45.6% and 32.8%, significantly lower than 70.8% and 63.7% of the negative group (both P<0.001). The 3-year OS and DFS of pathologic stage Ⅰ, Ⅱ, ⅢA, ⅢB and Ⅵ A were 76.2%, 57.4%, 64.7%, 35.0%, 33.3% (P<0.001) and 70.1%, 49.3%, 41.2%, 22.1%, 33.3% (P<0.001), respectively.The operation-related mortality was 3.3%. Multivariate analysis showed that chest pain, postoperative respiratory failure, pathological differentiation, more than 15 lymph node dissection and ypTNM stage were the independent prognostic factors of OS (P<0.05 for all). Conclusions: The planned neoadjuvant radiotherapy or chemoradiotherapy for the non-radical resection of advanced esophageal squamous cell carcinoma could result in favorable survival. The chest pain, postoperative respiratory failure, pathological differentiation, the number of lymph node resection and ypTNM stage are the independent prognostic factors of the prognosis of these patients.

[Effect of CCR1 gene overexpression on the migration of bone marrow - derived mesenchymal stem cells towards hepatocellular carcinoma]

Objective: To evaluate the effect of human CCR1 (hCCR1) gene overexpression on the migration of human bone marrow-derived mesenchymal stem cells (hMSCs) towards hepatocellular carcinoma (HCC), and to examine the application prospects of MSCs as gene delivery vectors in the treatment of HCC. Methods: The hCCR1 gene was subcloned into a lentiviral vector to generate the recombinant plasmid pLV-hCCR1. The pLV-hCCR1 plasmid and two other packaging plasmids were co-transfected into 293T cells using calcium phosphate, and the virus-containing supernatant was collected. hMSCs were then infected with the recombinant lentivirus, and the expression of hCCR1 mRNA and protein was analyzed by RT-PCR and Western blot, respectively. The effect of CCR1 gene overexpression on the in vitro migration of hMSCs was examined using the Transwell migration assay. Orthotopic nude mice models of HCC were established using the MHCC-97H-GFP cell line, and the mice were divided into two groups (n = 8 per group). hMSCs were then intravenously injected via the tail vein into the tumor-bearing nude mice to examine the effect of hCCR1 overexpression on the in vivo migration of hMSCs towards HCC. Unpaired Student's t-test was used for two-group comparisons, and one-way ANOVA was used for multi-group comparisons. Results: Restriction enzyme digestion and DNA sequencing demonstrated that the recombinant plasmid pLV-hCCR1 was constructed successfully. The LV-hCCR1 lentivirus packaged by 293T cells has high infection efficiency in hMSCs, and hCCR1 was overexpressed in hMSCs after LV-hCCR1 infection. Transwell migration assay showed that hCCR1-transfected hMSCs had significantly enhanced migration towards HCC cell line-derived condition medium (CM) compared with the control RFP-hMSCs [(134.8±15.7)/LPF vs (83.5±10.9)/LPF, t = 10.40, P < 0.01]. In vivo migration experiment also demonstrated that there was significantly higher number of hCCR1-hMSCs localized within the MHCC-97H-GFP xenografts than hMSCs-RFP on day 14 following intravenous injection of hMSCs in mice [(86.7±14.1)/HPF vs (54.5±9.6)/HPF, t = -7.32, P < 0.01]. Conclusion: Overexpression of CCR1 gene can significantly enhance the migration capacity of hMSCs towards HCC cells in vitro and in vivo. This study provides evidence for potential clinical application of MSCs as more effective delivery vehicles in cancer gene therapy.

