Adaptive functions of structural variants in human brain development

Quantifying the structural variants (SVs) in nonhuman primates could provide a niche to clarify the genetic backgrounds underlying human-specific traits, but such resource is largely lacking. Here, we report an accurate SV map in a population of 562 rhesus macaques, verified by in-house benchmarks of eight macaque genomes with long-read sequencing and another one with genome assembly. This map indicates stronger selective constrains on inversions at regulatory regions, suggesting a strategy for prioritizing them with the most important functions. Accordingly, we identified 75 human-specific inversions and prioritized them. The top-ranked inversions have substantially shaped the human transcriptome, through their dual effects of reconfiguring the ancestral genomic architecture and introducing regional mutation hotspots at the inverted regions. As a proof of concept, we linked APCDD1, located on one of these inversions and down-regulated specifically in humans, to neuronal maturation and cognitive ability. We thus highlight inversions in shaping the human uniqueness in brain development.

Impact of Salvage Versus Palliative Dose Bridging Radiation Therapy on Local Control and Overall Survival in Patients with DLBCL Receiving CD19 CAR T Cell Therapy

PURPOSE/OBJECTIVE(S)

In patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL), radiation therapy (RT) can be used to "bridge" patients during the period of chimeric antigen receptor T cell (CAR T) manufacturing. Although RT has been shown to improve local control (LC) in patients who receive RT versus do not, it is unknown whether there is an optimal dose.

MATERIALS/METHODS

This was a retrospective study of patients with DLBCL who received bridging RT and CAR T cell therapy between 8/2021 and 12/2022 at a single institution (IRB #202103122). Patient, disease, and treatment characteristics were abstracted. PET/CT and laboratory data were collected at various time points. RT data including dose, planning target volume (PTV), and body volume receiving 2Gy and 4 Gy were tested for associations with LC, overall survival (OS), cytokine release syndrome (CRS) and immune effect cell-associated neurotoxicity syndrome (ICANS). Statistical tests were performed using Python libraries.

RESULTS

Twenty-two patients with DLBCL were included for analysis. The median patient age was 68 (range 35-82) and the median prior lines of failed therapies was two. All patients had successful apheresis and subsequent CAR T manufacturing. No patients died before CAR T infusion. All patients had a pre-radiation PET/CT scan that showed Deauville 5 disease. Patients with limited stage disease received salvage dose RT (EQD2∼40Gy, n = 8) while patients with advanced disease received palliative dose RT (n = 14). The median PTV volume was 1332 cm3. With a median follow-up of 156 days (IQR 63 - 252 days) from CAR T infusion, 10 patients had died and six progressed at an RT target. A higher salvage RT dose was not associated with LC at the day 30 PET or day 90 PET time points. In a Cox regression model, no independent variable, including RT dose, was significantly associated with LC or OS, but post-RT residual target SUV trended toward an association with OS (HR 6.2, 95% CI 0.9 - 471.0, p = 0.06). Post-RT LDH was associated with CRS grade (ρ = -0.39, p = 0.05). Other non-significant associative trends were noted between CRS grade and post-RT absolute lymphocyte count (ALC) (ρ = - 0.33, p = 0.09) and residual target SUV max (ρ = - 0.37, p = 0.08) and between ICANS grade and pre- to post-RT LDH change (ρ = -0.38, p = 0.06) and post-RT lymphocyte count (ρ = 0.36, p = 0.07). In an exploratory analysis of body volume receiving integral doses of 4Gy or 2Gy and pre- and post-RT ALC change, it appeared that higher integral dose did lead to larger decreases in ALC (ρ = -0.32, p = 0.15 and ρ = -0.3, p = 0.18, respectively).

CONCLUSION

In this small series of patients with r/r DLBCL treated with bridging RT prior to CAR T therapy, RT dose was not associated with LC. However, higher post-RT target residual SUV was associated with worse OS. The impact of post-RT LDH on CRS and ICANS grades should be explored further.

Bridging Radiotherapy Prior to Chimeric Antigen Receptor T-Cell Therapy for B-Cell Lymphomas: An ILROG Multi-Institutional Study

PURPOSE/OBJECTIVE(S)

To report an ILROG multi-institutional analysis of bridging radiotherapy (BRT) prior to CD19-targeting chimeric antigen receptor T-cell (CAR T) therapy for relapsed/refractory aggressive B-cell lymphomas (BCL).

MATERIALS/METHODS

Weretrospectively reviewed 115 patients (pts) with diffuse large BCL (n = 101, 88%), primary mediastinal BCL (n = 11, 10%), mantle cell lymphoma (n = 2, 2%), and T-cell/histiocyte rich large BCL (n = 1, 1%) who received BRT prior to commercial CAR T from 2018-2020 across 6 institutions. BRT toxicities were graded per CTCAE v5.0, cytokine release syndrome (CRS) per ASTCT, and immune effector cell-associated neurotoxicity syndrome (ICANS) per either ASTCT or CTCAE v5.0. Progression-free survival (PFS) and overall survival (OS), measured from CAR T infusion, were estimated using the Kaplan-Meier method. PFS was modeled using Cox regression with stepwise variable selection.

RESULTS

BRTwas given prior to axicabtagene ciloleucel (axi-cel; n = 82, 71%), tisagenlecleucel (tisa-cel; n = 31, 27%), or brexucabtagene autoleucel (n = 2, 2%). Median age was 62 years with median of two prior lines of therapy. Most pts had advanced stage III/IV disease at leukapheresis (n = 87, 76%), elevated pre-leukapheresis LDH (n = 73, 63%), and bulky disease (n = 55, 50%) (1 lesion ≥7.5 cm). 78 pts (68%) had extranodal disease, 12 (10%) had central nervous system (CNS) involvement, and 36 (31%) had bone involvement. Systemic bridging therapy was given to 42 pts (37%). Median intervals from leukapheresis to BRT start and from BRT completion to CAR T infusion were 5 days (IQR -6, 11) and 12 days (IQR 9, 23), respectively. BRT was delivered to 163 total sites; most commonly the abdomen/pelvis (n = 58, 50%), head/neck (n = 34, 30%), thorax (n = 20, 17%), extremity/soft tissue (n = 20, 17%), and CNS (n = 13, 11%). Median biologically effective dose was 31.3 Gy (IQR 24, 39). Most common regimen was 30 Gy in 10 fractions (n = 27, 17%). 40 pts (35%) received comprehensive BRT (to all active lesions). There were no grade ≥3 BRT toxicities. Grade ≥3 CRS occurred in 9 pts (8%), including 8/82 (10%) after axi-cel and 1/31 (3%) after tisa-cel. Grade ≥3 ICANS occurred in 23 pts (20%), including 22/82 (27%) after axi-cel and 1/31 (3%) after tisa-cel. Median follow up was 26.9 months. 1- and 2-year OS rates were 60% and 49%. 1- and 2-year PFS rates were 41% and 35%. Comprehensive BRT associated with superior PFS (HR 0.34, 95% CI 0.19-0.62, p<0.001) in a multivariable model with age ≥60, ECOG ≥2, advanced stage, CNS disease, pre-leukapheresis LDH, and axi-cel.

CONCLUSION

In this multi-institutional study, pts receiving BRT prior to CAR T therapy for BCL frequently had bulky disease yet experienced favorable PFS and OS. There were no serious toxicities attributable to BRT, and the rates of CRS and ICANS are comparable to those after CAR T alone. Comprehensive BRT associated with superior PFS.

Effect of Dose to the Heart and Cardiac Substructures on Cardiac Toxicity after Breast Cancer Radiation

PURPOSE/OBJECTIVE(S)

Pre-existing cardiovascular disease, chemotherapy, and higher mean heart dose are known risk factors for cardiac toxicity after breast radiation therapy. However, the relationship between cardiac substructure radiation exposure and toxicity is not well understood. We hypothesized that mean heart dose is a surrogate for global cardiac radiation exposure but that more specific dosimetric thresholds for the heart and its substructures could be identified, which could be used to guide radiation planning for breast cancer patients in the future.

MATERIALS/METHODS

In this cohort study, all breast cancer patients who received curative intent breast or chest wall radiotherapy at a single high-volume institution in 2014 and 2017 were included (n = 841). Baseline characteristics included hormone therapy, chemotherapy, menopausal status, diabetes, dyslipidemia, pre-existing cardiac toxicity, and age at diagnosis. Outcomes included any cardiac toxicity, arrhythmia, cardiomyopathy, ischemia, valvular, pericardial disease, and death. The heart and substructures, including left ventricle, right ventricle, left atrium, right atrium, aortic valve, pulmonic valve, mitral valve, tricuspid valve, and left anterior descending artery, were delineated on the simulation CT for each patient. Dosimetric variables, including mean dose, max dose, and V1, 2, 3, 4, 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, and 70 Gy for the heart and substructures (in cc) were extracted. For each dosimetric variable, multivariable logistic regression was performed using baseline covariates in addition to the single dosimetric variable. Patients with missing data values were excluded. Results were combined and False Discovery Rate p-value correction was performed.

RESULTS

Multiple cardiac substructure dosimetric variables were associated with increased risk of mortality on multivariable analysis (p < 0.05). For left atrium and right atrium, V2, 3, 4, and 5 Gy were all significant. For right ventricle, mean dose, V1, 2, 3, 4, 5, 10, 15, 20, 25, 30, and 35 Gy were significant. For mitral valve, mean dose, max dose, V3, 4, and 5 Gy were significant. For tricuspid valve, mean dose was significant. For aortic valve, max dose, mean dose, V4, and V5 Gy were significant. For the whole heart, V1, 2, 3, 4, 5, 10, 15, 20, 25, 30, and 35 Gy were significant.

CONCLUSION

We have identified multiple dosimetric variables for the heart and its substructures which were associated with increased risk of mortality after breast cancer radiation. In fact, for certain structures, there were multiple exposure thresholds which showed increased risk of toxicity, highlighting the complex relationship between substructure dose and outcomes. Further study into these relationships will identify the most critical cardiac substructure constraints that could be used in radiation treatment planning.

