Repeated endoscopic treatment of gastric antral vascular ectasia

GAVE is a relatively rare acquired vascular disease. The most common treatment for GAVE is endoscopic therapy. Argon plasma coagulation（APC） is usually the first-line choice for endoscopic GAVE treatment, but its recurrence rate is high and often requires multiple repeated treatments. In this case, the GAVE patient recurred after two APC treatments. The results suggest that APC-treated patients with GAVE are prone to relapse. In conclusion, clinicians should regularly follow up patients who received APC treatment.

Safety and Efficacy of Stereotactic Radiosurgery with Concurrent Targeted Systemic Therapy for Brain Metastases

PURPOSE/OBJECTIVE(S)

Data describing the safety and efficacy of central nervous system (CNS)-active targeted systemic therapies in combination with stereotactic radiosurgery (SRS, 1 fraction) and/or radiotherapy (SRT, 3-5 fractions) for brain metastases are emerging but limited. We report rates of local and intracranial failure and radiation necrosis in patients receiving CNS-active targeted systemic therapy and SRS/SRT.

MATERIALS/METHODS

We retrospectively identified patients with intact brain metastases at two institutions from 2009-2022 who were treated with SRS/SRT and CNS-active targeted systemic therapy in any sequence. Patients were followed for a minimum of 3 months after SRS/SRT with brain MRI. Patients typically stopped the targeted agent 2-4 days prior to radiation and resumed 2-4 days after. Targeted therapies included inhibitors of ALK/ROS1 (Alectinib, Ceritinib, Crizotinib, Lorlatinib), EGFR (Afatinib, Erlotinib, Gefitinib, Osimertinib), BRAF (Dabrafenib, Encorafenib, Vemurafenib), MEK (Binimetinib, Trametinib), CDK 4/6 (Abemaciclib, Palbociclib, Ribociclib), HER2 (Afatinib, Lapatinib, Neratinib, Pertuzumab, Trastuzumab, T-DM1, T-DXd, Tucatinib), KRAS (Adagrasib and Sotorasib), PARP (Niraparib, Olaparib), VEGF(R) (Axitinib, Bevacizumab, Ramucirumab), and less-selective tyrosine (receptor) kinase inhibitors (Bosutinib, Brigatinib, Entrectinib, Lenvatinib, Pazopanib, Sorafenib, Sunitinib). Local failure (LF) and radiation necrosis were determined radiographically with clinical impression (grade 2 (symptomatic) or higher (G2+)) and compared between different systemic agents.

RESULTS

The study included 95 patients with 310 metastases (SRS 246, SRT 64 metastases). Most common primary histologies were non-small cell lung cancer (36% 34/95), breast cancer (28% 27/95), and melanoma (16% 15/95). Overall survival at 1 and 2 years was 80% (76/95) and 55% (52/95), respectively. Median follow-up was 16.6 (range 3-91) months. Median tumor size was 7mm (range 1-75mm). Median number of brain metastases per patient was 2.5 (range 1-12). The G2+ radiation necrosis rate was 5.8% (18/310) while the LF rate was 9.7% (30/310) per metastasis. There was no significant difference in G2+ radiation necrosis by class of targeted therapy. Sixty-two percent (59/95) of patients experienced distant intracranial failure. Median intracranial progression free survival (PFS) was 8.0 (range 0.4-61.4) months.

CONCLUSION

Although heterogeneous, patients treated with SRS/SRT and ongoing CNS-active targeted systemic therapies have on average >6 month intracranial PFS and little evidence of significant toxicity. We observed <6% G2+ radiation necrosis for this cohort, and no particular class of agent was associated with a significantly higher rate of G2+ radiation necrosis.

Integration of Multiparameter MRI into Conventional Pretreatment Risk Factors to Predict Adverse Features after Radical Prostatectomy

PURPOSE/OBJECTIVE(S)

The purpose of this study was to Integration of Multiparameter MRI into conventional pretreatment risk factors to develop nomogram for the prediction of adverse features (i.e., positive margin (PM) or extra-prostatic extension (EPE)) indicated for postoperative radiotherapy in patients with prostate cancer.

MATERIALS/METHODS

We analyzed 203 histologically proven prostate cancer patients underwent preoperative 3T multiparametric MRI including high b value (0, 1500 s/mm2) diffusion-weighted imaging between 2019 and 2022 at our hospital. Patients with a history of neoadjuvant hormonal therapy, or patients whose surgeon's experience was ≤3 years were excluded. Age, surgical technique, serum PSA level, PSA density, clinical T stage, and biopsy Gleason score were clinical predictors. MRI parameters include prostate volume, tumor size, ECE score, seminal vesicle invasion score, tumor location (apex, peripheral region, or bladder neck), apparent diffusion coefficient (ADC), tumor contact length (TCL), PI-RADS score. Predictors were used in nomograms developed from multivariable logistic regression analysis to estimate the probability of positive margin (PM) or extra-prostatic extension (EPE) after RP. The nomogram's predictive accuracy and discriminative ability were determined by the concordance index with calibration and receiver operating characteristic (ROC) curves.

