Acceptability and feasibility of a social entrepreneurship testing model to promote HIV self-testing and linkage to care among men who have sex with men

OBJECTIVES

HIV self-testing (HIVST) offers an opportunity to increase HIV testing among people not reached by facility-based services. However, the promotion of HIVST is limited as a consequence of insufficient community engagement. We built a social entrepreneurship testing (SET) model to promote HIVST linkage to care among Chinese men who have sex with men (MSM) in Guangzhou.

METHODS

The SET model includes a few key steps. Each participant first completed an online survey, and paid a US$23 (refundable) deposit to receive an HIVST kit and a syphilis self-testing (SST) kit. After the testing, the results were sent to the platform by the participants and interpreted by Center for Disease Control and Prevention (CDC) staff. Meanwhile, the deposit was returned to each participant. Finally, the Community based organizations (CBO) contacted the participants to provide counselling services, confirmation testing and linkage to care.

RESULTS

During April-June 2015, a total of 198 MSM completed a preliminary survey and purchased self-testing kits. The majority were aged < 34 years (84.4%) and met partners online (93.1%). In addition, 68.9% of participants had ever been tested for HIV, and 19.5% had ever performed HIVST. Overall, feedback was received from 192 participants (97.0%). Of these participants, 14 people did not use the kits; among those who did use the kits, the HIV and syphilis prevalences were 4.5% (eight of 178) and 3.7% (six of 178), respectively. All of the screened HIV-positive individuals sought further confirmation testing and were linked to care.

CONCLUSIONS

Using an online SET model to promote HIV and syphilis self-testing among Chinese MSM is acceptable and feasible, and this model adds a new testing platform to the current testing service system.

Impact of metabolic syndrome on the survival of Chinese patients with resectable esophageal squamous cell carcinoma

Metabolic syndrome (MetS) is associated with the risk of esophageal squamous cell carcinoma (ESCC). However, the impact of MetS on survival has not been evaluated. A retrospective review was performed on 596 consecutive Chinese patients with esophageal squamous cell carcinoma who received surgery between January 2005 and October 2007. The clinical data and pretreatment information related to MetS were reviewed. The impact of MetS on overall survival (OS) was estimated by Kaplan-Meier and Cox proportional hazards analyses. MetS was a significant and independent predictor for better survival in patients with resectable ESCC. The 3-year OS and 5-year OS for patients with and without MetS were 75.0% versus 57.8% and 65.1% versus 44.6%, respectively (P = 0.005 in the univariate analysis, P = 0.010 in multivariate analysis). However, there was no apparent influence of any single component of MetS on OS. The other independent prognostic factors identified in the univariate analysis included the following: gender, smoking status, alcohol use, the extent of radical surgical resection, T and N stage, and tumor differentiation. The results of the multivariate analysis included the extent of radical surgery resection, T and N stage, and tumor differentiation. MetS was also associated with greater tumor cell differentiation (P = 0.036). There was no association found between MetS status and postoperative complications. MetS is an independent prognostic factor for OS in patients with ESCC and is associated with better tumor cell differentiation.

[The evaluation of hearing aid effect in presbycusis]

Objective:To evaluate the effect of hearing aid in presbycusis. Method:Using the method of international outcome inventory for hearing aids(IOI-HA)and medium acoustic intensity(65 dBSPL) word recognition score(WRS), to evaluate the effect of hearing aid in moderate and severe presbycusis. Result:After the hearing aid of moderate presbycusis, The improved value of monosyllabic words and recognition rate in quite and noise statement(SNR=5) were 31.15%, 23.21%, 44.11%.However, improved values in severe presbycusis were 37.51%, 48.47%，50.17%, before and after hearing aid, the difference of the improved average value was statistically significant(P <0.05); Both the moderate and severe presbycusis were satisfacted with hearing aid.The IO-HA scores of moderate and severe presbycusis ranged from 15 to 34.The difference of IOIHA score of moderate and severe presbycusis had no statistical significance(P >0.05); moderate and severe presbycusis with high satisfaction with HA of quiet statement,and low satisfaction of monosyllabic words listening, and the degree of satisfaction was higher in patients with moderate to severe hearing loss in noise statement.Conclusion:Speech audiometry is an important method to assess the effect of hearing aid; IOI-HA is a timeconsuming short, subjective method.The combine of multiple evaluations have guiding significance to debugging of hearing aid expected effect and hearing aid device.

[Clinical characteristics of orthostatic hypertension with hemodynamic response of vasovagal syncope and postural orthostatic tachycardia syndrome in children and adolescents]

OBJECTIVE

To analyze the clinical characteristics of orthostatic hypertension (OHT) with hemodynamic response of vasovagal syncope (VVS) and postural orthostatic tachycardia syndrome (POTS) in children and adolescents.

METHOD

Children and adolescents admitted to the Second Xiangya Hospital from July 2008 to April 2015 were included, and divided into three groups according to the results of head-up tilt test (HUTT): OHT group, OHT+ VVS group, OHT+ POTS group. The clinical characteristics were analyzed.