Impact of Stomach Deformability on PTV Coverage in Patients with Gastric MALTs Treated with Deep Inspiration Breath Hold (DIBH) and Daily CT-based Image-guided Radiation Therapy (IGRT)

PURPOSE/OBJECTIVE(S)

Patients with extranodal marginal zone lymphomas of the stomach (gastric MALTs) have excellent prognoses. DIBH with CT-based IGRT is used to minimize unwanted dose to heart and lungs. However, the stomach presents unique challenges for RT given its deformability, which may not be adequately compensated by standard 6-dimensional shifts. We conducted a dosimetry study to evaluate our hypothesis that DIBH, CT-based IGRT, and fasting after midnight may not be sufficient to compensate for stomach deformability.

MATERIALS/METHODS

Patients included were treated with DIBH and had daily IGRT with cone-beam CTs (CBCTs). All patients were simulated in alpha cradles with arms up. The CTV consisted of stomach with a 1.0 to 1.5cm CTV to PTV margin. Patients were instructed to fast after midnight. CBCTs used for daily image guidance prior to RT were collected. The stomach was contoured on each CBCT and then overlayed on the simulation scan. The stomach volume outside the PTV was calculated both in absolute volume and as a percentage of daily stomach volume. The relative location of the volume of stomach outside the PTV was also recorded.

RESULTS

Five patients with biopsy-proven gastric MALTs who received definitive dose RT were included. Patients were followed for at least 11 months (range: 11 - 20 mo.), and all achieved a complete pathological response. Seventy daily CBCTs were used in the analysis. Across all images, the daily stomach volume was smaller than the CTV by a mean 99.3cc (range: <305.3cc - >108.9cc). The mean volume of stomach outside the PTV was 7.8cc (range: 0 - 75.5cc). This represented 3.1% of the daily stomach volume (range: 0 - 18.7%). Per patient, the mean percent volume outside the PTV ranged from 0.4% to 6.9%. In 3 of the 5 patients, the percent volume outside the PTV was <2.5%. The stomach was most often anterior to the PTV (31.4% of images). Medial and posterior extensions were the next most frequent, representing 21.4% and 14.3% of images, respectively. Of all the daily stomach contours, 15.7% remained wholly within the PTV.

CONCLUSION

DIBH with daily IGRT in patients with gastric MALTs may result in moderate underdosing of the stomach due to its deformability. Daily stomach volumes were different in size from the CTV, and patients had an average of 0.4% to 6.9% of stomach volume outside the PTV. Regions of decreased coverage were most frequently seen anteriorly. Future dosimetry studies may suggest non-isometric PTV expansions to better cover these areas.

Mass Measurement of Upper fp-Shell N=Z-2 and N=Z-1 Nuclei and the Importance of Three-Nucleon Force along the N=Z Line

Using a novel method of isochronous mass spectrometry, the masses of ^{62}Ge, ^{64}As, ^{66}Se, and ^{70}Kr are measured for the first time, and the masses of ^{58}Zn, ^{61}Ga, ^{63}Ge, ^{65}As, ^{67}Se, ^{71}Kr, and ^{75}Sr are redetermined with improved accuracy. The new masses allow us to derive residual proton-neutron interactions (δV_{pn}) in the N=Z nuclei, which are found to decrease (increase) with increasing mass A for even-even (odd-odd) nuclei beyond Z=28. This bifurcation of δV_{pn} cannot be reproduced by the available mass models, nor is it consistent with expectations of a pseudo-SU(4) symmetry restoration in the fp shell. We performed ab initio calculations with a chiral three-nucleon force (3NF) included, which indicate the enhancement of the T=1 pn pairing over the T=0 pn pairing in this mass region, leading to the opposite evolving trends of δV_{pn} in even-even and odd-odd nuclei.

[Influencing factors of mild cognitive impairment among the Chinese elderly: a meta-analysis]

Objective: To conduct a meta-analysis on the influencing factors of mild cognitive impairment (MCI) in the Chinese elderly. Methods: The literature related to the influencing factors of MCI in Chinese elderly population was retrieved through CNKI, Wanfang, VIP, PubMed, Embase and Web of Science databases up to March 13, 2022. Stata17.0 software was used to calculate the combined risk ratio (RR) with the 95% confidence interval (CI), test the heterogeneity, and assess the publication bias. Results: A total of 2 450 articles were retrieved, and 49 articles met the inclusion criteria, including 5 cohort studies and 44 case-control studies. Meta-analysis results showed that male (RR=0.778, 95%CI: 0.696-0.870, I²=73.1), education>6years (RR=0.428, 95%CI: 0.374-0.490, I²=86.9) and regular exercise (RR=0.496, 95%CI: 0.421-0.585, I²=81.5) were protective factors for MCI, while age≥70 years (RR=2.431, 95%CI: 2.086-2.833, I²=79.3), family history of dementia (RR=3.228, 95%CI: 2.140-4.867, I²=0.0), smoking (RR=1.214, 95%CI: 1.098-1.342, I²=78.8), alcohol consumption (RR=1.165, 95%CI: 1.047-1.297, I²=68.2), solitary living (RR=2.816, 95%CI: 2.123-3.736, I²=42.0), insomnia (RR=1.402, 95%CI: 1.093-1.799, I²=41.3), overweight/obesity (RR=1.431, 95%CI: 1.207-1.696, I²=75.9), hypertension (RR=1.731, 95%CI: 1.589-1.886, I²=67.1), hyperlipidemia (RR=1.722, 95%CI: 1.541-1.924, I²=63.9), diabetes mellitus (RR=1.495, 95%CI: 1.341-1.666, I²=71.6), cardiovascular diseases (RR=1.671, 95%CI: 1.446-1.932, I²=74.6) and cerebrovascular diseases (RR=2.309, 95%CI: 2.040-2.613, I²=76.3) were risk factors of MCI. Conclusion: The present study indicates that male, junior high school education or above and regular exercise are protective factors of MCI, while age≥70 years, family history of dementia, smoking, alcohol consumption, living alone, insomnia, overweight/obesity, hypertension, hyperlipidemia, diabetes, cardiovascular diseases and cerebrovascular diseases are risk factors of MCI.

[Research advances of adipose stem cell matrix gel in promoting wound healing]

In recent years, with the problem of aging population in China being prominant, the number of patients with chronic wounds such as diabetic foot, pressure ulcer, and vascular ulcer is increasing. Those diseases seriously affect the life quality of patients and increase the economy and care burden of the patients' family, which have been one of the most urgent clinical problems. Many researches have confirmed that adipose stem cells can effectively promote wound healing, while exogenous protease is needed, and there are ethical and many other problems, which limit the clinical application of adipose stem cells. Adipose stem cell matrix gel is a gel-like mixture of biologically active extracellular matrix and stromal vascular fragment obtained from adipose tissue by the principle of fluid whirlpool and flocculation precipitation. It contains rich adipose stem cells, hematopoietic stem cells, endothelial progenitor cells, and macrophages, etc. The preparation method of adipose stem cell matrix gel is simple and the preparation time is short, which is convenient for clinical application. Many studies at home and abroad showed that adipose stem cell matrix gel can effectively promote wound healing by regulating inflammatory reaction, promoting microvascular reconstruction and collagen synthesis. Therefore, this paper summarized the preparation of adipose stem cell matrix gel, the mechanism and problems of the matrix gel in promoting wound repair, in order to provide new methods and ideas for the treatment of chronic refractory wounds in clinic.

[Evaluation of safety and clinical efficacy of bilateral percutaneous kyphoplasty in treatment of osteoporotic thoraco-lumbar burst fractures]

Objective: To evaluate the safety and clinical efficacy of bilateral percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral burst fractures. Methods: It was a prospective study, 28 patients with osteoporotic thoraco-lumbar burst fractures who were treated in Beijing Chao-Yang Hospital from January 2021 to July 2021 were included, including 10 males and 18 females, with a median age of 73.6 years (range: 56.0-87.0 years). The X-ray radiographs, bone mineral density (BMD), CT three-dimensional reconstruction scan and MRI were taken and measured before operation to observe the fracture location and the posterior wall of the vertebral body, and further to determine the diagnosis. The X-ray radiographs and CT three-dimensional reconstruction scans were taken on the first day after operation and the last follow-up to observe whether there were bone cement leakage or not. The changes of kyphosis angle (KA), the height of anterior wall (HAW) and the height of posterior wall (HPW) before the operation, on the 1st day post operation and at the last follow-up were recorded. The visual analogue scale (VAS) of back pain and Oswestry dysfunction index (ODI) before the operation, 1 day post operation and at the last follow-up were used to evaluate the clinical effect of the operation. Results: All the patients were followed up for (12.2±6.0) months. The HAW on the 1st day post operation [(22.5±2.0) mm] was significantly increased as compared with that before the operation [(21.2±2.4) mm] (P<0.05). The HAW at the last follow-up [(18.9±1.6) mm] decreased signficantly as compared with that on the 1st day post opertion [(22.5±2.0) mm] (P<0.05). The HPW was also significantly corrected after surgery (P<0.05). At the end of the follow-up, the HPW [(27.2±1.3) mm] was comparable with that on the 1st day after surgery [(27.5±1.6) mm] (P>0.05). The KA on the 1st day after the operation (14.2°±1.5°) decreased significantly when compared with that before the operation (18.8°±1.3°) (P<0.05), but it was increased to 17.6°±1.4° at the last follow-up and was higher than that on the 1st day after the operation (P<0.05). There were bone cement leakage in 5 cases and adjacent vertebral fracture in 1 case. The VAS and ODI scores were all significantly lower on the 1st day and at last follow-up than that before the operation (all P<0.05). Conclusions: Bilateral PKP is effective, safe and reliable in the treatment of osteoporotic vertebral burst fracture. Careful evaluation of preoperative imaging data, accurate puncture and timing of bone cement injection are the key factors to ensure the success of the operation.

