[Influence of long-time video operation on hemodynamics of the retrobulbar arteries in operators]

Objective: To investigate the influence of long-time video operation on hemodynamics of the retrobulbar arteries in operators. Methods: From March to October, 2015, a total of 120 soldiers for office work engaged in video surveillance were enrolled as study group, and 155 fire fighters were enrolled as control group. The incidence of eye discomfort was compared between the two groups. Color Doppler ultrasound was used to measure and compare the peak systolic velocity (PSV) , end-diastolic velocity (EDV) , and resistance index (RI) of the central retinal artery (CRA) and the short posterior ciliary artery (SPCA) , and the correlation of video operation time with the hemodynamic parameters of the retrobulbar arteries was analyzed. Results: The study group had a significantly higher incidence rate of eye discomfort than the control group (P<0.05) . Compared with the control group, the study group had significant reductions in the PSV and EDV of the CRA and the SPCA and a significant increase in the RI of the CRA (P<0.05) . Video operation time was negatively correlated with the PSV and EDV of the CRA and the SPCA (r=-0.61, -0.54, -0.65, and-0.68, all P<0.05) and positively correlated with the RI of the CRA and the SPCA (r=0.56 and 0.63, P<0.05) . Conclusion: Long-time video operation can increase the incidence of eye discomfort and lead to increased blood resistance of the CRA and the SPCA and reduced retinal perfusion.

[Effects of video work on the ocular vascular hemodynamic and visual of the operators]

Objective: To investigate the effects of long time video display terminal (VDT) operation on the ocular vascular hemodynamic and visual acuity. Methods: During March and October 2015, 120 cases of video monitoring warriors were selected as study group, another 155 cases of logistics personnel as the control group. The low vision of the two groups was calculated and compared, and the color Doppler flow imaging was used to measure the central retinal artery (CRA) , short posterior ciliary artery (SPCA) , anterior ciliary artery (ACA) , (peak systolic velocity, PSV) , end diastolic velocity (EDV) and (resistance index (RI) . The differences of hemodynamic parameters between these two groups were evaluated, and the relationship between the visual acuity and each hemodynamic parameter was analyzed. Results: The visual acuity of the study group was[0.8 (0.4-1.2) ], much lower than the control group, and the rate of low version in the study group was 40.00%, much higher than that of the control group. Compared with the control group, both of ACA and CRA of SPCA, PSV and EDV in the study group were decreased, while RI of CRA, ACA were increased (P<0.05) ; Compared with the control group, no statistical significance was found in the RI of SPCA in the study group (P>0.05) . The PSV and EDV were negatively correlated with visual acuity (r value of PSV and visual acuity were -0.352, -0.265 and -0.304; r value of EDV and visual acuity were -0.324, -0.348 and -0.365, while RI was positively correlated with visual acuity (r value were 0.363, 0.326 and 0.344) . Conclusion: Our data suggest that long time video operation may be associated with changes of ocular vascular hemodynamic parameters and raise the incidence of low vision.

[Accuracy of computer aided measurement for detecting dental proximal caries lesions in images of cone-beam computed tomography]

Objective: To establish and validate a computer program used to aid the detection of dental proximal caries in the images cone beam computed tomography (CBCT) images. Methods: According to the characteristics of caries lesions in X-ray images, a computer aided detection program for proximal caries was established with Matlab and Visual C++. The whole process for caries lesion detection included image import and preprocessing, measuring average gray value of air area, choosing region of interest and calculating gray value, defining the caries areas. The program was used to examine 90 proximal surfaces from 45 extracted human teeth collected from Peking University School and Hospital of Stomatology. The teeth were then scanned with a CBCT scanner (Promax 3D). The proximal surfaces of the teeth were respectively detected by caries detection program and scored by human observer for the extent of lesions with 6-level-scale. With histologic examination serving as the reference standard, the caries detection program and the human observer performances were assessed with receiver operating characteristic (ROC) curves. Student t-test was used to analyze the areas under the ROC curves (AUC) for the differences between caries detection program and human observer. Spearman correlation coefficient was used to analyze the detection accuracy of caries depth. Results: For the diagnosis of proximal caries in CBCT images, the AUC values of human observers and caries detection program were 0.632 and 0.703, respectively. There was a statistically significant difference between the AUC values (P=0.023). The correlation between program performance and gold standard (correlation coefficient r(s)=0.525) was higher than that of observer performance and gold standard (r(s)=0.457) and there was a statistically significant difference between the correlation coefficients (P=0.000). Conclusions: The program that automatically detects dental proximal caries lesions could improve the diagnostic value of CBCT images.