RESULTS

(1) Patient characters: Table 1 lists the MRI characteristics of the patients. Median PSA level is 17.6ng/ml. All patients received extra-fascial resection. 44% of the patients underwent robotic surgery. 24% of the patients had positive margins. In 226 patients who was clinically confined to the prostate, 100 (44%) had a postoperative pathological upgrade of pT3a or above. 46 (29%) of the 158 patients with biopsy grade group (GG)1 was confirmed GG3-5 after RP.

CONCLUSION

Using mpMRI parameters and clinicopathological information, we produced nomograms that may accurately predict adverse Features that are indications for postoperative radiotherapy after RP, which may help individualize treatment decision-making.

Using Proteome Microarray and Gene Expression Omnibus Database to Screen Tumour-Associated Antigens to Construct the Optimal Diagnostic Model of Oesophageal Squamous Cell Carcinoma

AIMS

Autoantibodies against tumour-associated antigens (TAAs) are promising biomarkers for early immunodiagnosis of cancers. This study was designed to screen and verify autoantibodies against TAAs in sera as diagnostic biomarkers for oesophageal squamous cell carcinoma (ESCC).

MATERIALS AND METHODS

The customised proteome microarray based on cancer driver genes and the Gene Expression Omnibus database were used to identify potential TAAs. The expression levels of the corresponding autoantibodies in serum samples obtained from 243 ESCC patients and 243 healthy controls were investigated by enzyme-linked immunosorbent assay (ELISA). In total, 486 serum samples were randomly divided into the training set and the validation set in the ratio of 2:1. Logistic regression analysis, recursive partition analysis and support vector machine were performed to establish different diagnostic models.

RESULTS

Five and nine candidate TAAs were screened out by proteome microarray and bioinformatics analysis, respectively. Among these 14 anti-TAAs autoantibodies, the expression level of nine (p53, PTEN, GNA11, SRSF2, CXCL8, MMP1, MSH6, LAMC2 and SLC2A1) anti-TAAs autoantibodies in the cancer patient group was higher than that in the healthy control group based on the results from ELISA. In the three constructed models, a logistic regression model including four anti-TAA autoantibodies (p53, SLC2A1, GNA11 and MMP1) was considered to be the optimal diagnosis model. The sensitivity and specificity of the model in the training set and the validation set were 70.4%, 72.8% and 67.9%, 67.9%, respectively. The area under the receiver operating characteristic curve for detecting early patients in the training set and the validation set were 0.84 and 0.85, respectively.

CONCLUSIONS

This approach to screen novel TAAs is feasible, and the model including four autoantibodies could pave the way for the diagnosis of ESCC.

Threshold of 25(OH)D and consequently adjusted parathyroid hormone reference intervals: data mining for relationship between vitamin D and parathyroid hormone

PURPOSE

By recruiting reference population, we aimed to (1): estimate the 25(OH)D threshold that maximally inhibits the PTH, which can be defined as the cutoff value for vitamin D sufficiency; (2) establish the PTH reference interval (RI) in population with sufficient vitamin D.

METHODS

Study data were retrieved from LIS (Laboratory Information Management System) under literature suggested criteria, and outliers were excluded using Tukey fence method. Locally weighted regression (LOESS) and segmented regression (SR) were conducted to estimate the threshold of 25(OH)D. Multivariate linear regression was performed to evaluate the associations between PTH concentration and variables including 25(OH)D, gender, age, estimated glomerular filtration rate (EGFR), body mass index (BMI), albumin-adjusted serum calcium (aCa), serum phosphate(P), serum magnesium(Mg), and blood collection season. Z test was adopted to evaluate whether the reference interval should be stratified by determinants such as age and gender.

RESULTS

A total of 64,979 apparently healthy subjects were recruited in this study, with median (Q1, Q3) 25(OH)D of 45.33 (36.15, 57.50) nmol/L and median (Q1, Q3) PTH of 42.19 (34.24, 52.20) ng/L. The segmented regression determined the 25(OH)D threshold of 55 nmol/L above which PTH would somewhat plateau and of 22 nmol/L below which PTH would rise steeply. Multivariate linear regression suggested that gender, EGFR, and BMI were independently associated with PTH concentrations. The PTH RI was calculated as 22.17-72.72 ng/L for subjects with 25(OH)D ≥ 55 nmol/L with no necessity of stratification according to gender, age, menopausal status nor season.

CONCLUSION

This study reported 25(OH)D thresholds of vitamin D sufficiency at 55 nmol/L and vitamin D deficiency at 22 nmol/L, and consequently established PTH RIs in subjects with sufficient vitamin D for northern China population for the first time.

A Single Institution Experience of a Biweekly Head and Neck Contouring Peer Review

PURPOSE/OBJECTIVE(S)

Due to the complexity of head and neck radiotherapy, a single weekly chart rounds session is insufficient to review contours. A dedicated biweekly review of all head and neck contours (prior to treatment planning) that can fully assess images and targets can lead to better patient outcomes. A full review of all head and neck contours also increases the number of contours that resident physicians can observe.

MATERIALS/METHODS

In total, 38 consecutive patients treated between August 2022 and December 2022 were analyzed in a biweekly head and neck contouring peer review. Three head and neck faculty radiation oncologists and four resident physicians participated. An allotted 30-minute time was granted per review session. Changes were tracked and stratified by whether physician contours underwent no changes/minor changes/major changes. Other metrics including re-irradiation status and attendance were noted.