[Clinical characteristics of 272 437 patients with different histopathological subtypes of primary esophageal malignant tumors]

Objective: To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT). Methods: A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ² test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results: A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment. Conclusion: ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

[Assessment of quality of systematic reviews and Meta-analyses on efficacy and safety of COVID-19 vaccines]

Objective: To evaluate the methodology of the published systematic reviews and Meta-analyses (SR/MA) on efficacy and safety of coronavirus disease 2019 (COVID-19) vaccines. Methods: We conducted a retrieval for literatures published as of December 10, 2021 in English databases (Medline, Embase, Cochrane Library, Web of science) and Chinese databases (CNKI, Wanfang data, VIP, Sinomed). Two reviewers independently screened literatures and extracted data. The methodology of included SR/MA papers was assessed by A MeaSurement Tool to Assess systematic Review-2 (AMSTAR-2) tool in 16 items. Results: A total 22 SR/MA papers were included, in which 3 (13.6%) had low quality and 19 (86.4%) had very low quality. The main problems of these SR/MA included having no definite PICO (Participants, intervention, control and outcome), providing no preliminary research protocol, no list of excluded studies and justify the exclusions, making no evaluation and explanation or discussion of the risk of bias of original studies, no adequate evaluation of publication bias and discuss its likely impact on the results, etc. Conclusion: SR/MA for the efficacy and safety of COVID-19 vaccines had varied methodological deficiencies, further improvements are needed.

[Mechanism study of dendritic epidermal T lymphocytes in promoting healing of full-thickness skin defects wound on mice by regulating the proliferation and differentiation of epidermal stem cells in mice]

Objective: To explore the mechanism of dendritic epidermal T lymphocytes (DETCs) in promoting healing of full-thickness skin defect wound on mice by regulating the proliferation and differentiation of epidermal stem cells (ESCs) in mice. Methods: (1) Ten 8-week-old wild type (WT) male C57BL/6 mice (the same sex and kind below) were sacrificed to collect the skin of back for extracting DETCs to culture. Five WT and five 8-week-old T cell receptor (TCR) δ(-)/(-) mice were selected and enrolled in WT control group and TCR δ(-)/(-) control group, respectively. A full-thickness skin defect wound with diameter of 6 mm was made on both sides of spinal line on the back of mice without any treatment after injury. Another fifteen 8-week-old TCR δ(-)/(-) mice were selected and divided into phosphate buffer solution (PBS), DETC, and insulin-like growth factor-Ⅰ(IGF-Ⅰ) groups according to the random number table (the same grouping method below), with 5 mice in each group, and the same full-thickness skin defect wound was made on each mouse. Immediately after injury, mice in PBS, DETC, and IGF-Ⅰ groups were injected subcutaneously around each wound with 10 μL sterile PBS , DETCs (cell concentration of 1×10(6)/mL), and 5 mg/mL recombinant mice IGF-Ⅰ, respectively. The percentage of the residual wound area was calculated on post injury day (PID) 2, 4, 6, and 8. (2) Three 8-week-old WT mice were enrolled in WT control group and nine 8-week-old TCR δ(-)/(-) mice were divided into TCR δ(-)/(-) control group, PBS group, and DETC group, with 3 mice in each group. The full-thickness skin defect wound was made as in experiment (1) . On PID 3, the protein expression of IGF-Ⅰ in the epidermis tissue of wound margin was detected by chemiluminescence imaging analyzer. (3) Three 8-week-old WT mice were enrolled in WT control group and six 8-week-old TCR δ(-)/(-) mice were divided into PBS and DETC groups, with 3 mice in each group, and the full-thickness skin defect wound was made as in experiment (1). On PID3, DETCs were extracted from the wound margin epidermis tissue to detect the percentage of DETCs expressing IGF-Ⅰ by flow cytometer. (4) The mice were taken as in experiment (2) and divided into WT control, PBS, DETC, and IGF-Ⅰ groups. A straight full-thickness skin defect incision with length of 3 cm was made in the direction of one inner ear. Mice in WT control group didn't have any other treatment after injury, and immediately after injury, mice in PBS, DETC, and IGF-Ⅰ groups were injected subcutaneously around each wound with 10 μL sterile PBS, DETCs (cell concentration of 1×10(6)/mL), and 5 mg/mL recombinant mice IGF-Ⅰ, respectively. On PID 12, epidermis tissue of wound margin was collected, and immunofluorescence staining was performed to observe the number of keratin 15 positive cells. (5) The same mice were collected, grouped, and treated as in experiment (4). On PID12, the epidermis tissue of wound margin was collected and immunofluorescence staining was performed to observe the number of keratin 10 positive cells. (6) Twenty 3-day-old WT mice (the same below) were sacrificed to collect the whole skin, which was used to extract ESCs, with 5 mice detecting one index. The ESCs were divided into DETC co-culture group and control group, which were added with 1 mL DETCs (cell concentration of 1.25×10(6)/mL) and DETC medium, respectively. The percentage of 5-ethynyl-2'-deoxyuridine (EdU) positive cell on culture day (CD) 3, the percentages of CD49f(+) CD71(-) and keratin 14 positive cells on CD 5, and the percentage of keratin 10 positive cell on CD 10 in 2 groups were detected by flow cytometer. (7) Twenty mice were taken to extract ESCs, with 5 mice detecting one index. The ESCs were divided into control group and IGF-Ⅰ group, which were added with 1 mL sterile PBS and 10 ng/mL recombinant mice IGF-Ⅰ, respectively. The percentages of EdU positive cell, CD49f(+) CD71(-) cell, keratin10 positive cell, and keratin 14 positive cell were detected as in experiment (6). The sample in each group of experiments (6) and (7) was three. Data were statistically analyzed with analysis of variance for repeated measurement, one-way analysis of variance, and t test. Results: (1) On PID 4, 6, and 8, the percentage of residual wound area in TCR δ(-)/(-) control group was significantly higher than that in WT control group (t=2.78, 3.39, 3.66, P<0.05 or P<0.01). The percentage of residual wound area in DETC group and IGF-Ⅰgroup on PID 4, 6, and 8 was apparently lower than that in PBS group (t=2.61, 3.21, 3.88, 2.84, 2.91, 2.49, P<0.05 or P<0.01). (2) On PID 3, the protein expression of IGF-Ⅰ in the epidermis tissue of wound margin of mice in TCR δ(-)/(-) control group was significantly lower than that in WT control group (t=17.34, P<0.01). The protein expression of IGF-Ⅰ in the epidermis tissue of wound margin of mice in DETC group was significantly higher than that in PBS group (t=11.71, P<0.01). (3) On PID 3, the percentage of DETCs expressing IGF-Ⅰ in the epidermis tissue of wound margin of mice in PBS group was significantly lower than that in WT control group and DETC group (t=24.95, 27.23, P<0.01). (4) On PID 12, the number of keratin 15 positive cells in the epidermis tissue of wound margin of mice in PBS group was significantly lower than that in WT control group, DETC group, and IGF-Ⅰ group (t=17.97, 11.95, 7.63, P<0.01). (5) The number of keratin 10 positive cells in the epidermis tissue of wound margin of mice in PBS group was significantly higher than that in WT control group, DETC group, and IGF-Ⅰ group (t=11.59, 9.51, 3.48, P<0.05 or P<0.01). (6) The percentages of EdU positive cells on CD 3, CD49f(+) CD71(-) cells on CD 5, and keratin 14 positive cells on CD 5 in DETC co-culture group were respectively (43.5±0.6)%, (66.5±0.5)%, (69.3±1.7)%, apparently higher than (32.3±1.3)%, (56.4±0.3)%, (54.9±1.3)% in control group (t=7.97, 17.10, 6.66, P<0.01). The percentage of keratin 10 positive cells on CD 10 in DETC co-culture group was (55.7±0.7)%, significantly lower than (67.1±1.2)% in control group (t=8.34, P<0.01). (7) The percentages of EdU positive cells on CD 3, CD49f(+) CD71(-) cells on CD 5, and keratin 14 positive cells on CD 5 in IGF-Ⅰ group were respectively (42.1±0.9)%, (81.1±1.3)%, (66.8±1.0)%, apparently higher than (32.4±0.7)%, (74.9±0.7)%, (52.0±1.9)% in control group (t=8.39, 4.24, 7.25, P<0.05 or P<0.01). The percentage of keratin 10 positive cells on CD 10 in IGF-Ⅰ group was (53.5±1.1)% , significantly lower than (58.2±0.3)% in control group (t=3.99, P<0.05). Conclusions: DETCs can promote the proliferation and anti-apoptotic potential of ESCs and inhibit their differentiation into end-stage by secreting IGF-Ⅰ, thus promoting wound healing of full-thickness skin defects in mice.

[Current global development of screening guidelines for hepatocellular carcinoma: a systematic review]

Objective: The objective of the study was systematically summarized the current status of the hepatocellular carcinoma (HCC) screening guidelines, and evaluated the HCC screening guidelines according to the authoritative framework of cancer screening guidelines of authoritative institutions, which provided important value for the formulation of HCC screening evidence-based guidelines. Methods: Literature search was conducted in multiple databases from their inception dates to January 3, 2019. In addition, we sought relevant websites further was searched to identify potentially eligible studies. Two reviewers independently screened literature and extracted data. Qualitative description of the basic information, recommendations of HCC screening, source of evidence and update progress of the HCC screening guidelines was conducted. Results: At present, there were no independent HCC screening guidelines worldwide. There were only 17 clinical practice HCC guidelines briefly provided the recommendation of HCC screening. Current HCC screening guidelines only recommended screening for high-risk groups of HCC. All guidelines have identified patients with chronic hepatitis B, hepatitis C and cirrhosis as high-risk groups for HCC. Most of guidelines recommended screening intervals was 6 months. The latest guidelines in Europe and the United States recommended ultrasound for screening HCC. The combination of ultrasound and AFP was recommended in the Asian guidelines. Currently, HCC screening guidelines mainly recommended screening strategies based on factors such as risk of HCC, accuracy of screening modality, screening cost, etc.. The key factors such as screening efficacy and safety have not yet been considered comprehensively. Conclusions: There were no independent HCC screening guidelines worldwide. Only some clinical practice HCC guidelines briefly mentioned HCC screening. Currently, the guidelines only recommend screening for high-risk groups of HCC, with a screening interval of 6 months. There are differences in screening modalities recommended by European, American and Asian guidelines for screening HCC. It is suggested that the relevant institutions should formulate the evidence-based HCC screening guidelines by referring to the theoretical framework of other authoritative other cancer screening guidelines.

