[The influence of Ras-associated binding protein 23 knockdown on the migration and invasion of esophageal squamous cell carcinoma cells and its mechanism]

Objective: To investigate the role and the mechanism of Ras-associated binding protein23 (RAB23) in the migration and invasion of esophageal squamous cell carcinoma (ESCC) cells. Methods: RAB23 mRNA levels were measured in 16 pairs of ESCC and adjacent normal tissues via real-time polymerase chain reactions. RAB23 mRNA levels in the ESCC and adjacent normal tissues of dataset GSE20347 deposited in the Gene Expression Omnibus (GEO) database were also analyzed. Immunohistochemistry (IHC) was used to detect the RAB23 protein expressions in 106 pairs of ESCC and adjacent normal tissues, as well as in the lymph glands and primary tumor tissues of 33 patients with positive lymph nodes and 10 patients with negative lymph nodes. Endogenous RAB23 expression was transiently depleted using siRNAs (si-NC, si-RAB23-1, and si-RAB23-9) or stably reduced using shRNAs (sh-NC and sh-RAB23) in ESCC KYSE30 and KYSE150 cells, and the knockdown efficiency was tested using Western blot assays. Cell counting kit-8 assays and mouse xenograft models were used to test the proliferation of ESCC cells. Transwell assays and tail vein-pulmonary metastasis models in immunocompromised mice were used to examine the migration and invasion of ESCC cells. Cell adhesion assays were used to test the adhesion of ESCC cells. RNA-seq assays were used to analyze how RAB23 knockdown influenced the expression profile of ESCC cells and the implicated signal pathways were confirmed using Western blot assays. Results: The RAB23 mRNA expression in 16 cases of ESCC tissues was 0.009 7±0.008 9, which was markedly higher than that in adjacent normal tissues (0.003 2±0.003 7, P=0.006). GEO analysis on RAB23 expressions in ESCC and adjacent normal tissues showed that the RAB23 mRNA level in ESCC tissues (4.30±0.25) was remarkably increased compared with their normal counterparts (4.10±0.17, P=0.037). Among the 106 pairs of ESCC and tumor-adjacent normal tissues, 51 cases exhibited low expression of RAB23 and 55 cases showed high expression of RAB23, whereas in the paired tumor-adjacent normal tissues 82 cases were stained weakly and 24 strongly for RAB23 protein. These results indicated that RAB23 expression was markedly increased in ESCC tissues (P<0.001). Additionally, only 1 out of 33 primary ESCC tissues with positive lymph nodes showed low RAB23 protein expression. On the other hand, 7 samples of primary ESCC tissues with negative lymph nodes were stained strongly for RAB23 while its level in the other 3 samples was weak. These results showed that RAB23 expression was remarkably increased in primary ESCC tissues with positive lymph nodes compared with those with negative lymph nodes (P=0.024). Further tests showed that 32 out of 33 positive lymph nodes were stained strongly for RAB23, whereas no negative lymph nodes (n=10) exhibited high expression of RAB23 (P<0.001). Both transient and stable knockdown of endogenous RAB23 expression failed to cause detectable changes in the proliferation of KYSE30 cells in vitro and in vivo, but attenuated the migration and invasion of KYSE30 cells as well as the invasion of KYSE150 cells. RAB23 knockdown was found to significantly decrease the number of adhesive KYSE30 cells in the sh-RAB23 group (313.75±89.34) compared with control cells in the sh-NC group (1 030.75±134.29, P<0.001). RAB23 knockdown was also found to significantly decrease the number of adhesive KYSE150 cells in the sh-RAB23 group (710.5±31.74) compared with the number of control cells in the sh-NC group (1 005.75±61.09, P<0.001). RNA-seq assays demonstrated that RAB23 knockdown using two siRNAs targeting RAB23 mRNA markedly impaired focal adhesion-related signal pathways, and decreased the levels of phosphorylated FAK (p-FAK) and phosphorylated paxillin (p-paxillin) in KYSE30 and KYSE150 cells. Conclusions: Significantly increased RAB23 in ESCC tissues positively correlates with lymph node metastasis. Depleted RAB23 expression attenuates focal adhesion-related signal pathways, thus impairing the invasion, metastasis, and adhesion of ESCC cells.

[Clinical implications of Naples prognostic scores in patients with resectable Siewert type II-III adenocarcinoma of the esophagogastric junction]

Objective: To evaluate the clinical value of preoperative Naples prognostic scores (NPS) in patients with resectable Siewert type II-III esophagogastric junction adenocarcinoma (AEG). Methods: In this retrospective observational study we collected and analyzed relevant data of patients with Siewert Type II-III AEG treated in the Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital from January 2014 to December 2018. NPS were calculated using preoperative albumin concentration, total cholesterol concentration, neutrophil/lymphocyte ratio, and lymphocyte/monocyte ratio and used to allocate patients into three groups: NTS-0 (0 points), NTS-1 (1-2 points) and NTS-2 (3-4 points). Kaplan-Meier was used to calculate disease-free survival (DFS) and overall survival (OS) in each NPS group and the log-rank test to compare these groups. Univariate and multivariate survival analyes were performed using the Cox regression model. Time-dependent receiver operating characteristic curves were constructed to compare the relationships between four commonly used tools for evaluating inflammatory responses and nutritional status:NPS, systemic inflammatory response scores, nutrient control status (CONUT), and prognostic nutrition index (PNI). Results: The study cohort comprised 221 patients with AEG of median age 63.0 (36.0-87.0) years. There were 190 men (86.0%) and 31 women (14.0%). As to pTNM stage, 47 patients (21.3%) had Stage I disease, 68 (30.8%) Stage II, and 106 (48.0%) Stage III. One hundred and forty-seven patients (66.5%) had Siewert Type II disease and 74 (33.5%) Siewert type III. There were 45 patients (20.4%) in the NPS-0, 142 (64.2%) in the NPS-1 and 34 (15.4%) in the NPS-2 groups. Higher NPS scores were significantly associated with older patients (χ²=5.056, P=0.027) and higher TNM stages (H=5.204,P<0.001). The median follow-up was 39 (6-105) months; 16 patients (7.2%) were lost to follow-up. The median OS in the NPS-0, NPS-1, and NPS-2 groups were 78.4, 63.1, and 37.0 months, respectively; these differences are statistically significant (P=0.021). Univariate and multivariate Cox regression analysis identified the following as independently and significantly associated with OS in patients with Siewert Type II-III: TNM stage (Stage II: HR=2.182, 95%CI: 1.227-3.878, P=0.008; Stage III: HR=3.534, 95%CI: 1.380-6.654, P<0.001), tumor differentiation (G3: HR=1.995, 95%CI: 1.141-3.488, P=0.015), vascular invasion (HR=2.172, 95%CI: 1.403-3.363, P<0.001), adjuvant chemotherapy (HR=0.326, 95%CI: 0.200-0.531, P<0.001), NPS (NPS-1: HR=2.331, 95%CI: 1.371-3.964, P=0.002; NPS-2: HR=2.494, 95%CI: 1.165-5.341, P=0.019), SIS group (NPS-1: HR=2.170, 95%CI: 1.244-3.784, P=0.006; NPS-2: HR=2.291, 95%CI: 1.052-4.986, P=0.037), and CONUT (HR=1.597, 95% CI: 1.187-2.149, P=0.038). The median DFS in the NPS-0, NPS-1, and NPS-2 groups was 68.6, 52.5, and 28.3 months, respectively; these differences are statistically significant (P=0.009). Univariate and multivariate Cox regression analysis identified the following as independently and significantly associated with DFS in patients with Siewert Type II-III AEG: TNM stage (StageⅡ: HR=2.789, 95%CI:1.210-6.428, P=0.016; Stage III: HR=10.721, 95%CI:4.709-24.411, P<0.001), adjuvant chemotherapy (HR=0.640, 95% CI: 0.432-0.946, P=0.025), and NPS (NPS-1: HR=1.703, 95%CI: 1.043-2.782, P=0.033; NPS-2: HR=3.124, 95%CI:1.722-5.666, P<0.001). Time-dependent receiver operating characteristic curves showed that NPS was more accurate in predicting OS and DFS in patients with Siewert Type II-III AEG than were systemic inflammatory response scores, CONUT, or PNI scores. Conclusion: NPS is associated with age and TNM stage, is an independent prognostic factor in patients who have undergone resection of Siewert type II-III AEG, and is better than SIS, CONUT, or PNI in predicting survival.

