[Establishment and validation of a clinical prediction model for infection risk at the placement sites of skin and soft tissue expanders]

Objective: To establish a clinical prediction model for infection risk at the placement sites of skin and soft tissue expanders (hereinafter termed as expanders) and to validate the predictive value of the model. Methods: A retrospective observational study was conducted. Totally 2 934 patients who underwent skin and soft tissue dilatation surgery in the Department of Plastic Surgery of the First Affiliated Hospital of Air Force Medical University from January 2009 to December 2018 and met the selection criteria were included. There were 1 867 males and 1 067 females, with a median age of 18 years. Totally 3 053 skin and soft tissue expansion procedures were performed with 4 266 expanders implanted. The following indexes were selected as predictor variables, including patients' age, gender, marital status, ethnicity, hospital admission, surgical indication, disease duration, with/without history of smoking, history of drinking, history of blood transfusion, history of underlying diseases, and inability to use cephalosporin antibiotics due to allergy, number of expander in a single placement, rated volume of expander, water injection rate of expander in the first time, placement site of expander, anesthesia method, duration of operation, and with/without postoperative hematoma evacuation, and infection at the placement site of expander as the outcome variable. Univariate analysis of the data was performed using least absolute shrinkage and selection operator (LASSO) regression to screen the potential risk factors affecting infection at the placement sites of expanders, the factors selected by the univariate analysis were subjected to binary multivariate logistic regression analysis to screen the independent risk factors affecting infection at the placement sites of expanders, and a nomogram prediction model for the occurrence of infection at the placement sites of expanders was established. The C index and Hosmer-Lemeshow goodness of fit test were used to evaluate the discrimination and accuracy of the model, respectively, and the bootstrap resampling was used for internal verification. Results: The results of LASSO regression showed that age, gender, hospital admission, surgical indication, disease duration, history of drinking, history of heart disease, history of viral hepatitis, history of hypertension, inability to use cephalosporin antibiotics due to allergy, number of expander in a single placement, rated volume of expander, placement site of expander, postoperative hematoma evacuation were the potential risk factors for infection at the placement sites of expanders (regression coefficient=-0.005, 0.170, 0.999, 0.054, 0.510, -0.003, 0.395, -0.218, 0.029, 0.848, -0.116, 0.175, 0.085, 0.202). Binary multivariate logistic regression analysis showed that male, emergency admission, disease duration ≤1 year, inability to use cephalosporin antibiotics due to allergy, rated volumes of expanders ≥200 mL and <400 mL or ≥400 mL, and expanders placed in the trunk or the limbs were the independent risks factors for infection at the placement sites of expanders (odds ratio=1.37, 3.21, 2.00, 2.47, 1.70, 1.73, 1.67, 2.16, 95% confidence interval=1.04-1.82, 1.09-8.34, 1.38-2.86, 1.29-4.41, 1.07-2.73, 1.02-2.94, 1.09-2.58, 1.07-4.10, P<0.05 or P<0.01). The C index for evaluating the discriminative degree of the model was 0.63, the Hosmer-Lemeshow goodness of fit test for evaluating the accuracy of the model showed P=0.685, and the C index for internal validation by the bootstrap resampling was 0.60. Conclusions: Male, emergency admission, disease duration ≤1 year, inability to use cephalosporin antibiotics due to allergy, rated volume of expander ≥200 mL, and expanders placed in the trunk or the limbs are the independent risk factors for infection at the placement sites of expanders. The clinical prediction model for infection risk at the placement sites of expanders was successfully established based on these factors and showed a certain predictive effect.

Mesenchymal stem cells alleviate idiopathic pneumonia syndrome by modulating T cell function through CCR2-CCL2 axis

BACKGROUND

Idiopathic pneumonia syndrome (IPS) is a non-infectious fatal complication characterized by a massive infiltration of leukocytes in lungs and diffuse pulmonary injury after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Conventional immunosuppressive treatments for IPS have poor therapeutic effects. Safe and effective treatments are not yet available and under explorations. Our previous study demonstrated that mesenchymal stem cells (MSCs) can alleviate IPS, but the mechanisms remain unclear.

