Comparison of Methods for Measuring Radiotherapy Utilisation

AIMS

Evidence-based estimates of appropriate rates of radiotherapy utilisation are usually stated as the proportion of cancer patients who should receive radiotherapy at least once in their lifetime. However, the prolonged follow-up required to measure the lifetime radiotherapy rate limits its value in monitoring access to radiotherapy in routine practice. The objectives of this study were to evaluate shorter-term methods for measuring radiotherapy utilisation and to determine how well they predict the lifetime radiotherapy rate.

MATERIALS AND METHODS

The Ontario Cancer Registry provided records of all cases of cancer diagnosed in Ontario between 1984 and 2015. Records of all radiotherapy delivered by Ontario cancer centres were linked to individual cases in the Ontario Cancer Registry. Patients were followed forward for 20 years to determine the relationship between short-term and long-term rates of use of radiotherapy. Radiotherapy utilisation was also estimated by comparing total radiotherapy workload with cancer incidence; these measures were compared with observed long-term radiotherapy rates.

RESULTS

The rate of use of radiotherapy within 1 year of diagnosis (RT_1y) was strongly predictive of the rate of use of radiotherapy after 20 years (RT_20y); for each annual cohort of cases between 1984 and 1995, RT_20y was approximately equal to 1.3 × RT_1y. The number of cases treated for the first time with radiotherapy in a specified period, divided by the number of new cases diagnosed in the same period, was about equal to the proportion of cases treated with radiotherapy within 20 years of diagnosis (RT_20y).

CONCLUSIONS

The lifetime rate of use of radiotherapy may be predicted quite accurately from the rate observed within 1 year of diagnosis, or from the ratio of new cases treated to cancer incidence in a specified period. Either of these measures may therefore be used to audit radiotherapy utilisation against the existing evidence-based targets.

Enhanced electrocatalytic activity of water oxidation in an alkaline medium via Fe doping in CoS2 nanosheets

Fe–CoS₂/CC exhibits enhanced catalytic OER performance, needing an overpotential of 302 mV at 10 mA cm⁻² in 1.0 M KOH.

[Comparison of efficacy between sorafenib and sunitinib as first-line therapy for metastatic renal cell carcinoma and analyze prognostic factors for survival]

Objective: To investigate the efficacy and drug related adverse reactions of sorafenib and sunitinib as first-line tyrosine-kinase inhibitors (TKIs) for patients with metastatic renal cell carcinoma (mRCC) and analyze the clinical prognostic factor for survival. Methods: The data of 271 patients with metastatic renal cell carcinoma who had complete clinicopathological data were retrospectively analyzed, including 174 cases in sorafenib group and 97 cases in sunitinib group, to access patients' overall survival (OS) and progression-free survival (PFS). Prognostic values of all characteristics were determined by using univariate and multivariate Cox regression models. Results: The objective response rates (ORR) of the sorafenib and sunitinib groups were 14.9% and 19.6%, respectively, and the disease control rates (DCR) were 85.1% and 88.6%, respectively. No significant difference was found between the sorafenib and sunitinib group in ORR (P=0.325) or DCR (P=0.408). The most common grade 3 to 4 adverse events in the sorafenib group were hand-foot syndrome (6.7%), diarrhea (2.3%), and rash (2.3%). The most common grade 3 to 4 adverse events in the sunitinib group were neutropenia (6.2%), hand-foot syndrome (6.2%), and thrombocytopenia (4.6%). During the follow-up, 97 cases death occurred and 81 cases disease progression occurred in sorafenib group. The median PFS was 12 months (95% CI: 9-15 months), and the median OS was 25 months (95% CI: 21-29 months) in sorafenib group. While 74 cases death occurred and 40 cases disease progression occurred in sunitinib group, the median PFS was 12 months (95% CI: 10-12 months) and the median OS was 23 months (95% CI: 20-32 months) in sunitinib group. No significant difference was found between the sorafenib and the sunitinib group in PFS (P=0.771) or OS (P=0.548). Multivariate analysis showed Fuhrman grades (HR=1.358, 95%CI: 1.004-1.835), number of metastatic sites (HR=1.550, 95%CI: 1.143-2.101) and MSKCC risk grade (Intermediate risk group: HR=1.621, 95%CI: 1.117-2.232; Poor risk group: HR=2.890, 95%CI: 1.942-4.298) were independent prognostic factors for PFS. Fuhrman grades (HR=2.135, 95%CI: 1.533-2.974), number of metastatic sites (HR=1.774, 95%CI: 1.279-2.461) and MSKCC risk grade (Intermediate risk group: HR=1.415, 95%CI: 1.002-1.998; Poor risk group: HR=3.161, 95%CI: 2.065-4.838) were independent prognostic factors for OS. Conclusions: The results of this study indicate that sorafenib and sunitinib are both effective as the first-line TKIs for mRCC patients and sorafenib has comparable efficacy to sunitinib. But they have differences in the incidence of adverse effects. Fuhrman grades, number of metastatic sites and MSKCC risk grade are independent prognostic factors for mRCC patients.

