Lymphopenia During Definitive Chemoradiotherapy in Esophageal Squamous Cell Carcinoma: Association with Dosimetric Parameters and Patient Outcomes

BACKGROUND

The objective of this study was to investigate the relationship between clinical characteristics, as well as dosimetric parameters, and the risk of treatment-related lymphopenia in esophageal squamous cell carcinoma (ESCC) treated with definitive chemoradiotherapy (CRT).

MATERIALS AND METHODS

Clinical characteristics and dosimetric parameters were collected from 436 patients with ESCC who received definitive CRT from 2010 through 2017. Absolute lymphocyte counts (ALCs) were obtained before, during, and 1 month after CRT. Grade 4 (G4) lymphopenia was defined as ALC <0.2 × 10⁹ /L during CRT. Logistic regression analysis was used to evaluate the effect of each factor on predicting G4 lymphopenia. The relationship between lymphopenia and overall survival (OS) was examined, and a nomogram was developed to predict OS.

RESULTS

G4 lymphopenia was observed in 103 patients (23.6%) during CRT. Multivariate analysis indicated that planning target volume (PTV), lung V₁₀ , heart V₁₀ , performance status, and pretreatment lymphopenia were significant risk factors for G4 lymphopenia. Patients with G4 lymphopenia had significantly worse survival than those without. Based on multivariate analysis, clinical TNM stage, radiotherapy modality, pretreatment ALC, and G4 lymphopenia were predictive of OS and were incorporated into the nomogram, yielding a concordance index of 0.71.

CONCLUSIONS

G4 lymphopenia during definitive CRT was associated with larger PTVs, higher lung V₁₀ and heart V₁₀ , and worse survival.

IMPLICATIONS FOR PRACTICE

The purpose of this study was to investigate the relationship between clinical characteristics, as well as dosimetric parameters, and the risk of treatment-related lymphopenia in 436 patients with esophageal squamous cell carcinoma who received definitive chemoradiotherapy. Grade 4 (G4) lymphopenia was observed in 23.6% of patients during radiotherapy. G4 lymphopenia was associated with larger planning target volumes, higher lung V₁₀ and heart V₁₀ , and worse survival. Then, a nomogram was built based on multivariate analysis, yielding excellent performance to predict overall survival. Prospective studies are needed to investigate potential approaches for mitigating severe lymphopenia, which may ultimately convert into survival benefits.

Notoginsenoside R1 Protects Against the Acrylamide-Induced Neurotoxicity via Upregulating Trx-1-Mediated ITGAV Expression: Involvement of Autophagy

Acrylamide (ACR) is a common chemical used in various industries and it said to have chronic neurotoxic effects. It is produced during tobacco smoking and is also generated in high-starch foods during heat processing. Notoginsenoside R1 (NR1) is a traditional Chinese medicine, which is used to improve the blood circulation and clotting. The objective of this study was to investigate the mechanism of ACR-triggered neurotoxicity and to identify the protective role of NR1 by upregulating thioredoxin-1 (Trx-1). Our results have shown that NR1 could block the spatial and cognitive impairment caused by ACR administration. Bioinformatics analysis revealed that Trx-1 regulated autophagy via Integrin alpha V (ITGAV). NR1 could resist the ACR-induced neurotoxicity by upregulating thioredoxin-1 in PC12 cells and mice. The autophagy-related proteins like autophagy-related gene (ATG) 4B, Cathepsin D, LC3 II, lysosomal-associated membrane protein 2a (LAMP2a), and ITGAV were restored to normal levels by NR1 treatment in both PC12 cells and mice. Besides, we also found that overexpression of Trx-1 resisted ACR-induced autophagy in PC12 cells and downregulation of Trx-1 triggered autophagy induced by ACR in PC12 cells. Therefore, it could be concluded that Trx-1 was involved in the autophagy pathway. Besides, we also found that ITGAV was an intermediate node linking Trx-1 and the autophagy pathway.