Effects of Artemisia ordosica Crude Polysaccharide on Antioxidant and Immunity Response, Nutrient Digestibility, Rumen Fermentation, and Microbiota in Cashmere Goats

The objective of this experiment was to investigate the effect of dietary supplementation with Artemisia ordosica crude polysaccharide (AOCP) on growth performance, nutrient digestibility, antioxidant and immunity capacity, rumen fermentation parameters, and the microbiota of cashmere goats. A total of 12 cashmere goats (2 years old) with similar weight (38.03 ± 2.42 kg of BW ± SD) were randomly divided into two dietary treatments with six replicates. The treatments were as follows: (1) control (CON, basal diet); and (2) AOCP treatment (AOCP, basal diet with 0.3% AOCP). Pre-feeding was conducted for 7 days, followed by an experimental period of 21 days. The results showed that the ADG; feed/gain (F/G); and the digestibility of DM, CP, and ADF of cashmere goats in the AOCP group were greater than in the CON group (p < 0.05). Still, there was no significant effect on the digestibility of EE, NDF, Ca, and P (p > 0.05). Compared to the CON group, AOCP increased BCP, propionate, butyrate, isobutyrate, valerate, isovalerate, and TVFA concentrations (p < 0.05), but it reduced the protozoa numbers of acetate and A/P (p < 0.05). The serum CAT, GSH-Px, T-SOD, 1L-6, and NO levels were higher in AOCP than in the CON group (p < 0.05). The addition of AOCP increased the Sobs and Ace estimators (p < 0.05) and reduced the Simpson estimator in the ruminal fluid compared to the CON group (p < 0.05). Additionally, the AOCP group increased the colonization of beneficial bacteria by positively influencing GSH-Px and IL-6 (norank_f__F082, unclassified_p__Firmicutes), as well as bacteria negatively associated with F/G (norank_f__norank_o__Bacteroidales, unclassified_p__Firmicutes, and norank_f__F082). It decreased the colonization of potential pathogenic bacteria (Aeromonas and Escherichia-Shigella) (p < 0.05) compared to the CON group. In conclusion, 0.3% AOCP improves the growth performance, nutrient digestibility, antioxidant status, immune function, rumen fermentation, and microflora of cashmere goats.

Orientational Electrodeposition of Highly (002)-Textured Zinc Metal Anodes Enabled by Iodide Ions for Stable Aqueous Zinc Batteries

Regulating the crystallographic texture of the zinc (Zn) metal anode is promising to promote Zn reversibility in aqueous electrolytes, but the direct fabrication of specific textured Zn still remains challenging. Herein, we report a facile iodide ion (I-)-assisted electrodeposition strategy that can scalably fabricate highly (002) crystal plane-textured Zn metal anode (H-(002)-Zn). Theoretical and experimental characterizations demonstrate that the presence of I- additives can significantly elevate the growth rate of the Zn (100) plane, homogenize the Zn nucleation, and promote the plating kinetics, thus enabling the uniform H-(002)-Zn electrodeposition. Taking the electrolytic cell with the conventional ZnSO4-based electrolyte and commercial Cu substrate as a model system, the Zn texture gradually transforms from (101) to (002) as the increase of NaI additive concentration. In the optimized 1 M ZnSO4 + 0.8 M NaI electrolyte, the as-prepared H-(002)-Zn features a compact structure and an ultrahigh intensity ratio of (002) to (101) signal without containing the (100) signal. The free-standing H-(002)-Zn electrode manifests stronger resistance to interfacial side reactions than the conventional (101)-textured Zn electrode, thus delivering a high efficiency of 99.88% over 400 cycles and ultralong cycling lifespan over 6700 h (>9 months at 1 mA cm-2) and assuring the stable operation of full Zn batteries. This work will enlighten the efficient electrosynthesis of high-performance Zn anodes for practical aqueous Zn batteries.

Prognostic value of multiphase CT angiography: estimated infarct core volume in the patients with acute ischaemic stroke after mechanical thrombectomy

BACKGROUND AND PURPOSE

Recent studies reported the feasibility of quantifying a reliable infarct core (IC) volume using multiphase computed tomography (mCTA) based on deep learning, however its prognostic value was not fully clarified. Therefore, we aimed to evaluate the prognostic value of mCTA-estimated IC volume in patients with acute ischemic stroke (AIS) after mechanical thrombectomy (MT).

MATERIALS AND METHODS

We retrospectively reviewed patients who underwent mCTA and MT for large vessel occlusion in middle cerebral artery and (or) internal carotid artery within 6 hours after symptom onset between January 2018 and November 2019. Patients were dichotomized into good (modified Rankin Scale [mRS] score, 0-2) and poor (mRS, 3-6) outcome groups. mCTA-estimated IC volume were generated based on a multi-scale three-dimensional convolutional neural network. Univariate, multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were used to identify the independent variables, and evaluate their performances in predicting the clinical outcome.

RESULTS

Of 44 included patients, 27 (61.4%) patients achieved good outcome. National Institutes of Health Stroke Scale scores at admission [NIHSSpre] (odds ratio [OR], 1.191; 95%confidence interval [CI], 1.028-1.379; P=0.020) and mCTA-estimated IC volume (OR, 1.076; 95%CI, 1.016-1.140; P=0.013) were found to be independently associated with functional outcome in patients with AIS after MT. After integrating NIHSSpre and mCTA-estimated IC volume, optimal performance (area under the ROC curve, 0.874; 95%CI, 0.739-0.954) could be obtained in predicting the clinical outcome.

CONCLUSIONS

mCTA-estimated IC volume might be promising for predicting the prognosis, and assisting in making individualized treatment decision in patients with AIS.

Chlorpromazine affects autophagy in association with altered Rag GTPase-mTORC1-TFEB signaling

Autophagy is a critical protein and organelle quality control system, which regulates cellular homeostasis and survival. Growing pieces of evidence suggest that autophagic dysfunction is strongly associated with many human diseases, including neurological diseases and cancer. Among various autophagic regulators, microphthalmia (MiT)/TFE transcription factors, including transcription factor EB (TFEB), have been shown to act as the master regulators of autophagosome and lysosome biogenesis in both physiological and pathological conditions. According to the previous studies, chlorpromazine (CPZ), an FDA-approved antipsychotic drug, affects autophagy in diverse cell lines, but the underlying mechanism remains elusive. In our present study, we find that CPZ treatment induces TFEB nuclear translocation through Rag GTPases, the upstream regulators of mechanistic target of rapamycin complex 1 (mTORC1) signaling. Meanwhile, CPZ treatment also blocks autophagosome-lysosome fusion. Notably, we find a significant accumulation of immature autophagosome vesicles in CPZ-treated cells, which may impede cellular homeostasis due to the dysfunction of the autophagy-lysosome pathway. Interestingly and importantly, our data suggest that the expression of the active form of Rag GTPase heterodimers helps in reducing the accumulation of autophagosomes in CPZ-treated cells, further suggesting a major contribution of the Rag GTPase-mTORC1-TFEB signaling axis in CPZ-induced autophagic impairment.

UBQLN2 and HSP70 participate in Parkin-mediated mitophagy by facilitating outer mitochondrial membrane rupture

Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) are two aging-related neurodegenerative diseases that share common key features, including aggregation of pathogenic proteins, dysfunction of mitochondria, and impairment of autophagy. Mutations in ubiquilin 2 (UBQLN2), a shuttle protein in the ubiquitin-proteasome system (UPS), can cause ALS/FTD, but the mechanism underlying UBQLN2-mediated pathogenesis is still uncertain. Recent studies indicate that mitophagy, a selective form of autophagy which is crucial for mitochondrial quality control, is tightly associated with neurodegenerative diseases including Alzheimer's disease, Parkinson's disease, and ALS. In this study, we show that after Parkin-dependent ubiquitination of damaged mitochondria, UBQLN2 is recruited to poly-ubiquitinated mitochondria through the UBA domain. UBQLN2 cooperates with the chaperone HSP70 to promote UPS-driven degradation of outer mitochondrial membrane (OMM) proteins. The resulting rupture of the OMM triggers the autophagosomal recognition of the inner mitochondrial membrane receptor PHB2. UBQLN2 is required for Parkin-mediated mitophagy and neuronal survival upon mitochondrial damage, and the ALS/FTD pathogenic mutations in UBQLN2 impair mitophagy in primary cultured neurons. Taken together, our findings link dysfunctional mitophagy to UBQLN2-mediated neurodegeneration.

