[Research progress of macrophage polarization in silicosis fibrosis]

Silicosis is a common occupational disease, and its main characteristic pathological features are the formation of silicon nodules and diffuse pulmonary fibrosis. In the process of silicosis fibrosis, macrophages can be polarized into M1 macrophages and M2 macrophages. M1 macrophages play a pro-inflammatory role in the early stage of silicosis and release a variety of inflammatory factors, which is the core of inflammatory response. M2 macrophages promote inflammation resolution and tissue repair in silicosis fibrosis stage by secreting anti-inflammatory cytokines and pro-fibrotic mediators. M1/M2 polarization balance plays an important role in the occurrence and development of silicosis, and the regulation of macrophage polarization direction may play a positive role in the prevention and treatment of silicosis fibrosis. In this review, the role of macrophage polarization in silicosis fibrosis, the related signaling pathways regulating macrophage polarization in silicosis fibrosis, and the potential therapeutic targets based on macrophage polarization in silicosis fibrosis are reviewed, with a view to further strengthening the understanding of the mechanism of macrophage polarization in the pathogenesis and treatment of silicosis fibrosis.

Genetic variation of six specific SNPs of chronic obstructive pulmonary disease among Chinese population

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a chronic bronchitis (or) emphysema with a high disability and fatality rate. This study aimed to explore the correlation between the six selected single nucleotide polymorphisms (SNPs) and the risk of COPD in the Chinese population.

METHODS

The Agena MassARRAY platform was used to select six SNPs from 629 subjects for genotyping. The correlation between SNPs and COPD risk was evaluated using calculated odds ratios (ORs) and 95% confidence intervals (CIs). Multi-factor dimensionality reduction (MDR) was performed to analyze the impact of SNP interactions on COPD risk. Multiple comparisons were performed using Bonferroni- correction.

RESULTS

Our results indicated that rs4719841 and rs7934083 variants were associated with a reduced risk of COPD. The analysis results of age, gender and non-smokers showed that rs4719841 and rs7934083 were associated with reducing the risk of COPD. In addition, the results showed that the genetic models of rs4719841, rs7934083 and rs7780562 were related to the forced vital capacity, respiratory rate per second, and respiratory rate / forced vital capacity of COPD patients, respectively. The results of the MDR analysis showed that the three-locus model (rs4719841, rs7934083, and rs78750958) is the best for COPD risk assessment.

CONCLUSION

This study shows that rs4719841 and rs7934083 are associated with the risk of COPD in the Chinese population, which provides some insights for early screening, prevention, and diagnosis of COPD in high-risk populations.

Carboxymethylcellulose hydrogels with stable carbon quantum dots: Enabling dynamic fluorescence modulation, automatic erasure, and secure information encryption

Inspired by "disappear after reading", a time-modulated encryption hydrogel was synthesized by carboxymethyl cellulose with carbon quantum dots. Carboxymethyl cellulose in this system stabilized carbon quantum dots, which ensured the whole hydrogel worked well. The encryption/decryption of information depended on pH adjustment, application of EDTA and Cr (VI). Furthermore, an in-depth analysis of the fluorescence change mechanism uncovered that fluorescence quenching was potentially influenced by internal filtering effects and static quenching, which involved the amino, carboxyl, and hydroxyl groups present within the hydrogel.

Blocking Metal Nanocluster Growth through Ligand Coordination and Subsequent Polymerization: The Case of Ruthenium Nanoclusters as Robust Hydrogen Evolution Electrocatalysts

Metal nanoclusters providing maximized atomic surface exposure offer outstanding hydrogen evolution activities but their stability is compromised as they are prone to grow and agglomerate. Herein, a possibility of blocking metal ion diffusion at the core of cluster growth and aggregation to produce highly active Ru nanoclusters supported on an N, S co-doped carbon matrix (Ru/NSC) is demonstrated. To stabilize the nanocluster dispersion, Ru species are initially coordinated through multiple Ru─N bonds with N-rich 4'-(4-aminophenyl)-2,2:6',2''-terpyridine (TPY-NH2 ) ligands that are subsequently polymerized using a Schiff base. After the pyrolysis of the hybrid composite, highly dispersed ultrafine Ru nanoclusters with an average size of 1.55 nm are obtained. The optimized Ru/NSC displays minimal overpotentials and high turnover frequencies, as well as robust durability both in alkaline and acidic electrolytes. Besides, outstanding mass activities of 3.85 A mg-1 Ru at 50 mV, i.e., 16 fold higher than 20 wt.% Pt/C are reached. Density functional theory calculations rationalize the outstanding performance by revealing that the low d-band center of Ru/NSC allows the desorption of *H intermediates, thereby enhancing the alkaline HER activity. Overall, this work provides a feasible approach to engineering cost-effective and robust electrocatalysts based on carbon-supported transition metal nanoclusters for future energy technologies.