Highly Enhanced Antitumor Immunity by a Three-Barreled Strategy of the l-Arginine-Promoted Nanovaccine and Gene-Mediated PD-L1 Blockade

Weak T cell responses and immune checkpoints within tumors could be two key factors for limiting antitumor efficacy in the field of cancer immunotherapy. Thus, the combined strategy of tumor vaccines and immune checkpoint blockade has been widely studied and expected to boost antitumor immune responses. Herein, we first developed a two-barreled strategy to combine the nanovaccine with a gene-mediated PD-L1 blockade. On the one hand, polyethyleneimine (PEI) worked as a vaccine carrier to codeliver the antigen ovalbumin (OVA) and the adjuvant unmethylated cytosine-phosphate-guanine (CpG) to formulate the PEI/OVA/CpG nanovaccine through electrostatic binding, which realized both dendritic cell activation and antigen cross-presentation enhancement. On the other hand, the PD-L1 silence gene was loaded by PEI to form PEI/pshPD-L1 complexes, which were further in situ shielded by aldehyde-modified polyethylene glycol (OHC-PEG-CHO) via pH-responsive Schiff base bonds. The formed pshPD-L1@NPs could decrease PD-L1 expression on the tumor cells. However, such a combined two-barreled strategy improved feebly for tumor inhibition in comparison with monotherapy, exhibiting the antagonistic effect, which might be due to the limited T cell response enhancement in the tumor microenvironment. To solve this problem, we have further developed a three-barreled strategy to combine oral administration of l-arginine, which worked as an amplifier to induce robust T cell response enhancement, without causing the upregulation of other negative immune regulators. Superior antitumor behavior and tumor rechallenge protection were realized by the three-barreled strategy in B16F10-OVA (B16-OVA)-bearing mice. The unique three-barreled strategy we developed might offer a novel clinical therapeutic treatment.

SMS-based family planning communication and its association with modern contraception and maternal healthcare use in selected low-middle-income countries

BACKGROUND

The objectives of this study were to 1) measure the percentage of women who received SMS-based family planning communication, and 2) its association with modern contraception and maternal healthcare services among mothers. In recent years, there has been a growing interest surrounding mobile phone-based health communication and service delivery methods especially in the areas of family planning and reproductive health. However, little is known regarding the role of SMS-based family planning communication on the utilisation of modern contraception and maternal healthcare services in low-resource settings.

METHODS

Cross-sectional data on 94,675 mothers (15-49 years) were collected from the latest Demographic and Health Surveys in 14 low-and-middle-income countries. The outcome variables were self-reported use of modern contraception and basic maternal healthcare services (timely and adequate use of antenatal care, and of facility delivery services). Data were analysed using multivariate regression and random effect meta-analyses.

RESULTS

The coverage of SMS-based family planning communication for the pooled sample was 5.4% (95%CI = 3.71, 7.21), and was slightly higher in Africa (6.04, 95%CI = 3.38, 8.70) compared with Asia (5.23, 95%CI = 1.60, 8.86). Among the countries from sub-Saharan Africa, Malawi (11.92, 95%CI = 11.17, 12.70) had the highest percent of receiving SMS while Senegal (1.24, 95%CI = 1.00, 1.53) had the lowest. In the multivariate analysis, SMS communication shown significant association with the use of facility delivery only (2.22 (95%CI = 1.95, 2.83). The strength of the association was highest for Senegal (OR = 4.70, 95%CI = 1.14, 7.33) and lowest for Burundi (OR = 1.5; 95%CI = 1.01, 2.74). Meta analyses revealed moderate heterogeneity both in the prevalence and the association between SMS communication and the utilisation of facility delivery.

CONCLUSION

Although positively associated with using facility delivery services, receiving SMS on family planning does not appear to affect modern contraceptive use and other components of maternal healthcare services such as timely and adequate utilisation of antenatal care.

Selective determination of Ag+ in the presence of Cd2+, Hg2+ and Cu2+ based on their different interactions with gold nanoclusters