RESULT

Totally 629 cases were included, 300 cases in OHT group, 264 cases in OHT+ VVS group and 65 cases in OHT+ POTS group. Syncope and dizziness were the main symptoms of the three groups, and the proportion of patients complaining syncope in OHT+ VVS group was higher than that in OHT group (49.6% vs. 35.7%, χ(2)=11.211, P<0.05) and in OHT+ POTS group (49.6% vs. 27.7%, χ(2)=10.123, P<0.05). Baseline heart rate (HR)((78±14) beat/min vs. (77±12) beat/min, t=2.570, P<0.05), HUTT 3 min HR ((100±14) beat/min vs. (94±13) beat/min, t=17.464, P<0.05) and ΔHR ((22±12) beat/min vs. (17±9) beat/min, t=19.303, P<0.05) were higher in OHT+ VVS group than in OHT group. When compared with OHT group, baseline systolic blood pressure (SBP) ((105±10) mmHg(1 mmHg=0.133 kPa) vs. (103±10) mmHg, t=4.918, P<0.05), HUTT 3 min SBP((114±10) mmHg vs. (113±11) mmHg, t=4.046, P<0.05), baseline diastolic blood pressure (DBP)((64±6) mmHg vs. (63±7) mmHg, t=2.618, P<0.05), HUTT 3 min DBP((78±8) mmHg vs. (77±8) mmHg, t=3.302, P<0.05), HUTT 3 min HR ((107±14) beat/min vs. (94±13) beat/min, t=24.229, P<0.05) and ΔHR ((32±11) beat/min vs. (17±9) beat/min, t=39.146, P<0.05) in OHT+ POTS group were significantly higher, and baseline HR((75±14) beat/min vs. (77±12) beat/min, t=-4.221, P<0.05)in OHT+ POTS group was lower.

CONCLUSION

OHT with higher supine HR, upright HR and HR change is more susceptible to being complicated with VVS, while OHT with higher supine and upright SBP, higher supine and upright DBP and lower supine HR is more susceptible to being accompanied by POTS.

[Necessity of repeated roll test in horizontal semicircular canalithasis positioned diagnosis]

OBJECTIVE

To investigate the influence of repeated roll test in horizontal semicircular canalithasis(HSC-Can) positioned diagnosis, so as to investigate the cecessity of repeated roll test.

METHODS

The patients with a chief complaint of positional vertigo accepted two consecutive cycles roll test, the evoked nystagmus characteristics of each cycle recorded by video-nystagmuograph(VNG), whose direction, intensity, time and other parameters characteristics were analyzed in 51 HSC-Can.

RESULTS

Horizontal nystagmus in the same direction with turning were induced in HSC-Can roll test. In 51 HSC-Can, roll test cycle 1 and cycle 2 induced nystagmus same strength side in 26 cases(51.0%), of which 19 cases with stronger nystagmus intensity in cycle 2, another 7 cases were weaker; the opposite strength side of the two loops induced nystagmus, and cycle 1 evoked nystagmus intensity were weaker than cycle 2, based on cycle 2 results determined HSC-Can affected side in 25 cases (49.0%). Lesion and normal side in cycle 1 induced nystagmus duration (x±s, the same below) were (13.4±11.5)s and (14.1±9.9)s, respectively intensity (18.1±22.4)°/s and (13.0±12.0)°/s; as in cycle 2 induced nystagmus duration was (20.7±10.2)s and (18.0±12.0)s, strength respectively(40.4±28.0)°/s and (15.6 ±11.2)°/s. Cycle 2 ipsilateral rotor position evoked nystagmus showed longer duration and stronger intensity than cycle 1. Between two cycle induced ipsilateral nystagmus duration, intensity differences were statistically significant (t values were -4.233 and -5.154, P=0.000). 51 HSC-Can patients, 44 patients selected repositioning maneuver, after 1-2 times of maneuver, 41 cases (93.2%) showed complete resolution of symptoms, all cases's symptoms were improved; other 7 patients selected medication only.

CONCLUSION

The proposed suspicious HSC-Can patients should receive at least two cycles roll test, and mainly in the second cycle could determine the location of the responsible semicircular canals.

Pilot study of DNA methylation in the pathogenesis of chronic rhinosinusitis with nasal polyps

BACKGROUND

DNA methylation has been implicated in the pathogenesis of allergy and atopy. This study aimed to identify whether DNA methylation also plays an important role in the pathogenesis of nasal polyps (NP).

METHODOLOGY

NP tissues were obtained from 32 patients with chronic rhinosinusitis with bilateral NP. Biopsies of inferior turbinate mucosa (ITM) were taken from 18 patients who underwent rhinoseptoplasty (control group). The methylated genes, which were detected by DNA methylation microarray, were validated by methylation-specific polymerase chain reaction, bisulphite sequencing, real-time polymerase chain reaction and immunohistochemistry.

RESULTS

DNA methylation microarray identified 8,008 CpG islands in 2,848 genes. One hundred and ninety-eight genes were found to have a methylated signal in the promoter region in NP samples compared with ITM samples. The four top genes that changed, COL18A1, EP300, GNAS and SMURF1, were selected for further study. The methylation frequency of COL18A1 was significantly higher in NP samples than in ITM samples.

CONCLUSIONS

DNA methylation might play an important role in the pathogenesis of NP. Promoter methylation of COL18A1 was found to be significantly increased in NP tissues, further studies are necessary to confirm the significance of these epigenetic factors in the mechanisms underlying the development or persistence of NP.