Inverted perovskite solar cells using dimethylacridine-based dopants

Doping of perovskite semiconductors1 and passivation of their grain boundaries2 remain challenging but essential for advancing high-efficiency perovskite solar cells. Particularly, it is crucial to build perovskite/indium tin oxide (ITO) Schottky contact based inverted devices without predepositing a layer of hole-transport material3-5. Here we report a dimethylacridine-based molecular doping process used to construct a well-matched p-perovskite/ITO contact, along with all-round passivation of grain boundaries, achieving a certified power conversion efficiency (PCE) of 25.39%. The molecules are shown to be extruded from the precursor solution to the grain boundaries and the bottom of the film surface in the chlorobenzene-quenched crystallization process, which we call a molecule-extrusion process. The core coordination complex between the deprotonated phosphonic acid group of the molecule and lead polyiodide of perovskite is responsible for both mechanical absorption and electronic charge transfer, and leads to p-type doping of the perovskite film. We created an efficient device with a PCE of 25.86% (reverse scan) and that maintained 96.6% of initial PCE after 1,000 h of light soaking.

Mouth breathing induces condylar remodelling and chondrocyte apoptosis via both the extrinsic and mitochondrial pathways in male adolescent rats

The prevalence of mouth breathing is high in children and adolescents. It causes various changes to the respiratory tract and, consequently, craniofacial growth deformities. However, the underlying mechanisms contributing to these effects are obscure. Herein, we aimed to study the effects of mouth breathing on chondrocyte proliferation and death in the condylar cartilage and morphological changes in the mandible and condyle. Additionally, we aimed to elucidate the mechanisms underlying chondrocyte apoptosis and investigate any variations in the related pathways. Subchondral bone resorption and decreased condylar cartilage thickness were observed in mouth-breathing rats; further, mRNA expression levels of Collagen II, Aggrecan, and Sox 9 were lower in the mouth breathing group, while those of matrix metalloproteinase 9 increased. TdT-mediated dUTP nick end labelling staining and immunohistochemistry analyses showed that apoptosis occurred in the proliferative and hypertrophic layers of cartilage in the mouth breathing group. TNF, BAX, cytochrome c, and cleaved-caspase-3 were highly expressed in the condylar cartilage of the mouth-breathing rats. These results suggest that mouth breathing leads to subchondral bone resorption, cartilage layer thinning, and cartilage matrix destruction, inducing chondrocyte apoptosis via both the extrinsic and mitochondrial apoptosis pathways.

In-Situ Integration of a Hydrophobic and Fast-Zn2+-Conductive Inorganic Interphase to Stabilize Zn Metal Anodes

The irreversible issues of Zn anode stemming from dendrite growth and water-induced erosion have severely hindered the commercialization of rechargeable aqueous Zn batteries. Herein, a hydrophobic and fast-Zn2+-conductive zinc hexacyanoferrate (HB-ZnHCF) interphase layer is in-situ integrated on Zn by a rapid room-temperature wet-chemistry method to address these dilemmas. Different from currently proposed hydrophilic inorganic cases, the hydrophobic and compact HB-ZnHCF interphase effectively prevents the access of water molecules to Zn surface, thus avoiding H2 evolution and Zn corrosion. Moreover, the HB-ZnHCF with large internal ion channels, strong zincophilicity, and high Zn2+ transference number (0.86) permits fast Zn2+ transport and enables smooth Zn deposition. Remarkably, the resultant HB-ZnHCF@Zn electrode delivers unprecedented reversibility with 99.88% Coulombic efficiency over 3000 cycles, realizes long-term cycling over 5800 h (> 8 months, 1 mA cm-2) and 1000 h (10 mA cm-2), and assures the stable operation of full Zn battery with both coin- and pouch-type configurations.

Study on Corrosion Behavior and Mechanism of Ultrahigh-Strength Hot-Stamping Steel Based on Traditional and Compact Strip-Production Processes

Hot-stamping steel is a type of high-strength steel that is mainly used in key safety components such as the front and rear bumpers, A-pillars, and B-pillars of vehicles. There are two methods of producing hot-stamping steel, i.e., the traditional process and the near net shape of compact strip production (CSP) process. To assess the potential risks of producing hot-stamping steel using CSP, the microstructure and mechanical properties, and especially the corrosion behavior were focused on between the traditional and CSP processes. The original microstructure of hot-stamping steel produced by the traditional process and the CSP process is different. After quenching, the microstructures transform into full martensite, and their mechanical properties meet the 1500 MPa grade. Corrosion tests showed that the faster the quenching speeds, the smaller the corrosion rate of the steel. The corrosion current density changes from 15 to 8.6 μA·cm^-2. The corrosion resistance of hot-stamping steel produced by the CSP process is slightly better than that of traditional processes, mainly since the inclusion size and distribution density of CSP-produced steel were both smaller than those of the traditional process. The reduction of inclusions reduces the number of corrosion sites and improves the corrosion resistance of steel.

Bacterial antibiotic resistance among cancer inpatients in China: 2016-20

BACKGROUND

The incidence of infections among cancer patients is as high as 23.2-33.2% in China. However, the lack of information and data on the number of antibiotics used by cancer patients is an obstacle to implementing antibiotic management plans.

AIM

This study aimed to investigate bacterial infections and antibiotic resistance in Chinese cancer patients to provide a reference for the rational use of antibiotics.

DESIGN

This was a 5-year retrospective study on the antibiotic resistance of cancer patients.

METHODS

In this 5-year surveillance study, we collected bacterial and antibiotic resistance data from 20 provincial cancer diagnosis and treatment centers and three specialized cancer hospitals in China. We analyzed the resistance of common bacteria to antibiotics, compared to common clinical drug-resistant bacteria, evaluated the evolution of critical drug-resistant bacteria and conducted data analysis.

FINDINGS

Between 2016 and 2020, 216 219 bacterial strains were clinically isolated. The resistance trend of Escherichia coli and Klebsiella pneumoniae to amikacin, ciprofloxacin, cefotaxime, piperacillin/tazobactam and imipenem was relatively stable and did not significantly increase over time. The resistance of Pseudomonas aeruginosa strains to all antibiotics tested, including imipenem and meropenem, decreased over time. In contrast, the resistance of Acinetobacter baumannii strains to carbapenems increased from 4.7% to 14.7%. Methicillin-resistant Staphylococcus aureus (MRSA) significantly decreased from 65.2% in 2016 to 48.9% in 2020.

CONCLUSIONS

The bacterial prevalence and antibiotic resistance rates of E. coli, K. pneumoniae, P. aeruginosa, A. baumannii, S. aureus and MRSA were significantly lower than the national average.

Tailored engineering of Fe3O4 and reduced graphene oxide coupled architecture to realize the full potential as electrode materials for lithium-ion batteries

Developing advanced electrode materials with appropriate compositions and exquisite configurations is crucial in fabricating lithium-ion batteries (LIBs) with high energy density and fast charging capability plateau. Herein, a Fe₃O₄@reduced graphene oxide (Fe₃O₄@rGO) coupled architecture was rationally designed and in-situ synthesized. Monodispersed mesoporous Fe₃O₄ nanospheres were homogeneously formed and strongly bound on interconnected macroporous rGO frameworks to form well-defined three-dimensional (3D) hierarchical porous morphologies. This tailored Fe₃O₄@rGO coupled architecture fully exploited the advantages of Fe₃O₄ and rGO to overcome their inherent challenges, including spontaneous aggregating/excessive restacking tendency, sluggish ions diffusion/electrons transportation, and severe volume expansion/structural collapse. Benefitting from their synergistic effects, the optimized Fe₃O₄@rGO composite electrode exhibited an improved electrochemical reactivity, electrical conductivity, electrolyte accessibility, and structural stability. The optimized composite electrode displayed a high specific capacity of 1296.8 mA h g^-1 at 0.1 A g^-1 after 100 cycles, even retaining 555.1 mA h g^-1 at 2 A g^-1 after 2000 cycles. The electrochemical kinetics analysis revealed the predominantly pseudocapacitive behaviors of the Fe₃O₄@rGO heterogeneous interfaces, accounting for the excellent electrode performance. This study proposes a viable strategy for use in engineering hybrid composites with coupled architectures to optimize their potential as high-performance electrode materials for use in LIBs.

Cost-effectiveness of palbociclib plus fulvestrant as second-line therapy of women with HR+/HER2- advanced breast cancer - A Chinese healthcare system perspective

Aim

To evaluate the cost-effectiveness of palbociclib plus fulvestrant in the second-line treatment of women with hormone receptor-positive and human epidermal growth factor receptor 2-negative advanced breast cancer based on the latest published follow-up data from the perspective of the Chinese healthcare system.