In this work, a fluorescence method was developed for selective detection of Ag⁺ in the presence of Cd²⁺, Hg²⁺, and Cu²⁺ based on gold nanoclusters (AuNCs). That is, bovine serum albumin (BSA) templated AuNCs with double emission peaks were synthesized using BSA as a protective agent. AuNCs with uniform distribution and average size between 2.0 and 2.2 nm were synthesized using a green and simple method, and showed bright orange-red fluorescence under ultraviolet light. AuNCs have two emission peaks at 450 nm and 630 nm with an excitation wavelength of 365 nm. Under alkaline conditions, Cd²⁺ can combine with the surface sulfhydryl groups of BSA–AuNCs to form Cd–S bonds, which cause AuNCs to aggregate, resulting in an increase in fluorescence intensity at 630 nm. Conversely, due to the d¹⁰–d¹⁰ metal affinity interaction, the addition of Hg²⁺ can reduce the fluorescence peak at 630 nm. Ag⁺ was reduced to Ag⁰ by gold nuclei in AuNCs, forming a stable hybrid Au@ AgNCs species with blue-shifted and enhanced fluorescence. Finally, the paramagnetic behavior of Cu²⁺ combined with BSA causes the excited electrons of the gold cluster to lose their energy via ISC, eventually leading to simultaneous quenching of the two emission peaks. The results show that the limit of detection (LOD) of Ag⁺, Hg²⁺, Cd²⁺ and Cu²⁺ is 1.19 μM, 3.39 μM, 1.83 μM and 5.95 μM, respectively.

A fluorescence method was developed for selective detection of Ag⁺ in the presence of Cd²⁺, Hg²⁺, and Cu²⁺ based on gold nanoclusters. The limit of detection for Ag⁺, Hg²⁺, Cd²⁺ and Cu²⁺ is 1.19 μM, 3.39 μM, 1.83 μM and 5.95 μM, respectively.

Reference Intervals for Thyroid-Associated Hormones and the Prevalence of Thyroid Diseases in the Chinese Population

BACKGROUND

Thyroid diseases are highly prevalent worldwide, but their diagnosis remains a challenge. We established reference intervals (RIs) for thyroid-associated hormones and evaluated the prevalence of thyroid diseases in China.

METHODS

After excluding outliers based on the results of ultrasound screening, thyroid antibody tests, and the Tukey method, the medical records of 20,303 euthyroid adults, who visited the Department of Health Care at Peking Union Medical College Hospital from January 2014 to December 2018, were analyzed. Thyroid-associated hormones were measured by the Siemens Advia Centaur XP analyzer. The RIs for thyroid-associated hormones were calculated according to the CLSI C28-A3 guidelines, and were compared with the RIs provided by Siemens. The prevalence of thyroid diseases over the five years was evaluated and compared using the chi-square test.

RESULTS

The RIs for thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), and total triiodothyronine (TT3) were 0.71-4.92 mIU/L, 12.2-20.1 pmol/L, 3.9-6.0 pmol/L, 65.6-135.1 nmol/L, and 1.2-2.2 nmol/L, respectively. The RIs of all hormones except TT4 differed significantly between males and females. The RIs of TSH increased with increasing age. The prevalence of overt hypothyroidism, overt hyperthyroidism, subclinical hypothyroidism, and subclinical hyperthyroidism was 0.5% and 0.8%, 0.2% and 0.6%, 3.8% and 6.1%, and 3.3% and 4.7% in males and females, respectively, which differed from those provided by Siemens.

CONCLUSIONS

Sex-specific RIs were established for thyroid-associated hormones, and the prevalence of thyroid diseases was determined in the Chinese population.

Synthesis of Carbon Dots by Varying Doped Elements and Application in Serine Detection

Carbon dots (CDs) with different doping elements were successfully synthesized via a simple hydrothermal strategy. 3-amino-4-chlorophenylboronic acid, 3-aminobenzeneboronic acid, aniline, and benzene were used as precursors, respectively. The B/N co-doping CDs (BNCDs) derived from 3-aminobenzeneboronic acid show brightest fluorescence among the CDs products with quantum yield at 0.15. The fluorescence of BNCDs exhibits good photostability and excitation-independent emission behavior. The bright blue emission of BNCDs can be quenched by serine, which is a kind of neutral aliphatic amino acid containing hyroxyl groups with polarity. It is possibly due to the molecular collision between excited state of BNCDs and the ground state of serine. BNCDs can be served as fluorophore probe for the assay of serine based on the efficient quenching effect. The approach for the determination of serine shows a high sensitivity with a detection limit at 0.14 nM, which is lower than those of previous works. Furthermore, the present BNCDs system can be employed to monitor serine in real food and biological samples. The strategy may be a potential way for the application in food safety and biomedicine fields.