RESULTS

An average of 1.65 patients were discussed per review. Given the allotted time, on average this allowed for up to 18 minutes of discussion per patient. In contrast, our departmental chart rounds session is allotted 1 hour for 40+ patients to be discussed (1.5 minutes per patient). Overall, 10/38 patients underwent minor changes (26.3%) to contour structures and 1 patient underwent a major change (2.6%). Four patients (10.5%) were re-irradiation cases CONCLUSION: A dedicated biweekly half hour review session is both feasible and practical. Additional discussion of head and neck contours helps to implement improvements into a patient's treatment plan. Additional discussion and debate for primary and re-irradiation also increases the number of cases that a training resident physician can observe.

Feasibility of Omitting Contralateral Neck Irradiation in Patients with Node-Negative Sinonasal Squamous Cell Carcinoma Crossing the Midline

PURPOSE/OBJECTIVE(S)

This study aims to analyze the nodal target volume in patients with node-negative SNSCC crossing the midline.

MATERIALS/METHODS

One hundred and four patients with node-negative advanced sinonasal squamous cell carcinoma (SNSCC) crossing the midline were included. Survival rates were estimated and compared between treatment groups.

RESULTS

Sixty-four patients received contralateral ENI (contralateral ENI group), while forty patients did not (non-contralateral ENI group). The median follow-up time was 89.99 and 95.01 months in the contralateral and non-contralateral ENI groups, respectively. At 5 years, the regional relapse-free survival and contralateral regional relapse-free survival were 57.68% vs. 55.83% (p = 0.372), and 57.68% vs. 61.62% (p = 0.541), in contralateral ENI group vs. non-contralateral ENI group, respectively. Five-year overall survival, local relapse-free survival, and distant metastasis-free survival were similar in the two groups (all p > 0.05).

CONCLUSION

In patients with node-negative SNSCC crossing the midline, omission of contralateral ENI did not affect regional control and survival outcomes on the premise of receiving ipsilateral ENI covering at least levels Ib and II.

Attitudes and Barriers to Planned Family Building among Professionals and Trainees in Radiation Oncology

PURPOSE/OBJECTIVE(S)

The timing of residency training often coincides with peak biological fertility. However, family building is frequently deferred and may lead to unanticipated infertility. The attitudes and barriers to family planning are not well described among medical professionals and trainees in radiation oncology (RO).

MATERIALS/METHODS

The Society for Women in Radiation Oncology (SWRO) conducted an electronic survey among practicing physicians, physicists, and residents between January and February 2023, using email and social media as recruitment tools. The survey questions queried demographics, family planning, fertility. Frequencies of responses were summarized using descriptive statistics.

RESULTS

On interim analysis, 147 responses were collected; 123 (89.8%) were SWRO members. Gender identities reported were female (136, 93.2%), male (7, 4.8%), nonbinary or gender diverse (2, 1.4%), and transgender female (1, 0.7%). 95 (64.6%) respondents were age 35 or younger. The majority were practicing physicians (72, 49.0%) followed by RO residents (45, 30.6%), medical physicists (17, 11.6%), medical students, (5, 3.4%), and medical physics residents (4, 2.7%). Most respondents agreed that their reproductive timeline had been impacted by medical training (106, 76.3%). Of those who deferred parenthood due to training or career, 40 (36.7%) were dissatisfied with their choice and 33 (30.2%) were satisfied. 129 (92.8%) reported not receiving any information about fertility preservation during training. Only 65 (47.4%) felt they had a mentor with whom they could approach to discuss family planning. Overall, 84 (60.4%) expressed concern about their fertility and 34 (24.5%) had previously undergone fertility testing. 16 (11.5%) completed at least one cycle of elective fertility preservation and 12 (8.6%) were planning to do so. 39 (28.1%) had considered elective fertility preservation but not pursued it, while 65 (46.8%) had not considered it. Among those two groups, the common reported barriers to accessing fertility services were financial burden (n = 28, 28.6%), lack of awareness of available options (n = 12, 12.2%), difficulty accessing fertility services (n = 6, 6.1%), and difficulty finding time during training (n = 4, 4.1%). Insurance coverage for elective fertility preservation was fully or partially covered by insurance for 12 (8.8%), not covered for 53 (38.7%), and 72 (52.6%) were uncertain of their coverage.