Methods

In view of the PALOMA-3 trial, a Markov model was built for this purpose, which included three health states: progression-free survival (PFS), progressed disease (PD), and death. The cost and health utilities were mainly derived from the published literature. One-way sensitivity analysis and probabilistic sensitivity analysis were carried out to verify the robustness of the model.

Results

In the base case analysis, compared with the placebo plus fulvestrant arm, the palbociclib plus fulvestrant arm yielded an additional 0.65 quality-adjusted life years (QALYs) (2.56 QALYs vs. 1.90 QALYs) with an incremental cost of $36,139.94 ($55,482.06 vs. $19,342.12), resulting an incremental cost-effectiveness ratio (ICER) of $55,224.90/QALY, which was deeply higher than a willingness-to-pay (WTP) threshold of $34,138.28 per QALY in China. The results of one-way sensitivity analysis indicated that the utility of PFS, cost of palbociclib, and cost of neutropenia had a great influence on the ICER.

Conclusions

Palbociclib plus fulvestrant is unlikely to be cost-effective in comparison with placebo plus fulvestrant as second-line therapy of women with HR+/HER2- advanced breast cancer.

Realizing Textured Zinc Metal Anodes through Regulating Electrodeposition Current for Aqueous Zinc Batteries

Crystallography modulation of zinc (Zn) metal anode is promising to promote Zn reversibility in aqueous electrolytes, but efficiently constructing Zn with specific crystallographic texture remains challenging. Herein, we report a current-controlled electrodeposition strategy to texture the Zn electrodeposits in conventional aqueous electrolytes. Using the electrolytic cell with low-cost Zn(CH₃ COO)₂ electrolyte and Cu substrate as a model system, the texture of as-deposited Zn gradually transforms from (101) to (002) crystal plane as increasing the current density from 20 to 80 mA cm^-2 . Moreover, the high current accelerates the Zn nucleation rate with abundant nuclei, enabling uniform deposition. The (002) texture permits stronger resistance to dendrite growth and interfacial side reactions than the (101) texture. The resultant (002)-textured Zn electrode achieves deep cycling stability and supports the stable operation of full batteries with conventional V/Mn-based oxide cathodes.

Current census of oncology critical care medicine in China

OBJECTIVE

The purposes of this survey were to show the current situation of oncology critical care medicine in China by questionnaire, to understand the resource distribution of oncology critical care medicine and to analyze and evaluate the existing resources and reserve capacity of oncology critical care medicine in China.

METHODS

We conducted the survey mainly in the form of an online questionnaire. The Committee of Cancer Critical Care Medicine of the Chinese Anticancer Association (CACA) initiated the survey on 1 November 2017, and 36 member hospitals nationwide participated in the survey. The questionnaire included 10 items: investigator information, hospital information, general information of oncology critical care department, staffing of oncology critical care department, management in oncology critical care department, technical skills in oncology critical care department, patient source in oncology critical care department, equipment configuration in oncology critical care department, special skills in oncology critical care department and summary of the information.

RESULTS

The survey results included information from 28 member units, all of which were tertiary hospitals, distributed in 20 provinces and 4 direct-controlled municipalities. The results are as follows. (i) The total ratio of beds in the oncology critical care department to hospital beds was 1.06%, and the average number of beds in the oncology critical care department was 16.36. (ii) The ratio of physicians in the oncology critical care department to beds was ∼0.62:1, and the ratio of nurses to beds was ∼1.98:1. (iii) According to the census of the population and gross domestic product (GDP) of different regions conducted by the State Statistics Bureau in 2017, the ratio of beds in the oncology critical care department for tumor patients to the population was 4.55 beds per 10 million people, and the ratio of beds in the oncology critical care department to GDP was 8.00 beds per RMB 100 billion, on average. (iv) According to the requirements of the guidelines for the development and management of critical care medicine in China, the facilities in departments of oncology critical care medicine meet the requirements, and the technical skills of medical staff are competent.

CONCLUSION

The development of oncology critical care in China is becoming better, but there is still a certain gap compared with the intensive care unit standards in China and the average level of the nationwide. The development of oncology critical care medicine is urgent.

The interaction between E3 ubiquitin ligase Parkin and mitophagy receptor PHB2 links inner mitochondrial membrane ubiquitination to efficient mitophagy

The autophagic clearance of mitochondria has been defined as mitophagy, which is triggered by mitochondrial damage and serves as a major pathway for mitochondrial homeostasis and cellular quality control. PINK1 and Parkin-mediated mitophagy is the most extensively studied form of mitophagy, which has been linked to the pathogenesis of neurodegenerative disorders, including Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis. The current paradigm of this particular mitophagy pathway is that the ubiquitination of the outer mitochondrial membrane is the key step to enable the recognition of damaged mitochondria by the core autophagic component autophagosome. However, whether the inner mitochondrial membrane (IMM) is ubiquitinated by Parkin and its contribution to sufficient mitophagy remain unclear. Here, using molecular, cellular, and biochemical approaches, we report that prohibitin 2 (PHB2), an essential IMM receptor for mitophagy, is ubiquitinated by Parkin and thereby gains higher affinity to the autophagosome during mitophagy. Our findings suggest that Parkin directly binds to PHB2 through its RING1 domain and promotes K11- and K33-linked ubiquitination on K142/K200 sites of PHB2, thereby enhancing the interaction between PHB2 and MAP1LC3B/LC3B. Interestingly and importantly, our study allows us to propose a novel model in which IMM protein PHB2 serves as both a receptor and a ubiquitin-mediated base for autophagosome recruitment to ensure efficient mitophagy.

Effect of the Severe Plastic Deformation on the Corrosion Resistance of a Tantalum-Tungsten Alloy

Tantalum and its alloys are regarded as equipment construction materials for processing aggressive acidic media due to their excellent properties. In this study, the influence of severe rolling (90%) on the dissolution rate of a cold-rolled Ta-4%W sheet in different directions was investigated during immersion testing and the corresponding mechanism was discussed. The results show that the dissolution rate of the cold-rolled sample is significantly lower than that of the undeformed sample. The corrosion resistance followed the sequence of “initial” < “90%-ND” < “90%-RD” < “90%-TD”, while the strength is in positive correlation with the corrosion resistance. Severe rolling promotes grain subdivision accompanied by long geometrically necessary boundaries and short incidental dislocation boundaries on two scales in the cold-rolled sample. The volume elements enclosed by geometrically necessary boundaries form preferential crystallographic orientations. Such preferential crystallographic orientations can greatly weaken the electrochemical process caused by adjacent volume elements, resulting in greatly reduced corrosion rates in the severely deformed sample. The unexpected finding provides a new idea for tailoring the structures of tantalum alloys to improve both their strength and corrosion resistance.

Study on pickling technology to control fouling of ceramic membrane treating secondary treated effluent

The application of membrane technology in the field of water treatment was increasingly widespread, but membrane fouling still restricted its development, and the membrane needed to be chemically cleaned. This research focused on the high-efficiency pickling technology of ceramic membrane, and developed the cleaning technology of ceramic membrane in cooperation with surfactant. In the experiment, the municipal secondary effluent was used as the raw water, and the single-step, mixed and step-by-step cleaning effects of three strong acids, three weak acids and surfactants on ceramic membranes and polyvinylidene difluoride (PVDF) membranes were investigated. For ceramic membrane, the optimal cleaning combination was H₂SO₄ first and then DTAC, and the flux recovery rate could reach 96.94%; for PVDF membrane, the optimal cleaning combination was HNO₃ first and then H₂SO₄, and the flux recovery rate could reach 93.72%. In addition, the surface of initial, polluted, and cleaned membranes were analyzed by scanning electron microscope and contact angle, and the fouling mechanism of the ceramic membrane was analyzed. The results showed that through physical cleaning and chemical cleaning, most of the pollutants on the membrane surface and pores were removed. The cleaning method can effectively control the membrane pollution.