Developing a risk prediction model for multidrug-resistant bacterial infection in patients with biliary tract infection

BACKGROUND/AIMS

The aim of this study was to develop a tool to predict multidrug-resistant bacteria infections among patients with biliary tract infection for targeted therapy.

PATIENTS AND METHODS

We conducted a single-center retrospective descriptive study from January 2016 to December 2018. Univariate and multivariable logistic regression analysis were used to identify independent risk factors of multidrug-resistant bacterial infections. A nomogram was constructed according to multivariable regression model. Moreover, the clinical usefulness of the nomogram was estimated by decision curve analysis.

RESULTS

121 inpatients were randomly divided into a training cohort (n = 79) and validation cohort (n = 42). In multivariate analysis, 5 factors were associated with biliary tract infections caused by multidrug-resistant bacterial infections: aspartate aminotransferase (Odds ratio (OR), 13.771; 95% confidence interval (CI), 3.747-64.958; P < 0.001), previous antibiotic use within 90 days (OR, 4.130; 95% CI, 1.192-16.471; P = 0.032), absolute neutrophil count (OR, 3.491; 95% CI, 1.066-12.851; P = 0.046), previous biliary surgery (OR, 3.303; 95% CI, 0.910-13.614; P = 0.079), and hemoglobin (OR, 0.146; 95% CI, 0.030-0.576; P = 0.009). The nomogram model was constructed based on these variables, and showed good calibration and discrimination in the training set [area under the curve (AUC), 0.86] and in the validation set (AUC, 0.799). The decision curve analysis demonstrated the clinical usefulness of our nomogram. Using the nomogram score, high risk and low risk patients with multidrug-resistant bacterial infection could be differentiated.

CONCLUSIONS

This simple bedside prediction tool to predict multidrug-resistant bacterial infection can help clinicians identify low versus high risk patients as well as choose appropriate, timely initial empirical antibiotics therapy. This model should be validated before it is widely applied in clinical settings.

HMGB1 aggravates lipopolysaccharide-induced acute lung injury through suppressing the activity and function of Tregs

BACKGROUND

CD4⁺CD25⁺FoxP3⁺ T helper cells (Tregs), a subgroup of CD4⁺ T helper cells, are critical effectors that protect against acute lung injury (ALI) by contact-dependent suppression or releasing anti-inflammatory cytokines including interleukin-10 (IL-10), and transforming growth factor (TGF-β). HMGB1 (High mobility group box 1 protein) was identified as a nuclear non-histone DNA-binding chromosomal protein, which participates in the regulation of lung inflammatory response and pathological processes in ALI. Previous studies have suggested that Tregs overexpresses the HMGB1-recognizing receptor. However, the interaction of HMGB1 with Tregs in ALI is still unclear.

OBJECTIVE

To investigate whether HMGB1 aggravates ALI by suppressing immunosuppressive function of Tregs.

METHODS

Anti-HMGB1 antibody and recombinant mouse HMGB1 (rHMGB1) were administered in lipopolysaccharide (LPS)-induced ALI mice and polarized LPS-primed Tregs in vitro. The Tregs pre-stimulated with or without rHMGB1 were adoptively transferred to ALI mice and depleted by Diphtheria toxin (DT). For coculture experiment, isolated Tregs were first pre-stimulated with or without rHMGB1 or anti-HMGB1 antibody, then they were cocultured with bone marrow-derived macrophages (BMMs) under LPS stimulation.

RESULTS

Tregs protected against acute lung pathological injury. HMGB1 modulated the suppressive function of Tregs as follows: reduction in the number of the cells and the activity of Tregs, the secretion of anti-inflammatory cytokines (IL-10, TGF-β) from Tregs, the production of IL-2 from CD4⁺ T cells and CD11c⁺ DCs, and the M2 polarization of macrophages, as well as inducing proinflammatory response of macrophages.

CONCLUSIONS

HMGB1 could aggravate LPS induced-ALI through suppressing the activity and function of Tregs.