METHODS

Co-cultured pre-activated T cells and MSCs in vitro to observe the changes in the CCR2-CCL2 axis. By establishing an IPS mouse model and administering MSCs to further verify the results of in vitro experiments.

RESULTS

Co-culture of pre-activated T cells with MSCs in vitro modulated the CCR2-CCL2 axis, resulting in quiescent T cells and polarization toward CCR2⁺CD4⁺ T cell subsets. Blocking CCR2-CCL2 interaction abolished the immunoregulatory effect of MSCs, leading to re-activation of T cells and partial reversion of polarizing toward CCR2⁺CD4⁺ T cells. In IPS mouse model, application of MSCs prolonged the survival and reduced the pathological damage and T cell infiltration into lung tissue. Activation of CCR2-CCL2 axis and production of CCR2⁺CD4⁺ T cells were observed in the lungs treated with MSCs. The prophylactic effect of MSCs on IPS was significantly attenuated by the administration of CCR2 or CCL2 antagonist in MSC-treated mice.

CONCLUSIONS

We demonstrated an important role of CCR2-CCL2 axis in modulating T cell function which is one of the mechanisms of the prophylactic effect of MSCs on IPS.

LYG1 Deficiency Attenuates the Severity of Acute Graft-Versus-Host Disease via Skewing Allogeneic T Cells Polarization Towards Treg Cells

Acute graft-versus-host disease (aGVHD) is a lethal complication after allogeneic hematopoietic stem cell transplantation. The mechanism involves the recognition of host antigens by donor-derived T cells which induces augmented response of alloreactive T cells. In this study, we characterized the role of a previously identified novel classical secretory protein with antitumor function-LYG1 (Lysozyme G-like 1), in aGVHD. LYG1 deficiency reduced the activation of CD4⁺ T cells and Th1 ratio, but increased Treg ratio in vitro by MLR assay. By using major MHC mismatched aGVHD model, LYG1 deficiency in donor T cells or CD4⁺ T cells attenuated aGVHD severity, inhibited CD4⁺ T cells activation and IFN-γ expression, promoted FoxP3 expression, suppressed CXCL9 and CXCL10 expression, restrained allogeneic CD4⁺ T cells infiltrating in target organs. The function of LYG1 in aGVHD was also confirmed using haploidentical transplant model. Furthermore, administration of recombinant human LYG1 protein intraperitoneally aggravated aGVHD by promoting IFN-γ production and inhibiting FoxP3 expression. The effect of rhLYG1 could partially be abrogated with the absence of IFN-γ. Furthermore, LYG1 deficiency in donor T cells preserved graft-versus-tumor response. In summary, our results indicate LYG1 regulates aGVHD by the alloreactivity of CD4⁺ T cells and the balance of Th1 and Treg differentiation of allogeneic CD4⁺ T cells, targeting LYG1 maybe a novel therapeutic strategy for preventing aGVHD.

Mutations of the c-Kit and PDGFRA gene in gastrointestinal stromal tumors among hakka population of Southern China

Aims

The aim of the present study was to investigate mutation status of the cKit and PDGFRA genes in patients with a gastrointestinal stromal tumor (GIST).

Methods

In total, 96 patients with a GIST were included in the study, in which polymerase chain reaction amplification and gene sequencing were used to detect the sequences of exons 9, 11, 12, 13, 14, 17, and 18 in KIT and exons 12, 14, and 18 in PDGFRA.