[Multicenter study of human adenovirus infection in pediatric community-acquired pneumonia in China]

Objective: To investigate the predominant genotypes and epidemiological characteristics of human adenovirus (HAdV) in pediatric community-acquired pneumonia (CAP) in China. Methods: This was a repeated cross sectional study. Between November 2014 and November 2016, nasopharyngeal aspirates (NPAs) or throat swabs from each hospitalized pediatric patients diagnosed as CAP in 12 hospitals in Northern and Southern China were collected. Respiratory specimens were screened for 18 respiratory viruses including HAdV by using Luminex xTAG RVP Fast V2 multiplex Assay. Typing of HAdV and analysis for the epidemiological characteristic of HAdV were performed. Results: (1) A total of 2 723 hospitalized pediatric patients with CAP were enrolled in this study and 156 (5.7%, 156/2 723) respiratory specimens were positive for HAdV, and 74 (6.6%, 74/1 128) and 82 (5.1%, 82/1 595) were in Northern and Southern China, respectively. There was no significant difference in the positive detection rate between the Northern and Southern China. (2) In Northern China, the HAdV positive rate of children at the age of <6 months, 6 months-<1 years, 1-<3 years, 3-<5 years and ≥5 years was 5.9%(6/101), 6.7%(7/104), 10.3%(34/331), 4.1%(11/266) and 4.9%(16/326), respectively, and the incidence of HAdV infection peaked in children aged 1-3 years (χ(2)=11.511, P=0.021). While in Southern China the HAdV positive rate of children at the age of <6 months, 6 months-<1 years, 1-<3 years, 3-<5 years and ≥5 years was 2.2% (7/312), 4.6% (12/259), 6.3% (31/494), 7.3% (18/245) and 4.9%(14/285), respectively. There was no significant difference in the positive detection rate among age groups. (3) In 2015, the highest detection rate of HAdV in northern China was 12.5% (25/200) in winter, and in Southern China was 6.7% (35/525) in spring and 5.3% (19/357) in summer. (4) In 108 cases of HAdV positive specimens typing was done and 80 in cases classification was successfully performed.Totally 7 genotypes of HAdV, including HAdV-3 (n=32), HAdV-7 (n=9), HAdV-1 (n=12), HAdV-2 (n=15), HAdV-5 (n=10), HAdV-6 (n=1) and HAdV-4 (n=1), were detected. The predominant HAdV genotypes were HAdV-3 (30.8%, 8/26) and HAdV-7 (26.9%, 7/26) in Northern China, while HAdV-3 (44.4%, 24/54) and HAdV-2 (22.2%, 12/54) were the most prevalent genotypes in Southern China. Conclusions: HAdV is an important viral pathogen in pediatric CAP. The predominant HAdV genotypes and peak seasons of HAdV infections were different between Northern and Southern China. The predominant HAdV genotypes were HAdV-3 and HAdV-7 in Northern China, while HAdV-3 and HAdV-2 in Southern China. The peak season of HAdV infections was winter in Northern China. However, HAdV infections are more common in spring and summer in Southern China.

Breaking the Energy-Symmetry-Based Propagation Growth Blockade in Magneto-Optical Rotation

The magneto-optical polarization rotation effect has myriad applications in many research areas spanning the scientific spectrum, including space and interstellar research, nanotechnology, material science, biomedical imaging, and subatomic particle research. In the nonlinear magneto-optical rotation (NMOR) effect, the angle of rotation of a linearly polarized optical field in a magnetized medium is dependent upon its intensity. However, typical NMOR signals of conventional single-beam Λ -scheme atomic magnetometers are peculiarly small, requiring sophisticated magnetic shielding and high-frequency phase-sensitive detection. Here, we show the presence of an energy-symmetry-based propagation growth blockade that undermines the NMOR effect in conventional single-beam Λ -scheme atomic magnetometers. We further demonstrate, both experimentally and theoretically, an inelastic wave-mixing technique that breaks this NMOR blockade, resulting in more-than-2-orders-of-magnitude enhancement of the NMOR signal power amplitude that cannot be achieved with conventional single-beam Λ -scheme atomic magnetometers. This technique, demonstrated here with substantially reduced light intensities at near-room temperatures, may lead to many applications, especially in the field of biomagnetism and high-resolution low-field magnetic imaging.