Combination of the Manifold Dimensionality Reduction Methods with Least Squares Support vector machines for Classifying the Species of Sorghum Seeds

This study was carried out for rapid and noninvasive determination of the class of sorghum species by using the manifold dimensionality reduction (MDR) method and the nonlinear regression method of least squares support vector machines (LS-SVM) combing with the mid-infrared spectroscopy (MIRS) techniques. The methods of Durbin and Run test of augmented partial residual plot (APaRP) were performed to diagnose the nonlinearity of the raw spectral data. The nonlinear MDR methods of isometric feature mapping (ISOMAP), local linear embedding, laplacian eigenmaps and local tangent space alignment, as well as the linear MDR methods of principle component analysis and metric multidimensional scaling were employed to extract the feature variables. The extracted characteristic variables were utilized as the input of LS-SVM and established the relationship between the spectra and the target attributes. The mean average precision (MAP) scores and prediction accuracy were respectively used to evaluate the performance of models. The prediction results showed that the ISOMAP-LS-SVM model obtained the best classification performance, where the MAP scores and prediction accuracy were 0.947 and 92.86%, respectively. It can be concluded that the ISOMAP-LS-SVM model combined with the MIRS technique has the potential of classifying the species of sorghum in a reasonable accuracy.

Prognostic Value of 2-[(18)F] Fluoro-2-deoxy-D-glucose Positron Emission Tomography-Computed Tomography Scan Carried out During and After Radiation Therapy for Head and Neck Cancer Using Visual Therapy Response Interpretation Criteria

AIMS

To evaluate the prognostic utility of 2-[(18)F] fluoro-2-deoxy-d-glucose positron emission tomography-computed tomography (FDG PET-CT) carried out in the third week (iPET) and after completion (pPET) of definitive radiation therapy in patients with mucosal primary head and neck squamous cell carcinoma (MPHNSCC) and to investigate the optimal visual grading criteria for therapy response assessment.

MATERIALS AND METHODS

Sixty-nine consecutive patients with newly diagnosed MPHNSCC treated with radical radiation therapy with or without systemic therapy underwent staging. PET-CT, iPET and pPET were included. All PET-CT images were reviewed by using a visual grading system to assess metabolic response for primary tumour: 0 = similar to adjacent background blood pool activity; 1 = more than background but < mediastinal blood pool; 2 ≥ mediastinal blood pool and < liver; 3 ≥ liver; and 4 ≥ brain. The results were correlated with locoregional recurrence-free survival (LRFS), disease-free survival (DFS) and overall survival, using Kaplan-Meier analysis.

RESULTS

The median follow-up was 28 months (range 6-62), the median age was 61 years (range 39-81) and AJCC 7th edition clinical stage II, III and IV were six, 18 and 45 patients, respectively. The optimal threshold for non-complete metabolic response (non-CMR) was defined as focal uptake ≥ liver (grade 3) for iPET and focal uptake ≥ mediastinum (grade 2) for pPET. The 2 year Kaplan-Meier LRFS, DFS and overall survival estimates for primary CMR and non-CMR in iPET were 89.8% versus 71.5% (P = 0.062), 80.1% versus 65.3% (P = 0.132), 79.1% versus 72.1% (P = 0.328) and in pPET 86.2% versus 44.6% (P = 0.0005), 77.6% versus 41.2% (P = 0.006), 81.2% versus 40.6% (P = 0.01), respectively. The negative predictive value (NPV) for LRFS for patients achieving both primary and nodal CMR in iPET was 100%. No locoregional failure was observed in patients with both primary and nodal iPET CMR (P = 0.038), whereas those with nodal iPET CMR had no regional failure (P = 0.033). However, the positive predictive values (PPV) for LRFS and DFS for iPET and pPET were found to be poor: 30% and 36% for iPET and 35% and 39% for pPET, respectively.

CONCLUSION

Standardised criteria using visual assessment are feasible. The metabolic response using visual assessment with standardised interpretation criteria of iPET and pPET can be useful predictors of tumour control. Dose de-escalation can be considered on the basis of a high NPV for iPET. However, the PPV of iPET is poor, indicating that additional discriminative tools are needed.

Ammonia concentration and relative humidity in poultry houses affect the immune response of broilers

To investigate the effect of ammonia (NH3) and humidity on the immune response of broilers, broilers were exposed to 30 or 70 mg/kg atmospheric NH3 for 21 days. Additionally, birds were exposed to 35, 60, and 85% relative humidity (RH). The relative weights of lymphoid organs, serum total protein, serum globulin, serum albumin, serum lysozyme, proliferation index of peripheral blood lymphocytes, and splenic cytokine gene expression were determined. Exposure to 70 mg/kg NH3 decreased the relative weight of the spleen during the experimental period, serum lysozyme concentration in the first and second weeks, and serum globulin concentration in the third week. The proliferation of peripheral blood lymphocytes was reduced. High levels of NH3 caused increase in IL-1β gene expression in the experimental period and IL-4 gene expression in the first week. Birds exposed to 85% RH had lower thymus and bursa of Fabricius weights in the third week and serum lysozyme concentration in the first week; IL-1β and IL-4 expressions were higher in the second and third weeks and first and second weeks, respectively, than in birds exposed to 60% RH. IL-4 expression was lower during the first week, and IL-1β expression was higher during the second week with 35% RH than with 60% RH. In conclusion, high NH3 level in the poultry house suppressed the immune response of broiler chickens. Neither high nor low RH benefited the immune response of broilers. Furthermore, there was an interactive effect between NH3 and RH on the immune response of broilers.