CONCLUSION

The study highlights the impact of training on family building plans of medical professionals in RO. Despite high levels of concern about fertility, few respondents received education about fertility options in training and a limited number had access to mentors to discuss this issue. Significant barriers exist to accessing fertility services, including knowledge gaps about insurance coverage, highlighting a need for further exploration of these barriers and advocacy for improved family planning support for those in RO who desire it.

piRNA-18 Inhibition Cell Proliferation, Migration and Invasion in Colorectal Cancer

Colorectal cancer is one of the most prevalent malignancies worldwide. Evidences indicate that piRNA-18 are closely involved and contributed to tumorigenesis and cancer progression. Therefore, it is very necessary to investigate the effects of piRNA-18 on the proliferation, migration, and invasiveness of colorectal cancer cells, so as to provide theoretical basis for finding new biomarkers and accurate diagnosis and treatment of colorectal cancer. Here, Five pairs of colorectal cancer tissue samples and their corresponding adjacent samples were analyzed by real-time immunofluorescence quantitative PCR and the difference in piRNA-18 expression among colorectal cancer cell lines was further verified. MTT assay were used to study the changes in the proliferation of colorectal cancer cell lines after piRNA-18 overexpression. Wound-healing assay and Transwell assay were used to study the changes in migration and invasion. Flow cytometry were used to study the changes in apoptosis and cycle. SC inoculation of colorectal cancer cell lines into nude mice were used to observe the effect in the proliferation. piRNA-18 was lowlier expressed than adjacent tissues and normal intestinal mucosal epithelial cells in colorectal cancer and colorectal cancer cell line. After overexpression of piRNA-18, cell proliferation and migration as well as invasiveness in SW480 and LOVO cells decreased. The cell lines with piRNA-18 overexpression had obvious G1/S phase arrest in cell cycle, and the weight and volume of subcutaneously transplanted tumors are decreased. Our findings highlighted that piRNA-18 may play an inhibitory role in colorectal cancer.

Neurologic Events and Outcomes in Patients Receiving Proton and Photon Reirradiation for High Grade Non-Codeleted Gliomas

PURPOSE/OBJECTIVE(S)

Patients undergoing reirradiation (ReRT) for high grade glioma are at risk for tumor progression, pseudoprogression, and radiation necrosis. We investigated factors associated with neurologic events and disease control after re-irradiation with protons and photons at a single academic center.

MATERIALS/METHODS

We reviewed records and MRIs of patients receiving scanning beam proton (since center opening in 2016) and photon (since 2015) reirradiation in ≥10 fractions for grade 3 anaplastic astrocytoma (AA) and grade 4 glioblastoma (GBM), excluding 1p19q co-deleted oligodendrogliomas and extensive multifocal/leptomeningeal disease. The primary endpoint was time from ReRT to ≥ grade 2 pseudoprogression or radiation necrosis (PsP/RN, grade 2: moderate symptoms requiring outpatient steroids/bevacizumab, grade 3: severe symptoms leading to admission or surgical intervention). Dose was converted to EQD2 using a/b = 3. Cox proportional hazards model was used to calculate survival and time to PsP/RN.

RESULTS

A total of 53 patients were included (26 protons, 27 photons, median KPS 80). Patients receiving protons had more favorable features. Compared to the photons, the proton group was younger (48 vs. 58) and more likely to have AA (46% vs. 22%) and resection within 3 months (42% vs 26%). The proton group also had a longer interval from prior RT (57 vs. 39 months) and were less likely to receive bevacizumab at reRT (15% vs. 59%). CTV was 130 cc for protons vs 99 cc for photons, and most had active disease at time of ReRT identified on planning MRI (76% protons, 85% photons). Median OS was 10.5 months (14.1 months protons, 8.1 months photons), with time from initial RT the only significant factor on multivariate analysis. Median PFS was 9.4 months (9.8 months protons, 6.2 months photons). 9 patients (18%) had ≥ grade 3 PsP/RN (8 proton, 1 photon) and 21 patients (41%) had ≥ grade 2 PsP/RN (16 proton, 5 photon). Grade 3 events included 1 seizure (photon group), 1 hemorrhage, 1 thalamic stroke, 1 shunt placement, 1 re-resection, and PSP4 4 PsP/RN requiring admission. Protons were associated shorter time to ≥ grade 2 PsP/RN (4 months vs. not reached, p = 0.027). When accounting for bevacizumab use at time of reRT, the association between protons and PsP/RN lost significance but there remained a trend (grade 2, p = 0.095, HR 2.4; grade 3, p = 0.105, HR 5.8). CTV, MGMT status, EQD2, and interval from prior RT were not associated with PsP/RN.

CONCLUSION

High grade neurologic events were common in patients with predominantly active, unresected high grade gliomas receiving ReRT. Though ascertainment and survival bias are significant limitations, pseudoprogression and necrosis appeared to be more prominent in patients receiving protons. These results contribute to ongoing efforts to both optimize ReRT for high grade glioma and investigate biologic effects of proton therapy.

The impact of social media on guideline-concordant cervical cancer-screening: insights from a national survey

OBJECTIVES

Cervical cancer is one of the leading causes of cancer mortality in women, yet routine screenings lead to early detection and sometimes even prevention. Screening is an effective way to prevent cervical cancer, and it has been implemented in many countries and regions worldwide, especially in developed countries. However, the incidence of cervical cancer remains a public health problem due to screening disparities in the population. Social media engagement and overloading of online health information may be the cause of this disparity.

STUDY DESIGN

Cross-sectional study.

METHODS

Data from the Health Information National Trends Survey (a national survey conducted by the National Cancer Institute) was used to characterise cervical cancer screening into two dimensions; namely, high-frequency screening and guideline-concordant screening. The differences between these two screening frequency behaviours were compared by applying ordered logistic regression and binary logistic regression, and the mechanisms of guideline-concordant screening were explored.