Results

KIT mutations were detected in 65 cases (67.71%), of which 81.54% (53/65) were located on exon 11, 12.31% (8/65) were located on exon 9, 4.61% (3/65) were located on exon 17, which included a concomitant mutation of exon 9 and 11, and 4.08% (2/65) were located on exon 13, which included a concomitant mutation on exon 11. The most common mutation in exon 11 was deletion, which accounted for 77.36% (41/53) of the cases, followed by a point mutation observed in 22.64% (12/53) of the cases. Among the 31 GIST cases without a KIT mutation, a mutation in PDGFRA was detected in 5 cases (5.21%, 5/96; 16.13%, 5/31). With respect to gender, age, tumor max diameter, tumor position, and mitotic index, there were no significant differences between KIT/PDGFRA mutations and non-mutations.

Conclusions

GIST mainly occurs in the stomach, and the cytological morphology is mainly spindle cells, and the mutations mainly occur in KIT genes. We need a large sample size to analyze the regularity of GIST gene mutations in Hakka population and understand the independent prognostic correlation of all KIT/PDGFRA genotypes.

Controlled Release of Curcumin from HPMC (Hydroxypropyl Methyl Cellulose) Co-Spray-Dried Materials

In order to achieve the controlled release of curcumin, HPMC (hydroxypropyl methyl cellulose) was spray dried with curcumin and lactose. The spray-dried materials were pressed into tablets with a diameter of 8 mm, and their release characteristics in vitro were measured. In vitro experiments showed that the release of curcumin from the HPMC mixture was significantly slower due to the sustained-release property of HPMC as a typical excipient. The release profile of curcumin from the HPMC mixture was relatively stable for a controlled release. SEM images show that the HPMC co-spray-dried powders have crumpled surfaces due to the large molecular weight of HPMC. DSC, XRD, FTIR, N2 adsorption, and TGA have been measured for the spray-dried curcumin materials. This work indicates that HPMC can be used as a controlled-release excipient for curcumin preparations.

Quantitative proteomic analysis reveals that serine/threonine kinase is involved in Streptococcus suis virulence and adaption to stress conditions

The eukaryotic-type serine/threonine kinase of Streptococcus suis serotype 2 (SS2) performs critical roles in bacterial pathogenesis. In this study, isobaric tags for relative and absolute quantification (iTRAQ) MS/MS were used to analyze the protein profiles of wild type strain SS2-1 and its isogenic STK deletion mutant (Δstk). A total of 281 significant differential proteins, including 147 up-regulated and 134 down-regulated proteins, were found in Δstk. Moreover, 69 virulence factors (VFs) among these 281 proteins were predicted by the Virulence Factor Database (VFDB), including 38 downregulated and 31 up-regulated proteins in Δstk, among which 15 down regulated VFs were known VFs of SS2. Among the down-regulated proteins, high temperature requirement A (HtrA), glutamine synthase (GlnA), ferrichrome ABC transporter substrate-binding protein FepB, and Zinc-binding protein AdcA are known to be involved in bacterial survival and/or nutrient and energy acquisition under adverse host conditions. Overall, our results indicate that STK regulates the expression of proteins involved in virulence of SS2 and its adaption to stress environments.

Up-regulated ONECUT2 and down-regulated SST promote gastric cell migration, invasion, epithelial-mesenchymal transition and tumor growth in gastric cancer

OBJECTIVE

Gastric cancer is a common malignancy, with high metastasis and poor prognosis. Our purpose was to explore potential molecular mechanisms of gastric cancer.

PATIENTS AND METHODS

A total of 10 pairs of gastric cancer tissues and adjacent normal gastric tissues were collected for RNA sequencing (RNA-seq), followed by differential expression analysis. Combining qRT-PCR results, two novel genes were selected for in-depth analysis, including up-regulated ONECUT and down-regulated SST. To investigate the effects of ONECUT and SST on the biological behaviors of gastric cancer cells, gastric cancer cell lines were transfected by ONECUT2 knockdown and SST overexpression. Afterwards, cell migration and invasion were examined using transwell assays, and the expressions of epithelial-mesenchymal transition (EMT)-related proteins were measured by Western blot analysis. Furthermore, cell viability was detected by CCK-8 assay. Finally, tumorigenicity in nude mice was performed.