A novel multivariate scoring system for determining the prognosis of lymph node-negative esophageal squamous cell carcinoma following surgical therapy: an observational study

BACKGROUND

Identifying patients with esophageal squamous cell carcinoma (ESCC) with negative prognostic factors, which have an extremely low survival rate, has been problematic.

METHODS

We retrospectively collected clinical data for 648 patients with lymph node-negative ESCC who were treated at the Sun Yat-Sen University Cancer Center from 1990 to 2005. Survival difference was compared using Kaplan-Meier analysis and multivariate Cox regression analysis.

RESULTS

We identified advancing age, smoking history, alcohol consumption history, decreased forced expiratory volume in 1 s (FEV1), surgical procedure, tumor location, number of resected lymph nodes, poor tumor differentiation, and surgical stage as independent prognostic risk factors. Furthermore, based on the results of multivariate analysis, we constructed a novel scoring system that included the factors of age, smoking history, alcohol consumption history, number of resected lymph nodes, tumor differentiation, and surgical stage. Risk score (RS) was computed with the scoring system, and patients were divided into Class A (RS: 0-5) and Class B (RS: 6-10). P < 0.001 indicated statistical significance. A significant difference (p < 0.001) demonstrated that Class B was strongly related to a low survival rate and poor prognosis.

CONCLUSION

We developed a new simple flexible scoring system of high prognostic significance, which has the potential to guide postoperative therapeutic strategies and follow-up frequency and to provide better prognostic information for patients and their families.

Testicular fluorine-18 fludeoxyglucose uptake on positron emission tomography CT in patients with lymphoma: clinical significance and management impact

OBJECTIVE

This is the first case series examining the role of fluorine-18 fludeoxyglucose ((18)F-FDG) positron emission tomography-CT (PET-CT) in the diagnosis of lymphoma, and its impact on the clinical management of patients with secondary testicular involvement. This study explores the clinical significance of abnormal testicular uptake, maximum standardized uptake values and the diagnostic value of the CT component in PET-CT scans of these patients.

METHODS

The case notes and PET scans of 12 patients with diagnosis of lymphoma that were reported to have abnormal (18)F-FDG uptake in the testes were examined. Case notes were reviewed for the underlying diagnosis, indication for the scan and its effect on the management decision.

RESULTS

12 patients demonstrated abnormal (18)F-FDG uptake on the PET-CT scans (mean age, 63 years; range, 37-82 years). Seven patients were diagnosed with testicular lymphoma. Six out of the seven (86%) patients received additional intrathecal chemotherapy in addition to their systemic chemotherapy, and one patient had testicular radiotherapy.

CONCLUSION

This study establishes the importance of identifying and reporting abnormal (18)F-FDG uptake in the testes on PET-CT in patients with lymphoma. (18)F-FDG PET-CT is superior to conventional imaging in identifying testicular lymphoma and has significant management impact. It also emphasizes the importance of incorporating the testes as part of the scan coverage.

ADVANCES IN KNOWLEDGE

The appearances of testicular lymphoma on (18)F-FDG PET-CT can be variable and abnormal testicular uptake warrants further investigations and confirmation. FDG PET-CT is an important tool and can be used in addition to conventional imaging in the identification of testicular lymphoma.

A dosimetric analysis of volumetric-modulated arc radiotherapy with jaw width restriction vs 7 field intensity-modulated radiotherapy for definitive treatment of cervical cancer

OBJECTIVE

Radiation therapy treatment planning was performed to compare the dosimetric difference between volumetric-modulated arc radiotherapy (RapidArc™ v. 10; Varian® Medical Systems, Palo Alto, CA) and 7-field intensity-modulated radiotherapy (7f-IMRT) in the definitive treatment of cervical cancer.

METHODS

13 patients with cervical cancer were enrolled in this study. Planning target volume (PTV) 50 and PTV60 were prescribed at a dose of 50 and 60 Gy in 28 fractions, respectively. The dose to the PTV60 was delivered as a simultaneous integrated boost to the pelvic lymph nodes. Owing to the mechanical limitation of the multileaf collimator in which the maximum displacement was limited to 15 cm, two types of RapidArc with different jaw width restrictions (15 and 20-23 cm) were investigated to evaluate their dosimetric differences. The RapidArc plan type with dosimetric superiority was then compared against the 7f-IMRT on the target coverage, sparing of the organs at risk (OARs), monitor units, treatment time and delivery accuracy to determine whether RapidArc is beneficial for the treatment of cervical cancer.

RESULTS

The 15-cm jaw width restriction had better performance compared with the restrictions that were longer than 15 cm in the sparing of the OARs. The 15-cm RapidArc spared the OARs, that is, the bladder, rectum, small intestine, femoral heads and bones, and improved treatment efficiency compared with 7f-IMRT. Both techniques delivered a high quality-assurance passing rate (>90%) according to the Γ3mm,3% criterion.