MetaMap: an atlas of metatranscriptomic reads in human disease-related RNA-seq data

Background

With the advent of the age of big data in bioinformatics, large volumes of data and high-performance computing power enable researchers to perform re-analyses of publicly available datasets at an unprecedented scale. Ever more studies imply the microbiome in both normal human physiology and a wide range of diseases. RNA sequencing technology (RNA-seq) is commonly used to infer global eukaryotic gene expression patterns under defined conditions, including human disease-related contexts; however, its generic nature also enables the detection of microbial and viral transcripts.

Findings

We developed a bioinformatic pipeline to screen existing human RNA-seq datasets for the presence of microbial and viral reads by re-inspecting the non-human-mapping read fraction. We validated this approach by recapitulating outcomes from six independent, controlled infection experiments of cell line models and compared them with an alternative metatranscriptomic mapping strategy. We then applied the pipeline to close to 150 terabytes of publicly available raw RNA-seq data from  more than 17,000 samples from more than 400 studies relevant to human disease using state-of-the-art high-performance computing systems. The resulting data from this large-scale re-analysis are made available in the presented MetaMap resource.

Conclusions

Our results demonstrate that common human RNA-seq data, including those archived in public repositories, might contain valuable information to correlate microbial and viral detection patterns with diverse diseases. The presented MetaMap database thus provides a rich resource for hypothesis generation toward the role of the microbiome in human disease. Additionally, codes to process new datasets and perform statistical analyses are made available.

Shock wave propagation, plasticity, and void collapse in open-cell nanoporous Ta

We systematically investigate the wave propagation, plasticity and void collapse, as well as the effects of porosity, specific surface area and impact velocity, in a set of open-cell nanoporous Ta, during shock compression, via performing large-scale non-equilibrium molecular dynamics simulations. The shock wave propagation presents an impedance, sensitive to porosity, but not to specific surface area. Such surprising phenomena are due to the similar sensitivities in density and stress variations to porosity or specific surface area. Upon impact, shock front shapes change from ramped to steep ones, with increasing porosity, specific surface area or impact velocity, owing to the transition from the heterogeneous to homogeneous plasticity along transverse directions. This transition of plasticity arises by (i) the strong impedance on large deformation bands as porosity increases; and (ii) the transition from deformation twinning to dislocation slips, and to amorphization, as the specific surface area or impact velocity increases. Shock-induced plasticity, including their nucleation, growth and interactions, also facilitates the collapse of voids.

Overexpression of Ecm22 improves ergosterol biosynthesis in Saccharomyces cerevisiae

Ergosterol biosynthesis in Saccharomyces cerevisiae is complex and the underlying mechanism of regulation remains unclear. To clarify the influence of transcriptional regulation on the ergosterol content, transcription factor Ecm22 was overexpressed in S. cerevisiae. Results showed that the overexpression of ECM22 led to an increased invasive growth. Fluconazole susceptibility testing indicated that strains overexpressing ECM22 could grow at 20 μg_{(fluconazole)}  ml^-1 . By contrast, the control failed to grow at 16 μg_{(fluconazole)}  ml^-1 . Among truncated ECM22 fragments, only the 1440-bp DNA fragment exerted almost the same impact on ergosterol content as that of the full-length gene. In a 5-l bioreactor, the highest ergosterol yield of the recombinant reached 32∙7 mg g_{(dry cell weight)} ^-1 , which was increased by about 20% compared with that of the control. In this work, a novel approach for enhancing the ergosterol production by overexpressing a transcription factor in S. cerevisiae was developed.