RESULTS

The factors influencing high-frequency screening and guideline-concordant screening were different. Only self-efficacy (odds ratio [OR] = 1.16; 95% confidence interval [CI] = 0.98, 1.37) had a significant positive association with the high-frequency screening behaviour. Social media engagement (OR = 0.57; 95% CI = 0.33, 0.96) was shown to have a significant negative impact on guideline-concordant screening. A theory-based mechanism of screening behaviour found that traditional health perception factors no longer influence guideline-concordant screening behaviour, whereas environmental factors (e.g., social media) significantly reduce guideline-concordant screening behaviour.

CONCLUSIONS

The results from this study indicate that while the internet has become the main channel through which women acquire health resources, and social media has become a main platform for people to obtain health information, online information cannot guide people to engage in appropriate healthy behaviours. Overloading of online health information and the digital divide may lead to excessive screening. Consequently, it is important to address the screening disparity caused by health behaviours as a result of environmental factors and the digital divide.

[The clinical practice and consideration for donor liver expansion]

Liver transplantation is the most effective method to address end-stage liver disease. However, there is a huge imbalance between organ supply and demand in China. Recently,effective expansion of the donor liver has become a hot research direction in academia. Authors' group comprehensively integrates domestic and foreign evidence-based medical evidence, the latest academic outcomes and clinical experience. Based on the innovative viewshed of crossfusion between biomedical engineering and medicine, author group systematically elaborate in the main strategies for expanding the liver donor pool, including the multichannel expansion of marginal donor liver,multidimensional innovation of technologies in transplant surgery and diversified exploration of alternative resources of organs. The author group aims to promote the construction of a large cohort,the integration of big data,and the output of high quality research,achieving innovative theory and clinical translation in organ transplantation,thus promoting the higher quality development of liver transplantation in China.

The Society for Women in Radiation Oncology: Where are We Five Years Later?

PURPOSE/OBJECTIVE(S)

The Society for Women in Radiation Oncology (SWRO) was founded in 2017 with a mission to promote representation and gender equity in the field of radiation oncology (RO). SWRO members include faculty and trainee radiation oncologists and medical physicists. We aim to assess the current experiences of SWRO members using a comprehensive survey of gender-related workforce issues we developed. Data was used to establish a 5-year benchmark.

MATERIALS/METHODS

From January to February 2023, an anonymous survey was distributed to current SWRO members. Questions included demographics, family planning/fertility issues, perceptions of the field, and membership needs. Descriptive statistics were used to summarize frequencies of the multiple-choice items on the survey.

RESULTS

On interim analysis, 115 of 680 (17%) completed the survey from 11 countries, 81% of which reside in the US. 55% were faculty physicians, 26% resident physicians, 10% faculty physicists, and 3% physics residents. The majority were female (97%) and either married or in a domestic partnership (74%). 47% reported having at least one child, and 26% reported that they or their partner became pregnant during residency. Length of leave was impacted by residents' desire to complete residency training on schedule. 53% felt RO was perceived as family-friendly, but much fewer (17%) agreed that it is. After clinical responsibilities (70%), insufficient mentorship was cited as the second most common limitation to professional productivity (35%). 48% reported being somewhat or extremely satisfied with current mentorship availability at their institution, while 56% reported being similarly satisfied with the mentorship available within the field. 69% reported seeking or having sought female mentorship outside of their institution. Unwanted sexual comments, attention, or advances by superiors or colleagues was reported by 38% of respondents. Additionally, 72% either agreed or strongly agreed that SWRO membership and participation were a valuable use of their time, with the top three reasons for joining being networking opportunities, mentorship opportunities, and increasing the visibility of women and gender minorities in RO. Suggested improvements included increasing female physics representation and advocacy, and physics-related events, as well as providing opportunities for members to socialize and interact.

CONCLUSION

This study provides an update on the experiences of women and gender minorities in the field of RO since the creation of SWRO in 2017. The study highlights ongoing targets for improvement such as gender-based obstacles, opportunity for additional education and advocacy, support of family-friendly culture shifts, mentorship, and increased physics inclusion and advocacy. These findings support the need for organizations such as SWRO to continue to promote representation and gender equity in RO.

Host response of Nicotiana benthamiana to the parasitism of five populations of root-lesion nematode, Pratylenchus coffeae, from China

In a recent survey of nematodes associated with tobacco in Shandong, China, the root-lesion nematode Pratylenchus coffeae was identified using a combination of morphology and molecular techniques. This nematode species is a serious parasite that damages a variety of plant species. The model plant benthi, Nicotiana benthamiana, is frequently used to study plant-disease interactions. However, it is not known whether this plant species is a host of P. coffeae. The objectives of this study were to evaluate the parasitism and pathogenicity of five populations of the root-lesion nematode P. coffeae on N. benthamiana.N. benthamiana seedlings with the same growth status were chosen and inoculated with 1,000 nematodes per pot. At 60 days after inoculation, the reproductive factors (Rf = final population densities (Pf)/initial population densities (Pi)) for P. coffeae in the rhizosphere of N. benthamiana were all more than 1, suggesting that N. benthamiana was a good host plant for P. coffeae.Nicotiana. benthamiana infected by P. coffeae showed weak growth, decreased tillering, high root reduction, and noticeable brown spots on the roots. Thus, we determined that the model plant N. benthamiana can be used to study plant-P. coffeae interactions.