Breastfed 13 month-old infant of a mother with COVID-19 pneumonia: a case report

BACKGROUND

In China, mothers with confirmed or suspected COVID-19 pneumonia are recommended to stop breastfeeding. However, the evidence to support this guidance is lacking. There have been relatively few cases reported about direct breastfeeding an infant by a mother with SARS-CoV-2 pneumonia. Therefore, it is necessary to assess the safety of breastfeeding and the possible protective effects of breast milk on infants.

CASE PRESENTATION

This report analyzes the case of a mother who continued breastfeeding her 13 month-old child when both were diagnosed with confirmed COVID-19 pneumonia. We describe the clinical presentation, diagnosis, treatment, and outcome. The presence of SARS-CoV-2 nucleic acid was determined in maternal serum, breast milk, nasopharyngeal (NP) swabs and feces, and in infant serum, NP swabs and feces. IgM and IgG antibodies against SARS-CoV-2 were assessed in maternal serum and breast milk and in infant serum. SARS-CoV-2 nucleic acid was not detected in the breast milk, and antibodies against SARS-CoV-2 were detected in the mother's serum and milk.

CONCLUSIONS

The present case further confirms that the possibility of mother-to-child transmission about SARS-CoV-2 via breast milk alone was very small, and breast milk is safe for direct feeding of infants.

Peroxisome proliferator activated receptor γ promotes mineralization and differentiation in cementoblasts via inhibiting Wnt/β-catenin signaling pathway

Peroxisome proliferator activated receptor γ (PPARγ) is a member of the nuclear receptor family of transcription factors, which involved in inflammation regulating and bone remodeling. Rare studies explored the effects of PPARγ on mineralization and differentiation in cementoblasts. To explore the potential approaches to repair the damaged periodontal tissues especially for cementum, the present study aims to investigate the effects and the regulating mechanism of PPARγ on mineralization and differentiation in cementoblasts. Murine cementoblast cell lines (OCCM-30) were cultured in basic medium for 24 hours/48 hours or in mineralization medium for 3/7/10 days, respectively at addition of dimethyl sulphoxide, rosiglitazone (PPARγ agonist), GW9662 (PPARγ antagonist), lithium chloride (LiCl), tumor necrosis factor-α (TNF-α), or respective combination. Expression of mineralization genes alkaline phosphatase (ALP), runt related transcription factors 2 (RUNX2), and osteocalcin (OCN) were detected by quantitative real-time polymerase chain reaction or/and Western blot. ALP staining and alizarin red staining were used to evaluate the mineralization in OCCM-30 cells. The change of β-catenin expression and translocation in cytoplasm/nucleus was analyzed by Western blot and immunofluorescence. The results showed that PPARγ agonist rosiglitazone improved the expression of ALP, RUNX2, and OCN, deepened ALP staining, increased mineralized nodules formation, and decreased β-catenin expression in the nucleus. LiCl, an activator of the Wnt signaling pathway, inhibited the expression of mineralization genes and reversed the upregulated expression of mineralization genes resulted from rosiglitazone. Under inflammatory microenvironment, rosiglitazone not only suppressed the expression of interleukin-1β caused by TNF-α, but improved the expression of mineralization genes in OCCM-30 cells. In conclusion, PPARγ could promote mineralization and differentiation in cementoblasts via inhibiting the Wnt/β-catenin signaling pathway, which would shed new light on the treatment of periodontitis and periodontal tissue regeneration.

A novel application of drug-eluting transarterial chemoembolization in treating non-liver cancers

This case series aimed to preliminarily evaluate the efficacy and safety of drug-eluting beads transarterial chemoembolization (DEB-TACE) in patients with lung, renal, gastric, and other non-liver cancers.Twenty-four patients who underwent DEB-TACE or DEB-TACE combined with other therapies were reviewed in this case series. Treatment responses were assessed at 1 month after treatment according to the modified Response Evaluation Criteria in Solid Tumors. Overall survival (OS) and adverse events were recorded.In the total patients, the objective response and disease control rate were 79.2% and 87.5%, respectively. And the mean OS in total patients was 14.7 months (95% confidence interval: 9.6-19.9 months). The number of patients who had generalized aches, nausea, vomit, fever, abdominal discomfort, chest discomfort, elevated blood pressure, cough, loss of appetite, and headache in total patients were 7 (29.2%), 11 (45.8%), 6 (25.0%), 2 (8.3%), 3 (12.5%), 3 (12.5%), 1 (4.2%), 1 (4.2%), 1 (4.2%), and 1 (4.2%), respectively. The objective response rates in patients with lung, renal, gastric, and other non-liver cancer were 70.0%, 85.7%, 100.0%, and 80.0%, respectively. In patients with lung, renal, gastric, and other non-liver cancers, the mean values of the OSs were 13.4 months, 12.4 months, 7.6 months, and 20.3 months, respectively. And the most common adverse events in lung cancer patients, renal carcinoma patients, gastric cancer patients, and patients with other non-liver cancers were post-embolization syndrome.DEB-TACE may be an effective and safe therapeutic option in patients with lung, renal, gastric, and other non-liver cancers.