MUC1- and Survivin-based DNA Vaccine Combining Immunoadjuvants CpG and interleukin-2 in a Bicistronic Expression Plasmid Generates Specific Immune Responses and Antitumour Effects in a Murine Colorectal Carcinoma Model

DNA vaccination is a promising cancer treatment due to its safety, but poor immunogenicity limits its application. However, immunoadjuvants, heterogeneous prime-boost strategies and combination with conventional treatments can be used to improve the antitumour immune effects. A CpG motif and interleukin-2 (IL-2) cytokine are often used as adjuvants. In this study, a DNA vaccine containing a CpG motif was constructed to evaluate its adjuvant effect. The results show that the cytotoxicity of the DNA vaccine was increased fivefold, and survival lifetime was prolonged twofold by the CpG motif adjuvant. To simplify the industrial production process, a bicistronic plasmid was constructed to carry the fusion genes of survivin/MUC1 (MS) and IL-2 and with a CpG motif in its backbone. The results showed that the antitumour effect of the bicistronic vaccine was the same as that of the two vaccine co-injected regime. Furthermore, the vaccine could suppress metastatic tumour foci by 69.1% in colorectal carcinoma-bearing mice. Moreover, the vaccine induced survivin- and MUC1-specific immune responses in splenocytes and induced the immune promoting factor CCL-19 and GM-CSF upregulated, while metastatic-associated factor MMP-9 and immunosuppressing factor PD-L1 downregulated in tumour tissue. When combining the vaccine with the chemotherapy drug oxaliplatin, the survival was prolonged by about 2.5-fold. In conclusion, the DNA vaccine containing a CpG motif in bicistronic form showed good effects on colorectal cancer by inhibiting both tumour growth and metastasis, and combination with oxaliplatin could improve its antitumour effects.

Detection of glutathione based on MnO2 nanosheet-gated mesoporous silica nanoparticles and target induced release of glucose measured with a portable glucose meter

The authors describe a novel method for the determination of glutathione (GSH). Detection is based on target induced release of glucose from MnO₂ nanosheet-gated aminated mesoporous silica nanoparticles (MSNs). In detail, glucose is loaded into the pores of MSNs. Negatively charged MnO₂ nanosheets are assembled on the MSNs through electrostatic interactions. The nanosheets are reduced by GSH, and this results in the release of glucose which is quantified by using a commercial electrochemical glucose meter. GSH can be quantified by this method in the 100 nM to 10 μM concentration range, with a 34 nM limit of detection. Graphical abstract Glucose is loaded into the pores of mesoporous silica nanoparticles (MSNs). MnO₂ nanosheets are assembled on MSNs through electrostatic interactions. Glutathione (GSH) can reduce the nanosheets, and this results in the release of glucose which is quantified by using a commercial glucose meter.

Tannerella forsythia and coating color on the tongue dorsum, and fatty food liking associate with fat accumulation and insulin resistance in adult catch-up fat

BACKGROUND/OBJECTIVES

We aimed to determine the alteration of Tannerella forsythia and coating color on the dorsal tongue, and fatty food liking in catch-up fat in adult (CUFA), as well as the probable associations between fat accumulation, insulin resistance (IR) and these changes.

SUBJECTS/METHODS

T. forsythia on the tongue dorsum, fatty food liking, fat accumulation and insulin sensitivity were investigated in CUFA humans and rats, and tongue-coating color was observed in CUFA individuals. We further determined the changes of fatty food liking, fat accumulation and IR in T. forsythia-infected rodents by oral lavage.

RESULTS

Increases in fat accumulation, IR, percentage of subjects with yellow tongue coating and that with T. forsythia detected were observed in CUFA individuals. Additionally, the fat ranking scores were significantly lower and the hedonic ratings of low-fat options of sampled food were lower, while the ratings of high-fat options were remarkably higher in CUFA subjects. Additionally, T. forsythia level elevated in CUFA rats, and fatty food liking, fat accumulation and IR increased in CUFA and T. forsythia-infected animals, with the increases in T. forsythia infection and fatty food liking preceding the occurrence of fat accumulation and IR.