Morroniside protects against cerebral ischemia/reperfusion injury by inhibiting neuron apoptosis and MMP2/9 expression

The aim of the present study was to investigate the effect of morroniside against matrix metalloproteinase (MMP)2/9 and focal cerebral ischemia/reperfusion (I/R) injury in rats. A rat model of focal cerebral I/R injury rats was established and rats were administered with 30, 90 or 270 mg/kg/day morroniside for 7 days. The expression of MMP2/9 and neuronal apoptosis were assessed. In addition, the expression of active caspase-3, B-cell lymphoma 2 (Bcl-2) and Bcl-2-associated X protein (Bax) were measured. The results revealed that MMP2 and MMP9 expression was upregulated and the percentage of apoptotic neurons was increased in rats with focal cerebral I/R injury compared with the control. However, treatment with morroniside significantly inhibited I/R-induced MMP2/9 expression and neuron apoptosis compared with the untreated I/R injury group. Morroniside administration also decreased the expression of active caspase-3 and increased the Bcl-2/Bax ratio compared with untreated rats with focal cerebral I/R injury. The inhibitory effect of morroniside on MMP2/9 expression and neuron apoptosis was dose dependent. In summary, the results of the present study suggest that morroniside is able to protect against cerebral I/R injury in the brain and may have potential as a therapeutic treatment for patients who have suffered a stroke.

[Prognostic value of pretreatment neutrophil-to-lymphocyte ratio (NLR) in locally advanced non-small cell lung cancer patients treated with thoracic radiation]

Objective: The aim of this retrospective study was to evaluate the prognostic significance of pretreatment Neutrophil-to-Lymphocyte Ratio(NLR) in locally advanced non-small cell lung cancer(NSCLC) patients treated with thoracic radiotherapy. Methods: We retrospectively analyze 420 patients who received thoracic radiotherapy alone, sequential chemoraiotherapy or concurrent chemoradiotherapy for locally advanced stage NSCLC from January 2007 to December 2010 of our hospital. The patients were divided into two groups (high NLR group and low NLR group) with appropriate cutoff point using the receiver operating characteristic (ROC) curve method. The survival curve was established by Kaplan-Meier method. The Log-rank test was used to compare the survival of the two NLR groups and the multivariate analysis was carried out by Cox regression model. Results: Among the 420 patients, 99 received radiotherapy alone, 139 received sequential chemoradiotherapy and 182 received concurrent chemoradiotherapy. 345 patients died and 75 were still alive. The median follow-up time was 5.2 years and the median overall survival was 22 months. The cut-off value of pretreatment NLR was 2.1. The 5-year PFS and OS rates in high NLR group and low NLR group were 10.6% vs 15.7% (P=0.033) and 15.5% vs 22.7% (P=0.012). Multivariate analysis confirmed that pretreatment NLR (hazard ratio 1.06, P=0.041) was independent prognostic factor of OS. Conclusions: Our study revealed that the pretreatment NLR is the independent prognostic factor of OS in patients with locally advanced stage NSCLC treated with thoracic radiotherapy. However, NLR is still greatly influenced by patient's condition and treatment which needs further research.

Surface premelting/recrystallization governing the collapse of open-cell nanoporous Cu via thermal annealing

We systematically investigate the collapse of a set of open-cell nanoporous Cu (np-Cu) materials with the same porosity and shape but different specific surface areas, during thermal annealing, by performing large-scale molecular dynamics simulations. Two mechanisms govern the collapse of np-Cu. One is direct surface premelting, facilitating the collapse of np-Cu, when the specific surface area is less than a critical value (∼2.38 nm-1). The other is recrystallization followed by surface premelting, accelerating the sloughing of ligaments and the annihilation of voids, when the critical specific surface area is exceeded. Surface premelting results from surface reconstruction by prompting localized "disordering" and "chaos" on the surface, and the melting temperature reduces linearly with the increase of the specific surface area. Recrystallization is followed by surface premelting as the melting temperature is below the supercooling point, where a liquid is unstable and instantaneously recrystallizes.

Diagnostic Accuracy of Amino Acid and FDG-PET in Differentiating Brain Metastasis Recurrence from Radionecrosis after Radiotherapy: A Systematic Review and Meta-Analysis

BACKGROUND

Current studies that analyze the usefulness of amino acid and FDG-PET in distinguishing brain metastasis recurrence and radionecrosis after radiation therapy are limited by small cohort size.