Positive result of Sars-Cov-2 in faeces and sputum from discharged patients with COVID-19 in Yiwu, China

Background

With the effective prevention and control of COVID‐19 in China, the number of cured cases has increased significantly. Further monitoring of the disease prognosis and effective control of the “relapse” of the epidemic has become the next focus of work. This study analysed the clinical prognosis of discharged COVID‐19 patients by monitoring their SAR‐CoV‐2 nucleic acid status, which provided a theoretical basis for medical institutions to formulate discharge standards and follow‐up management for COVID‐19 patients.

Methods

We included 13 discharged COVID‐19 patients who were quarantined for 4 weeks at home. The patient's daily clinical signs were recorded and sputum and faecal specimens were regularly sent for detection of SARS‐CoV‐2 nucleic acid.

Results

The time between initial symptoms and meeting discharge criteria was 18 to 44 days with an average of 25 ± 6 days. The faecal samples of two patients still tested positive after meeting the discharge criteria and the sputum samples of four patients returned positive 5 to 14 days after discharge. The rate of the recurring positive test result in samples from the respiratory system was 31% (4/13).

Conclusion

Under the present discharge criteria, the high presence of SARS‐CoV‐2 nucleic acid in faecal and respiratory samples of discharged COVID‐19 patients indicates potential infectivity. Therefore, we suggest that faecal virus nucleic acid should be tested as a routine monitoring index for COVID‐19 and a negative result be added to the criteria. Simultaneously, we should strengthen the regular follow‐up of discharged patients with continuous monitoring of the recurrence of viral nucleic acid.

The positive rate of SARS‐CoV‐2 nucleic acid in faeces and respiratory tract of discharged COVID‐19 patients both were high, which indicate potential infectivity.

Clinical course and predictors of 60-day mortality in 239 critically ill patients with COVID-19: a multicenter retrospective study from Wuhan, China

BACKGROUND

The global numbers of confirmed cases and deceased critically ill patients with COVID-19 are increasing. However, the clinical course, and the 60-day mortality and its predictors in critically ill patients have not been fully elucidated. The aim of this study is to identify the clinical course, and 60-day mortality and its predictors in critically ill patients with COVID-19.

METHODS

Critically ill adult patients admitted to intensive care units (ICUs) from 3 hospitals in Wuhan, China, were included. Data on demographic information, preexisting comorbidities, laboratory findings at ICU admission, treatments, clinical outcomes, and results of SARS-CoV-2 RNA tests and of serum SARS-CoV-2 IgM were collected including the duration between symptom onset and negative conversion of SARS-CoV-2 RNA.

RESULTS

Of 1748 patients with COVID-19, 239 (13.7%) critically ill patients were included. Complications included acute respiratory distress syndrome (ARDS) in 164 (68.6%) patients, coagulopathy in 150 (62.7%) patients, acute cardiac injury in 103 (43.1%) patients, and acute kidney injury (AKI) in 119 (49.8%) patients, which occurred 15.5 days, 17 days, 18.5 days, and 19 days after the symptom onset, respectively. The median duration of the negative conversion of SARS-CoV-2 RNA was 30 (range 6-81) days in 49 critically ill survivors that were identified. A total of 147 (61.5%) patients deceased by 60 days after ICU admission. The median duration between ICU admission and decease was 12 (range 3-36). Cox proportional-hazards regression analysis revealed that age older than 65 years, thrombocytopenia at ICU admission, ARDS, and AKI independently predicted the 60-day mortality.