RESULTS

Gastric cancer cell migration and invasion were inhibited in BGC823 cells transfected by shONECUT2. Similar results were observed in SST overexpression in MGC803 cells. Silencing ONECUT2 or overexpressing SST reduced the expressions of mesenchymal markers (N-cadherin and vimentin), STAT3, fibronectin, Wnt2, β-catenin and increased epithelial marker (E-cadherin), p-STAT3, smad2/3, α-catenin protein levels. In addition, inhibiting ONECUT2 or elevated SST suppressed tumor cell viability in vitro. Moreover, ONECUT2 silencing or elevated SST significantly inhibited tumor growth in vivo.

CONCLUSIONS

Up-regulated ONECUT2 and down-regulated SST promote gastric cell migration, invasion, epithelial-mesenchymal transition and tumor growth in gastric cancer.

Effect of additive-assisted fat transplantation on fat graft survival rate: A preliminary experimental study based on a rabbit animal model

BACKGROUND

Improving the survival rate of fat grafts is yet a difficult problem in the field of autologous fat transplantation. Prevailing methods such as making nanofat and SVF are time-consuming. Hence, the role of additives application in the improvement of fat graft survival during fat transplantation was considered and preliminarily evaluated in a rabbit animal model.

METHODS

A rabbit animal model was established where rabbit ears were injected with a mixture of 1.5mL of adipose tissue and 1mL of saline (group A), 1.5mL of adipose tissue and 1mL of botulinum toxin A (BoNTA) (group B), 1.5mL of adipose tissue and 1mL of prostaglandin E2 (groupC), 1.5mL of adipose tissue and 1mL of PDRN (group D) respectively. Then, the extents of neovascularization and inflammation were evaluated on the 7th, 14th, 28th, 42nd, 56th and 70th day after injection by ELISA assays and H&E and immunofluorescence staining.

RESULTS

The results showed that pre-treatment with BoNTA, prostaglandin E2 and PDRN improved graft volume and weight. The H&E and immunofluorescence staining revealed that BoNTA, prostaglandin E2 and PDRN improved the graft angiogenesis. Simultaneously, TNF-α expression level detected by ELISA was the lowest in the PDRN group.

CONCLUSION

Henceforth, the present preliminary study suggests that pre-transplantation treatment with BoNTA, prostaglandin E2 and PDRN can improve the fat graft angiogenesis and graft integrity, whereby the effect of adding PDRN may be significant.

Proliferation and migration of hepatocellular carcinoma are accelerated by LINC01287 via the miR-559/TCF12 axis

OBJECTIVE

To uncover the role of LINC01287 in the progression of hepatocellular carcinoma (HCC) and the indicated molecular mechanism.

PATIENTS AND METHODS

Relative levels of LINC01287 and miR-559 in 32 pairs of HCC tissues and normal ones, as well as HCC cell lines were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Receiver operating characteristic (ROC) curves and Kaplan-Meier curves were depicted for assessing the diagnostic and prognostic potentials of LINC01287 in HCC, respectively. Proliferative and migratory capacities in HCC cells influenced by LINC01287 were assessed by cell counting kit-8 (CCK-8) and transwell assay, respectively. The regulatory loop LINC01287/miR-559/TCF12 was ascertained by Dual-Luciferase reporter assay. The involvement of the regulatory loop in the progression of HCC was examined via rescue experiments.

RESULTS

LINC01287 was upregulated in HCC tissues and cell lines, whereas miR-559 was downregulated. LINC01287 displayed certain diagnostic and prognostic potentials in HCC. Knockdown of LINC01287 could inhibit proliferative and migratory capacities in HCC cells. The regulatory loop LINC01287/miR-559/TCF12 was responsible for the aggravation of HCC.

CONCLUSIONS

LINC01287 drives proliferative and migratory capacities in HCC via targeting the miR-559/TCF12 axis.