PURPOSE

Our aim was to assess the diagnostic accuracy of amino acid and FDG-PET in differentiating brain metastasis recurrence from radionecrosis after radiation therapy.

DATA SOURCES

Studies were retrieved from PubMed, Embase, and the Cochrane Library.

STUDY SELECTION

Fifteen studies were included from the literature. Each study used PET to differentiate radiation necrosis from tumor recurrence in contrast-enhancing lesions on follow-up brain MR imaging after treating brain metastasis with radiation therapy.

DATA ANALYSIS

Data were analyzed with a bivariate random-effects model. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were pooled, and a summary receiver operating characteristic curve was fit to the data.

DATA SYNTHESIS

The overall pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of PET were 0.85, 0.88, 7.0, 0.17, and 40, respectively. The area under the receiver operating characteristic curve was 0.93. On subgroup analysis of different tracers, amino acid and FDG-PET had similar diagnostic accuracy. Meta-regression analysis demonstrated that the method of quantification based on patient, lesion, or PET scan (based on lesion versus not, P = .07) contributed to the heterogeneity.

LIMITATIONS

Our study was limited by small sample size, and 60% of the included studies were of retrospective design.

CONCLUSIONS

Amino acid and FDG-PET had good diagnostic accuracy in differentiating brain metastasis recurrence from radionecrosis after radiation therapy.

Elastostatic reversibility in thermally formed bulk metallic glasses: nanobeam diffraction fluctuation electron microscopy

The unparalleled shaping ability of bulk metallic glasses can revolutionize commercial products having multi-length scale features with a processing time of several minutes. Despite the widespread shaping ability of these polymer-like multicomponent alloys, thermoplastic forming (TPF) can severely degrade the intrinsic properties, particularly when complex stress states are activated. The present work emphasizes the importance of elastostatic loading (ESL) which not only fully reverses deteriorated room temperature plasticity originating under TPF or post-cryostatic conditions, but also activates a rejuvenation mechanism by rendering an extended resistance against strain softening. Furthermore, the reduction in the supercooled liquid region and crystallization enthalpy measured by differential scanning calorimetry are found to be temporary, and can be fully reversed to the initial condition. HRTEM imaging of the samples are performed with an imaging spherical aberration corrector. Individual nanobeam diffraction patterns obtained by the fluctuation electron microscopy (FEM) measurements are acquired using a scanning transmission electron microscope with a probe size of 1.2 nm from a 10 × 10 raster, yielding 100 diffraction patterns. The normalized variance of a series of nanodiffraction patterns of the post-elastostatically loaded sample reveals a height decrease in the first broad peak of normalized intensity variance V(k) suggesting modifications in the medium-range structural order which in turn dramatically restores the mechanical and thermal properties. Overall, the combination of TPF and post-ESL treatment in advanced glassy metals can open a new avenue for ultra-high mechanical and thermal performance micro- and nanomechanical devices for biosensors, MOSFETs and robotics.

Imidacloprid is hydroxylated by Laodelphax striatellus CYP6AY3v2

Laodelphax striatellus (Fallén) is one of the most destructive pests of rice, and has developed high resistance to imidacloprid. Our previous work indicated a strong association between imidacloprid resistance and the overexpression of a cytochrome P450 gene CYP6AY3v2 in a L. striatellus imidacloprid resistant strain (Imid-R). In this study, a transgenic Drosophila melanogaster line that overexpressed the L. striatellus CYP6AY3v2 gene was established and was found to confer increased levels of imidacloprid resistance. Furthermore, CYP6AY3v2 was co-expressed with D. melanogaster cytochrome P450 reductase (CPR) in Spodoptera frugiperda 9 (SF9) cells. A carbon monoxide difference spectra analysis indicated that CYP6AY3v2 was expressed predominately in its cytochrome P450 (P450) form, which is indicative of a good-quality functional enzyme. The recombinant CYP6AY3v2 protein efficiently catalysed the model substrate P-nitroanisole to p-nitrophenol with a maximum velocity (V_max ) of 60.78 ± 3.93 optical density (mOD)/min/mg protein. In addition, imidacloprid itself was metabolized by the recombinant CYP6AY3v2/nicotinamide adenine dinucleotide 2'-phosphate reduced tetrasodium salt (NADPH) CPR microsomes in in vitro assays (catalytic constant (K_cat ) = 0.34 pmol/min/pmol P450, michaelis constant (K_m ) = 41.98 μM), and imidacloprid depletion and metabolite peak formation were with a time dependence. The data provided direct evidence that CYP6AY3v2 is capable of hydroxylation of imidacloprid and conferring metabolic resistance in L. striatellus.