[Effects of dendritic epidermal T cells on proliferation and apoptosis of epidermal cells in wound margin of mice]

Objective: To explore the effects of dendritic epidermal T cells (DETC) on proliferation and apoptosis of epidermal cells in wound margin of mice and its effects on wound healing. Methods: Twenty-eight healthy specific pathogen free (SPF) C57BL/6 wild-type (WT) male mice aged 8-12 weeks and 60 SPF T lymphocyte receptor δ-knockout (TCR δ(-/-)) male mice aged 8-12 weeks were selected to conduct the following experiments. (1) Eight WT mice were selected to isolate epidermal cells and primarily culture DETC according to the random number table. Morphological observation and purity identification of DETC by flow cytometer were detected immediately after culture and on culture day (CD) 15 and 30, respectively. (2) According to the random number table, 5 WT mice and 5 TCR δ(-/-) mice were selected and enrolled into WT control group and TCR δ(-/-) group. Round full-thickness skin defect with diameter of 6 mm was made on the back of each mouse. The wound healing condition was observed immediately after injury and on post injury day (PID) 2, 4, 6, 8, 10, and the percentage of residual wound area was calculated. (3) Mice were selected to group and reproduce model of full-thickness skin defect as in experiment (2). On PID 3, the tissue of wound margin was collected for hematoxylin eosin staining, and the length of new epithelium was measured. (4) Mice were selected to group and reproduce model of full-thickness skin defect as in experiment (2). On PID 3, epidermal tissue of wound margin was collected to determine expression of proliferating cell nuclear antigen (PCNA) using Western blotting for evaluation of proliferation of epidermal cell. (5) Mice were selected to group and reproduce model of full-thickness skin defect as in experiment (2). On PID 3, epidermal tissue of wound margin was selected and digested into single-cell suspension, and apoptosis of cells was detected by flow cytometer. (6) Forty TCR δ(-/-) mice were selected to carry out the same treatment as in experiments (2)-(5). According to the random number table, these mice were enrolled into TCR δ(-/-) control group and TCR δ(-/-)+ DETC group, with 5 mice in each group for each experiment. Round full-thickness skin defect was made on the back of each mouse. DETC in the number of 1×10(5) (dissolution in 100 μL phosphate with buffer purity above 90%) were injected through multiple points of wound margin of mice in TCR δ(-/-)+ DETC group immediately after injury, and equal volume of phosphate buffer was injected into mice of TCR δ(-/-) control group with the same method as above. Data were processed with one-way analysis of variance for repeated measurement, t test, and Bonferroni correction. Results: (1) Along with the culture time elapse, the number of dendritic structures of DETC increased gradually. The percentage of T lymphocytes was 4.67% and 94.1% of these T lymphocytes were DETC. The purity of DETC on CD 15 was 18.50% and the purity of DETC on CD 30 was 98.70%. (2) Immediately after injury, the wound healing condition of mice in WT control group and TCR δ(-/-) group was similar. The wound healing speed of mice in TCR δ(-/-) group was slower than that in WT control group on PID 2-10. The percentages of residual wound area of mice in TCR δ(-/-) group on PID 2, 4, 6, 8, and 10 were increased significantly compared with those in WT control group (t=3.492, 4.425, 4.170, 4.780, 7.318, P<0.01). (3) The length of new epithelium of mice in TCR δ(-/-) group on PID 3 was (359 ± 15) μm, which was obviously shorter than that in WT control group [(462±26) μm, t=3.462, P<0.01]. (4) Immediately after injury, wound condition of mice in TCR δ(-/-)+ DETC group and TCR δ(-/-) control group was similar. Compared with TCR δ(-/-)+ DETC group, the wound healing speed of mice in TCR δ(-/-) control group were obviously slower on PID 2-10. The percentages of residual wound area of mice in TCR δ(-/-)+ DETC group on PID 2, 4, 6, 8, and 10 were decreased significantly compared with those in TCR δ(-/-) control group (t=2.308, 3.725, 2.698, 3.707, 6.093, P<0.05 or P<0.01). (5) On PID 3, the length of new epithelium of mice in TCR δ(-/-)+ DETC group was (465±31) μm, which was obviously longer than that in TCR δ(-/-) control group [(375±21) μm, t=2.390, P<0.05]. (6) On PID 3, PCNA expression of epidermal cell in wound margin of mice in TCR δ(-/-) group was 1.25±0.04, which was obviously lower than that in WT control group (2.01±0.09, t=7.415, P<0.01). (7) On PID 3, PCNA expression of epidermal cell in wound margin of mice in TCR δ(-/-)+ DETC group was 1.62±0.08, which was significantly higher than that in TCR δ(-/-) control group (1.05±0.14, t=3.561, P<0.05). (8) On PID 3, apoptosis rate of epidermal cell in wound margin of mice in TCR δ(-/-) group was (16.1±1.4)%, which was higher than that in WT control group [(8.1±0.6)%, t=5.363, P<0.01]. (9) On PID 3, apoptosis rate of epidermal cell in wound margin of mice in TCR δ(-/-)+ DETC group was (11.4±1.0)%, which was obviously lower than that in TCR δ(-/-) control group [(15.4±1.4)%, t=2.377, P<0.05]. Conclusions: DETC participates in the process of wound healing though promoting the proliferation of epidermal cells in wound margin and inhibit the apoptosis of these cells.

[Quality assessment of global guidelines on colorectal cancer screening]

OBJECTIVE

To systematically review and assess the quality of guidelines on colorectal cancer screening worldwide to provide guidance for the development of high-quality colorectal cancer screening guidelines in mainland China.

METHODS

CNKI, WanFang Data, VIP, SinoMed, PubMed, Embase, and Web of Science were systematically searched to identify guidelines on colorectal cancer screening from inception to Jun. 20th, 2018, and so were some websites and major search engines about the development of the guidelines from the existing literature (search date: Aug. 3rd, 2018). Two experienced reviewers independently examined these abstracts and then extracted information, and the Appraisal of Guidelines for Research and Evaluation II (AGREE II) were used to evaluate the methodological quality of these guidelines by four well trained reviewers.

RESULTS

In this study, 46 guidelines published from 1994 to 2018 were finally included in our analysis from 10 countries and 5 regions, among which 5 were from mainland China. The quality of these guidelines was relatively high in domain 1 (scope and purpose) and domain 4 (clarity of presentation), and medium in domain 2 (stakeholder involvement). While in the other three domains (domain 3: rigour of development; domain 5: applicability; domain 6: editorial independence), the results were quite different among these guidelines. The quality of evidence-based guidelines (defined by the criteria based on World Health Organization guideline development handbook) was generally higher than that of the common guidelines. Existing guidelines from mainland China were not evidence-based guidelines, which were of low quality.

CONCLUSION

The colorectal cancer screening guidelines all over the world are generally large in number, low in quality, different in statements, and so are the guidelines in China. There are no evidence-based guidelines in mainland China, which cannot provide effective guidance for colorectal cancer screening, so we need to pay more attention to the establishment of guidelines with high quality and high credibility for colorectal cancer screening as well as for cancer screening based on the national condition, in order to provide reasonable guidance for practice in public health and improve the health conditions in our society.

[Surgical results and sagittal alignment analysis of different fusion levels for degenerative scoliosis]

Objective: To retrospectively investigate the effects of long segment fusion and short segment fusion on lumbar sagittal alignment and quality of life in patients with degenerative scoliosis. Methods: From January 2011 to December 2014, 75 patients with degenerative scoliosis were treated with pedicle screw fixation. Total of 56 females and 19 males were included in this study. Fifty-four patients underwent short-segment fusion (≤3 segments) and 21 patients underwent long-segment fusion (>3 segments). The average age of the patients was (63±8) years. The patients were followed-up for a mean time of (2.9±1.3) years. The postoperative follow-up included Cobb angle, pelvic tilt, sacral slope, lumbar lordosis, visual analogue scale of pain on lumbar and lower extremities and Oswestry disability index. Fusion levels, blood loss, surgery length and postoperative hospital stay were recorded. All above parameters were evaluated statistically with Student's t test. Results: The short segment fusion group averaged (1.8±0.7) segments, and the long segment fusion group averaged (5.2±1.6) segments. Coronal Cobb angle changed from (21.3±7.8) degrees preoperatively to (15.3±5.6) degrees at final follow-up in short-segment fusion group (t=2.315, P=0.024) and from (44.5±11.2) degrees preoperatively to (11.4±5.8) degrees at the final follow-up in long-segment fusion group (t=8.214, P<0.01). In the short segment fixation group, the preoperative lumbar lordosis changed from (44.3±9.7) degrees to (48.9±8.2) degrees at final follow-up (t=2.123, P=0.038), and it changed from (25.3±9.5) degrees to (52.1±11.2) degrees in the long segment fusion group (t=5.982, P<0.01). The sacral slope in the short segment fusion group increased from (22.6±6.8) degrees preoperatively to (34.1±7.5) degrees at the final follow-up (t=2.872, P=0.006), and it increased from (12.1±9.5) degrees to (37.8±8.4) degrees in long segment fusion group (t=7.314, P<0.01). The pelvic tilt in the short segment fusion group changed from (23.5±5.5) degrees preoperatively to (19.5±4.7) degrees at final follow-up (t=2.217, P=0.031), and it decreased from (27.1±6.1) degrees to (22.9±4.3) degrees in the long segment fusion group(t=2.131, P=0.045). The visual analogue scale of pain on lumbar and lower extremities and Oswestry disability index were all improved after the operation in both groups. Conclusions: Both short segment fusion and long segment fusion can achieve satisfactory surgical results and improves the spinal-pelvic parameters. Short segment fusion can reduce surgery trauma and shorten hospital stay relative to long segment fixation.