CONCLUSIONS

Severe complications are common and the 60-day mortality of critically ill patients with COVID-19 is considerably high. The duration of the negative conversion of SARS-CoV-2 RNA and its association with the severity of critically ill patients with COVID-19 should be seriously considered and further studied.

SPEN induces miR-4652-3p to target HIPK2 in nasopharyngeal carcinoma

SPEN family transcriptional repressor (SPEN), also known as the SMART/HDAC1-associated repressor protein (SHARP), has been reported to modulate the malignant phenotypes of breast cancer, colon cancer, and ovarian cancer. However, its role and the detail molecular basis in nasopharyngeal carcinoma (NPC) remain elusive. In this study, the SPEN mRNA and protein expression was found to be increased in NPC cells and tissues compared with nonmalignant nasopharyngeal epithelial cells and tissues. Elevated SPEN protein expression was found to promote the pathogenesis of NPC and lead to poor prognosis. Knockdown of SPEN expression resulted in inactivation ofPI3K/AKT and c-JUN signaling, thereby suppressing NPC migration and invasion. In addition, miR-4652-3p was found to be a downstream inducer of SPEN by targeting the homeodomain interacting protein kinase 2 (HIPK2) gene, a potential tumor suppressor that reduces the activation of epithelial-mesenchymal transition (EMT) signaling, thereby reducing its expression and leading to increased NPC migration, invasion, and metastasis. In addition, SPEN was found to induce miR-4652-3p expression by activating PI3K/AKT/c-JUN signaling to target HIPK2. Our data provided a new molecular mechanism for SPEN as a metastasis promoter through activation of PI3K/AKT signaling, thereby stimulating the c-JUN/miR-4652-3p axis to target HIPK2 in NPC.

[Brief discussion on the taboo and application of stem cell transplantation in the treatment of liver cancer]

Liver cancer is the second-highest mortality cancer in China. It is highly occult, and there is no effective treatment so far. In recent years, stem cell transplantation, especially mesenchymal stem cell (MSCs) transplantation, has been widely used in the treatment of various diseases. Nevertheless, the industry has reached a consensus that malignant tumors are the forbidden area of this transplantation therapy. This is closely related to the two main characteristics of stem cells themselves, namely "self-renewal" and "pluripotency". The following is an overview of the reasons why stem cells, especially MSCs, have become taboo in tumor treatment and their potential application methods, so as to provide some references for further research on this therapy.

High-Rate and Long-Life Intermediate-Temperature Na-NiCl2 Battery with Dual-Functional Ni-Carbon Composite Nanofiber Network

Improved power and cycle performances are eagerly required in intermediate-temperature sodium-metal halide (Na-MH) batteries. The existence of the low conductivity NiCl₂ layer and the growth of the Ni and the NaCl particles limit the broader application of Na-NiCl₂ battery. Herein, nickel-carbon composite nanofiber (NCCN) networks are synthesized by a multisolution electrospinning method to construct a novel three-dimensional cathode for Na-NiCl₂ battery. The battery with the NCCN-based cathode shows significant improvement in rate and cycle performance at 190 °C. A capacity twice that of a conventional electrode after 100 cycles and 80% of the initial capacity after 400 cycles are observed at a current of 57 mA g^-1. The NCCN-based cathode normally works more than 350 cycles without obvious degradation at a high current of 338 mA g^-1, that is, a rate of 2C. Furthermore, in situ electrochemical impedance spectroscopy reveals faster electron and ion transport processes precisely on the charging and discharging processes of the NCCN-based cathode. It is found that the NCCNs can not only play the role of a continuous conductivity network but also limit the growth of grains. With the blocking effect of the carbon fibers, the volume expansions of Ni and NaCl grains are well restricted and their sizes were smaller than 500 nm and 7 μm after 50 cycles, respectively.