Unique CoWO4@WO3 heterostructured nanosheets with superior electrochemical performances for all-solid-state supercapacitors

Transition metal oxide-based battery-type electrode materials with well-defined nanostructure have shown great potential in supercapacitors, due to their high electrical conductivity and superior redox activity. Herein, promising CoWO₄@WO₃-1 heterostructured nanosheets with rich oxygen vacancies are designed via a two-step in situ construction process and following thermal treatment. The CoWO₄@WO₃-1 heterostructured nanosheet arrays grown on a flexible carbon cloth substrate can provide an effective nanoporous framework, facilitate electrons/ions transport, and generate effective synergistic effect of high conductivity from WO₃ and superior redox activity from CoWO₄. As a result, the as-prepared CoWO₄@WO₃-1 electrodes exhibit a high area specific capacity of 578.6 mF cm^-2 at a current density of 0.5 mA cm^-2 and keep 98.38% capacity retention at 20 mA cm^-2 over 30 000 cycles. Additionally, all-solid-state supercapacitors assembled with CoWO₄@WO₃-1 as cathodes and O_v-NiMoO₄ as anodes show a maximum area energy density of 13.93 mW h cm^-2 and power density of 6502.11 mW cm^-2, keeping outstanding cycling stability of 98.1% capacity retention over 20 000 cycles.

MRI-based radiomics analysis in differentiating solid non-small-cell from small-cell lung carcinoma: a pilot study

AIM

To investigate the ability of a T2-weighted (W) magnetic resonance imaging (MRI)-based radiomics signature to differentiate solid non-small-cell lung carcinoma (NSCLC) from small-cell lung carcinoma (SCLC).

MATERIALS AND METHODS

The present retrospective study enrolled 152 eligible patients (NSCLC = 125, SCLC = 27). All patients underwent MRI using a 3 T scanner and radiomics features were extracted from T2W MRI. The least absolute shrinkage and selection operator (LASSO) logistic regression model was used to identify the optimal radiomics features for the construction of a radiomics model to differentiate solid NSCLC from SCLC. Threefold cross validation repeated 10 times was used for model training and evaluation. The conventional MRI morphology features of the lesions were also evaluated. The performance of the conventional MRI morphological features, and the radiomics signature model and nomogram model (combining radiomics signature with conventional MRI morphological features) was evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS

Five optimal features were chosen to build a radiomics signature. There was no significant difference in age, gender, and the largest diameter. The radiomics signature and conventional MRI morphological features (only pleural indentation and lymph node enlargement) were independent predictive factors for differentiating solid NSCLC from SCLC. The area under the ROC curves (AUCs) for MRI morphological features, and the radiomics model, and nomogram model was 0.69, 0.85, and 0.90 (ROC), respectively.

CONCLUSIONS

The T2W MRI-based radiomics signature is a potential non-invasive approach for distinguishing solid NSCLC from SCLC.

Detection of Appearance and Behavior Anomalies in Stationary Camera Videos Using Convolutional Neural Networks

The automatic detection and tracking of appearance and behavior anomalies in video surveillance systems is one of the promising areas for the development and implementation of artificial intelligence. In this paper, we present a formalization of these problems. Based on the proposed generalization, a detection and tracking algorithm that uses the tracking-by-detection paradigm and convolutional neural networks (CNNs) is developed. At the first stage, people are detected using the YOLOv5 CNN and are marked with bounding boxes. Then, their faces in the selected regions are detected and the presence or absence of face masks is determined. Our approach to face-mask detection also uses YOLOv5 as a detector and classifier. For this problem, we generate a training dataset by combining the Kaggle dataset and a modified Wider Face dataset, in which face masks were superimposed on half of the images. To ensure a high accuracy of tracking and trajectory construction, the CNN features of the images are included in a composite descriptor, which also contains geometric and color features, to describe each person detected in the current frame and compare this person with all people detected in the next frame. The results of the experiments are presented, including some examples of frames from processed video sequences with visualized trajectories for loitering and falls.

Detection of Brucella spp. during a serosurvey of pig-hunting and regional pet dogs in eastern Australia

Brucellosis is a zoonotic disease with worldwide distribution. Brucella suis serotype 1 is thought to be maintained in the Australian feral pig population, with disease prevalence higher in Queensland (Qld) than New South Wales (NSW). Pig hunting is a popular recreational activity in rural Qld and NSW, with feral pigs in these states thought to carry B. suis. Brucellosis associated with B. suis has been diagnosed in dogs engaged in pig hunting in some of these areas. A total of 431 dogs from northern Qld and north‐west NSW were recruited. Two distinct cohorts of clinically healthy dogs were tested – (1) 96 dogs from central, north and far north Queensland actively engaged in pig‐hunting and (2) 335 dogs from rural and remote north‐west NSW that were primarily companion (non‐pig hunting) animals. Serum samples were tested for antibodies to Brucella spp. using the Rose Bengal test (RBT) test followed by complement fixation testing (CFT) for RBT‐positive samples. A subset of samples was retested using RBT and CFT. Seven dogs were considered seropositive for B. suis from Qld and remote NSW, including 4/96 (4.2%; 95% CI 3.5% to 4.3%) from the pig‐hunting cohort and 3/335 (0.9%) from the regional pet dog cohort. The use of RBT and CFT in dogs to detect anti‐Brucella antibodies requires validation. Veterinarians treating pig‐hunting dogs and physicians treating pig hunters in central, north and far north Qld need to be aware of the zoonotic risk posed by B. suis to these groups.

Non-flammable, dilute, and hydrous organic electrolytes for reversible Zn batteries

Rechargeable Zn batteries hold great practicability for cost-effective sustainable energy storage but suffer from irreversibility of the Zn anode in aqueous electrolytes due to parasitic H₂ evolution, corrosion, and dendrite growth. Herein, we report a non-flammable, dilute, and hydrous organic electrolyte by dissolving low-cost hydrated Zn(ClO₄)₂·6H₂O in trimethyl phosphate (TMP), which homogenizes plating/stripping and enables in situ formation of a Zn₃(PO₄)₂–ZnCl₂-rich interphase to stabilize the Zn anode. A dilute 0.5 m Zn(ClO₄)₂·6H₂O/TMP electrolyte featuring a H₂O-poor Zn²⁺-solvation sheath and low water activity enables significantly enhanced Zn reversibility and a wider electrochemical window than the concentrated counterpart. In this formulated electrolyte, the Zn anode exhibits a high efficiency of 99.5% over 500 cycles, long-term cycling for 1200 h (5 mA h cm⁻² at 5 mA cm⁻²) and stable operation at 50 °C. The results would guide the design of hydrous organic electrolytes for practical rechargeable batteries employing metallic electrode materials.

A non-flammable, dilute, and hydrous organic electrolyte can homogenize Zn plating/stripping, suppress water decomposition, and form organic–inorganic hybrid interphase on Zn, thus contributing to highly reversible Zn metal batteries.

Optical coherence tomography-defined vulnerable plaque characteristics in relation to functional severity of coronary stenoses stratified by quantitative flow ratio

Background

The functional severity and morphological features of epicardial lesions are both related to plaque vulnerability and adverse coronary events. However, their relationship remains controversial, especially in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS).

Purpose

This study aimed to examine whether quantitative flow ratio (QFR), an angiography-based computation of fractional flow reserve, was associated with optical coherence tomography (OCT)-defined vulnerable plaques such as thin-cap fibroatheromas (TCFAs) in a board spectrum of population, including patients presenting stable angina and NSTE-ACS.

Methods

We identified patients who underwent OCT examinations from 2 prospective cohorts and then assessed interrogated vessels with QFR. Lesions were divided into tertiles: QFR-T1 (QFR &lt;0.85)&lt;qfr),&gt;, QFR-T2 (0.85 to 0.93) and QFR-T3 (QFR &gt;0.93).

Results

This post-hoc analysis included 83 lesions from 79 patients (mean age: 61.5±9.8 years, males: 58%). Patients with NSTE-ACS accounted for the majority of the population (67%). The median % diameter stenosis and median QFR value were 42% (36 to 49%) and 0.88 (0.83 to 0.95), respectively. The prevalence of OCT-TCFA was significantly higher in QFR-T1 (50%) than in QFR-T2 (14%) and QFR-T3 (19%) (p=0.003 and 0.018, respectively). Overall significant differences were observed among tertiles in maximum lipid arc, thinnest fibrous cap thickness (FCT), and minimal lumen area (MLA) (p=0.017, 0.040, and &lt;0.001, respectively). The Spearman's correlation analysis showed that QFR was significantly related to MLA (ρ = 0.537, p&lt;0.001), % area stenosis (ρ = –0.512, p&lt;0.001), maximum lipid arc (ρ = –0.360, p=0.002), lipid length (ρ = –0.242, p=0.038), lipid index (ρ = –0.333, p=0.004), and thinnest FCT (ρ = 0.315, p=0.006). In the multivariable analysis, QFR ≤0.80 remained as a significant determinant of TCFAs regardless of the presence of NSTE-ACS and the level of low-density lipoprotein cholesterol (adjusted odds ratio = 4.387, 95% confidence interval: 1.297 to 14.839, p=0.017). In addition, QFR demonstrated moderate predictive ability for OCT-TCFA (area under the curve = 0.72, 95% confidence interval: 0.58 to 0.86, p=0.003) with the best cutoff of ≤0.86 (sensitivity: 65%; specificity: 73%; negative predictive value: 85%; accuracy: 71%).