[Introduction on 'assessing the risk of bias of individual studies' in systematic review of health-care intervention programs revised by the Agency for Healthcare Research and Quality]

This paper summarizes the Risk of Bias of Individual Studies in Systematic Reviews of Health Care Interventions revised by the Agency for Healthcare Research and Quality (AHRQ) and introduces how to use Revman software make risk of bias graph or risk of bias summary. AHRQ tool can be used to evaluate following study designs: RCTs, cohort study, case-control study (including nested case-control), case series study and cross-sectional study. The tool evaluates the risk of bias of individual studies from selection bias, performance bias, attrition bias, detection bias and reporting bias. Each of the bias domains contains different items, and each item is available for the assessment of one or more study designs. It is worth noting that the appropriate items should be selected for evaluation different study designs instead of using all items to directly assess the risk of bias. AHRQ tool can be used to evaluate risk of bias individual studies when systematic reviews of health care interventions is including different study designs. Moreover, the tool items are relatively easy to understand and the assessment process is not complicated. AHRQ recommends the use of high, medium and low risk classification methods to assess the overall risk of bias of individual studies. However, AHRQ gives no recommendations on how to determine the overall bias grade. It is expected that future research will give corresponding recommendations.

[Percutaneous endoscopic transforaminal lumbar interbody fusion for lumbar spinal stenosis]

Objective: To evaluate the clinical effects of percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) for L(4/5) single-segment lumbar spinal stenosis. Methods: From September 2016 to March 2018, 7 patients with L(4/5) single-segment lumbar spinal stenosis were treated by PE-TLIF in the Department of Orthopedics, Beijing Chaoyang Hospital. There were 1 male and 6 females, with a mean age of (57±13) years(43-77 years). The operation time, intraoperative blood lose, blood transfusion and complications were recorded, and the pain relief effects were evaluated by visual analog scale (VAS) score and Oswestry dability index (ODI). The indexes before and after the operation were compared with t test. Results: The average of follow-up time was 13.3 months (6-21 months), and the clinical symptoms relieved significantly. The VAS scores of low back pain and leg pain at 3-day postoperatively and at the last follow-up were (2.28±0.48), (1.57±0.53) and (0.42±0.53), (0.14±0.37), respectively; and the VAS scores were significantly improved when compared with those before the operation[(7.42±0.78), (6.14±1.77)](t=19.718, 6.672, 18.520, 7.937, all P<0.05). At the last follow-up, the ODI score was also significantly lower than that before surgery (54%±10% and 15%±9%, t=12.551, P<0.05). During the follow-up period, one patient had transient hyperreflexia after surgery, and the other 6 patients had no significant complications. None nerve root injury or lower extremity paralysis occurred. Conclusion: PE-TLIF can obtain satisfactory short-term results in the treatment of single-segment lumbar spinal stenosis, with a lower incidence of complications and rapid recovery after surgery.

Facilitating the measurement of circulatory hydrogen sulfide with fluorescence probe-coated microplates

OBJECTIVE

The hydrogen sulfide (H₂S) role in pathogenesis of various diseases were wildly addressed in recent decade. The circulatory (plasma or serum) and biological fluid H₂S measurement is still an enormous issues due to the technical limitation. This paper aimed to develop a novel measurement method based on fluorescence probe.

METHODS

Firstly, 20 μL ethanol was used to dissolve 100 pmol fluorescence probe, then added in a 96-well plate. An equal volume of ethanol was also added to the blank well of the plate. The plate was placed in a dark room for about 1 h until the fluorescence probe was evenly coated in the 96-well microplate and dried. The plate was frozen at -20 °C for later use. Secondly, the plasma or serum sample was added with saturated ammonium sulfate buffer (pH 7.8) and then centrifuged to remove the proteins. The equal volume supernatant liquid was added to the probe-coated well and the probe-uncoated well. The plate was incubated in a dark environment at 37 °C for 2 h. Finally, after incubation, the fluorescence density was acquired at Λ_Ex/Λ_Em 340/445 nm in a microplate reader. The differences of the fluorescence density values between the probe-coated well and probe-uncoated well were counted and H₂S concentration of plasma/serum was calculated by standard curve with NaHS.

RESULTS

The method had high sensitivity (from 0.3 to 100 μmol/L) and specificity for measuring H₂S as compared with other biologically relevant reactive sulfur species and sulfur-containing amino acid. Serum H₂S concentrations were assayed in 188 health volunteers using this method [(12.1±3.5) μmol/L, 95%CI: 4.6-19.8 μmol/L], and the frequency distribution showed a normal tendency(one-sample Kolmogorov-Smirnov test, P>0.1). The serum H₂S concentrations in 30 hypertension patients were decreased compared with 22 age- and gender-matched health individuals (paired-samples t test, t=9.937, P<0.001). There were no differences of H₂S concentration in serum [(19.66±2.32) μmol/L] or plasma [(18.67±2.07) μmol/L], between the samples acquired from artery [(19.34±0.51) μmol/L] or vein [(18.99±0.50) μmol/L] of male Wistar rats (repeated measurement of ANOVA, P=0.38). One week frozen samples did not affect the detection. The values of the repeated measurement did not differ (two-way ANOVA, P>0.05).

CONCLUSION

The present method is easily performed with high sensitivity, specificity and repeatability for circulatory H₂S. It is also quick and may apply for large samples.

Randomized controlled trial of S-1 versus docetaxel in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy (East Asia S-1 Trial in Lung Cancer)

BACKGROUND

Chemotherapy remains a viable option for the management of advanced non-small-cell lung cancer (NSCLC) despite recent advances in molecular targeted therapy and immunotherapy. We evaluated the efficacy of oral 5-fluorouracil-based S-1 as second- or third-line therapy compared with standard docetaxel therapy in patients with advanced NSCLC.

PATIENTS AND METHODS

Patients with advanced NSCLC previously treated with ≥1 platinum-based therapy were randomized 1 : 1 to docetaxel (60 mg/m2 in Japan, 75 mg/m2 at all other study sites; day 1 in a 3-week cycle) or S-1 (80-120 mg/day, depending on body surface area; days 1-28 in a 6-week cycle). The primary endpoint was overall survival. The non-inferiority margin was a hazard ratio (HR) of 1.2.

RESULTS

A total of 1154 patients (577 in each arm) were enrolled, with balanced patient characteristics between the two arms. Median overall survival was 12.75 and 12.52 months in the S-1 and docetaxel arms, respectively [HR 0.945; 95% confidence interval (CI) 0.833-1.073; P = 0.3818]. The upper limit of 95% CI of HR fell below 1.2, confirming non-inferiority of S-1 to docetaxel. Difference in progression-free survival between treatments was not significant (HR 1.033; 95% CI 0.913-1.168; P = 0.6080). Response rate was 8.3% and 9.9% in the S-1 and docetaxel arms, respectively. Significant improvement was observed in the EORTC QLQ-C30 global health status over time points in the S-1 arm. The most common adverse drug reactions were decreased appetite (50.4%), nausea (36.4%), and diarrhea (35.9%) in the S-1 arm, and neutropenia (54.8%), leukocytopenia (43.9%), and alopecia (46.6%) in the docetaxel arm.

CONCLUSION

S-1 is equally as efficacious as docetaxel and offers a treatment option for patients with previously treated advanced NSCLC.

CLINICAL TRIAL NUMBER

Japan Pharmaceutical Information Center, JapicCTI-101155.

[Topping-off surgery versus double-segment fusion for treatment of lumbar degenerative disease with mid-long term follow-up]

Objective: To compare the mid-long term clinical effect of Topping-off surgery and lumbar fusion surgery for two-segmental lumbar degenerative disease. Methods: From March 2009 to March 2012, one hundred and twenty-six consecutive patients (Topping-off surgery and two-segment PLIF surgery) were studied in Orthopedics Department, Beijing Chao-Yang Hospital, Capital Medical University.The VAS and ODI were used to assess clinical symptoms.All patients underwent flexion/extension radiographs examinations before surgery, 1, 2 years and last follow-up postoperatively.Lumbar lordosis, sacral slop, data of Coflex segment and adjacent segment (disc height index, range of motion, foraminal height, foraminal width and Pfirrmann classification of intervertebral disc in MRI) were recorded.The paired double-tailed t test was used to analyze the differences in the results from baseline to each postoperative time point.The paired double-tailed t test was used in both groups to analyze the differences in the results from baseline to each postoperative time point.The Chi-square test was used to evaluate the differences between the incidences of adjacent segment degeneration(ASD) in the groups. Logistic regression analysis was used to analyze risk factors for developing radiographic ASD. Results: In topping-off group, 60 patients, average operation time was (134.5±10.2) min. The average blood loss was (301.5±64.6) ml.In fusion group, 68 patients, average age (58.3±4.6) years.The average follow-up time was (47.5±5.1) months.The average operation time was (158.6±19.3) min (P=0.000). The average blood loss was (413.6±131.3) ml (P=0.000). Sex, age, body mass index and intervertebral disc grading were matched between the two groups.Better improvement in VAS back pain score was noted in the topping-off group over the fusion group (P=0.030). Both groups achieved good recovery in ODI and improvement in VAS leg pain and back pain scores at last follow-up postoperatively.In the Topping-off group, FH increased from 10.5 mm at baseline to 11.8 mm at 1 year after surgery (P=0.000) and then decreased mildly in the third postoperative year, while in the fusion group, showed no significant change at all postoperative time points.In the fusion group, the disc height and FW at the same segment were no significant change after first year follow-up, while ROM was significantly decreased after surgery (P=0.000). Foraminal height, foraminal width and intervertebral disc height of adjacent segment of Coflex implant level were found decreased at the end of the postoperative follow-up, while compared with preoperative data no significant difference (P>0.05). At last follow-up, eight patients (13.3%) in the Topping-off group and eighteen patients (26.5%) in the fusion group developed ASD (P=0.033). Conclusions: Topping-off surgery compared with two-segment lumbar fusion surgery can achieve a good result in cases with pre-existing mild or moderate adjacent segment degeneration, restrict the adjacent segment's range of motion and reduce the adjacent segment degeneration. Under strict indications, Topping-off surgery is an acceptable alternative to fusion surgery for the treatment of two-segment lumbar disease.