Association of polypharmacy and Parkinson's disease prevalence

OBJECTIVE

Polypharmacy and multiple diseases are common in geriatric practice; however, such kind of multiple interventions might result in adverse effects. Some previous studies have found the association of polypharmacy and Parkinson's disease, to confirm this relationship, we conducted a meta-analysis to analyze this issue quantitively.

MATERIALS AND METHODS

In total, we included 8 studies, 165,689 polypharmacy subjects and 373,660 non-polypharmacy controls, and 5644 PD patients among these subjects and controls.

RESULTS

For model without any adjustment, polypharmacy group has a significantly higher prevalence than control, OR = 2.53, 95 %CI [2.00, 3.20] (p < 0.001). However, this model showed a very high heterogeneity (I2 = 91 %, p < 0.001). In age, gender and disease history adjusted model, polypharmacy group has a significantly higher prevalence than control, OR = 1.43, 95 %CI [1.35, 1.52], p < 0.001. The heterogeneity decreased to zero (I2 = 0 %, p < 0.45).

CONCLUSION

In this study we have found an association between PD risk and polypharmacy, a better designed prospective long-term cohort study might be required for further discussion on this issue (Tab. 1, Fig. 5, Ref. 14).

[miR-758-3p inhibits the proliferation and invasion of non-small cell lung cancer cells by targeting NUSAP1]

Objective: To investigate the biological function of miR-758-3p and the underlying mechanism in non-small cell lung cancer (NSCLC). Methods: miR-758-3p mimics was transfected to A549 NSCLC cells, miRNA control was used as a negative control, cells transfected with nucleolar and spindle associated protein 1 (NUSAP1)-overexpression vector indicated as NUSAP1 group, cells co-transfected with miR-758-3p mimics and NUSAP1-overexpression vector indicated as miR-758-3p mimics+ NUSAP1 group. The effects of miR-758-3p on the proliferation, migration and invasion abilities of A549 cells were detected by cell counting kit-8 (CCK-8) and Transwell assays, respectively. Bioinformatics and dual luciferase reporter assay were used to predict and verify the target gene of miR-758-3p. Results: The expressions of miR-758-3p and NUSAP1 in A549 cells were significantly up-regulated at 24 hours after transfection with miR-758-3p mimics (P<0.05). Compared with the miRNA control group (1.15±0.06), the OD value of miR-758-3p mimic group (0.78±0.06) was significantly decreased at 72 hours after transfection (P<0.05). The number of migrated cells of miR-758-3p mimic group (119.04±11.49) was significantly lower than that of the control group (271.38±19.05) (P<0.05). The number of invaded cells of miR-758-3p mimic group (71.33±5.36) was significantly lower than the control group (164.30±8.11) (P<0.05). The result of dual-luciferase reporter assay showed that NUSAP1 was a direct target of miR-758-3p. Moreover, up-regulation of NUSAP1 abolished the inhibitory effects of miR-758-3p on the proliferation, migration and invasion abilities of A549 cells. Conclusion: miR-758-3p inhibits the proliferation, migration and invasion of NSCLC cells by targeting NUSAP1.

Repair of facial scars using free and pedicle-expanded deltopectoral flaps

This study aimed to evaluate the effectiveness and long-term outcomes of free and pedicled, expanded deltopectoral flaps with perforation of the internal thoracic artery to repair facial scars. This retrospective review was of 37 patients who presented between June 2013 and June 2019 with various types of facial scar. Ten patients received a free expanded deltopectoral flap and 27 a pedicled, expanded deltopectoral flap. During the stage-one operation, the expander was implanted into the deltopectoral area and fully expanded by normal saline injection. In stage two, the facial lesions were incised, and the free or pedicled flap transferred to reconstruct the defect. Flap necrosis did not occur in the 10 patients treated with free flaps. Two patients need to have the pedicle trimmed three months after surgery because it had become bloated. Distal necrosis occurred in five of 27 patients who received a pedicled, expanded deltopectoral flap. Healing by conservative treatment was noted in two cases and healing after skin grafting was documented in the other three. All 37 patients achieved satisfactory results. A pedicled, expanded deltopectoral flap appears to be a reliable and safe option for the treatment of facial scars.