Conclusions

Lower QFR was related to OCT-TCFA and other vulnerable plaque characteristics in angiographically mild-to-intermediate stable lesions and culprit lesions from NSTE-ACS. The QFR might be a useful tool for ruling out high-risk, rupture-prone plaques without using any pressure wires or vasodilators.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): The Jiangsu Provincial Key Research and Development Program Flow diagram of patient selectionOCT findings according to QFR tertiles

Size-Dependent Cobalt Catalyst for Lithium Sulfur Batteries: From Single Atoms to Nanoclusters and Nanoparticles

The sulfur redox conversion with catalytically improved kinetics is promising to mitigate the polysulfides shuttling. While the size of electrocatalyst always brings different catalytic behaviors for various heterogeneous catalytic reactions, it is yet to be explored for Li-S batteries. Herein, a systematical study of size-dependent catalytic activity toward polysulfides conversion and the relevance to electrochemical performance are reported, by constructing Co catalysts with different atomic scales from single atoms, atomic clusters to nanoparticles. Fundamental electrocatalytic studies are focused by probing the reduction kinetics and activation energies of sulfur chemistry. The single atomic Co shows the best charge transfer/kinetic toward sulfur redox, especially for the rate-determining reaction (Li₂ S₄  ↔ Li₂ S) as demonstrated by the significantly lowered energy barrier for Li₂ S nucleation/dissolution. This is owing to stronger geometric deformation of the catalyst with lower aggregation extent when it interacts with sulfur species, thus leading to decreased Gibbs free energy changes as elucidated by DFT calculations. The superior catalytic activity of single atomic Co promises a high specific capacity (4.98 mAh cm^-2 ) at an areal loading of 4.3 mg cm^-2 over long-term cycling. The finding emphasizes the significance of the size-dependent catalytic activity to the reaction kinetics and the overall performance of Li-S batteries.

Organic-Inorganic Hybrid SEI Induced by a New Lithium Salt for High-Performance Metallic Lithium Anodes

The practical application of the metallic lithium anode is suppressed by the highly unstable interface between electrolytes and lithium metal during the process of lithium plating/stripping. A perfect solid electrolyte interphase (SEI) can inhibit detrimental parasitic reactions, thereby improving the cycling performance of the metallic lithium anode. In this work, a high-purity solid lithium difluorobis(oxalato) phosphate (LiDFOP) is synthesized and an outstanding organic-inorganic hybrid SEI is obtained in an ether-based electrolyte for the first time induced by LiDFOP. The preferential reduction of LiDFOP can form an SEI rich in LiF and Li_xPO_yF_z species, thereby improving the conductivity and stability of the SEI. In addition, cationic-induced ring-opening polymerization between LiDFOP and 1,3-dioxolane endows the SEI with excellent adaptability to the reiterative volume change of the metallic lithium anode. Therefore, the Li/Cu battery maintains a high coulombic efficiency of 98.37% at a current density of 2 mA/cm² for 200 cycles, and the Li/Li symmetrical battery shows stable voltage hysteresis over 1000 h even under the condition of 5 mA/cm². The Li/S battery fabricated employing the electrolyte with LiDFOP shows significant improvement of cycling performance as well. These results manifest that the formation of an organic-inorganic hybrid SEI from LiDFOP can be employed as a new strategy to overcome the problem from the unstable SEI in metallic lithium batteries.

Simultaneous implant placement with autogenous onlay bone grafts: a systematic review and meta-analysis

Several authors have suggested that implants can be placed simultaneously with onlay bone grafts without affecting outcomes. Therefore, the purpose of this study was to answer the following clinical questions: (1) What are the outcomes of implants placed simultaneously with autogenous onlay bone grafts? And (2) is there a difference in outcomes between simultaneous vs delayed placement of implants with autogenous onlay bone grafts? Databases of PubMed, Embase, and Google Scholar were searched up to 15 November 2020. Data on implant survival was extracted from all the included studies (single arm and comparative) to calculate point estimates with 95% confidence intervals (CI) and pooled using the DerSimonian–Laird meta-analysis model. We also compared implant survival rates between the simultaneous and delayed placement of implants with data from comparative studies. Nineteen studies were included. Five of them compared simultaneous and delayed placement of implants. Dividing the studies based on follow-up duration, the pooled survival of implant placed simultaneously with onlay grafts after <2.5 years of follow-up was 93.1% (95% CI 82.6 to 97.4%) and after 2.5–5 years was 86% (95% CI 78.6 to 91.1%). Implant survival was found to be 85.8% (95% CI 79.6 to 90.3%) with iliac crest grafts and 95.7% (95% CI 83.9 to 93.0%) with intra-oral grafts. Our results indicated no statistically significant difference in implant survival between simultaneous and delayed placement (OR 0.43, 95% 0.07, 2.49, I²=59.04%). Data on implant success and bone loss were limited. Data indicates that implants placed simultaneously with autogenous onlay grafts have a survival rate of 93.1% and 86% after a follow-up of <2.5 years and 2.5–5years respectively. A limited number of studies indicate no significant difference in implant survival between the simultaneous and delayed placement of implants with onlay bone grafts. There is a need for randomized controlled trials comparing simultaneous and delayed implant placement to provide robust evidence.

Non-concentrated aqueous electrolytes with organic solvent additives for stable zinc batteries

Rechargeable aqueous zinc batteries (RAZBs) are promising for large-scale energy storage because of their superiority in addressing cost and safety concerns. However, their practical realization is hampered by issues including dendrite growth, poor reversibility and low coulombic efficiency (CE) of Zn anodes due to parasitic reactions. Here, we report a non-concentrated aqueous electrolyte composed of 2 m zinc trifluoromethanesulfonate (Zn(OTf)2) and the organic dimethyl carbonate (DMC) additive to stabilize the Zn electrochemistry. Unlike the case in conventional aqueous electrolytes featuring typical Zn[H2O]6 2+ solvation, a solvation sheath of Zn2+ with the co-participation of the DMC solvent and OTf- anion is found in the formulated H2O + DMC electrolyte, which contributes to the formation of a robust ZnF2 and ZnCO3-rich interphase on Zn. The resultant Zn anode exhibits a high average CE of Zn plating/stripping (99.8% at an areal capacity of 2.5 mA h cm-2) and dendrite-free cycling over 1000 cycles. Furthermore, the H2O + DMC electrolytes sustain stable operation of RAZBs pairing Zn anodes with diverse cathode materials such as vanadium pentoxide, manganese dioxide, and zinc hexacyanoferrate. Rational electrolyte design with organic solvent additives would promote building better aqueous batteries.

Comparative transcriptomic and metabolomic analyses of carotenoid biosynthesis reveal the basis of white petal color in Brassica napus

The molecular mechanism underlying white petal color in Brassica napus was revealed by transcriptomic and metabolomic analyses. Rapeseed (Brassica napus L.) is one of the most important oilseed crops worldwide, but the mechanisms underlying flower color in this crop are known less. Here, we performed metabolomic and transcriptomic analyses of the yellow-flowered rapeseed cultivar 'Zhongshuang 11' (ZS11) and the white-flowered inbred line 'White Petal' (WP). The total carotenoid contents were 1.778-fold and 1.969-fold higher in ZS11 vs. WP petals at stages S2 and S4, respectively. Our findings suggest that white petal color in WP flowers is primarily due to decreased lutein and zeaxanthin contents. Transcriptome analysis revealed 10,116 differentially expressed genes with a fourfold or greater change in expression (P-value less than 0.001) in WP vs. ZS11 petals, including 1,209 genes that were differentially expressed at four different stages and 20 genes in the carotenoid metabolism pathway. BnNCED4b, encoding a protein involved in carotenoid degradation, was expressed at abnormally high levels in WP petals, suggesting it might play a key role in white petal formation. The results of qRT-PCR were consistent with the transcriptome data. The results of this study provide important insights into the molecular mechanisms of the carotenoid metabolic pathway in rapeseed petals, and the candidate genes identified in this study provide a resource for the creation of new B. napus germplasms with different petal colors.