Fabricating s-collidine-derived vinylene-linked covalent organic frameworks for photocatalysis

Research into vinyl-linked covalent organic frameworks (COFs) has grown significantly in recent years due to various attractive properties. Herein, we design and synthesize two highly crystalline and stable 2,4,6-collidine-derived vinylene-linked 2D COFs. Both COFs can act as efficient photocatalysts to facilitate visible-light-driven aerobic oxidation. The TM-TBT-COF was observed to exhibit superior activity and recyclability owing to its excellent semiconducting properties.

Search for Λ[over ¯]-Λ Baryon-Number-Violating Oscillations in the Decay J/ψ→pK^{-}Λ[over ¯]+c.c

We report on the first search for Λ[over ¯]-Λ oscillations in the decay J/ψ→pK^{-}Λ[over ¯]+c.c. by analyzing 1.31×10^{9}  J/ψ events accumulated with the BESIII detector at the BEPCII collider. The J/ψ events are produced using e^{+}e^{-} collisions at a center of mass energy sqrt[s]=3.097  GeV. No evidence for hyperon oscillations is observed. The upper limit for the oscillation rate of Λ[over ¯] to Λ hyperons is determined to be P(Λ)=[B(J/ψ→pK^{-}Λ+c.c.)/B(J/ψ→pK^{-}Λ[over ¯]+c.c.)]<4.4×10^{-6} corresponding to an oscillation parameter δm_{ΛΛ[over ¯]} of less than 3.8×10^{-18}  GeV at the 90% confidence level.

[Effect of hollow compression screw internal fixation in treating McCrory-Bladin type Ⅱ lateral process fracture of the talus: open versus arthroscopy surgery]

In order to explore the clinical efficacy of hollow compression screw internal fixation in the treatment of lateral process fracture of the talus under open surgery versus arthroscopy procedure, a retrospective cohort study was conducted to analyze the clinical data of 33 patients with lateral process fracture of the talus admitted to Xuzhou Central Hospital from January 2019 to December 2021. There were 19 males (19 feet) and 14 females (14 feet), aged 18 to 50 years, with an average age of (32.2±9.3) years. According to the modified McCrory-Bladin classification, all patients were classified as type Ⅱ. Based on the different surgical methods, the patients were divided into the arthroscopy group (21 cases, treated with double-tunnel subtalar arthroscopy combined with hollow compression screw internal fixation) and the open group (12 cases, treated with open reduction and internal fixation with hollow compression screw). The operation time was observed and the surgical effects were evaluated using the visual analogue scale (VAS) of pain, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, the Foot Function Index (FFI), and the Foot and Ankle Ability Measure (FAAM), which includes the FAAM-ADL (activity of daily living subscale) and the FAAM-S (sport subscale). All the patients of the two groups achieved stage Ⅰ wound healing. On the first day after the operation, the mean VAS score of the arthroscopy group was 2.4±0.7, which was significantly lower than that of the open group (3.4±1.6) (P=0.020). No significant difference was observed in terms of the follow-up time, operation time and AOFAS score between the two groups (all P>0.05). The FFI score of the arthroscopy group was significantly lower than that of the open group, and the FAAM-ADL and FAAM-S scores were significantly higher than those in the open group (all P<0.05). Two cases of dorsal foot numbness occurred in the open group after the operation, and the incidence of complications was not significantly different from that of the arthroscopy group (P=0.054). For McCrory-Bladin type Ⅱ lateral process fracture of the talus, the use of compression screw internal fixation could achieve reliable results, however, compared to open surgery, arthroscopy procedure obtained mini trauma and better functions.

[A randomized controlled study on the long-term efficacy of intra-cervical lymphatic immunotherapy for adult allergic rhinitis]

Objective: To determine the long-term efficacy and safety of intra-cervical lymphatic immunotherapy (ICLIT) for adult allergic rhinitis (AR) by comparing it with subcutaneous immunotherapy (SCIT). Methods: A total of 100 adult AR patients with dust mite allergy in Department of Otorhinolaryngology, First People's Hospital of Foshan from Feb 2018 to Dec 2019 were randomly divided into two groups, 50 in SCIT group [including 42 males and 8 females, aging (32.55±9.72) years] and 50 in ICLIT group [including 45 males and 5 females, aging (31.33±9.84) years]. The changes in total symptom score (total system score, TSS), nasal symptom score (total nasal symptom score, TNSS), eye symptom score (total ocular scoring system, TOSS), drug score (total medication score, TMS), and quality of life score of the two groups of patients were evaluated before and after treatment, and the adverse reactions of all patients during the treatment period were recorded. The changes in the level of dust mite specific IgE (sIgE) in the serum were evaluated. GraphPad Prism 9.0 software was used for statistical analysis. Results: In the SCIT group, 38 patients completed treatment and follow-up, with a dropout rate of 24%. In the ICLIT group, 48 patients completed treatment and follow-up, with a dropout rate of only 4%. The scores of TSS, TNSS, TOSS, TMS, and quality of life in the ICLIT group before treatment were 32.1±3.0, 27.3±3.1, 4.8±2.8, 2.3±0.9, and 68.1±28.7, respectively; After 36 months of treatment, the scores were 21.8±11.4, 18.1±9.4, 3.7±2.9, 1.3±1.1, and 36.0±26.7, respectively, which were significantly lower than those before treatment (all P<0.001). After 36 months of treatment, the TSS of the ICLIT group improved by 10.3±11.2 compared to before, while the TSS of the SCIT group improved significantly by 21.9±11.0 compared to before, with statistically significant differences between the groups (P<0.001). No serious systemic adverse reactions occurred in both groups of patients. Conclusions: ICLIT treatment for adult AR has long-term efficacy, high safety, and high compliance, but its long-term efficacy is not as good as SCIT. ICLIT can be considered as a new complementary option for AR immunotherapy.