CONCLUSION

RapidArc with a 15-cm jaw width restriction spares the OARs and improves treatment efficiency in cervical cancer compared with 7f-IMRT.

ADVANCES IN KNOWLEDGE

This study describes the dosimetric superiority of RapidArc with a 15-cm jaw width restriction and explores the feasibility of using RapidArc for the definitive treatment of cervical cancer.

Multi-color flow cytometric immunophenotyping for detection of minimal residual disease in AML: past, present and future

Current chemotherapeutic regimens achieve CR in a large percentage of patients with AML. However, relapse after CR remains a significant problem. The presence of leukemic cells at levels too low to be detected by conventional microscopy, termed minimal residual disease (MRD), has been associated with an increased risk of relapse and shortened survival. Detection of MRD requires the use of highly sensitive ancillary techniques. Multi-color flow cytometric immunophenotyping is a sensitive method for quick and accurate detection of MRD. Use of this method in patient management may result in lower rates of relapse and improved survival, and is an effective means of assessing novel therapeutic agents. This method can be used in the vast majority of patients with AML, regardless of the immunophenotypic, cytogenetic and molecular genetic abnormalities present. Unfortunately, conflicting data regarding optimum methods of measurement and reporting, as well as the expertize required to interpret results have limited broad application of this technique. We provide a broad overview of this technique, including its advantages and limitations, and discuss the methods employed at our institution. We also review several possible areas of future investigation.

Etazolate abrogates the lipopolysaccharide (LPS)-induced downregulation of the cAMP/pCREB/BDNF signaling, neuroinflammatory response and depressive-like behavior in mice

Increasing evidence has indicated that immune challenge by bacterial lipopolysaccharide (LPS) induces depressive-like behavior, neuroinflammatory response and upregulates phosphodiesterase-4 (PDE4), an enzyme that specifically hydrolyzes cyclic adenosine monophosphate (cAMP). However, whether the potential PDE4 inhibitor etazolate prevents the LPS-induced depressive-like behavior remains unclear. Here using a model of depression induced by the repeated administration of LPS during 16days, and then investigated the influence of LPS on the expression of PDE4, interleukin-1β (IL-1β) and antidepressant action of etazolate in mice through forced swimming, novelty suppressed feeding, sucrose preference and open-field tests. Our results showed that etazolate pretreatment facilitated the recovery from weight loss and prevented the depressive-like behavior induced by repeated LPS administration. Moreover, the antidepressant action of etazolate was paralleled by significantly reducing the expression levels of PDE4A, PDE4B, PDE4D and IL-1β and up-regulating the cAMP/phosphorylated cAMP response-element binding protein (pCREB)/brain-derived neurotrophic factor (BDNF) signaling in the hippocampus and prefrontal cortex of mice. These results indicate that the effects of etazolate on the depressive-like behavior induced by repeated LPS treatment may partially depend on the inhibition of PDE4 subtypes, the activation of the cAMP/pCREB/BDNF signaling and the anti-inflammatory responses in the hippocampus and prefrontal cortex.

[Selection of reference genes for quantitative real-time PCR in six oil-tea camellia based on RNA]

qRT-PCR is becoming a routine tool in molecular biology to study gene expression. It is nec- essary to find stable reference genes when performing qRT-PCR. The expression of genes cloned in oil-tea camellia currently can't be accurately analyzed because of a lack of suitable reference genes. We collected different tissues (including roots, stems, leaves, flowers and seeds) from six oil-tea camellia species to determine stable reference genes. Five novel and ten traditional reference gene sequences were selected from the RNA-seq database of Camellia oleifera C. Abel seeds and specific PCR primers were designed for each. Cycle threshold (Ct) data were obtained from each reaction for all samples. Three different software tools, geNorm, NormFinder and BestKeeper were applied to calculate the expression stability of the candidate reference genes according to the Ct values. The results were similar between analyzed by the three software packages, and indicated that the traditional gene TUBa-3, AC17a and the novel gene CESA were relatively stable in all species and tissues. However, no genes were sufficiently stable across all species and tissues, thus the optimal number of reference genes required for accurate normalization varied from two to six. Finally, the relative expression ofsqualene synthase (SQS) and squalene epoxidase (SQE) genes related to important ingredients squalene and tea saponin in oil-tea camellia seeds were compared by using stable to less stable reference genes. The comparison results validated the selection of reference genes in the current study. In summary, different optimal numbers of suitable reference genes were found for the different tissues of six oil-tea camellia species.