Identification of the Lowest T=2, J^{π}=0^{+} Isobaric Analog State in ^{52}Co and Its Impact on the Understanding of β-Decay Properties of ^{52}Ni

Masses of ^{52g,52m}Co were measured for the first time with an accuracy of ∼10  keV, an unprecedented precision reached for short-lived nuclei in the isochronous mass spectrometry. Combining our results with the previous β-γ measurements of ^{52}Ni, the T=2, J^{π}=0^{+} isobaric analog state (IAS) in ^{52}Co was newly assigned, questioning the conventional identification of IASs from the β-delayed proton emissions. Using our energy of the IAS in ^{52}Co, the masses of the T=2 multiplet fit well into the isobaric multiplet mass equation. We find that the IAS in ^{52}Co decays predominantly via γ transitions while the proton emission is negligibly small. According to our large-scale shell model calculations, this phenomenon has been interpreted to be due to very low isospin mixing in the IAS.

GS-9857 in patients with chronic hepatitis C virus genotype 1-4 infection: a randomized, double-blind, dose-ranging phase 1 study

GS-9857, an inhibitor of the hepatitis C virus (HCV) nonstructural protein (NS) 3/4A, demonstrates potent activity against HCV genotypes 1-6 and improved coverage against commonly encountered NS3 resistance-associated variants (RAVs). In this study, the safety, tolerability, antiviral activity and pharmacokinetics (PK) of GS-9857 were evaluated in patients with chronic HCV genotype 1-4 infection. Patients with genotype 1-4 infection received placebo or once-daily GS-9857 at doses ranging from 50 to 300 mg for 3 days under fasting conditions. GS-9857 was well tolerated; all reported adverse events (AEs) were mild or moderate in severity. Diarrhoea and headache were the most commonly reported AEs. Grade 3 or 4 laboratory abnormalities were observed in 17% of patients receiving GS-9857; there were no Grade 3 or 4 abnormalities in alanine aminotransferase, aspartate aminotransferase or alkaline phosphatase levels. GS-9857 demonstrated potent antiviral activity in patients with chronic HCV infection, achieving mean and median maximum reductions in HCV RNA of ≥3 log10 IU/mL following administration of a 100-mg dose in patients with HCV genotype 1a, 1b, 2, 3 or 4 infection. The antiviral activity of GS-9857 was unaffected by the presence of pretreatment NS3 RAVs. In patients with genotype 1-4 infection, GS-9857 exhibited linear PK and was associated with a median half-life of 29-42 h, supporting once-daily dosing. Thus, the tolerability, efficacy and pharmacokinetic profile of GS-9857 support its further evaluation for treatment of patients with chronic HCV infection.

[Radiographic study of Coflex interspinous device for lumbar spinal stenosis]

OBJECTIVE

To assess the radiography change of lumbar spinal stenosis (LSS) treated with the implantation of Coflex interspinous device retrospectively.

METHODS

Sixty patients (34 male and 26 female) with LSS who underwent the decompression and Coflex device implanted surgery from January 2010 to December 2013 were followed up. The mean age of the patients was 59.4 years. There were 33 cases underwent Coflex surgery and 27 cases underwent Topping-off surgery. The Coflex segment ranged from L1/2 to L4/5 (L1-2: 1, L2-3: 5, L3-4: 19, L4-5: 35). The foraminal height, foraminal width and intervertebral space height change of the Coflex segment as well as its adjacent segment were recorded pre-/post-operatively and at last follow-up.Meanwhile, the Oswestry Disability Index(ODI) and Visual Analog Scale(VAS) were measured in all patient pre-/post-operatively and at last follow-up. The measurement data was recorded asx±s. And the independent and paired samples t-test was used to conduct the statistical analysis.

RESULTS

The foraminal height(FH) increased from (19.82±2.38) mm to (22.28±2.95) mm (P<0.05) post-operatively, and the FH decreased to (19.31±3.32) mm at the last follow up(P>0.05, compared to the post-operation). The average foraminal width(FW) was 11.2 mm, 11.58 mm and 11.12 mm at pre-/post-operation and follow up, which had no significant different change(P>0.05). The post-operative intervertebral space height (ISH) increased from (7.84±1.56) mm to (10.05±2.39) mm(P<0.05), and the ISH decreased to (7.91±1.77) mm at the last follow up(P>0.05, compared to the post-operation). The amount of the decreased FH and ISH had no significant difference when comparing the Coflex segment with its adjacent (Coflex±1) segments (P>0.05). The lumbar lordosis(LL) was 43.13°±15.93°, 38.41°±10.82° and 43.10°±13.21° at pre-/post-operation and follow up, there was no significant difference between pre- and post-operation(P>0.05). All patients showed statistically significant improvement(P<0.05) in the clinical outcome assessed in the VAS and ODI at the time of follow up compared to the pre-operation. The ODI score decreased from 65.12±13.56 to 9.89±1.77; the VAS score decreased from 8.02±1.81 to 1.66±0.51.

CONCLUSIONS

Coflex device could temporarily improve the FH and ISH after operation. However, it could not maintain the improvement as the follow-up time extended. The surgical decompression is the responsible factor for the good clinical outcome but not the improvement of FH.

A phase 3b study of sofosbuvir plus ribavirin in treatment-naive and treatment-experienced Korean patients chronically infected with genotype 2 hepatitis C virus

In Korea, patients with chronic hepatitis C virus (HCV) infection are typically treated with pegylated interferon-alpha plus ribavirin, but interferons are contraindicated in many patients and are often poorly tolerated, particularly by the elderly and those with advanced liver disease. No interferon-free treatment regimens are approved in Korea. Sofosbuvir is an oral nucleotide analog inhibitor of the HCV nonstructural 5B RNA polymerase. It is approved in the USA, European Union and Japan for treating a number of HCV genotypes, including genotype 2. Genotype 2 has a seroprevalence of 38-46% in Korea. This single-arm, phase 3b study (NCT02021643) examined the efficacy and safety of sofosbuvir plus ribavirin (12-week duration) in chronic genotype 2 HCV-infected treatment-naive and treatment-experienced Korean patients with and without cirrhosis. The proportion of patients with sustained virologic response 12 weeks after treatment discontinuation (SVR12) was 97% (125/129), with 96% (101/105) of treatment-naive and 100% (24/24) of treatment-experienced patients achieving SVR12. Two patients experienced virologic failure (n = 1, on-treatment failure; n = 1, relapse). No patient discontinued study treatment due to an adverse event (AE). The most common treatment-emergent AEs were headache (18%, 23/129) and pruritus (15%, 19/129). Few patients had grade 3 AEs (5%, 6/129) or grade 3 laboratory abnormalities (12%, 15/129). No grade 4 AE was reported. These data suggest that 12 weeks of treatment with the all-oral, interferon-free regimen of sofosbuvir plus ribavirin is effective and well tolerated in Korean patients with chronic genotype 2 HCV infection.

Sofosbuvir plus ribavirin for the treatment of patients with chronic genotype 1 or 6 hepatitis C virus infection in Hong Kong

BACKGROUND

In Hong Kong, most patients with hepatitis C virus (HCV) have either genotype 6a or 1b infection.

AIM

To evaluate the efficacy and safety of sofosbuvir with ribavirin in treatment-naïve patients in Hong Kong with HCV genotype 1 or 6.

METHODS

In an open-label study, patients were randomised to sofosbuvir 400 mg once daily plus ribavirin 1000-1200 divided twice daily for 12 (n = 10), 16 (n = 11) or 24 (n = 10) weeks. The primary endpoint was the percentage of patients with HCV RNA < LLOQ (lower limit of quantification, 25 IU/mL) 12 weeks after cessation of therapy (SVR12).

RESULTS

All 31 patients (20 HCV genotype 1 and 11 genotype 6) had HCV RNA < LLOQ by Week 4 of treatment and at their last on-treatment visit. SVR12 rates were high in all treatment groups: 100% (10/10) for 12 weeks, 100% (11/11) for 16 weeks and 90% (9/10) for 24 weeks of therapy. The only patient who did not reach SVR12 had genotype 1 HCV and relapsed at post-treatment Week 4. Sofosbuvir with ribavirin was generally well tolerated. The most common adverse events were malaise (13%) and upper respiratory tract infection (13%), followed by anaemia (10%). No patients experienced serious adverse events. One patient discontinued treatment at Week 16 because of an adverse event. The event, upper respiratory tract infection, was not considered treatment related by the investigator. This subject achieved SVR12.

CONCLUSIONS

The all-oral regimen sofosbuvir plus ribavirin is effective in treatment-naïve patients in Hong Kong with genotype 1 or 6 HCV.

TRIAL REGISTRATION NUMBER

NCT02021643.

Evaluation of the predictors of postoperative aggravation of shoulder imbalance in severe and rigid thoracic or thoracolumbar scoliosis

OBJECTIVE

To study the predictors of postoperative aggravation of shoulder imbalance in severe and rigid thoracic or thoracolumbar scoliosis.