Treatment of secondary lower limb lymphedema after gynecologic cancer with complex decongestive therapy

Secondary lower extremity lymphedema is a common complication of treatment for gynecological cancers. Conservative therapy plays an important role in the treatment of patients with secondary lower extremity lymphedema; in particular, complex decongestive therapy (CDT) has been recognized as an effective nonoperative technique for these patients. But CDT therapy for secondary lower extremity lymphedema remains a problem in China because this technique and its effectiveness have not achieved widespread use and popularity. Our goal was to assess effects of CDT in patients with secondary lower limb lymphedema after treatment for gynecological cancers. The retrospective study consisted of 60 patients who were treated with 20 sessions of CDT. Assessments included objective changes in limb circumference, degree of LE, imaging features, and incidence of erysipelas before and after CDT treatment. We found that CDT can effectively improve lymph stasis and promote backflow, and decrease circumference, interstitial fluid content, and incidence of erysipelas of lymphedematous lower limb. Our results demonstrate that CDT is an effective treatment method for patients with secondary lower limb lymphedema following treatment for gynecologic cancers. This technique should be more widely utilized and popularized in China to improve the quality of life of millions of patients with secondary lower limb lymphedema.

[NUSAP1 promotes lung cancer progression by activating AKT/mTOR signaling pathway]

Objective: To investigate the inhibitory effects of nucleolar and spindle associated protein 1 (NUSAP1) on lung cancer and the related mechanisms. Methods: A549 cells were transfected with NUSAP1 siRNA, the cell proliferation, migration and invasion, and apoptosis were detected by CCK8, Transwell and flow cytometry, respectively. Western blot was used to detect the expressions of apoptosis and AKT/mTOR signal pathway related proteins. Results: Compared with the negative control group, the proliferation [(0.610±0.058) vs (1.724±0.067), P<0.05], migration [(178.267±14.780) vs (272.464±36.232), P<0.05] and invasion [(73.527±6.617) vs (120.585±13.235), P<0.05] of NUSAP1 deleted A549 cells were significantly inhibited, while the apoptosis [(3.572±0.214)% vs (11.358±1.047)%, P<0.05] was significantly increased. The expressions of apoptosis related protein Bax and active-caspase 3 were increased (P<0.05), while the expressions of anti-apoptosis protein Bcl-2 and proliferation related protein P70, the phosphorylation levels of AKT and mTOR were reduced in NUSAP1 knockdown cells (P<0.05). Conclusion: NUSAP1 knockdown can inhibit the proliferation, migration and invasion, and promote the apoptosis of tumor cells through suppressing AKT/mTOR signaling pathway in lung cancer cells.

Successful interruption of seasonal influenza transmission under the COVID-19 rapid response in Zhejiang Province, China

Objectives

The objective of this study was to evaluate whether the non-pharmaceutical interventions (NPIs) introduced to curb the spread of coronavirus disease 2019 (COVID-19) also interrupted the transmission of influenza.

Study design

This is a descriptive epidemiological study.

Methods

Data on changes in the number of reported influenza cases, number of influenza-like illness (ILI) visits, ILI percentage and influenza virus positivity were compared between the first 18 weeks of 2020 and the same period of 2019.

Results

The changes in the weekly average number of influenza cases were statistically significant between 2020 and 2019 (−4319 vs −525 per week; P < 0.05). The slopes of regression lines for the number of ILI visits were also statistically significant between 2020 and 2019 (−911 vs −98 per week; P < 0.05).

Conclusions

This study found that the prevalence of influenza was substantially decreased when NPIs were implemented for the containment of COVID-19.

•

The prevalence of influenza was substantially decreased when non-pharmaceutical interventions were implemented for the containment of coronavirus disease 2019.