The levels of bone turnover markers 25(OH)D and PTH and their relationship with bone mineral density in postmenopausal women in a suburban district in China

This study evaluated the levels of bone turnover markers (BTMs) and investigated relationships between them and bone mineral density (BMD) in postmenopausal women in China suburban district. The prevalence of osteoporosis was 25.03 % at lumbar spine and 6.23 % at femoral neck, and BTMs were negatively correlated with BMDs.

INTRODUCTION

The aims of this study were to evaluate the levels of bone turnover markers (BTMs), including serum N-terminal procollagen of type I collagen (P1NP), beta C-terminal cross-linked of type I collagen (β-CTX), 25-hydroxyvitamin D [25(OH)D], and parathyroid hormone (PTH), and to investigate relationships between these markers and bone mineral density (BMD) as well the prevalence of osteoporosis in postmenopausal women of suburban district.

METHODS

A population of 4822 postmenopausal women aged 55-69 years old (62.22 ± 6.75) from the suburban district was recruited voluntarily. BMD was measured at the lumbar spine, femoral neck, and total hip using dual-energy X-ray absorptiometry; 2251 women in this group had the serum BTMs 25(OH)D and PTH tested.

RESULTS

The prevalence of osteoporosis was 25.03 % at lumbar spine and 6.23 % at femoral neck. The median (interquartile range) values of serum P1NP, β-CTX, 25(OH)D, and PTH were 59.3 ng/mL (44.7-75.52), 0.370 ng/mL (0.280-0.490), 23.0 ng/mL (17.1-30.5), and 31.4 pg/mL (24.9-39.7), respectively. Serum P1NP and β-CTX levels presented significantly negative correlations with BMDs at the all the sites (Beta_std = -0.098 to -0.208, respectively, P < 0.001), whereas PTH levels were negatively correlated with BMDs of the femoral neck and total hip (Beta_std = -0.062 and -0.054, P < 0.01, respectively). Serum 25(OH)D had positive associations with BMDs at total hip (Beta_std = 0.051, P < 0.01).

CONCLUSIONS

The BMD of postmenopausal women in China suburban area is higher than that in downtown area, and over 60 % of the participants had their serum 25(OH)D level over 20 ng/mL. BTMs were negatively correlated with BMDs, suggesting that BTMs are reliable factors for early declines in BMD.

[Effects of anti-PD-L1 monoclonal antibody and EGFR-TKI on the expression of PD-L1 and function of T lymphocytes in EGFR-mutated lung cancer cells]

Objective: To investigate the effects of anti-PD-L1 monoclonal antibody and EGFR-TKI on expression of soluble PD-L1 and function of T lymphocytes in EGFR-mutated lung cancer cells. Methods: Flow cytometry was used to analyze the expression of membrane PD-LI. ELISA was performed to detect the level of sPD-L1 in the supernatant of cultured EGFR-mutated and wild type lung cancer cells before and after erlotinib treatment.After treated with anti-PD-L1 monoclonal antibody alone and in combination with erlotinib, the proliferation of T lymphocytes in co-culture system was measured using Cell Counting Kit-8 (CCK-8) assay. The expression levels of PD-LI and IFN-γ in tumor cells and T lymphocytes treated with erlotinib in co-culture system were analyzed by flow cytometry and ELISA, respectively. Results: PD-L1 was highly expressed in EGFR-mutated lung cancer PC9 cells (78.7±3.1)% and HCC827 cells (82.7±2.6)%.After treated with erlotinib, the expression rates of membrane PD-L1 in PC9 and HCC827 cells were down-regulated (64.7%±3.1% and 73.0%±2.6%, respectively), significantly lower than that in the two cell lines without erlotinib treatment (P<0.05), and the expression levels of sPD-L1 in the supernatant of PC9 and HCC827 cells were also down-regulated (0.680±0.120)ng/ml and (0.903±0.047)ng/ml, respectively, significantly lower than that in the two cell lines without erlotinib treatment (P<0.01). However, no significant changes of membrane PD-L1 and sPD-L1 expression were found in EGFR wild type lung cancer cells (H1299 and A549) before and after erlotinib treatment. In the co-culture system composed of T cells and EGFR-mutated lung cancer cells, treatment with erlotinib alone promoted the proliferation of T lymphocytes (P<0.05), and combined treatment of anti-PD-L1 monoclonal antibody with erlotinib had a stronger effect (P<0.05). In the co-culture system composed of T cells and EGFR wild type cell lines, the proliferation of T cells was not changed after using erlotinib alone or combination of erlotinib and anti-PD-L1 monoclonal antibody (P>0.05). Before and after treatment with erlotinib, the secretion levels of IFN-γ were (856.0±70.3)pg/ml and (1 697.3±161.0)pg/ml, respectively, showing a significant difference (P<0.001). The expression rates of membrane PD-L1 were (76.2±0.5)% and (50.9±0.9)%, respectively, also showing a significant difference (P<0.001). However, no significant changes in the expression of IFN-γ and membrane PD-L1 were found in the co-culture system composed of T cells and A549 cells. Conclusions: Anti-PD-L1 monoclonal antibody combined with EGFR-TKI can effectively promote the proliferation and secretion function of T lymphocytes in the microenvironment of EGFR-mutated lung cancer cells.