Enteral versus parenteral nutrition in critically ill patients with severe pancreatitis: a meta-analysis

Whether enteral nutrition (EN) is superior to parenteral nutrition (PN) in critically ill patients with severe acute pancreatitis remains unknown. The objective of this meta-analysis was to assess the effects of EN versus PN on clinical outcomes in a subgroup of pancreatitis patients. Relevant randomized controlled trials (RCTs) were searched in Scopus, PubMed and Web of Science from inception to August 2016. Ultimately, five RCTs including 348 patients were enrolled in this analysis. Compared with PN, EN was associated with a significant reduction in overall mortality (risk ratio (RR)=0.36, 95% confidence interval (CI) 0.20-0.65, P=0.001) and the rate of multiple organ failure (RR=0.39, 95% CI 0.21-0.73, P=0.003). EN should be recommended as the preferred route of nutrition for critically ill patients with severe acute pancreatitis.

Laparoscopic extraperitoneal uterine suspension with suture line instead of mesh

OBJECTIVE

To compare the safety and effectiveness of two different materials (mesh and suture line) used in laparoscopic extraperitoneal uterine suspension.

DESIGN

A retrospective observational study.

SETTING

Gynaecology departments in two hospitals in China.

POPULATION

Women with symptomatic pelvic organ prolapse (POP) of stage II or higher.

METHODS

The women were divided into two groups according to the two different materials for laparoscopic extraperitoneal uterine suspension: mesh or suture line. The baseline characteristics, perioperative details, complications, objective and subjective indexes of the two groups were compared.

MAIN OUTCOME MEASURES

The primary outcome was subjective satisfaction rate based upon validated questionnaires. The secondary outcome was objective anatomic assessment with the POP-Q system.

RESULTS

No difference was found in baseline characteristics and perioperative details except that there were more cases of cardiovascular disease (CVD) and associated other surgeries in the Line than the Mesh group (36 versus 19, P < 0.05; 12 versus 2, P < 0.05). Statistically significant improvements were found in anatomical measures of points Aa, Ba, Ap, Bp, C and TVL (P < 0.01), as well as functional and quality-of-life measures (P < 0.01 for PFDI-20 and PFIQ-7) between both groups. The postoperative PFDI-20, PFIQ-7 and PGI-I scores were not different between two groups (P > 0.05). Two cases of deep wound infection were observed in Mesh group at 3-month follow up.

CONCLUSIONS

Laparoscopic extraperitoneal linear uterine suspension is easy to perform and is associated with fewer mesh-related complications. It is more secure, especially in elderly women and in those with physical complications.

TWEETABLE ABSTRACT

Laparoscopic extraperitoneal linear uterine suspension is safe, with fewer mesh-related complications.