METHODS

In this study, 49 patients with severe and rigid thoracic or thoracolumbar scoliosis were analyzed retrospectively. The patients underwent whole-spine anteroposterior and lateral radiography preoperatively and postoperatively. On the radiographs, we measured parameters, including T1 tilt, radiographic shoulder height (RSH), proximal curve, middle curve, distal curve, apical vertebral translation (AVT) of the middle curve, thoracic trunk shift (TTS), coronal balance, and sagittal balance. We regarded RSH and T1 tilt as postoperative shoulder balance parameters and divided the patients into improved and aggravated groups of shoulder imbalance. Univariate analysis, receiver operating characteristic (ROC) curve, and multivariate logistic regression analyses were used in the statistical analyses.

RESULTS

The RSH was -17.01 ± 21.85 mm before surgery and 4.76 ± 18.11 mm at follow-up. The T1 tilt angle was -10.20° ± 19.53° before surgery and -2.72° ± 13.48° at follow-up. The results of the univariate analysis suggest that preoperative RSH and proximal to middle curve change ratio were significantly higher in the patients in the improved RSH group (p < 0.01). In addition, preoperative RSH, preoperative T1 tilt, and apical vertebral translation of the middle curve were significantly higher, and preoperative proximal curve, postoperative proximal curve, and preoperative distal curve were significantly lower in the patients with improved T1 tilt group (p < 0.01). In a binary logistic regression analysis, preoperative RSH [B = -0.120, odds ratio (OR) = 0.887, p = 0.006] was found to be an independent predictor of postoperative aggravation of RSH. Similarly, preoperative T1 tilt (B = -0.488, OR = 0.614, p = 0.001) was found to be an independent predictor of postoperative aggravation of T1 tilt. Moreover, the relationship between changes in RSH and T1 tilt was either concordant or discordant.

CONCLUSION

Several radiographic parameters were found to affect postoperative aggravation of RSH and T1 tilt. In particular, preoperative RSH and T1 tilt were found to be independent predictive factors of postoperative aggravation of RSH and T1 tilt, respectively.

Using the modified Delphi method to establish a new Chinese clinical consensus of the treatments for cervical radiculopathy

PURPOSE

Although cervical radiculopathy is very common, there is no standard treatment for this condition, with little high-level evidence available to guide the treatment choice. Thus, this study aimed to review the current data on the management of cervical radiculopathy; and, further, to establish a new Chinese clinical consensus of the treatments for cervical radiculopathy using the Delphi method.

METHODS

First, a systematic review of the previously established treatment guidelines and of articles related to cervical radiculopathy was conducted to establish a protocol for the clinical consensus of the treatment for cervical radiculopathy. Second, from February 2012 to June 2014, we performed a modified Delphi survey in which the current professional opinions from 30 experienced experts, representing almost all of the Chinese provinces, were gathered. Three rounds were performed, and consensus was defined as ≥70% agreement.

RESULTS

Consensus of the treatments for cervical radiculopathy was reached on seven aspects, including the proportion of patients requiring only non-surgical therapies; the effectiveness of neck immobilization, physiotherapy, pharmacologic treatment; surgical indications; contraindications; surgery.

CONCLUSIONS

The modified Delphi study conducted herein reached a consensus concerning several treatment issues for cervical radiculopathy. In the absence of high-level evidence, at present, these expert opinion findings will help guide health care providers to define the appropriate treatment in their regions. Items with no consensus provide excellent areas for future research.

Identification of the man-made barium copper silicate pigments among some ancient Chinese artifacts through spectroscopic analysis

This article describes the complementary application of non-invasive micro-Raman spectroscopy and energy dispersive X-ray fluorescence spectrometry to the characterization of some ancient Chinese silicate artifacts. A total of 28 samples dated from fourth century BC to third century AD were analyzed. The results of chemical analysis showed that the vitreous PbO-BaO-SiO2 material was used to sinter these silicate artifacts. The barium copper silicate pigments including BaCuSi4O10, BaCuSi2O6 and BaCu2Si2O7 were widely identified from colorful areas of the samples by Raman spectroscopy. In addition, other crystalline phases such as Fe2O3, BaSi2O5, BaSO4, PbCO3 and quartz were also identified. The present study provides very valuable information to trace the technical evolution of man-made barium copper silicate pigments and their close relationship with the making of ancient PbO-BaO-SiO2 glaze and glass.

Conduction control at ferroic domain walls via external stimuli

Intriguing functionalities at nano-sized domain walls have recently spawned a new paradigm for developing novel nanoelectronics due to versatile characteristics. In this study, we explore a new scenario to modulate the local conduction of ferroic domain walls. Three controlling parameters, i.e., external electrical field, magnetic field and light, are introduced to the 90° domain walls (90° DWs) of BiFeO₃. Electrical modulation is realized by electrical transport, where the mobility of 90° DWs can be altered by gating voltage. We further use the ferromagnetic/antiferromagnetic coupling to reveal the inherent magnetism at the DWs. With an established magnetic nature, magnetotransport has been conducted to introduce magnetic controlling parameter, where a giant positive magnetoresistance change can be observed up to 200%. In addition, light modulated conduction, a core factor for multifunctional applications, is successfully demonstrated (current enhancement by a factor of 2 with 11 W white lamp). These results offer new insights to discover the tunability of domain wall nanoelectronics.

Targeting autophagy overcomes Enzalutamide resistance in castration-resistant prostate cancer cells and improves therapeutic response in a xenograft model

Macro-autophagy is associated with drug resistance in various cancers and can function as an adaptive response to maintain cell survival under metabolic stresses, including androgen deprivation. Androgen deprivation or treatment with androgen receptor (AR) signaling inhibitor (ARSI), Enzalutamide (MDV-3100, ENZA) or bicalutamide induced autophagy in androgen-dependent and in castration-resistant CaP (castration-resistant prostate cancer (CRPC)) cell lines. The autophagic cascade triggered by AR blockage, correlated with the increased light chain 3-II/I ratio and ATG-5 expression. Autophagy was observed in a subpopulation of C4-2B cells that developed insensitivity to ENZA after sustained exposure in culture. Using flow cytometry and clonogenic assays, we showed that inhibiting autophagy with clomipramine (CMI), chloroquine or metformin increased apoptosis and significantly impaired cell viability. This autophagic process was mediated by AMP-dependent protein kinase (AMPK) activation and the suppression of mammalian target of rapamycin (mTOR) through Raptor phosphorylation (Serine 792). Furthermore, small interfering RNA targeting AMPK significantly inhibited autophagy and promoted cell death in CaP cells acutely or chronically exposed to ENZA or androgen deprivation, suggesting that autophagy is an important survival mechanism in CRPC. Lastly, in vivo studies with mice orthotopically implanted with ENZA-resistant cells demonstrated that the combination of ENZA and autophagy modulators, CMI or metformin significantly reduced tumor growth when compared with control groups (P<0.005). In conclusion, autophagy is as an important mechanism of resistance to ARSI in CRPC. Antiandrogen-induced autophagy is mediated through the activation of AMPK pathway and the suppression of mTOR pathway. Blocking autophagy pharmacologically or genetically significantly impairs prostate cancer cell survival in vitro and in vivo, implying the therapeutics potential of autophagy inhibitors in the antiandrogen-resistance setting.

Orthorhombic BiFeO3

A new orthorhombic phase of the multiferroic BiFeO3 has been created via strain engineering by growing it on a NdScO(3)(110)(o) substrate. The tensile-strained orthorhombic BiFeO3 phase is ferroelectric and antiferromagnetic at room temperature. A combination of nonlinear optical second harmonic generation and piezoresponse force microscopy revealed that the ferroelectric polarization in the orthorhombic phase is along the in-plane {110}(pc) directions. In addition, the corresponding rotation of the antiferromagnetic axis in this new phase was observed using x-ray linear dichroism.

Inorganic phosphorus fractionation and its translocation dynamics in a low-P soil

The translocation of different inorganic phosphorus (Pi) forms in a low-P soil (Langfang experimental station, Hebei province, China) over time was investigated using P fractionation extraction and a (32)P tracer technique. The L-value and P availability of the soil was assessed using 5 different maize genotype (Zea mays L.) cultivars. The results showed that the different Pi fractions in the soil increased in the order of H(2)SO(4)-extractable P (Ca(10)-P) > Na(3)C(6)H(5)O(7)-Na(2)S(2)O(4)-extractable P (O-P) > NH(4)Ac-extractable P (Ca(8)-P) > NaHCO(3)-extractable P (Ca(2)-P), NH(4)F-extractable P (Al-P), NaOH-Na(2)CO(3)-extractable P (Fe-P), and the content of plant-unavailable P (Ca(10)-P + O-P) was high, up to 79.1%, which might be an important reason for P deficiency in this low-P soil. The (32)P tracer results showed that after the addition of (32)P-Pi to the soil with no P fertilizer applied for 25 d, 29.0% of (32)P was quickly transformed into Ca(2)-P (rapidly available P), and 66.1% of (32)P was transformed into Al-P, Fe-P and Ca(8)-P (slowly available P). Only 5.0% of (32)P was transformed into O-P and Ca(10)-P (plant-unavailable P). Moreover, in the soil with P fertilizer applied, (32)P transformation into Ca(2)-P increased, and the transformation into Ca(8)-P + Fe-P + AL-P and O-P, Ca(10)-P significantly decreased compared to the soil with no P fertilizer applied (p < 0.05). This result suggested a higher rate for water-soluble P transformation to slowly available and plant-unavailable P in P deficient soil than in soil with sufficient P. The results of maize L-value determination showed that different genotype maize cultivars had different soil P-use efficiency and low-P tolerance mechanisms. Low-P tolerant cultivar DSY-32 regulated soil P-use efficiency and plant P content according to exogenous P fertilizer application. However, another low-P tolerant cultivar, DSY-2, used soil P more efficiently, regardless of the application of exogenous P.

Mass measurements of the neutron-deficient 41Ti, 45Cr, 49Fe, and 53Ni nuclides: first test of the isobaric multiplet mass equation in f p-shell nuclei

Isochronous mass spectrometry has been applied to neutron-deficient 58Ni projectile fragments at the HIRFL-CSR facility in Lanzhou, China. Masses of a series of short-lived T(z)=-3/2 nuclides including 41Ti, 45Cr, 49Fe, and 53Ni have been measured with a precision of 20-40 keV. The new data enable us to test for the first time the isobaric multiplet mass equation (IMME) in fp-shell nuclei. We observe that the IMME is inconsistent with the generally accepted quadratic form for the A=53, T=3/2 quartet. We perform full space shell model calculations and compare them with the new experimental results.