[Detection of peripheral follicular helper T cells in rheumatoid arthritis]

OBJECTIVE

To detect cell frequency and surface markers of peripheral CD4⁺CXCR5+ follicular helper T (Tfh) cells and analyze the correlation between CD4⁺CXCR5⁺Tfh cells and rheumatoid arthritis (RA) disease activity.

METHODS

Forty RA patients meeting the American College of Rheumatology classification criteria for RA and twenty healthy controls (HC) were included. The peripheral blood mononuclear cells and sera were collected. The expressions of CD4+CXCR5⁺Tfh cells (CXCR5, C-X-C chemokine receptor type 5) and inducible T cell costimulator (ICOS), programmed death 1 positive (PD-1), interleukin-21 receptor (IL-21R) and CD40 ligand (CD40L) positive on CD4⁺CXCR5⁺Tfh cells were analyzed by flow cytometry. The transcript levels of B-cell lymphoma 6 (Bcl-6), as well as IL-21 and IL-21R, were measured by real-time polymerase chain reaction. Besides, serum IL-21 and CXCL13 concentrations were determined by enzyme-linked immunosorbent assay. The potential association between Tfh cells and RA disease activity was detected.

RESULTS

The cell surface marker of CXCR5⁺ on CD4⁺ cells was significantly increasingly higher across the following groups versus HC: total RA patients (16.75±3.92 vs.7.49±1.84, P<0.001); RA patients with low disease activity or remission (16.62±3.43 vs. 7.49±1.84, P<0.001); RA patients with moderate disease activity (16.82±3.07 vs. 7.49±1.84, P<0.001) and RA patients with high disease activity (16.87±5.50 vs. 7.49±1.84, P<0.001). Besides, the percentages of ICOS+, PD-1⁺, IL-21R⁺ on CD4⁺CXCR5⁺Tfh cells in the RA patients were significantly higher than that of HC (ICOS⁺CD4⁺CXCR5⁺cells, 8.37±4.28 vs. 3.72±1.81, P<0.001; PD-1⁺CD4⁺CXCR5⁺cells, 1.57±1.10 vs. 0.24±0.30, P=0.035; IL-21R⁺CD4⁺CXCR5⁺ cells, 4.60 ±4.05 vs. 0.20±0.19, P=0.006). But the percentage of CD40L⁺ on CXCR5⁺CD4⁺Tfh cells in the RA patients was not significantly higher than that of HC (3.38±3.71 vs. 0.54±0.34, P=0.135). The IL-21R mRNA expression was elevated significantly (5.00±4.94 vs. 0.74±0.55, P<0.001) in the RA patients but not in Bcl-6 mRNA[4.54(3.33, 7.23) vs. 5.31(2.81, 7.44), P=0.329]or IL-21 mRAN[0.72(0.26, 3.45) vs. 0.56(0.27, 3.71), P=0.195]. Additionally, the serum interleukin-21 (IL-21) and CXCL13 levels in the RA patients were higher than in the healthy controls [IL-21, (200.49±154.56) ng/L vs. (8.21±5.95) ng/L, P<0.001; CXCL13, (93.72±49.72) ng/L vs. (43.09±1.28) ng/L, P<0.001] and were both positively correlated with RA disease activity indexes, including erythrocyte sedimentation rate, the disease activity score in 28 joints (ESR-based or CRP-based), clinical disease activity index, and simplified disease activity index. However, none of the Tfh cells, anti-citrullinated protein antibody or rheumatoid factor had any relationship with RA disease activity.

CONCLUSION

Peripheral Tfh cells and their relevant cytokines are higher in RA patients than healthy controls, indicating Tfh cells may participate in the pathogenesis of RA, therefore, blocking the pathway of Tfh cells may be reasonable cellular targets for therapeutic intervention.