Non-Anticoagulant Activities of Low Molecular Weight Heparins-A Review

Low molecular weight heparins (LMWHs) are derived from heparin through chemical or enzymatic cleavage with an average molecular weight (Mw) of 2000-8000 Da. They exhibit more selective activities and advantages over heparin, causing fewer side effects, such as bleeding and heparin-induced thrombocytopenia. Due to different preparation methods, LMWHs have diverse structures and extensive biological activities. In this review, we describe the basic preparation methods in this field and compare the main principles and advantages of these specific methods in detail. Importantly, we focus on the non-anticoagulant pharmacological effects of LMWHs and their conjugates, such as preventing glycocalyx shedding, anti-inflammatory, antiviral infection, anti-fibrosis, inhibiting angiogenesis, inhibiting cell adhesion and improving endothelial function. LMWHs are effective in various diseases at the animal level, including cancer, some viral diseases, fibrotic diseases, and obstetric diseases. Finally, we briefly summarize their usage and potential applications in the clinic to promote the development and utilization of LMWHs.

HIGH LONG-TERM DRUG-FREE REMISSION RATE FOR ACUTE VOGT-KOYANAGI-HARADA DISEASE WITH AN APPROPRIATE IMMUNOSUPPRESSIVE REGIMEN

PURPOSE

To report the clinical profile and outcomes of acute Vogt-Koyanagi-Harada disease with a strict immunosuppression regimen and investigate the risk factors for a prolonged disease course.

METHODS

A total of 101 patients with acute Vogt-Koyanagi-Harada (202 eyes) with more than 24 months of follow-up were recruited from January 2011 to June 2020. They were divided into two groups according to the interval between the onset of Vogt-Koyanagi-Harada and treatment. Oral prednisone was gradually tapered off by a diminished dose according to a relatively strict protocol. Patient responses to the treatment regimen were classified as long-term drug-free remission or chronic recurrent.

RESULTS

Ninety-six patients (95.0%) achieved long-term drug-free remission without recurrence, while 5 (5.0%) had chronic recurrence. Most patients achieved good best-corrected visual acuity (90.6% ≧20/25). A generalized estimation equation model demonstrated that time of visit, ocular complications, and cigarette smoking were independent risk factors for a longer disease course, and smokers required a higher drug dose and longer treatment course than nonsmokers.

CONCLUSION

An immunosuppressive regimen with an appropriate tapering speed can lead to long-term drug-free remission in patients with acute Vogt-Koyanagi-Harada. Cigarette smoking significantly affects ocular inflammation.

Anti-marine biofouling adhesion performance and mechanism of PDMS fouling-release coating containing PS-PEG hydrogel

Polystyrene microspheres compounded with polyethylene glycol-based hydrogel (PS-PEG)/polydimethylsiloxane (PDMS) coatings were prepared using the physical blending method. The chemical structure, surface and interface properties, interlayer adhesion, and tensile properties were tested in this paper. Furthermore, the antifouling performance was evaluated through bovine serum albumin fluorescent protein adsorption testing, marine bacteria adhesion testing, and benthic diatom adhesion testing. The results showed that the coating performance was best when 20 wt% PS-PEG hydrogel was added. Its surface energy was only 19.21 mJ/m2, the maximum breaking strength was 1.24 MPa, the maximum elongation rate was 675 %, the elastic modulus was 2.53 MPa, and the anti-stripping rate was 100 %. In addition, the coating with added 20 wt% PS-PEG hydrogel bacterial adherence rate was 5.36 % and 2.45 % after rinsing and washing, respectively, and the removal rate was 54.29 %. In the benthic diatom adhesion test, the chlorophyll concentration a-value was only 0.0017 mg/L after washing with added 20 wt% hydrogel, and the protein desorption rate was 84.19 % higher than PDMS in the fluorescent protein adsorption test. This coating has the 'low adhesion' and 'desorption' characteristics in the three growth stages of biofouling. Meanwhile, the low surface energy of the silicone is stable, and the hydrogel also dynamically migrates to the surface to gradually form a hydration layer, both are synergistic. When 20 wt% PS-PEG hydrogel was added, the coating demonstrated excellent antifouling performance due to its high hydration layer, low surface energy, high elasticity, and high interlayer adhesion. This research is expected to contribute to the practical applications of hydrogel coatings in marine antifouling.