CONCLUSIONS

T. forsythia and yellow coating on the dorsal tongue and fatty food liking associate fat accumulation and IR in CUFA. Moreover, we tentatively put forward that T. forsythia, which is very important in yellow tongue-coating microbiota, and its consequent increases in fatty food liking, might be crucial in the development of fat accumulation and IR in CUFA.

Genetic analysis of a hybrid sterility gene that causes both pollen and embryo sac sterility in hybrids between Oryza sativa L. and Oryza longistaminata

Oryza longistaminata originates from African wild rice and contains valuable traits conferring tolerance to biotic and abiotic stress. However, interspecific crosses between O. longistaminata and Oryza sativa cultivars are hindered by reproductive barriers. To dissect the mechanism of interspecific hybrid sterility, we developed a near-isogenic line (NIL) using indica variety RD23 as the recipient parent and O. longistaminata as the donor parent. Both pollen and embryo sac semi-sterility were observed in F₁ hybrids between RD23 and NIL. Cytological analysis demonstrated that pollen abortion in F₁ hybrids occurred at the early bi-nucleate stage due to a failure of the first mitosis in microspores. Partial embryo sacs in the F₁ hybrids were defective during the functional megaspore formation stage. Most notably, nearly half of the male or female gametes were aborted in heterozygotes S40ⁱS40^l, regardless of their genotypes. Thus, S40 was indicated as a one-locus sporophytic sterility gene controlling both male and female fertility in hybrids between RD23 and O. longistaminata. A population of 16 802 plants derived from the hybrid RD23/NIL-S40 was developed to fine-map S40. Finally, the S40 locus was delimited to an 80-kb region on the short arm of chromosome 1 in terms with reference sequences of cv. 93-11. Eight open reading frames (ORFs) were localized in this region. On the basis of gene expression and genomic sequence analysis, ORF5 and ORF8 were identified as candidate genes for the S40 locus. These results are helpful in cloning the S40 gene and marker-assisted transferring of the corresponding neutral allele in rice breeding programs.

[Dynamic alteration of microRNA in high phosphorus induced calcification of vascular smooth muscle cell]

OBJECTIVE

To study the change of microRNA during the early stage of high phosphorus induced vascular smooth muscle cell (VSMC) calcification and its related mechanism.

METHODS

The in vitro calcification model was created through stimulating VSMC cell line A7r5 with high Pi (2.6 mmol/L) for 7 d. The calcification was validated through ocresolphthalein complexone colorimetry to detect the cellular calcium content, real-time PCR to measure the calcification-related gene expression and alizarin red staining to observe the formation of calcium nodules. Based on the cell calcification model, microRNA microarray array was applied to screen the profiles of microRNA expression in VSMC following high Pi stimulation for different periods (0, 3 and 12 h). The array data were analyzed by TAM tool to explore the activated signaling pathway.

RESULTS

The calcium content of A7r5 cells induced by high Pi was increased 9.6 times high as cells without Pi treatment (P<0.05). VSMC contractile phenotype genes (SM-α actin, SM22) were down-regulated (P<0.05), while calcification-related genes (BMP2, MSX2, Runx2) were up-regulated (P<0.05) in VSMC stimulated by high Pi. The calcium nodules were obviously formed in cells after 7 d high Pi treatment. In microarray experiment, 680 individual microRNAs were detected in high Pi-treated VSMCs at different time points (0, 3 and 12 h). Among these genes, miR-183, miR-664 and miR-9* were increased whereas miR-542-5P, let-7f and miR-29a were decreased in time-dependent manners. Twenty-six kinds of signaling pathways, including cell apoptosis, differentiation and proliferation, were significantly activated. All these activated pathways were associated with calcification.

CONCLUSION

This study implies that microRNA changed in high Pi-induced VSMCs may involve in the process of calcification.

Study of clinical diagnosis of cervical glandular intraepithelial neoplasia

OBJECTIVE

To preliminarily evaluate the clinical significance of different methods in diagnosis of cervical glandular intraepithelial neo- plasia (CGIN).

MATERIALS AND METHODS

Clinical manifestations, ThinPrep cytologic test (TCT), cervical biopsy, and pathological features of 106 patients with CGIN admitted to Beijing Obstetrics and Gynecology Hospital between 2008 and 2011 were retrospectively analyzed.