Effect of COVID-19 on delivery plans and postnatal depression scores of pregnant women

INTRODUCTION

Owing to the coronavirus disease 2019 outbreak Hong Kong hospitals have suspended visiting periods and made mask wearing mandatory. In obstetrics, companionship during childbirth has been suspended and prenatal exercises, antenatal talks, hospital tours, and postnatal classes have been cancelled. The aim of the present study was to investigate the effects of these restrictive measures on delivery plans and risks of postpartum depression.

METHODS

We compared pregnancy data and the Edinburgh Postpartum Depression Scale (EPDS) scores of women who delivered between the pre-alert period (1 Jan 2019 to 4 Jan 2020) and post-alert period (5 Jan 2020 to 30 Apr 2020) in a tertiary university public hospital in Hong Kong. Screening for postpartum depression was performed routinely using the EPDS questionnaire 1 day and within 1 week after delivery.

RESULTS

There was a 13.1% reduction in the number of deliveries between 1 January and 30 April from 1144 in 2019 to 994 in 2020. The EPDS scores were available for 4357 out of 4531 deliveries (96.2%). A significantly higher proportion of women had EPDS scores of ≥10 1 day after delivery in the post-alert group than the pre-alert group (14.4% vs 11.9%; P<0.05). More women used pethidine (6.2% vs 4.6%) and fewer used a birthing ball (8.5% vs 12.4%) for pain relief during labour in the post-alert group.

CONCLUSIONS

Pregnant women reported more depressive symptoms in the postpartum period following the alert announcement regarding coronavirus infection in Hong Kong. This was coupled with a drop in the delivery rate at our public hospital. Suspension of childbirth companionship might have altered the methods of intrapartum pain relief and the overall pregnancy experience.

Apical sparing strain pattern observed in danon disease: insights from a global registry

Background

Danon Disease (DD) is a rare X-linked autophagic disorder due to mutations in the Lysosomal Associated Membrane Protein 2 (LAMP-2) gene and causes severe cardiac manifestations. Measurement of longitudinal strain (LS) has been shown to provide diagnostic insights into different etiologies of hypertrophic cardiomyopathies compared to conventional echocardiographic parameters.

Purpose

The aim of this study was to describe the pattern of global and regional LS in DD.

Methods

A retrospective, international registry, using medical records provided by patients, was formed to describe the natural history of DD. Complete echocardiogram images were available for review and LS was analyzed globally and regionally (basal, mid, apex).

Results

A total of eighteen DD patients (male 72%, mean age 17.2±10 years) had sufficient quality echocardiographic images for both traditional and myocardial strain evaluation. Notable traditional echocardiographic parameters included a mean EF of 60±11%, LV mass index 200±159 g/m2, intraventricular septal diameter 17.7±10.3 mm, LV posterior wall diameter 16.1±7.7 mm, LA volume index 21.9±13 mL/m2. Global longitudinal strain was reduced with a mean of −12.1±4.9% with an observed regional strain gradient: apex (−16.6±6.6%), mid (−10.9±4.7%) and basal (−9.2±4.5%). Bull's eye plot patterns reflected an apical sparing pattern that was similar to that described in cardiac amyloidosis.

Conclusion

In this DD cohort, we describe for the first time a strain pattern characterized by reduction in global longitudinal strain with apical sparing, which was originally pathognomonic for cardiac amyloidosis. This strain pattern in conjunction with a paradoxically normal LA volume may discriminate patients with DD from other hypertrophic conditions.

Funding Acknowledgement

Type of funding source: None

Knockdown of long noncoding RNA SNHG7 inhibits the proliferation and promotes apoptosis of thyroid cancer cells by downregulating BDNF

OBJECTIVE

Recently, long noncoding RNAs (lncRNAs) have got much attention for their role in tumor progression. LncRNA small nucleolar RNA host gene 7 (SNHG7) was studied in this research to identify how it affects the development of thyroid cancer (TC).

PATIENTS AND METHODS

SNHG7 expression was detected by quantitative Real-time polymerase chain reaction (qRT-PCR) in both TC cells and tissue samples. Pearson's Chi-square test was used to determine the association of SNHG7 expression with several clinicopathological factors. Moreover, colony formation assay, cell proliferation and cell apoptosis assay were conducted. In addition, by performing qRT-PCR and Western blot assay, the underlying mechanism was explored.

RESULTS

SNHG7 expression level was higher in TC samples than that in corresponding ones. The SNHG7 expression was associated with tumor size and TNM stage. Moreover, TC cell proliferation was inhibited, and TC cell apoptosis was induced after SNHG7 was knocked down in vitro. Moreover, the mRNA and protein expressions of brain-derived neurotrophic factor (BDNF) were downregulated after knockdown of SNHG7. Furthermore, the expression level of BDNF was positively related to the expression of SNHG7 in TC tissues.

CONCLUSIONS

These results suggested that knockdown of SNHG7 could inhibit TC cell proliferation and induce cell apoptosis via downregulating BDNF, which might be a potential therapeutic target in TC.

Replacing true unenhanced imaging in renal carcinoma with virtual unenhanced images in dual-energy spectral CT: a feasibility study

AIM

To investigate the clinical value of virtual unenhanced (VNC) spectral computed tomography (CT) images to replace the conventional true unenhanced spectral CT images (TNC) in diagnosing renal carcinoma.

MATERIALS AND METHODS

Fifty-six cases of renal carcinoma confirmed by histopathology underwent conventional plain CT and contrast-enhanced spectral CT at arterial phase (AP) and venous phase (VP). VNC images were generated on an AW4.6 workstation. The CT attenuation, image noise, contrast-to-noise ratio (CNR), and signal-noise-ratio (SNR) of the renal lesions and normal kidneys, long and short axis diameters of the lesion were measured from the three image sets and analysed using one-way analysis of variance (ANOVA). Two radiologists evaluated image quality subjectively using a five-point score, and lesion signature using a three-point score. Image quality scores were compared statistically and tested for consistency.

RESULTS

The two reviewers had good agreement for subjective evaluation (Kappa>0.70) and there was no difference in the quality of the scores among the three image groups. The lesion signature scores were all above the acceptable level. The CNR and SNR values in VNC were significantly higher than in TNC (p<0.05). VNC images had lower renal noise than in TNC (p<0.05). There was no difference in the long and short axis diameters of the lesion among the three image groups. VNC had higher CT attenuation values for the lesion and kidney than TNC (p<0.05), but the differences were <5 HU.

CONCLUSION

VNC images in spectral CT may be used to replace the conventional plain CT to reduce imaging duration and radiation dose in diagnosing renal carcinoma.

Current research and prevention of aflatoxins in China

Since their discovery in the 1960s, aflatoxins were found to have a considerable impact on the health of humans and animals as well as the country’s economy and international trade. Aflatoxins are often found in nuts, cereals and animal feeds, which has a significant danger to the food industry. Over the years, several steps have been undertaken worldwide to minimise their contamination in crops and their exposure to humans and animals. China is one of the largest exporters and importers of food and animal feed. As a result, many studies have been carried out in China related to aflatoxins, including their distribution, pollution, detection methods, monitoring, testing and managing. Chinese scientists studied aflatoxins in microbiological, toxicological, ecological effects as well as policies relating to their controlling. China has thus put into practice a number of strategies aiming at the prevention and control of aflatoxins in order to protect consumers and ensure a safe trade of food and feed, and the status and enlargement of these strategies are very important and useful for many consumers and stakeholders in China. Therefore, this article aims at the detriment assessments, regulations, distribution, detection methods, prevention and control of aflatoxins in China. It equally provides useful information about the recent safety management systems in place to fight the contamination of aflatoxins in food and feed in China.

KMT2D and TP53 mutation status improve the prognostic value of the International Prognostic Index (IPI) stratification in ENKTL patients

Extranodal NK/T-cell lymphoma nasal type (ENKTL) is a subtype of T cell lymphoma with poor prognosis. In this study, we designed a new prognostic model specifically for ENKTL to improve the risk stratification. In 29 ENKTL patients, we screened mutations in 9 ENKTL-associated genes using next-generation sequencing (NGS). We have found that mutated KMT2D was associated with the inferior overall survival (OS) and progression free survival (PFS) and KMT2D or TP53 mutations were associated with a higher mortality rate. Moreover, the difference in PFS among different stratifications was not significant using the International Prognostic Index (IPI) alone but was significant after the mutation status of KMT2D and TP53 were incorporated into the IPI model, forming a harmonious risk stratification reflecting the clinical features and genetic information of ENKTL. In summary, we demonstrate that the prognostic value of the IPI system can be enhanced by integrating the status of genetic mutations.