•

Changes in the weekly average number of influenza cases were statistically significant between 2020 and 2019 (−4319 vs −525 per week; P < 0.05).

•

Changes in the number of influenza-like illness visits were also statistically significant between 2020 and 2019 (−911 vs −98 per week; P < 0.05).

PHACTR1, a pro-atherosclerotic mechanosensitive PPARgamma corepressor in endothelial cells

Background

Numerous genome-wide association studies revealed that SNPs at phosphatase and actin regulator 1 (PHACTR1) locus are strongly correlated with coronary artery disease (CAD). However, the mechanism linking these variants to CAD remains uncertain.

Purpose

We studied the biological functions and molecular mechanisms of PHACTR1 in atherosclerosis.

Methods and results

Analysis of GTEx database showed that CAD-related SNPs in PHACTR1 are cis-eQTLs for PHACTR1 in arteries. Therefore, we generated Phactr1 knockout mice and crossed them with apolipoprotein E-deficient (ApoE−/−) mice to induce atherosclerosis by high-fat/high-cholesterol (HF-HC) diet. Phactr1 deficiency significantly inhibited atherosclerosis with decreased inflammatory cell infiltration. Western blot showed that PHACTR1 was restricted to endothelial cells (ECs) in mice. Mechanistically, RNAseq of aortic ECs revealed that the major molecular function of PHACTR1 was transcriptional regulation. PPARγ/RXRα was the top transcription factor, and PPARγ target gene expression substantially increased in Phactr1−/− mice. Moreover, we generated endothelial cell specific Phactr1−/−, ApoE−/− mice and found decreased atherosclerotic plaque area in aortic sinus. In vitro, PHACTR1 associated with PPARγ and inhibited PPARγ transcriptional activity. The inhibitory effect of PHACTR1 on PPARγ required its shuttling from cytosol to nucleus triggered by disturbed flow, a well-established pro-atherosclerotic stimulus.

Conclusion

Our results identified PHACTR1 as a mechanosensitive corepressor of PPARγ in ECs to promote atherosclerosis. Endothelial PHACTR1 is a potential therapeutic target for atherosclerosis treatment.

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Natural Science Foundation of China (NSFC), China Postdoctoral Science Foundation (CPSF)

Comparing nanoparticle polymeric micellar paclitaxel and solvent-based paclitaxel as first-line treatment of advanced non-small-cell lung cancer: an open-label, randomized, multicenter, phase III trial

BACKGROUND

Polymeric micellar paclitaxel (pm-Pac) is a novel Cremophor EL-free, nanoparticle micellar formulation of paclitaxel. We aimed to compare the efficacy and safety between pm-Pac plus cisplatin and solvent-based paclitaxel (sb-Pac) plus cisplatin in advanced non-small-cell lung cancer (NSCLC).

PATIENTS AND METHODS

A total of 448 stage IIIB to IV NSCLC patients were randomly assigned (2:1) to receive six 3-week cycles of either pm-Pac (230 mg/m²) plus cisplatin (70 mg/m²; n = 300), followed by dose escalation of pm-Pac to 300 mg/m² from the second 3-week cycle if prespecified toxic effects were not observed after the first cycle, or sb-Pac (175 mg/m²) plus cisplatin (70 mg/m²; n = 148). The primary end point was objective response rate (ORR) assessed by independent review committees (IRCs). The secondary end points included IRC-assessed progression-free survival (PFS), overall survival (OS), and safety.

RESULTS

Patients in the pm-Pac-plus-cisplatin group showed significant improvements in IRC-assessed ORR compared with those in the sb-Pac-plus-cisplatin group (50% versus 26%; rate ratio 1.91; P < 0.0001). Additionally, subgroup analysis showed that a higher ORR was consistently observed in both squamous and nonsquamous histological types. IRC-assessed median PFS was significantly higher in the pm-Pac-plus-cisplatin group than in the sb-Pac-plus-cisplatin group (6.4-month versus 5.3-month; hazard ratio 0.63; P = 0.0001). Median OS was not significantly different between the two groups. The incidence of treatment-related serious adverse events (9% versus 18%; P = 0.0090) was significantly lower in the pm-Pac-plus-cisplatin group than in the sb-Pac-plus-cisplatin group.