[Effects of tibial second toe free flap bridged with blood flow and nerve in the treatment of severe flexion contracture of the proximal interphalangeal joint]

Objective: To investigate the effects of tibial second toe free flap bridged with blood flow and nerve in the treatment of severe flexion contracture of the proximal interphalangeal joint. Methods: A retrospective observational study was conducted. From March 2013 to October 2019, 9 patients with severe flexion contracture (type Ⅲ) of the proximal interphalangeal joint after trauma operation, conforming to the inclusion criteria, were hospitalized in Suzhou Ruihua Orthopaedic Hospital, including 5 males and 4 females, aged from 17 to 62 years. After the contracture tissue affecting the extension of the proximal interphalangeal joint was cut off, and the scar tissue was resected, the size of the volar wound near the proximal interphalangeal joint in extended position was 2.0 cm×1.0 cm-2.5 cm×1.5 cm, with the length of proper digital artery and nerve defect being 1.0-1.5 cm. A free flap of the same size as the wound was cut from the tibial side of the second toe and transplanted to repair the wound, and the defective proper digital artery and nerve was repaired by bridging with the tibial proper plantar digital artery and nerve of about 1.5 cm in length. The full-thickness skin graft was taken from the proximal tibial side of the lower leg to repair the wound at flap donor site. The wound at skin graft donor site was sutured directly. The survival of flap and skin graft was observed after operation. The patients were followed up, and at the last follow-up, the recovery of the affected finger and the second toe, including the donor and recipient areas were observed, the two-point discrimination distances of the flap repaired site and the pulp of the affected finger were observed and measured at the same time, the blood flow patency of bridged vessel of the affected finger was examined by Allen test, and the function of the proximal interphalangeal joint of the affected finger was evaluated according to Chinese Medical Association's standard for the range of motion of proximal interphalangeal joint. Results: The flaps and skin grafts survived smoothly after operation. The follow-up after operation lasted for 5 to 22 months, with a mean of 10 months. At the last follow-up, the flap repaired site had good shape, good color and texture, with the two-point discrimination distance being 9-12 mm, and the two-point discrimination distance of the pulp of the affected finger was 6-10 mm; the Allen test results of the affected fingers were all negative (i.e., the bridged vessels had good blood flow patency), with no recurrence of flexion contracture, and the function of the proximal interphalangeal joint was evaluated as excellent; the skin graft area of the second toe was not ruptured but was a little pigmented, and the flexion and extension activities of toe were good. Conclusions: The tibial second toe free flap bridged with blood flow and nerve has reliable therapeutic effect in the treatment of severe flexion contracture of the proximal interphalangeal joint, and the color and texture of the flap repaired area are good. Bridging to repair the severely contracted proper digital artery and nerve is beneficial to improve the blood supply of the finger body and rebuild the sensation.

Association study between C10orf90 gene polymorphisms and colorectal cancer

Background

Colorectal cancer (CRC) is the third most common malignant tumor in the world. The morbidity and mortality rates in Western countries have decreased, but they are still on the rise in China. C10orf90 is associated with a variety of cancers, but the correlation between C10orf90 and CRC is not yet known.

Methods

A total of 1,339 subjects were randomly enrolled in our study. After extracting their DNA, three single-nucleotide polymorphisms (SNPs) of C10orf90 were genotyped to analyze the potential relationship between these variants and CRC risk. PLINK software packages (version 1.07) were used to evaluate multiple genetic models by calculating the odds ratio (OR) and 95% confidence interval (95% CI). The best SNP-SNP interaction model was defined by the multifactor dimensionality reduction (MDR) analysis.

Results

C10orf90 rs12412320 was significantly associated with CRC risk (p = 0.006) and might be associated with the lower CRC risk (OR: 0.78; 95% CI: 0.65-0.93). The relationship of rs12412320 with lower CRC risk was found in people aged >60 years and ≤60 years, women, non-smokers, or non-drinkers. Rs11245008 in people aged ≤60 years and rs11245007 among men had a higher CRC susceptibility. Rs12412320 was related to the lower risk of advanced stages (III/IV stage), while rs11245007 might be associated with the higher risk of advanced stages (III/IV stage). Moreover, rs12412320 had the most significant relationship with the susceptibility to rectal cancer.

Conclusion

This study is the first to report between C10orf90 gene polymorphisms and CRC risk in Chinese people, which suggests that C10orf90 rs12412320 might play a crucial role in preventing CRC occurrence.

[Membrane anatomy in right colon cancer: definition and identification of mesocolic completeness]

Complete mesocolic excision (CME) and D3 resection of right colon cancer have been widely implemented, but the definition and identification of the completeness of the mesentery have not been fully agreed, especially the dorsal and medial borders. In this paper, we proposed the dorsal fascia of the colonic mesentery as the dorsal border of the mesocolon and the line connecting the roots of the ileocolic artery and the middle colic artery (ICA-MCA line) as the medial border of the CME by systematically studying the relationship between the mesentery and the mesenteric bed from the theory of membrane anatomy, combined with surgical experience and in-depth review of ontogenetic anatomy. We also proposed the visible "superior mesenteric vein notch" and "middle colic artery triangle" on surgical specimens as identifiers of mesocolic completeness.