Effects of Surface Tension and Yield Stress on Mucus Plug Rupture: A Numerical Study

We study the effects of surface tension and yield stress on mucus plug rupture. A three-dimensional simplified configuration is employed to simulate mucus plug rupture in a collapsed lung airway of the tenth generation. The Herschel-Bulkley model is used to take into account the non-Newtonian viscoplastic fluid properties of mucus. Results show that the maximum wall shear stress greatly changes right prior to the rupture of the mucus plug. The surface tension influences mainly the late stage of the rupture process when the plug deforms greatly and the curvature of the mucus-air interface becomes significant. High surface tension increases the wall shear stress and the time needed to rupture since it produces a resistance to the rupture, as well as strong stress and velocity gradients across the mucus-air interface. The yield stress effects are pronounced mainly at the beginning. High yield stress makes the plug take a long time to yield and slows down the whole rupture process. When the effects induced by the surface tension and yield forces are comparable, dynamical quantities strongly depend on the ratio of the two forces. The pressure difference (the only driving in the study) contributes to wall shear stress much more than yield stress and surface tension per unit length. Wall shear stress is less sensitive to the variation in yield stress than that in surface tension. In general, wall shear stress can be effectively reduced by the smaller pressure difference and surface tension.

Colitis following the use of immune checkpoint inhibitors: A real-world analysis of spontaneous reports submitted to the FDA adverse event reporting system

BACKGROUND

Although colitis has been reported in patients treated with immune checkpoint inhibitors (ICIs), associations between colitis and ICIs had not been thoroughly assessed in real-world studies. Here, we identified and characterized significant colitis-associated with ICIs.

METHODS

Based on the Food and Drug Administration Adverse Event Reporting System (FAERS) from January 2004 to December 2019, the disproportionality analysis and Bayesian analysis, including the reporting odds ratio (ROR), the proportional reporting ratio (PRR), the Bayesian confidence propagation neural network (BCPNN) and the multi-item gamma Poisson shrinker (MGPS) algorithms were adopted to data mining of the suspected adverse events of colitis after ICIs administrating. Clinical characteristics of patients with ICIs-associated colitis and the time to onset of colitis following different ICI regimens were collected.

RESULTS

A total of 3786 reports of colitis adverse events were identified with ICIs. Seven ICI monotherapies were associated with the reporting of colitis. Statistically significant ROR, PRR, information component (IC), and empirical Bayesian geometric mean (EBGM) emerged for all ICI monotherapies and combination therapies. ICIs-associated colitis affected mostly male (53.51%), with a wide mean age range (60.65 to 72 years). Colitis adverse events were commonly reported in patients with melanoma and lung cancer. Adverse outcomes of colitis concerning ICI were mainly outcomes of hospitalization-initiated or prolonged and other serious. Among colitis cases, 17.43% cases of colitis concerning ICI lead to death. The adverse event ofcolitis occurred earliest in ipilimumab monotherapy with a median time to onset of 64.21 days (IQR: 27-69 days) among all monotherapies.

CONCLUSIONS

ICI may lead to severe and disabling ICIs-associated colitis during therapy. Analysis of FAERS data identified signals for adverse events of colitis with ICI regimens. Practitioners should consider the factors that may increase the likelihood of colitis. The findings support a continued surveillance and risk factor identification studies.

The potential correlation between bacterial diversity and the characteristic volatile flavour of traditional dry sausages from Northeast China

The objective of this study was to explore the correlation between bacterial communities and volatile compounds in traditional dry sausages from different regions in Northeast China. The bacterial community structure of dry sausages from five different regions as determined by high-throughput sequencing technology demonstrated that Firmicutes and Proteobacteria were the predominant phyla; Lactobacillus, Staphylococcus, Leuconostoc, Lactococcus and Weissella were the predominant genera; and Staphylococcus xylosus, Lactobacillus sakei, Weissella hellenica, Leuconostoc citreum, Lactococcus raffinolactis and Lactobacillus plantarum were the predominant species. Meanwhile, a total of 120 volatile compounds were detected in sausages from five different regions and mainly included alcohols, acids, aldehydes, ketones, esters and terpenes. Furthermore, the potential correlations between the core bacteria and major volatile compounds (64) were explored based on Spearman's correlation analysis. Positive correlations were found between W. hellenica, Lb. sakei, Lactococcus lactis, Lactobacillus alimentarius, Lb. plantarum and carboxylic acids and alcohols. Lc. lactis, Lb. alimentarius and Lb. plantarum were associated with the production of most esters, aldehydes and ketones. This study provides a deep insight into the relationship between the bacterial community and the volatile flavour profile of dry sausages, which may be helpful for the production of fermented dry sausages.