Direct mass measurements of short-lived A=2Z-1 nuclides (63)Ge, (65)As, (67)Se, and (71)Kr and their impact on nucleosynthesis in the rp process

Mass excesses of short-lived A=2Z-1 nuclei (63)Ge, (65)As, (67)Se, and (71)Kr have been directly measured to be -46,921(37), -46,937(85), -46,580(67), and -46,320(141)  keV, respectively. The deduced proton separation energy of -90(85)  keV for (65)As shows that this nucleus is only slightly proton unbound. X-ray burst model calculations with the new mass excess of (65)As suggest that the majority of the reaction flow passes through (64)Ge via proton capture, indicating that (64)Ge is not a significant rp-process waiting point.

Assessment of soil contamination with Cd, Pb and Zn and source identification in the area around the Huludao Zinc Plant

The distribution characteristics of heavy metals (cadmium (Cd), lead (Pb) and zinc (Zn)) in the natural soil profiles around the Huludao Zinc Plant (HZP), an old industrial base in Northeast China, were analyzed. The pollutant source was identified using (210)Pb isotope technique to evaluate the geochemical characteristics of Pb and the historical production records of HZP. The results indicated: dust precipitation from HZP was the primary source of the pollutants. The average deposition rates of Cd, Pb and Zn were 0.33, 1.75, and 30.97 g/m(2)year, respectively at 1 km away after HZP, and 0.0048, 0.035, and 0.20 g/m(2) year, respectively at 10 km away after HZP. There is a risk of secondary pollution to the environment as well as the food chain in seriously polluted areas used for cultivation.

A single nucleotide polymorphism and sequence analysis of CSN1S1 gene promoter region in Chinese Bos grunniens (yak)

The aim of this study was to investigate the polymorphism of the CSN1S1 gene promoter region in 4 Chinese yak breeds, and compare the yak CSN1S1 gene promoter region sequences with other ruminants. A Polymerase Chain Reaction-Single Strand Conformation Polymorphism protocol was developed for rapid genotyping of the yak CSN1S1 gene. One hundred fifty-eight animals from 4 Chinese yak breeds were genotyped at the CSN1S1 locus using the protocol developed. A single nucleotide polymorphism of the CSN1S1 gene promoter region has been identified in all yak breeds investigated. The polymorphism consists of a single nucleotide substitution G-->A at position 386 of the CSN1S1 gene promoter region, resulting in two alleles named, respectively, G(386) and A(386), based on the nucleotide at position 386. The allele G(386) was found to be more common in the animals investigated. The corresponding nucleotide sequences in GenBank of yak (having the same nucleotides as allele G(386) in this study), bovine, water buffalo, sheep, and goat had similarity of 99.68%, 99.35%, 97.42%, 95.14%, and 94.19%, respectively, with the yak allele A(386.).

Rapid detection of bovine milk in yak milk using a polymerase chain reaction technique

Yak milk contains a greater percentage of protein and has better quality than bovine milk. There has been an increasing focus on yak milk and milk products during the last few years. In the present study, a PCR-based assay was developed for the specific identification of bovine milk in yak milk by designing 3 primers targeting the mitochondrial ND1 gene. The use of 3 primers in a single PCR reaction set yielded 2 amplification fragments of 293 and 190 bp from bovine milk DNA, whereas only 1 amplification fragment of 293 bp was obtained in yak milk DNA. The technique was applied to raw and heat-treated binary mixtures of yak and bovine milks and enabled the specific detection of bovine milk with a detection limit of 0.1%. The assay developed is sensitive, fast, and straightforward, and it might be useful in the quality control of yak milk and milk products.

N-ethoxybenzylimidazoles: a novel acid-sensitive linker for controlled release of therapeutics from drug delivery systems

Abstract #2156

Background:&#x2028; Drug delivery systems (DDS) are useful for cancer therapies because they can target tumors and cancer cells more specifically than cancer therapeutics alone. An important component of a DDS is the triggering mechanism for drug release. This presentation will highlight a new class of N-linked imidazoles as potential acid-sensitive cleavable linkers for use in cancer DDSs. These acid-sensitive linkers are designed to exploit the lower extracellular pH of some tumors and the endosomes and lysosomes within cells to trigger the controlled release of therapeutic agents from drug delivery vessels. Cleavage of N-ethoxybenzylimidazoles (NEBIs) exhibit a 10-fold increase in the rate of hydrolysis in mild aqueous acidic solutions (at pH = 5.5) compared to solutions at normal, physiological pH. The rate of hydrolysis can be tuned to range from minutes to months through the addition of electron donating or withdrawing groups.&#x2028; The NEBI linker can be used to conjugate a cytotoxic agent to a carrier. Carriers for this DDS include molecules such as tumor specific antibodies, polymers/nanoparticles, peptides, and ligands, that can target cancer cells or accumulate around tumors. Cytotoxic agents include FDA approved small molecules and chemotherapeutics.&#x2028; Methods and Materials:&#x2028; The NEBI was developed into a bifunctional crosslinker containing a carboxylic acid and an azide for conjugation of cancer therapeutics to carriers. For simplicity, we used Human Serum Albumin (HSA) as our model carrier and doxorubicin as our model cytotoxic agent. The NEBI was conjugated to doxorubicin through a simple amide coupling. The NEBI was then conjugated to an alkyne containing HSA via “Click Chemistry.”&#x2028; Results:&#x2028; We were able to load approximately 1-2 doxorubicin molecules per HSA. Imaging studies have shown that our HSA conjugates to doxorubicin via a NEBI linker (HSA-NEBI-dox) localize in lysosomes. Cytotoxicity studies show HSA-NEBI-dox is cytotoxic while HSA conjugates to doxorubicin via a stable linkage is not.&#x2028; Discussion:&#x2028; We were able to develop methods for conjugating doxorubicin to HSA. The techniques used here can be applied to conjugate other carriers and other cancer therapeutics. We will continue to develop the NEBI linker and demonstrate how the linker can be used to conjugate trastuzumab to doxorubicin. We chose use trastuzumab, a monoclonal antibody, as a carrier because it is known to bind to the HER2 receptor. HER2 is over expressed in 25%-30% of breast cancers. Trastuzumab not only targets cancer cells that are over expressing the HER2 receptor, but binding of trastuzumab to the HER2 receptor can trigger receptor mediated endocytosis, which can lead to controlled release of doxorubicin within the cell.&#x2028; &#x2028;

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2156.

Src family kinase oncogenic potential and pathways in prostate cancer as revealed by AZD0530

Prostate cancer is the most frequently diagnosed cancer in American men. We have previously demonstrated that Src mediates androgen-independent proliferation in prostate cancer. We sought to investigate the Src-mediated oncogenic pathways and tumor biology using AZD0530, a novel Src family kinase/Abl dual-kinase inhibitor that is entering phase II clinical trials. We show that while both Src and Abl are expressed in all prostate cancer cell lines, Src but not Abl is activated in the prostate. Furthermore, Src activation is inhibited by AZD0530 in a rapid and dose-dependent manner. We show that Src mediates cell proliferation in DU145 and PC3 cells at the G1 phase of cell cycle. Src inhibition resulted in decreased binding of beta-catenin to the promoters of G1 phase cell cycle regulators cyclin D1 and c-Myc. C-Myc may also be regulated at the protein level by extracellular signal-regulated kinase 1/2 and GSK3beta. Cell motility factors focal adhesion kinase, p130CAS and paxillin activation in DU145 and PC3 cells were also inhibited. Administration of AZD0530 in mice reduced orthotopic DU145 xenograft growth by 45%. We have further delineated the Src-mediated oncogenic growth and migration pathways in prostate cancer and established mechanistic rationale for Src inhibition as novel therapy in the treatment of prostate cancer.

Effects of external phosphorus on the cell ultrastructure and the chlorophyll content of maize under cadmium and zinc stress

Using scanning electron microscopy (SEM) and transmission electron microscopy (TEM) analysis, it was found that the ultrastructure of chloroplasts were changed, the shape of the chloroplasts altered and the numbers of grana that were asymmetrical increased; the numbers of grana and thylakoids decreased under the stress of Cd and Zn. The results indicated that the complex pollution involving Cd and Zn resulted in the membrane system of chloroplasts being damaged. When external phosphorus was applied, the numbers of damaged chloroplasts were significantly reduced and the nucleoli were better formed than those that did not receive phosphorus treatment. Moreover, many phosphate deposits were found in the vacuoles and on the surface of the roots, which were formed by phosphorus complexing with Cd (K(sp)=2.53x10(-33)) and Zn (K(sp)=9.00x10(-33)), respectively. Treatment with phosphorus conduced an increased chlorophyll content in plants compared with those that did not receive external phosphorus.

Operating characteristics of solid-state fermentation bioreactor with air pressure pulsation

The development of solid state fermentation (SSF) technology is very important to the production of cellulase and ultimately to the utilization of natural cellulose. However, inadequate dissipation of heat generated by biological activities has prevented solid state fermentation from large-scale applications. The paper deals with the development of a novel SSF bioreactor with air pressure pulsation. By developing a measurement and control system under Virtual Instrument (VI) concept, performance of SSF bioreactor with pressure pulsation was studied by cultivating Trichoderma koningii in solid medium made of wheat bran and corncob. The cooling effects of pressure pulsation on solid porous beds are discussed. Experimental results show that pressure pulsation enhances medium moisture evaporation, and hence, heat dissipation. Furthermore, through changing the pressure pulsation directions, it is able to mitigate the temperature gradients in the bioreactor. To sum up, pressure pulsation can provide the microbes with a growing environment at optimal temperature and medium water content.