Multifunctional Organohydrogels for pH-Responsive Fluorescent and Electrostimulus Writing

Hydrogels have attracted widespread attention in anticounterfeiting due to their unique physical/chemical properties and designability. However, hydrogels' poor mechanical properties and sluggish response to chemical stimuli pose challenges for their wide application. A fluorescent tough organohydrogel capable of freeform writing of information is reported in this work. By incorporation of the fluorescent monomer 7-methylacryloxy-4-methylcoumarin into the polyacrylamide network in a covalently cross-linked manner while intertwining with the carboxymethyl cellulose sodium network, a fluorescent tough organohydrogel with a dual-network structure is prepared. The organohydrogel shows acid-base-mediated adjustable fluorescence through the transformation of fluorescent monomers. Ion printing and electrical stimulation design achieved free information storage and encryption. In addition, the prepared organohydrogel has good antifreezing properties and can be encrypted and decrypted at subzero temperatures. The encrypted information in the organohydrogel can be read only after UV-light irradiation. These patterned fluorescent organohydrogels should find applications in protected message displays for improved information security.

Prediction of Anatomical Presentation during Radiotherapy of Nasopharyngeal Carcinoma Using GAN-LSTM for Plan Adaption Decision

PURPOSE/OBJECTIVE(S)

During treatment, patients frequently undergo anatomical changes that might result in dose degradation. Adaptive radiation therapy (ART) is now available to overcome this problem. However, this method is time-consuming, and the lack of criteria to trigger replanning prevents its widespread use. To overcome these obstacles, anatomical presentation models are necessary. In this study, we developed a novel deep-learning method to make a series of predictions for the remaining treatment course.

MATERIALS/METHODS

Total 230 nasopharyngeal carcinoma patients who received radiotherapy in 33 fractions were enrolled. The data included cone-beam computed tomography (CBCT) and planning CT images. CBCT image quality was improved to CT level using an in-house software. A generative adversarial network-long short-term memory network model was proposed, with the generation abilities of the former network and forecasting abilities of the latter. To predict the anatomical presentation for 3-6 weeks, we trained four models. The planning CT and CBCT acquired earlier were used as the input. Physicians segmented the gross target volume (GTVnx) and parotid glands on prediction and real CBCT (ground truth). Contours, dosimetry parameters, and plan adaptation decision were used to evaluate the models.

RESULTS

The table shows the overall performance of the test set (18 cases). The anatomical changes were predicted over the treatment course with a dice similarity coefficient (DSC) of 0.96, 0.90 and 0.92 and mean distance to agreement (MDA, in mm) of 0.37, 0.70, and 0.60 for GTVnx, left parotid, and right parotid, respectively. Bland-Altman analysis revealed that dosimetry parameters did not show significant difference between prediction and ground truth. The prescription coverage (%) of GTVnx, V30 of the left parotid, and V30 of the right parotid had mean absolute biases of 0.09, 1.09, and 0.27, respectively. At week 6, there were two cases that required plan adaptation, and the model effectively triggered replanning one week in advance.

CONCLUSION

We developed a framework that predicts the anatomical changes occurring in future fractions. Establishing such a framework provides a proactive approach to ART and saves clinical time by anticipating and preparing for treatment strategies in advance.

Tumor Treatment Response Assessed During the Concurrent Chemoradiotherapy for Nasopharyngeal Patients

PURPOSE/OBJECTIVE(S)

To evaluate intratumoral treatment response distribution with using FDG-PET/CT during the chemoradiotherapy of nasopharyngeal patients (NPC).

MATERIALS/METHODS

A total of 5 of 30 patients with stage III-IVA NPC were enrolled in the institutional protocol for induction/concurrent chemoradiotherapy with radiation dose of 70 Gy in 33 fractions. For each patient, a pre-radiation treatment FDG-PET/MRI image (SUV0) and a mid-treatment image (SUVm) at the treatment dose of 31.8 Gy were obtained. Followed by deformable PET/MRI registration between SUV0 and SUVm, the tumor voxel SUV reduction ratio was obtained to construct a tumor dose response matrix (DRM). Tumor SUVavid was also constructed by limiting tumor voxel SUVm > a given value. Spatial correlations of the tumor SUV0, SUVm, SUVavid and DRM were determined.