MTA1 modulated by miR-30e contributes to epithelial-to-mesenchymal transition in hepatocellular carcinoma through an ErbB2-dependent pathway

MTA1 is a metastasis-associated protein, which is essential to epithelial-to-mesenchymal transition (EMT). However, information concerning its up- and downstream regulation is rare. We investigated its upstream regulation and downstream effector in human hepatocellular carcinoma (HCC). In total, 94 paired HCC and adjacent tissue samples were involved in the study, and the results indicated that decreased miR-30e levels were associated with increased MTA1 levels in human HCC. miR-30e exerted its regulation of MTA1 transcription by binding to its 3'-untranslated region, and was negatively associated with EMT. Furthermore, significantly higher expression of MTA1 was associated with overexpression of v-erb-b2 avian erythroblastic leukemia viral oncogene homolog 2 (ErbB2) in human HCC, and MTA1 can promote transcription of ErbB2 by binding with histone deacetylase 2 (HDAC2) and acting as a promoter. The EMT promotion effect caused by MTA1 largely depended on ErbB2, and reducing the activity of ErbB2 can significantly attenuate EMT promotion by causing overexpression of MTA1 both in vitro and in vivo. In general, downregulation of miR-30e can increase levels of MTA1 in human HCC, and furthermore promote cell invasion and metastasis by promoting ErbB2.

[Efficacy and safety of oseltamivir in children with suspected influenza: a multicenter randomized open-label trial]

Objective: To evaluate the efficacy and safety of oseltamivir in the treatment of suspected influenza in children. Method: A multicenter, randomized and open-label trial was conducted among 229 individuals with suspected influenza which were collected from the clinic of 5 hospitals in Guangdong province (Guangzhou Women and Children's Medical Center, Shenzhen Baoan District Maternity and Child Care Service Center, the Second Affiliated Hospital of Shantou University Medical College, Dongguan Maternity and Child Care Service Centre, Yuexiu District Children's Hospital of Guangzhou) from April to July 2015. They were randomized either to oseltamivir group (oseltamivir 30-75 mg, twice daily for 5 days) or control group who were given symptom relief medicines for 5 days. Result: No significant difference was found between two groups in influenza symptoms of the patients before the treatment(P>0.05). Altogether 229 individuals (114 in oseltamivir group, 115 in control group) were analyzed for efficacy, in which 73 individuals (42 oseltamivir, 31 control), 31.9%, were identified as influenza-infected through laboratory test. No significant difference was found between the two groups in the duration of fever although shortened. In the 229 individuals , the cumulative alleviation proportion between oseltamivir and control group was not significantly different (P>0.05): the median duration of illness was 69.9 hours (95% CI 65.3-91.5) in oseltamivir group and 75.4 hours (95%CI 63.9-91. 7) in control group; the median duration of fever was 40.4 hours (95%CI 31.5-53.4) in oseltamivir group and 44.0 hours (95%CI 33.2-50.0) in control group. In the 73 individuals, the cumulative alleviation proportion between oseltamivir and control group was significantly different (P<0.05). The median duration of illness was 61.2 hours (95%CI 48.0-121. 0) in oseltamivir group, being significantly shorter than that of 116.0 hours (95%CI 91.5-175.0) in control group. But it was not significantly different that the median duration of fever was 32.8 hours (95%CI 24.0-47.0 ) in oseltamivir group and 55.8 hours (95%CI 43.6-78.3 ) in control group (P>0.05). And the median duration of fever in 60 individuals (38 oseltamivir, 22 control) was significantly different between two groups(P<0.05), who had finished a course of taking oseltamivir in the 73 individuals, 34.8 hours (95%CI 24.0-48.5 ) in oseltamivir group being significantly shorter than that of 53.3 hours (95%CI 43.6-104.0 ) in control group. There was certain difference in side effects rate between the two groups (oseltamivir 10%, control 2%, P<0.05). The main side-effects were gastrointestinal symptoms (stomachache, diarrhea, poor appetite, vomiting). Conclusion: The duration of illness and fever in suspected influenza patients treated with oseltamivir was shorter than those in the patients treated with no oseltamivir, the difference was not statistically significant, when 31.9% was confirmed with positive result of virus test in suspected influenza in children. But in these patients with positive result of virus test, the duration of illness was significantly shortened with treatment with oseltamivir as compared with no treatment with oseltamivir, and it would be better if full oseltamivir course was completed for reducing the duration of fever. Oseltamivir treatment was safe with mild side effects.