[Panuveitis with oral and genital ulcer misdiagnosed as Behcet's disease: two cases report and literature review]

Here we reported two patients who presented with panuveitis and were transferred from ophthalmologists to rheumatologists, for both the patients had oral and genital ulcers. They were misdiagnosed with Behcet's disease at first glance. Two young males presented with acute uveitis with history of recurrent oral and genital ulcers. They initially presented with symptoms and signs resembling Behcet's disease and were treated with systemic steroids with suboptimal responses. Routine laboratory test revealed syphilis and human immunodeficiency virus (HIV) infection. After treatment of penicillin and anti HIV virus therapy, the panuveitis was relived. The other patient was lost in the follow up. Recently epidemiological data indicate that syphilis and HIV infection increase, which can mimic the manifestation of Behcet's disease. Diagnosis of sexual transmitted diseases, such as HIV or syphilis needs to be ruled out in all cases that mimic the clinical feature of Behcet's disease, especially for those who had a history of high risk behaviors. Every patient should have history analysis in detail. Screening of sexual transmitted diseases, such as HIV or syphilis is important especially in those rapid progressive panuveitis. Also, other virus infections, such as cytomegalovirus, epstein-barr virus or Herpes simplex virus can cause mucosa ulcers and uveitis. CD4 T cell count is a very important marker to indicate that the patient has immunodeficiency. Erythema nodosa and pseudofolliculitis are the third common clinical manifestation in Chinese Behcet's disease patients. Rheumatologist should watch out for patients without skin involvement when making the diagnosis of Behcet's disease. Syphilis-associated uveitis usually has a good prognosis. Treatment of antibiotics can get good response, 92% uveitis can be relieved, with 67% improved vision. Acute syphilitic posterior placoid chorioretinitis (ASPPC) is a clinically and angiographically distinct manifestation of ocular syphilis. Systemic glucocorticoid can be used in syphilis induced posterior uveitis, sleritis and optic neuritis, and it can also prevent the Hector's reaction. However, for patients diagnosed with both HIV and syphilis, regular antibiotic can not prevent relapse. So doctors need to follow up them regularly. Patients who present with uveitis, oral and genital ulcers can be easily diagnosed with Behcet's disease. Rheumatologists need to be aware of the reemergence of sexual transmitted disease. High degree of clinical suspicion can allow ophthalmologists and rheumatologists to diagnose and treat the disease early. Correct diagnoses timely can get the good treatment response, and rescue the vision. Treatment with regular antivirus and Penicillin can receive the good response, and moreover glucocorticoid can relieve the inflammation.

Expression of claudin-1 and its relationship with lymphatic microvessel generation in hypopharyngeal squamous cell carcinoma

We investigated the relationship between claudin-1 and micro-lymphatic vessel density (MLVD) by detecting claudin-1 and protein D2-40 expression in cancer tissue specimens obtained from 97 patients with hypopharyngeal squamous cell carcinoma (HSCC). We also explored the correlation between the expression of these proteins and clinical tumor stage, pathological grading, and clinical prognosis in the patients. Moreover, we studied the mechanism of lymph node metastasis in HSCC, thereby providing information for treating HSCC and inhibiting lymph node metastasis. We detected levels of claudin-1 and protein D2-40 expression in cancer tissue from 97 patients with HSCC and para-tumor tissue from 90 patients by immunohistochemistry; we analyzed the correlation between markers and clinicopathological features by using the Pearson chi-square test and conducted survival analysis by the log-rank test. Claudin-1 expression was high in HSCC and was related to tumor differentiation and lymph node metastasis; Kaplan-Meier analysis showed that claudin-1 expression was related to patient survival rate (P = 0.012). There was a significant relationship between MLVD in the tissues adjacent to the carcinoma and the indices of histopathological grade, clinical stage, and lymph node metastasis. There was also a positive correlation between claudin-1 expression and MLVD. High expression of claudin-1 might induce the generation of tumor lymphatic vessels, which increases metastasis in the lymph node. Because claudin-1 is related to patient survival rate, it may be useful as a monitoring index for postoperative HSCC and might be a new target for treating the disease.

Alendronate sodium/vitamin D3 combination tablet versus calcitriol for osteoporosis in Chinese postmenopausal women: a 6-month, randomized, open-label, active-comparator-controlled study with a 6-month extension

This study compares efficacy of ALN/D5600 versus that of calcitriol in osteoporotic Chinese postmenopausal women. ALN/D5600 produced greater bone mineral density (BMD) increases, greater bone turnover marker decreases, and less vitamin D insufficiency. This study provided detailed clinical information regarding ALN/D5600 treatment versus calcitriol 0.25 μg/day. The study did not evaluate fracture risk.

INTRODUCTION

The aim of this study is to investigate efficacy of alendronate 70 mg/vitamin D3 5600 IU combination tablets (ALN/D5600) versus calcitriol in osteoporotic Chinese postmenopausal women.

METHODS

This study is a 6-month, randomized, open-label, active-comparator study with 6-month extension (clinicaltrials.gov number NCT01350934) in postmenopausal women aged >55 years with osteoporosis (low bone mineral density (BMD) with/without prior fragility fracture). Patients were randomized to ALN/D5600 once weekly or calcitriol 0.25 μg daily. The primary efficacy end point of the base study was percent change from baseline in lumbar spine BMD (month 6). Hypercalcemia and hypercalciuria were safety events of special interest.