Preoperative level of serum amyloid A is superior to C-reactive protein in the prognosis of esophageal squamous cell carcinoma

Preoperative elevations in the levels of serum amyloid A (SAA) or C-reactive protein (CRP) have been reported to be prognostic indicators in several malignancies. The aim of this study is to evaluate the serum levels of SAA and CRP in the prognosis of esophageal squamous cell carcinoma (ESCC). In total, 252 patients with ESCC who had undergone surgery with curative-intent were retrospectively recruited. The specificity, sensitivity, and prognostic value of SAA or CRP levels were measured as the area under the receiver operating characteristic (ROC) curve (AUC). The clinical value of SAA and CRP levels as prognostic indicators was evaluated using Cox's proportional hazards model. The 1-, 3-, and 5-year overall survival (OS) rates for the entire cohort of patients with ESCC were 71.0%, 61.0%, and 43.0%, respectively. The correlation between the levels of SAA and CRP was significant (r(2) = 0. 685, P < 0.001). The ROC analysis showed that the levels of CRP were associated with a significantly lower overall accuracy than were the SAA levels (AUC, 0.615 vs. 0.880; P < 0.001). For the complete cohort, the median OS was 52.0 months longer in patients with low preoperative serum levels of SAA (72.0 months) compared with patients who had high SAA levels (20.0 months, P < 0.001). The median OS among patients with low CRP levels was also longer compared with the patients who had high CRP levels (72.0 vs. 51.0 months, respectively; P < 0.001). Subgroup analyses showed that the preoperative elevated levels of SAA could find significant differences in OS for stage I, stage II, and stage III (P < 0.001, P = 0.001, and P < 0.001, respectively), whereas the increased levels of CRP could only find a difference in OS for stage II cancers. After a multivariate analysis, preoperative elevated level of SAA was found to be an independently and significant prognostic factor (P < 0.001). Our study indicates that the preoperative levels of SAA and CRP can act as prognostic factors, and that elevated levels of these proteins are associated with negative effects on the survival of patients with ESCC. SAA showed a higher prognostic value than CRP in both cohort and subgroup analysis.

Support vector machine-based nomogram predicts postoperative distant metastasis for patients with oesophageal squamous cell carcinoma

Background:

We aim to develop effective models for predicting postoperative distant metastasis for oesophageal squamous cell carcinoma (OSCC) for the purpose of guiding tailored therapy.

Methods:

We used data from two centres to establish training (n=319) and validation (n=164) cohorts. All patients underwent curative surgical treatment. The clinicopathological features and 23 immunomarkers detected by immunohistochemistry were involved for variable selection. We constructed eight support vector machine (SVM)-based nomograms (SVM1–SVM4 and SVM1'–SVM4'). The nomogram constructed with the training cohort was tested further with the validation cohort.

Results:

The outcome of the SVM1 model in predicting postoperative distant metastasis was as follows: sensitivity, 44.7% specificity, 90.9% positive predictive value, 81.0% negative predictive value, 65.6% and overall accuracy, 69.5%. The corresponding outcome of the SVM2 model was as follows: 44.7%, 92.1%, 82.9%, 65.9%, and 70.1%, respectively. The corresponding outcome of the SVM3 model was as follows: 55.3%, 93.2%, 87.5%, 70.7%, and 75.6%, respectively. The SVM4 model was the most effective nomogram in prediction, and the corresponding outcome was as follows: 56.6%, 97.7%, 95.6%, 72.3%, and 78.7%, respectively.Similar results were observed in SVM1', SVM2', SVM3', and SVM4', respectively.

Conclusion:

The SVM-based models integrating clinicopathological features and molecular markers as variables are helpful in selecting the patients of OSCC with high risk of postoperative distant metastasis.

PSGL-1/selectin and ICAM-1/CD18 interactions are involved in macrophage-induced drug resistance in myeloma

Chemoresistance is the major obstacle in multiple myeloma (MM) management. We previously showed that macrophages protect myeloma cells, on a cell contact basis, from melphalan or dexamethasone-induced apoptosis in vitro. In this study, we found that macrophage-mediated myeloma drug resistance was also seen with purified macrophages from myeloma patients' bone marrow (BM) in vitro and was confirmed in vivo using the human myeloma-SCID (severe combined immunodeficient) mouse model. By profiling differentially regulated and paired plasma membrane protein genes, we showed that PSGL-1 (P-selectin glycoprotein ligand-1)/selectins and ICAM-1/CD18 played an important role in macrophage-mediated myeloma cell drug resistance, as blocking antibodies against these molecules or genetic knockdown of PSGL-1 or ICAM-1 in myeloma cells repressed macrophages' ability to protect myeloma cells. Interaction of macrophages and myeloma cells via these molecules activated Src and Erk1/2 kinases and c-myc pathways and suppressed caspase activation induced by chemotherapy drugs. Thus, our study sheds new light on the mechanism of drug resistance in MM and provides novel targets for improving the efficacy of chemotherapy in patients.

Optimal selection for multiple quantitative trait loci and contributions of individuals using genetic algorithm

Two methods (Scheme A and Scheme B) were developed to optimize the relative weights on quantitative trait loci (QTL) and contributions of selected individuals simultaneously to maximize selection response while constraining the rate of inbreeding to the rate observed in gene assisted selection (GAS). In Scheme A, both the relative weights give to QTL and contributions of the selected individuals were optimized using a genetic algorithm. The possible solutions for relative weights of QTL and contributions of the selected individuals were encoded simultaneously. A physical selection population was used to evaluate the fitness of each encoded solution using stochastic simulation with 50 replicates. The fitness of each solution was the mean of all replicates for accumulative discounted sum of genetic means of all generations in physical selection population. In Scheme B, the optimization for relative weights on QTL was similar to Scheme A, and also was implemented based on a genetic algorithm. However, unlike Scheme A, an optimal contribution algorithm (OC) was used to optimize contributions of selection candidates. When compared with GAS, Schemes A and B resulted in up to 15.88 and 22.26% extra discounted sum of genetic value of all generations in a long planning horizon, respectively. Compared GAS+OC and Scheme B, most of the increase (about 78%) in genetic gain was produced by only optimizing contributions of selected individuals. The optimization for relative weight given to QTL just avoided the long-term loss (about 22%) observed in GAS scheme.