CONCLUSION

Pm-Pac plus cisplatin yielded superior ORR and PFS along with a favorable safety profile and should become an option for patients with advanced NSCLC.

CLINICAL TRIAL IDENTIFIER

ClinicalTrials.gov NCT02667743; https://clinicaltrials.gov/ct2/show/NCT02667743.

Development of a Novel Double Antibody Sandwich Quantitative Enzyme-Linked Immunosorbent Assay for Detection of Porcine Epidemic Diarrhea Virus Antigen

Porcine epidemic diarrhea virus (PEDV) causes acute diarrhea and dehydration in sucking piglets with a high mortality rate. Here, we developed a double antibody sandwich quantitative enzyme-linked immunosorbent assay (DAS-qELISA) for detection of PEDV using a specific monoclonal antibody against PEDV N protein and anti-PEDV rabbit serum. Using DAS-qELISA, the detection limit of recombinant PEDV N protein and virus titer were approximately 1 μg/L and 10^2.0 TCID₅₀/ml, respectively. A total of 90 intestinal and 237 fecal samples were then screened for the presence of PEDV using DAS-qELISA and reverse transcriptase PCR (RT-PCR). DAS-qELISA had a high specificity of 98.1% and sensitivity of 93.5%. The accuracy rate between DAS-qELISA and RT-PCR was 95.7%. More importantly, the viral antigen concentrations remained unchanged before and after one inactivated vaccine preparation by using the DAS-qELISA. These results suggest DAS-qELISA could be used for antigen detection of inactivated vaccine samples and clinical samples. It is a novel method for diagnosing diseases and evaluation of the PEDV vaccine.

MicroRNA-148a regulates the MAPK/ERK signaling pathway and suppresses the development of esophagus squamous cell carcinoma via targeting MAP3K9

OBJECTIVE

Esophagus squamous cell carcinoma (ESCC) was a dominant histological type of esophagus cancer, which has a very high incidence due to distant metastasis and local invasion. MicroRNA-148a (miR-148a) functioned as a tumor suppressor in a variety of cancers. The purpose of our study was to explore the vital role of miR-148a in esophagus squamous cell carcinoma.

PATIENTS AND METHODS

The Kaplan-Meier method was applied to calculate the 5-year overall survival of esophagus squamous cell carcinoma patients. Real Time-quantitative Polymerase Chain Reaction (RT-qPCR) and Western blot were conducted to calculate the mRNA levels of miR-148a and genes. The cell counting kit-8 (CCK-8) and transwell assays were performed to measure the proliferative and invasive ability.

RESULTS

MiR-148a was observed to be significantly downregulated and the downregulation of miR-148 predicted poor prognosis of esophagus squamous cell carcinoma patients. MAP3K9 was a target gene of miR-148a and its expression was mediated by miR-148a through directly binding to the 3'-untranslated region (3'-UTR) of its mRNA in the esophagus squamous cell carcinoma. Moreover, miR-148a remarkably inhibited the proliferation and invasion through directly targeting to MAP3K9 via extracellular-signal-regulated kinase (ERK)/mitogen-activated protein kinase (MAPK) pathway and epithelial-mesenchymal transition (EMT) in the ESCC cells. In addition, overexpression of miR-148a inhibited the growth of ESCC in vivo.

CONCLUSIONS

MiR-148a inhibited the proliferation and invasion through directly targeting to MAP3K9 by ERK/MAPK pathway and EMT in ESCC cells. The newly identified miR-148a/MAP3K9 axis provides a novel insight into the pathogenesis of the esophagus squamous cell carcinoma.