RESULTS

A total of 219 patients (ALN/D5600 n = 111, calcitriol n = 108) were randomized. Baseline characteristics were similar, 30.3 % baseline 25-hydroxyvitamin D (25(OH)D) ≤15 ng/mL. At months 6 and 12, changes in lumbar spine BMD from baseline were 3.5 versus 1.6 % and 5.2 versus 2.3 % for ALN/D5600 versus calcitriol (between-group differences p < 0.001), respectively. Between-group differences for ALN/D5600 versus calcitriol were significant (p < 0.001) at months 6 and 12 for change from baseline in procollagen type 1 N-terminal propeptide (-59.1 versus -16.8 %, -68.1 versus -17.0 %) and serum C-telopeptides (-79.2 versus -27.2 %, -76.2 versus -24.2 %). Drug-related adverse events (AEs) and discontinuations due to drug-related AEs occurred in 15 (14.0 %) versus 8 (7.4 %) patients and 3 (2.8 %) versus 0 patients in the ALN/D5600 and calcitriol group, respectively. Hypercalciuria 12-month incidence (24-h urine Ca >300 mg) was 8.4 (ALN/D5600) versus 13.9 % (calcitriol) (p > 0.05). One patient (calcitriol) had hypercalcemia.

CONCLUSIONS

ALN/D5600 produced greater increases in lumbar spine BMD and greater decreases in bone turnover markers versus calcitriol in osteoporotic Chinese women. It is not known whether the greater increase in BMD results in fewer fractures. ALN/D5600 was generally well tolerated in Chinese patients.

[Systemic lupus erythmatosus and panniculitis presenting as multiple ulcers: one case report]

A 36-year-old woman had an 8-year history of systemic lupus erythematosus (SLE) and was being treated with 10 mg/d of prednisone. She presented with a 6-month history of intermittent fever and multiple painful multi skin erythematous macules in her button, hips and extremities that had slowly enlarged to 8 cm×4 cm in diameter. The lesions started as painful erythematous macules, which eventually ulcerated and scared. Laboratory tests showed leukopenia, protenuria, positive anti-double strand DNA and hypocomplementemia. Cultures of the bottom ulcer were E. Coli, fugus and Tuberculous mycobacteria were both negative. Biopsy was performed and revealed necrosis of epidermis, thrombus and cellulose degeneration in epidermis with neutrophils karyorrhexis and vasculitis. Her SLE was active, so she was prescribed antibiotics for 2 weeks and prednisone was added to 60 mg/d for a month. However her skin ulcers did not relieve. When prednisone was added to 120 mg/d with combination therapy of cyclophosphamide and hydroxychloroquine, her skin ulcer cicatrized gradually.

Nuclear factor-κB activation in perihematomal brain tissue correlates with outcome in patients with intracerebral hemorrhage

Background

Nuclear factor-κB (NF-κB) plays an important role in the inflammatory response after intracerebral hemorrhage (ICH). We therefore proposed that NF-κB activation in perihematomal brain tissue might correlate with clinical outcome in patients with ICH. To confirm this, we studied clinical data of 45 patients with ICH and NF-κB activation in perihematomal brain tissue and analyzed predictors of clinical outcome as well as the predictive value of NF-κB activation.

Methods

Forty-five patients with spontaneous basal ganglia hemorrhage were prospectively investigated. The clinical data were collected, which include demographics, alcohol and tobacco abuse, stroke risk factors, neuroimaging variables at presentation, Glasgow Coma Scale (GCS) at admission, number of days in hospital, mechanical ventilation, pneumonia, and outcome. Clinical outcome was assessed by the modified Rankin Scale at 6 months after ICH. Perihematomal brain tissue was collected, and NF-κB activation was detected using immunohistochemistry. Univariate analysis and multivariate logistic regression analysis were performed to determine predictors of the poor outcome.

Results

Immunohistochemical detection showed that NF-κB p65 was expressed in the nuclei of neurons and glial cells in all patients. The number of nuclear NF-κB p65-positive cells was 54 ± 21. Six months after ICH, 18 (40%) patients achieved a favorable functional outcome (mRS ≤ 3) while 27 (60%) had a poor functional outcome (mRS 4 to 6). In univariate analysis, predictors of poor functional outcome were lower GCS score on admission (P = 0.004), larger hematoma volume (P = 0.004), intraventricular extension (P = 0.047), midline shift (P = 0.005), NF-κB activation (P < 0.0001), mechanical ventilation (P = 0.018), and co-morbidity with pneumonia (P = 0.002). In multivariate logistic regression analysis, NF-κB activation was the only independent predictor of poor outcome at 6 months after ICH.

Conclusions

NF-κB activation is closely related to clinical outcome 6 months after ICH in humans. Therefore, it could be useful to predict prognosis of ICH accurately and should be further evaluated as a target for therapeutic strategies of ICH in the future.