RESULTS

The mean and coefficient variation (CV) of the SUV0, SUVm and DRM for all tumors were 5.05 (52%), 2.72 (49%) and 0.64 (63%) (Table contains the individual data), which were smaller than those on the SUVs of head-n-neck HPV+ patients reported previously due to the induction chemotherapy, but had much larger DRM mean and CV. The inter-tumoral CVs of SUV0 and DRM were 29% and 27%, which were much lower than those of the intra-tumoral CVs 43% and 57%. Meanwhile, the intra-tumoral variations on SUV0 was smaller than the one of head-neck HPV+ patients, but the DRM intra-variation was much larger. There was a weak correlation between SUV0 and SUVm with the correlation coefficient 0.13, a medium correlation of -0.55 between SUV0 and DRM, but a strong correlation, 0.72, between SUVm and DRM. However, the spatial correlation between tumor DRM and SUVavid was getting weaker as the SUVavid value increasing and equal 0.47 with SUVavid value > 3.

CONCLUSION

The spatial dose response DRM for NPC in the concurrent chemoradiotherapy was relatively high, while had relatively low baseline tumor metabolic activity SUV0. It was most likely due to the induction chemotherapy. In addition, the tumor dose response showed vary large intra-tumoral variation. The high correlations between DRM and SUVm imply that SUVavid could be used partially to guide adaptive modification of NPC treatment with carefully selected boundary value.

Efficacy and Safety of High-Dose Vitamin C Combined with Total Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer (HCCSC R02 Study)

PURPOSE/OBJECTIVE(S)

Forpatients with locally advanced rectal cancer (LARC), the standard treatment is fluoropyrimidine (FU) -based neoadjuvant chemoradiotherapy (NCRT) combined with curative surgery. The CAO/ARO/AIO-04 trial and FORWARC trial reported that the addition of oxaliplatin to FU -based NCRT contributed to improve pathologic complete response (pCR), nevertheless, increased the acute therapeutic toxicity. Some studies showed that vitamin C (VitC) had potential benefits on anti-tumor therapy and anti-inflammatory response. Therefore, we conducted this HCCSC R02 study to explore the efficacy and safety of adding a high-dose intravenous VitC to mFOLFOX6/XELOX -based NCRT in LARC.

MATERIALS/METHODS

HCCSCR02 study was designed as a prospective, single-center phase II trial, which including pts aged 18-75 years with stage II/III rectal adenocarcinoma, distance from anus ≤12cm. The enrollment criteria included: staged with MRI as cT3/cT4 or cN1/2, or mesorectal fascia involvement (MRF+), or difficult to preserve the anus. Patients with glucose-6-phosphate dehydrogenase enzyme(G6PD) deficiency were excluded. Pelvic intensity modulated radiation therapy (IMRT) was given in 45-50.4Gy/25-28 fractions. Concurrently, two cycles of chemotherapy (mFOLFOX6 or XELOX) were administered during IMRT, as well as intravenous VitC (24g) delivered daily after the end of each radiation therapy. Additional 2-3 cycles of mFOLFOX6 / XELOX were adopted between the completion of radiotherapy and surgery. The primary endpoint was pCR rate. The secondary endpoints included radiation-related toxicities, overall survival (OS) and disease-free survival (DFS). This study is still recruiting.

RESULTS

From May 15, 2021 to Feb 8, 2023, 19 pts were recruited and finished all the scheduled NCRT, of which the proportion of cT4, cT3, cN2, cN1 were 31.6%, 63.2%, 52.6%, 36.8%, respectively. In addition, 10 pts (52.6%) were diagnosed as MRF+ initially, and 8 pts (42.1%) had a lower primary tumor(≤5cm) who were considered difficult for anal preservation before NCRT. All subjects enrolled were confirmed to be proficient mismatch repair (pMMR). As a result, 18 pts underwent a total mesorectal excision (TME) all with R0-resection, and 8 pts were evaluated as pCR (44.4%, 8/18, confidence interval: 0.246-0.663), 11 as major pathological response rate (MPR) (61.6%, 11/18), respectively. The anus preservation rate in patients with lower diseases was 87.5% (7/8). One case accepted a watch-and-wait strategy because of clinical complete response (cCR). Overall, grade 3 toxicities were observed in 4 pts, including 3 leucopenia (15.8%, 3/19), 2 neutropenia (10.5%, 2/19) and 1 diarrhea (5.3%, 1/19). No grade 4 adverse event was observed.