Overexpression of UBE2C correlates with poor prognosis in gastric cancer patients

OBJECTIVE

The ubiquitin-conjugating enzyme E2C (UBE2C) has been known as a crucial factor upregulated in various tumors. The functions of UBE2C is mainly involved in the pathway protein ubiquitination. This study investigates the expression of UBE2C in gastric cancers and its correlation with overall survival rate.

MATERIALS AND METHODS

Real-time PCR (RT-PCR) and Western blotting were performed to determine the expression of UBE2C in gastric cancer samples and adjacent normal tissues. Immunohistochemical staining was used to assess the expression of UBE2C in 216 paraffin-embedded gastric cancer tissues.

RESULTS

The mRNA and relevant protein levels of UBE2C in gastric cancer tissues are significantly greater than those in the adjacent normal tissues. Also, the expression of UBE2C is found to correlate with lymphatic metastasis, serosa invasion, TNM (Malignant Tumors) staging and Lauren's classification (p<0.05). The univariate analysis shows that the overexpression of UBE2C associates with poor prognosis (p=0.001). The multivariate analysis demonstrates that expression of UBE2C, lymphatic metastasis, and TNM staging are independent prognostic indicators.

CONCLUSIONS

This study shows that overexpression of UBE2C contributes to the development of gastric cancer, and UBE2C has the potential to be exploited as a therapeutic target.

Twist2 and CD24 expression alters renal microenvironment in obesity associated kidney cancer

OBJECTIVE

Obesity emerged as a major public health problem worldwide, and prolonged condition with increased BMI causes various metabolic disorders include the development of kidney cancer. The metabolic changes alter the renal microenvironment and thereby promoting tumor. Hence, detailed studies of genes that regulate these this changes are keen to understand.

MATERIALS AND METHODS

Initially, we successfully initiate kidney tumor using prolonged intake of a high-fat diet in Wistar rats, which are confirmed with pathological changes observed through histological sectioning. The expression of Twist2 and CD24 was assessed using Immunohistology and Western Blotting in a different time interval of kidney cancer.

RESULTS

The rats fed with high-fat diet for 8 months shows 1.5 times increased in body mass whereas rats fed with high-fat diet for 16 months shows triple the size when compared with controls. Histological sectioning confirms the development of lesions and proteinaceous casts in 8 months high-fat fed rats, whereas we observed the high proliferative mass of cells in 16 months high-fat fed rats. Interestingly, we also observed elevated expression of Twist2 in initial stages of kidney cancer, which are down-regulated in the latter stages of kidney cancer. The experiments with CD24 shows the gradual increase of the expression of CD24 as a tumor develops to the next level.

CONCLUSIONS

The correlation between Twist2 and CD24 expression conclude that Twist2 overexpression in initial stage augments CD24 to express more in the latter stage of kidney cancer. Reversely, the overexpression of CD24 and down-regulation of Twist2 in later stages of kidney cancer suggest the CD24 expression is dependent on Twist2 expression level.

P902Danon disease: clinical features and outcomes

Background

Danon Disease (DD) is a rare X-linked autophagic vacuolar myopathy, characterized by high penetrance and severe cardiomyopathy; cognitive, skeletal muscle and vision impairment may occur as well. Due to its rarity, clinical presentation and outcomes are still uncertain.

Purpose

To describe clinical features and outcomes of DD in female and male patients

Methods

Individuals and families from United Kingdom, Australia, and United States were recruited through via advertisements on Facebook groups related to DD. Participants completed a survey about symptoms and medical history and provided their medical records to the research team.

Results

A total of 44 patients (54.5% female) with positive genetic testing for DD were included. De novo mutations occurred in one out of four patients. Cardiomyopathy occurred in 86.3% of patients (18/24 females, 20/20 males) at a mean age of 7.3 years for males and 19.4 years for females (p=0.001). Females presented with either hypertrophic cardiomyopathy (HCM, 66.7%) or dilated cardiomyopathy (DCM, 8.3%) whereas males presented with HCM 90% of the time. 34.2% of patients were diagnosed with Wolff-Parkinson-White syndrome.

Twelve patients (7 females, 5 males) underwent cardiac magnetic resonance (CMR) Out of the 9 cases, 8 (88.9%) exhibited extensive patchy late gadolinium-enhancement (LGE) in multiple segments of the left ventricle; 3 cases also had right ventricular LGE. Median cardiac mass index was 155 g/m2 (Q1-Q3: 70–237; v.n. 31–79 g/m2). Overall, 17 (38.6%) patients died or required or heart transplant (HTx). Median age at the time of death or HTx was 17 years and 42 years in males and females, respectively (p=0.025 by the log-rank test)

Cognitive impairment, mainly described as learning disabilities, was diagnosed in 90.0% of males (18/20) and 79.2% (19/24) of females; intelligence quotient (IQ) measurement was reported in 8 patients (3 females, 5 males) and 7 of them showed IQ below the average. Symptomatic skeletal myopathy was present in 28 (63.3%) of patients, with a higher prevalence in males (85% vs. 45.8%; p<0.01). Retinopathy was reported in 14 (31.2%) patients and occurred equally in both genders (p=0.34).

Conclusions

DD causes significant cardiac morbidity with the need for transplant at a young age; in 25% of cases DD is due to a de novo mutation. While in males DD is more frequently multisystemic with a more rapid clinical deterioration, in females the clinical presentation is variable. However, the presence of severe cases in females warrant the clinicians to screen for DD in both sexes with clinical manifestations or positive family history

Acknowledgement/Funding

Rocket Pharmaceuticals

P1216Evaluation of alphavbeta3 integrin-targeted positron emission tomography and photoacoustic tracer for imaging of carotid plaque in apoE–/– mice

Background

Cardiovascular disease is the leading cause of death in the world. The majority of cardiovascular events result from the rupture of vulnerable atherosclerotic plaques, which are characterized by high and active macrophage content. The integrin αVβ3 is expressed by activated macrophages and endothelial cells in atherosclerotic lesions and thus is a marker of high-risk plaques. Therefore, 89Zr-RGD-melanin nanoparticle (MNP) positron emission tomography (PET)/photoacoustic imaging (PAI) imaging of αVβ3 expression in plaques might provide a novel noninvasive biomarker of plaque vulnerability.

Purpose

In this study, the intrinsic photoacoustic signals and the native strong chelating properties with metal ions of MNP, positron-emitting metal ions 89Zr and αVβ3 integrins targeting ability of cyclic c (RGDfC) peptide was employed to construct an efficient nanoplatform. And we evaluated the feasibility of 89Zr-RGD-MNP PET/PAI of αVβ3 expression in vivo and in vitro.

Methods

We conjugated αVβ3 integrins, cyclic c (RGDfC) peptide, to MNP and chelated the long-lived positron-emitting nuclide 89Zr. The bio-stability and targeting action was detected in macrophages. And the PET/PAI imaging was performed in apoE−/− mice with partial carotid ligation leading to atherosclerosis. In PET imaging, tracer uptake was measured in the stenotic areas of the carotid arteries, as well as on the contralateral side at different time points in vivo. In PAI, photoacoustic signal was measured in the atherosclerosis of the carotid arteries in vivo. Melanin staining and immunohistochemistry of αVβ3 expression were detected in atherosclerosis of the carotid arteries.

Results

89Zr-RGD-MNP showed excellent bio-stability and targeting action. PET imaging showed specific tracer accumulation at plaques in the left carotid artery, confirmed by competitive receptor blocking studies and the contrast in the right carotid artery. In the biodistribution studies, the left carotid (5.29%±0.78%) showed higher uptake than the right carotid (2.11%±1.55%). PAI showed the PA signal in the surgery group (452±85 a.u.) were stronger than the control (156±45 a.u.) and blocking group (254±66 a.u). The result was consistent with PET imaging and the presence of nanoparticles, as indicated by pathological examinations. These results presented good in vivo multimodality imaging (PET/PAI) properties.

Conclusions

We have developed 89Zr-labeled atherosclerotic plaques imaging agents based on the natural melanin nanoparticle. 89Zr-RGD-MNP demonstrates specific tracer accumulation in mice atherosclerotic carotid plaques. In this model, its uptake was associated with αVβ3 expression. 89Zr-RGD-MNP is a potential tracer for noninvasive imaging in atherosclerosis.

Acknowledgement/Funding

National Natural Science Foundation of China 81770452, 81470401