A systematic review on the use of daily subcutaneous administration of teriparatide for treatment of patients with osteoporosis at high risk for fracture in Asia

This systematic review aimed to examine the evidence for teriparatide in Asia for osteoporosis with a high fracture risk and for exploratory (unapproved) bone-related indications. MEDLINE (1946+), EMBASE (1966+), and ClinicalTrials.gov (2008+) were searched (16 August 2013); all studies of daily subcutaneous teriparatide 20 μg for bone-related conditions from China, Hong Kong, Japan, Republic of Korea, Philippines, Singapore, and Taiwan were included. Evidence on efficacy/safety was retrieved primarily from randomized controlled trials (10 publications) of postmenopausal women from Japan and China. In these studies, teriparatide was well tolerated; subjects had significantly greater increases in lumbar spine bone mineral density (BMD) from baseline compared with placebo, antiresorptive agents, or elcatonin/calcitonin; bone turnover markers increased from baseline and were sustained at elevated levels during teriparatide treatment. Few studies reported fracture risk, pain, or quality of life; one study showed a lower incidence of new-onset vertebral fracture with teriparatide versus antiresorptive agents. Nonrandomized studies (nine publications, one unpublished trial) conducted mainly in Taiwan, Japan, and the Republic of Korea provided supporting data for efficacy. The exploratory (unapproved) use of teriparatide (17 publications) for fracture healing and osteonecrosis of the jaw was described primarily in case reports. The clinical effectiveness of teriparatide for treatment of postmenopausal women with osteoporosis who are at high risk of fracture in Asia is focused primarily on improvements in BMD and tolerability. Recommended additional studies may include assessment of fracture risk and the effect of teriparatide on pain, quality of life, and mortality in Asia.

Gefitinib maintenance therapy in Chinese advanced-stage lung adenocarcinoma patients with EGFR mutations treated with prior chemotherapy

The aim of this study was to determine the response of advanced-stage non-small cell lung cancer (NSCLC) patients with or without EGFR mutations to platinum-based chemotherapy with or without gefitinib maintenance. Patients were treated with four cycles of platinum-based chemotherapy. Patients with wild-type EGFR were observed (group 1; n=15). EGFR mutation-positive patients were randomly assigned to observation (group 2; n=7) or gefitinib maintenance (group 3; n=7). The median patient age was 59 years. The 1-year progression-free survival rates in groups 1, 2, and 3 were 6.7%, 28.6%, and 57.1%, respectively (p = 0.049); the 1-year overall survival rates were 53.3%, 57.1 %, and 100%, respectively (p = 0.111). The results indicate that patients with advanced-stage NSCLC with EGFR mutations have a better response to chemotherapy followed by gefitinib than chemotherapy alone and a better response to chemotherapy than wild-type patients.

KEYWORDS

chemotherapy, gefitinib, NSCLC, tyrosine kinase inhibitors.

Associations of polymorphisms in the SOST gene and bone mineral density in postmenopausal Chinese Women

The bone mineral density (BMD) of a total of 1,379 healthy postmenopausal Chinese women was measured. Ten tagging SNPs of the sclerostin (SOST) gene were genotyped. Our results suggest that the polymorphisms of the rs2023794 and rs74252774 in the SOST gene were associated with BMD of the lumbar spine in postmenopausal Chinese women.

INTRODUCTION

The purpose of the study was to determine the associations between polymorphisms of SOST gene and BMD in postmenopausal Chinese women.

METHODS

A total of 1,379 independent healthy postmenopausal Chinese women including 703 in our previous study were recruited. The BMD of the lumbar spine 1-4 (L1-4) and left proximal femur including total hip and femoral neck were measured by dual-energy X-ray absorptiometry. Ten tagging SNPs (rs1234612, rs1513670, rs1634330, rs1708635, rs2023794, rs7220711, rs74252774, rs851057, rs851058, and rs865429) of the SOST gene were genotyped.

RESULTS

The rs2023794 and rs74252774 and the haplotype ACCATTCT of SOST gene were associated with age and body mass index (BMI) adjusted L1-4 BMD (P values were 0.010, 0.007, and 0.007, respectively) even after performing the Bonferroni multiple-significance-test correction. There was a clear trend in these regions that the CC genotype of the rs2023794 and the TT genotype of the rs74252774 have higher BMD values than other genotypes. The contributions of the rs2023794 and rs74252774 to the phenotypic variation of L1-4 BMD were 0.6 and 0.7 %, respectively. We failed to find any association between the 10 SNPs and 6 haplotypes of the SOST gene and BMD at the hip site in this study.

CONCLUSIONS

Our results suggest that the polymorphisms of the rs2023794 and rs74252774 in the SOST gene were associated with BMD of the lumbar spine in a large sample of postmenopausal Chinese women.