Sox2 targets cyclinE, p27 and survivin to regulate androgen-independent human prostate cancer cell proliferation and apoptosis

OBJECTIVES

Sox2 is a major transcription factor and the transforming growth factor-α (TGF-α)/EGFR autocrine loop is a hallmark of prostate cancer progression. In this study, we have evaluated the effects and potential mechanisms of Sox2 on cell proliferation and apoptosis, and investigated effects of TGF-α on expression of Sox2 on androgen-independent human prostate cancer cells.

MATERIALS AND METHODS

Expression of Sox2 has been determined by RT-PCR, western blot analysis and immunocytochemistry, using RNAi and over-expression strategy to study functions of Sox2 in DU145 and PC-3 cells. Changes in level of proliferation, cell cycle and apoptosis profiles were measured by MTT, colony-forming, bromodeoxyuridine incorporation assays, cell cycle and annexin V analysis.

RESULTS

Sox2 was expressed in six human prostate cancer cell lines, and its inhibition reduced cell proliferation and induced apoptosis in DU145 cells. We have shown that knock-down of Sox2 inhibited G(1) to S phase transition concomitantly with down-regulation of cyclin E and up-regulation of p27 proteins. Conversely, over-expression of Sox2 led to the opposite effect in PC-3 cells but its inhibition induced apoptosis by down-regulation of survivin in DU145 cells. We also found that TGF-α up-regulated Sox2 and survivin protein expression via the EGFR/PI3K/AKT pathway.

CONCLUSIONS

Sox2 expression is necessary for cell proliferation and evasion of apoptosis in prostate cancer cells and TGF-α could regulate Sox2 and survivin expression by activating the EGFR/PI3K/AKT pathway.

The association between bacterial colonization and inflammatory pattern in Chinese chronic rhinosinusitis patients with nasal polyps

BACKGROUND

Chronic rhinosinusitis with nasal polyps (CRSwNP) can be subdivided according to the mucosal inflammatory patterns. In mainland China, apart from interleukin (IL)-5-positive and IL-17-positive polyps, a large group of patients with IL-5/IL-17/interferon-gamma (IFNγ)-negative nasal polyps (referred to as key cytokine-negative (KCN) polyps) can be found.

OBJECTIVE

To further study the KCN polyps and evaluate the associations between bacterial colonization and mucosal inflammatory pattern in KCN vs IL-5-positive nasal polyps.

METHODS

Nasal polyp or nasal turbinate tissue was obtained from 89 Chinese CRSwNP patients and 36 nonatopic control subjects during surgery. Samples without and after SEB exposure were processed for the assessment of pro-inflammatory cytokines and mediators by immunoassay. Prior to surgery, nasal swabs were taken from each patient for microbiological evaluation.

RESULTS

Overall, 80% polyp tissue did not express IL-5, with about 70% (49/71) of these being KCN. Key cytokine-negative nasal polyps were characterized by the synthesis of mediators promoting neutrophilic inflammation (myeloperoxidase (MPO), IL-1β, IL-6 and IL-8), whereas IL-5-positive nasal polyps were characterized by the synthesis of mediators promoting eosinophilic inflammation (IL-5, ECP, total IgE and SE-IgE). Key cytokine-negative nasal polyps were associated with greater Gram-negative bacterial load compared with controls, while IL-5-positive nasal polyps were associated with greater Gram-positive bacterial colonization vs controls and KCN polyps.

CONCLUSION

Our findings suggest that the bacteria colonizing nasal polyps of CRSwNP patients may impact on or be determined by the presence/absence of IL-5.

Aryl hydrocarbon receptor in association with RelA modulates IL-6 expression in non-smoking lung cancer

Aryl hydrocarbon receptor (AhR) is a ligand-activated transcription factor that is activated by cigarette smoke. Previously, we demonstrated that AhR is overexpressed in lung adenocarcinomas (ADs). In this study we observed that AhR expression is significantly correlated with nuclear RelA (a nuclear factor-κB (NFκB) subunit) and cytosolic interleukin-6 (IL-6) in 200 non-small cell lung cancer patients, especially among never smokers. Overexpression of AhR increased IL-6 expression in H1355 cells and immortalized human bronchial epithelial cells BEAS-2B. As NFκB inhibitor and knockdown RelA expression greatly reduced constitutive AhR-induced IL-6 expression, we hypothesized that AhR expression, in the absence of exogenous ligand, is able to modulate NFκB activity and subsequently upregulate IL-6 expression, thus promoting the development of lung AD. Specifically, AhR overexpression significantly increased NFκB activity, whereas interference with AhR expression significantly reduced NFκB activity and IL-6 expression in H1355 cells. We demonstrated that AhR associates with RelA in the cytosol and nucleus of human lung cells. Furthermore, AhR overexpression enhanced nuclear localization of AhR and RelA, and increased the association of AhR-RelA with the NFκB response element of the IL-6 promoter. However, p50 was not involved. Our results indicate that AhR, without exposure to a ligand, associates with RelA, which then positively modulates NFκB activity and then upregulates IL-6 expression in human lung cells. Thus we have identified a new mechanism for lung tumorigenesis in non-smokers.