RESULTS

Among 146 cases diagnosed with CGIN, 87 (59.6%) had L-CGIN and 59 (40.4%) H-CGIN. Thirty-seven patients (25.6%) were found to have simple CGIN and 109 (74.6%) had CGIN complicated with cervical intraepithelial neoplasia (CIN). TCT revealed atypical glandular cells (AGC) in 20 patients (13.7%), six of whom had L-CGIN (6.9%) and 14 (23.7%) had H-CGIN with statistical significance between two groups (p < 0.05). TCT detected AGC in 13 cases (35.1%) with simple CGIN and seven with mixed CGIN (6.4%) (P<0.05). Endocervical curettage (ECC) revealed AGC abnormality in ten cases (25.6%). Cervical biopsy under colposcope revealed 32 patients (22.9%) had CGIN, including 15 L-CGIN (18.3%), and 17 H-CGIN (29.3%) with no statistical significance (p > 0.05). Among those diagnosed with CGIN by colposcope-assisted cervical biopsy, 19 (51.4%) had simple CGIN and 13 (11.9%) mixed CGIN (p < 0.05).

CONCLUSION

Preoperative diagnostic rate of simple CGIN was higher than CGIN complicated with CIN.

Evaluation of the GenoType(®) MTBDRplus line probe assay on sputum-positive samples in routine settings in China

BACKGROUND

Rapid molecular methods have been recommended for early detection of drug-resistant tuberculosis (TB).

OBJECTIVE

To evaluate the performance of the GenoType(®) MTBDRplus assay in routine settings in China.

METHODS

Sputum-positive samples were collected consecutively from 1 April to 31 December 2010. MTBDRplus results were compared to those of conventional drug susceptibility testing (DST). The McNemar χ(2) test and κ coefficient were used to assess performance.

RESULTS

Of 427 smear-positive sputum samples collected, conventional DST and MTBDTplus confirmed drug resistance in 326. The sensitivities and specificities for MTBDRplus in detecting isoniazid (INH) and rifampicin (RMP) resistance were respectively 76.47%, 95.44%, 85.94% and 93.13%. The McNemar χ(2) test indicated no significant difference between the two methods (P = 0.106 for INH and P = 0.083 for RMP). The κ values for INH, RMP and multidrug resistance were respectively 0.75, 0.75 and 0.70.

CONCLUSIONS

Although the MTBDRplus assay was moderately concordant with conventional DST in detecting INH and RMP resistance, as a prospective rapid molecular method for MDR-TB detection, potential resistant mutations need to be incorporated to improve the accuracy of detection.

Angular sway propagation in One Leg Stance and quiet stance with Inertial Measurement Units for older adults

Postural stability degrades with age, threating the health and life quality of the older adults. One Leg Stance (OLS) is one of the standard and commonly adopted assessments for postural stability, and the postural sway in OLS has been demonstrated to be related with age. The propagation of postural sway between body segments could be a hint to the underlying mechanism of balance control. However, it is not yet fully understood. Therefore, the aim of this paper was to study the angular sways and their propagation of the head, trunk, and lower limb in healthy older adults. A cross-correlation of the normalized angular speeds was performed and the experiment with 68 older adults was conducted. The results showed that the head, hip and ankle joints affected the transfer of angular sway with a relatively lower correlation and longer latency.

Evaluation of the workload and drowsiness during car driving by using high resolution EEG activity and neurophysiologic indices

Sleep deprivation and/or a high workload situation can adversely affect driving performance, decreasing a driver's capacity to respond effectively in dangerous situations. In this context, to provide useful feedback and alert signals in real time to the drivers physiological and brain activities have been increasingly investigated in literature. In this study, we analyze the increase of cerebral workload and the insurgence of drowsiness during car driving in a simulated environment by using high resolution electroencephalographic techniques (EEG) as well as neurophysiologic variables such as heart rate (HR) and eye blinks rate (EBR). The simulated drive tasks were modulated with five levels of increasing difficulty. A workload index was then generated by using the EEG signals and the related HR and EBR signals. Results suggest that the derived workload index is sensitive to the mental efforts of the driver during the different drive tasks performed. Such workload index was based on the estimation the variation of EEG power spectra in the theta band over prefrontal cortical areas and the variation of the EEG power spectra over the parietal cortical areas in alpha band. In addition, results suggested as HR increases during the execution of the difficult driving tasks while instead it decreases at the insurgence of the drowsiness. Finally, the results obtained showed as the EBR variable increases of its values when the insurgence of drowsiness in the driver occurs. The proposed workload index could be then used in a near future to assess on-line the mental state of the driver during a drive task.