Ultrasound-assisted handling force reduction during the solar silicon wafers production

Surface adhesion between wet wafers poses great challenges for silicon wafer handling. It has been shown that both the shear and normal handling forces of the solar silicon wafers can be dramatically reduced by using the ultrasound energy. Approximately 20 and 5 times reduction in horizontal and vertical forces were achieved by as low power as 10W, and a good agreement was found between the measured values and the predictions of a simple model for the effect of longitudinal vibration we developed.

The Effect of Microstructure, Thickness Variation, and Crack on the Natural Frequency of Solar Silicon Wafers

Vibration is one of the most common loading modes during handling and transport of solar silicon wafers and has a great influence on the breakage rate. In order to control the breakage rate during handling and facilitate the optimization of the processing steps, it is important to understand the factors which influence the natural frequency of thin silicon wafers. In this study, we applied nonlinear finite element method to investigate the correlation of natural frequency of thin solar silicon wafer with material microstructures (grain size and grain orientation), thickness variation and crack geometry (position and size). It has been found that the natural frequency for anisotropic single crystal silicon wafer is a strong function of material orientation. Less than 10% thickness variation will have a negligible effect on natural frequency. It is also found out that cracks smaller than 20 mm have no dominant effect on the first five natural frequency modes anywhere in the silicon wafer.

Long term temporal and spatial changes in the distribution of polychlorinated biphenyls and polybrominated diphenyl ethers in Scottish soils

Long term changes in polychlorinated biphenyl (PCB) and polybrominated diphenyl ether (PBDE) concentrations in soil from four transects across Scotland were measured in three surveys conducted between 1990 and 2007-9. Overall PCB level declined during this period (22.5 to 4.55 ng/g, p<0.001) but PBDEs increased (0.68 to 2.55 ng/g, p<0.001), reflecting the ban on PCB use in the 1980s while PBDE use increased until about 2004 when the use of penta-mix congener ceased in Europe. The proportion of lighter PCB congeners (28+52) present declined (p<0.001) primarily between 1990 and 1999. However, the proportion of lighter PBDE congeners (47+99) in the soil samples increased (p<0.01) from 1990 to 1999 and declined (p<0.001) thereafter, probably reflecting the introduction of legislation banning penta-BDE products and the degradation of lighter congeners and their translocation. PCBs were slightly higher in two southernmost transects but PBDE concentrations were significantly higher (p<0.001) in the two southern transects than in the two northern transects. This may reflect proximity to areas of high population and industrial activity. It is concluded that temporal and spatial changes in the distribution of PCBs and PBDEs reflect geography, physical processes and legislation.

Neural network integration of field observations for soil endocrine disruptor characterisation

A neural network approach was used to predict the presence and concentration of a range of endocrine disrupting compounds (EDCs), based on field observations. Soil sample concentrations of endocrine disrupting compounds (EDCs) and site environmental characteristics, drawn from the National Soil Inventory of Scotland (NSIS) database, were used. Neural network models were trained to predict soil EDC concentrations using field observations for 184 sites. The results showed that presence/absence and concentration of several of the EDCs, mostly no longer in production, could be predicted with some accuracy. We were able to predict concentrations of seven of 31 compounds with r(2) values greater than 0.25 for log-normalised values and of eight with log-normalised predictions converted to a linear scale. Additional statistical analyses were carried out, including Root Mean Square Error (RMSE), Mean Error (ME), Willmott's index of agreement, Percent Bias (PBIAS) and ratio of root mean square to standard deviation (RSR). These analyses allowed us to demonstrate that the neural network models were making meaningful predictions of EDC concentration. We identified the main predictive input parameters in each case, based on a sensitivity analysis of the trained neural network model. We also demonstrated the capacity of the method for predicting the presence and level of EDC concentration in the field, identified further developments required to make this process as rapid and operator-friendly as possible and discussed the potential value of a system for field surveys of soil composition.

The performance of enhanced coagulation for treating slightly polluted raw water combining polyaluminum chloride with variable charge soil

The feasibility and effectiveness of treating pollutants in slightly polluted raw water by variable charge soil and polyaluminum chloride (PAC) was investigated. Removal efficiencies of turbidity, phenol, aniline, algae and heavy metals (Cu(2+), Zn(2+) and Pb(2+)) were used to evaluate the coagulation performance. The results indicated that the addition of variable charge soil as a coagulant aid is advantageous due to the improvement of removal efficiencies. The tests also demonstrated that the presence of variable charge soil increased the removal of turbidity rather than adding residuary turbidity. The use of variable charge soil produced settleable flocs of greater density and bigger size. The main mechanism involved in the PAC coagulation was supposed to be sweep flocculation as well as charge-neutralization. Variable charge soil played a promoted aid role by adsorption in the enhanced coagulation process. It is concluded that the enhanced coagulation by PAC and variable charge soil, as coagulant and adsorbent, is more effective and efficient than traditional coagulation.