Genome-wide association study of conduct disorder symptomatology

Conduct disorder (CD) is one of the most prevalent childhood psychiatric conditions, and is associated with a number of serious concomitant and future problems. CD symptomatology is known to have a considerable genetic component, with heritability estimates in the range of 50%. Despite this, there is a relative paucity of studies aimed at identifying genes involved in the susceptibility to CD. In this study, we report results from a genome-wide association study of CD symptoms. CD symptoms were retrospectively reported by a psychiatric interview among a sample of cases and controls, in which cases met the criteria for alcohol dependence. Our primary phenotype was the natural log transformation of the number of CD symptoms that were endorsed, with data available for 3963 individuals who were genotyped on the Illumina Human 1M beadchip array. Secondary analyses are presented for case versus control status, in which caseness was established as endorsing three or more CD symptoms (N = 872 with CD and N = 3091 without CD). We find four markers that meet the criteria for genome-wide significance (P<5 × 10(-8)) with the CD symptom count, two of which are located in the gene C1QTNF7 (C1q and tumor necrosis factor-related protein 7). There were six additional SNPs in the gene that yielded converging evidence of association. These data provide the first evidence of a specific gene that is associated with CD symptomatology. None of the top signals resided in traditional candidate genes, underscoring the importance of a genome-wide approach for identifying novel variants involved in this serious childhood disorder.

A Grain Boundary Engineering Approach to Materials Reliability

Intergranular degradation processes, (e.g., corrosion, stress corrosion, cracking, creep cracking) are a frequent cause of premature and unpredictable service failure of engineering components. Recent advances in (1) understanding structure-property relationships for grain boundaries, and (2) characterization techniques for grain boundaries in polycrystalline materials, have provided the means for improved component lifetime prediction, and the opportunity to engineer intergranular-degradation resistant microstructures.

In this work, we present our previously developed geometric models for grain boundary structure and grain size effects on intergranular degradation susceptibility. Specific examples are presented of the successful application of the ‘grain boundary engineering’ approach to the prediction and mitigation of intergranular corrosion, stress corrosion cracking, and creep cracking in Ni-based materials.

Grain Boundary Engineered Lead Alloys

The present work reports oii the effect of grain boundary structure on intergranular corrosion and creep by grain boundary diffusion in polycrystalline lead (Pb). “Special” boundaries characterized by low-Σ misorientations in the Coincident Site Lattice (CSL) model have been shown to exhibit resistance to grain boundary sliding and corrosion. PbCa and PbCaSn alloys having “special” grain boundary frequencies greater than 50% showed a 30 fold reduction in steady-state creep compared with corresponding as-received alloys containing 10% to 28% of low-Σ CSL boundaries in the microstructure of comparable grain size. At the same time, increasing the frequency of “special” boundaries enhanced alloy ductility with no compromize in tensile strength. Results from electrochemical corrosion tests on polarizied Pb alloys immersed in H2SO4 (S.G.=1.28) at 70°C indicate a clear correlation between the frequency of “special” boundaries and the prolifíeration of intergranular corrosion resulting in bulk weight loss from grain-dropping. Collectively, these results advocate adopting a “gram boundary design” approach in developing advanced lead-acid battery electrodes.

Establishment of a novel human esophageal squamous cell carcinoma cell line (ESC-410) and its partial biological characterization

Esophageal cancer exhibits an uneven geographical distribution strikingly, resulting in focal endemic high-incidence areas in several countries worldwide including China, which might be associated with the environmental and genetic risk factors in those areas. Permanent cancer cell lines are invaluable tools in understanding the biology of cancers and experimental therapeutics. To enrich cell line panel and animal models of human esophageal squamous cell carcinoma (ESCC) from different geographical areas and investigate the environmental and genetic risk factors in the carcinogenesis of ESCC, a novel human esophageal squamous cancer cell line (ESC-410) was established. The cell line grew adherent as a monolayer and maintained stable growth rate with a doubling time of 53 h and distinct epithelial morphological appearance; it was maintained in vitro for 18 months and subcultured for more than 50 passages. Ultrastructural examination revealed large irregular nuclei, desmosome, and tonofilaments; karyotype analysis showed a modal number of chromosomes that ranged from 35 to 73, with a median of 57, and 77% of analyzed cells were hyperdiploidy; reverse transcription polymerase chain reaction (RT-PCR) detected the mRNA expressions of CK8, CK18, and CK19 in the established cells; immunofluorescence assay identified the protein expressions of neurotrophin receptor p75 and integrin α6 (CD49f) in the ESC-410 cell line; xenotransplantation of ESC-410 cells into athymic nude mice subcutaneously induced the formation of solid tumor masses in about 2 weeks. By histopathological examination, heterogeneity of xenograft tumor was observed, as same as that of human primary ESCC. All findings and evidence in this experimental study suggested that this cell line might be a useful model in vitro and in vivo in cellular and molecular studies as well as in testing novel therapies for human ESCC.