Ultrasound-guided ablative therapy for hepatic malignancies : a comparison of the therapeutic effects of microwave and radiofrequency ablation

BACKGROUND

Radiofrequency ablation (RFA) is currently the most widely used thermal ablative technique for unresectable hepatic malignancies. However, microwave ablation (MWA) is also gaining popularity worldwide. With a cooled-tip electrode, MWA produces necrotic effects comparable to RFA without damaging soft tissues along the electrode track. In this study, the authors compared the efficacy of these two ablative modalities in the treatment of primary or secondary liver cancer.

MATERIALS AND METHODS

Ultrasound-guided MWA was employed to treat 230 cases of liver cancer with a total of 349 nodules and a diameter of 0.8-11.4 cm [mean: 5.7 +/- 2.1 cm]. Meanwhile, ultrasound-guided RFA was performed in 92 cases of liver cancer with 173 nodules in total and a diameter of 2.0-10.2 cm [mean: 5.4 +/- 1.9 cm]. The clinical data were retrospectively analyzed to identify the differences between MWA and RFA in terms of their operative safety, local ablative effect, cost efficiency, and cumulative survival rate.

RESULTS

The patient parameters were comparable. The area of coagulative necrosis was similar in both groups. The tumor complete ablation rate was 83.7% (292/349) for the MWA group and 86.7% (150/173) for the RFA group, which showed no significant difference (P = 0.75). The one-year and two-year cumulative survival rate were all comparable between the two groups (P = 0.66, P = 0.41), which were 90.0% (198/220), 81.6% (120/147) for the MWA group, and 91.8% (78/85), 81.0% (34/42) for the RFA group, respectively. Moreover, both the tumor type and number had no influence on survival rate for the two methods. In addition, there was no significant difference in complication rates between the two groups. The cost for performing one MWA procedure was about 40% lower than that of RFA ($1200 vs $2000).

CONCLUSIONS

Both MWA and RFA are safe and effective ablative treatments for liver cancer. Additionally, MWA has the advantage of cost efficiency.

Concentrations and geographic distribution of selected organic pollutants in Scottish surface soils

Concentrations of selected persistent organic pollutants (POPs) representing three chemical classes (polycyclic aromatic hydrocarbons (PAH), polybrominated diphenyl ethers (PBDE) and polychlorinated biphenyls (PCB) and the organic pollutant diethylhexyl phthalate (DEHP), were determined in surface soil samples (0-5 cm) collected at 20 km grid intersects throughout Scotland over a three-year period. Detectable amounts of all chemical classes and most individual congeners were present in all samples. There were no consistent effects of soil or vegetation type, soil carbon content, pH, altitude or distance from centres of population on concentrations which exhibited extreme variation, even in adjacent samples. It is concluded that soil POPs and DEHP concentrations and associated rates of animal and human exposure were highly variable, influenced by multiple, interacting factors, and not clearly related to local sources but possibly related to wet atmospheric deposition and the organic carbon content of the soil.

Short- and long-term temporal changes in soil concentrations of selected endocrine disrupting compounds (EDCs) following single or multiple applications of sewage sludge to pastures

Temporal changes in soil burdens of selected endocrine disrupting compounds were determined following application to pasture of either sewage sludge or inorganic fertilizer. Soil polycyclic aromatic hydrocarbon and polychlorinated biphenyl concentrations were not altered. Changes in concentrations of diethylhexyl phthalate (DEHP) and PBDEs 47 and 99 differed with season but concentrations remained elevated for more than three weeks after application, when grazing animals are normally excluded from pasture. It is concluded that single applications of sewage sludge can increase soil concentrations of some, but not all classes of EDCs, possibly to concentrations sufficient to exert biological effects when different chemicals act in combination, but patterns of change depend on season and soil temperature. Analysis of soil from pasture subjected to repeated sludge applications, over 13 years, provided preliminary evidence of greater increases in soil burdens of all of the EDC groups measured, including all of the PBDE congeners measured.

Plasmon resonances and strong electric field enhancements in side-by-side tangent nanospheroid homodimers

The plasmon resonance and electric field enhancement in a side-by-side tangent nanospheroid homodimer (TNSHD) have been investigated theoretically by using DDA and FDTD methods, respectively. The simulation results indicate that this side-by-side TNSHD has its novel optical properties. We find that the plasmon resonance with a distinct Fano lineshape can be achieved and the electric field intensity can be enhanced strongly. The tunability of the Fano resonance could provide important applications in biosensing. The obtained electric field enhancement might open a promising pathway for surface-enhanced Raman scattering (SERS) and light trapping in solar cells.