CONCLUSION

The addition of high-dose VitC to the mFOLFOX6/XELOX-based NCRT in LARC showed a promising pCR, well tolerance, particularly low rate of diarrhea, thus warrants further investigation.

CLINICAL TRIAL INFORMATION

NCT04801511.

More Efficient Auto-Segmentation Framework Using Patient-Specific Information for CBCT-Guided Adaptive Radiotherapy

PURPOSE/OBJECTIVE(S)

Accurate and fast delineation of regions of interest (ROIs) is critical for online adaptive radiotherapy (ART). Due to the noise, artifacts and low contrast of soft tissue on cone-beam computed tomography (CBCT), the CBCT-guided ART (CBCTgART) needs an effective tool to assist the segmentation of ROIs. This study aims to develop an efficient auto-segmentation workflow with personalized modeling for CBCTgART based on deep learning (DL) model.

MATERIALS/METHODS

Five hundred fifty-two patients with nasopharyngeal carcinoma were enrolled in this study. At the beginning, a cycle consistent adversarial network (CycleGAN) model was trained on 172 patients' CBCT/CT paired images to improve the image quality of CBCT to CT level. A generalized segmentation model was trained using the planning CT (pCT) and contour data from 530 patients. For personalized modeling, the generalized segmentation model was fine-tuned on the specific patient's pCT and contour to get the personalized model. When CBCT images were available, the trained CycleGAN model transformed the CBCT to synthetic pCT. Then the personalized auto-segmentation model generated the contour of ROIs on the synthetic pCT. We randomly selected 22 patients for model test. The proposed method (DL-personalized) was compared with other DL methods based on the same architecture of network: regular deep learning method (DL-regular), which was trained on the CBCT and corresponding contours, and generalized model in our framework (DL-generalized). So, 22 personalized, 1 generalized and 1 regular DL models were tested. The paired t-test was performed to test the significance for mean dice similarity coefficient (DSC), mean distance to agreement (MDA), and Hausdorff distance (HD) between the alternative and proposed methods.

RESULTS

Two ROIs were included: the clinical target volume (CTV) and nasopharynx gross tumor volume (GTVnx). The proposed DL-personalized model achieved better results compared with others as shown in the table. The accuracy and robustness of our proposed framework was reliable. All of p values were under 0.01, which indicated the statistically significant difference.

CONCLUSION

The proposed framework utilizing patient-specific information can improve the segmentation accuracy of ART. This method has potential to be integrated into the ART workflow to improve efficiency.

Effect of Segmental Abutting Esophagus-Sparing Technique to Reduce Severe Esophagitis in Limited-Stage Small-Cell Lung Cancer Patients Treated with Concurrent Hypofractionated Thoracic Radiation and Chemotherapy

PURPOSE/OBJECTIVE(S)

To evaluate the effect of segmental abutting esophagus-sparing (SAES) radiotherapy to reduce severe (G3+) acute esophagitis from 20% to 5% in patients with limited-stage small cell lung cancer (LS-SCLC) treated with concurrent chemoradiotherapy.

MATERIALS/METHODS

Patients with a clinical target volume (CTV) ≤1 cm close to the esophagus were enrolled in the experimental arm (45 Gy in 3 Gy daily fractions in 3 weeks) of an ongoing phase III randomized clinical trial (NCT02675088), which enrolled patients with histologically confirmed SCLC and clinically staged as LS or I-IIIB (AJCC 7th). This trial was designed to determine whether HYPO TRT (45 Gy in 3 Gy QD, experimental arm) has the same efficacy as CF TRT (60 Gy in 2 Gy QD, controlled arm) in patients with LS-SCLC. The whole esophagus was divided into the involved esophagus and abutting esophagus (AE) to receive different dose limitations according to the distance from the edge of the CTV. The primary endpoint was grade ≥ 3 acute esophagitis.

RESULTS

From 1 May 2021 to 30 April 2022, 30 patients were enrolled and completed four cycles of planned chemotherapy and radiotherapy. Our patient population was predominantly male (66.7% men vs. 33.3% women), with a median age of 62 years. A majority of patients presented with Stage N2-3 (90.0%) and T2-4 (76.7%), in which 4 patients had ultracentral-located primary tumors. With the SAES technique, all dosimetric parameters were significantly reduced for the whole esophagus and AE. The maximal and mean dose of the esophagus (47.4±1.9 Gy and 13.5 ± 5.8 Gy, respectively) and AE (42.9±2.3 Gy and 8.6 ± 3.6 Gy, respectively) in the SAES plan were significantly lower than those (esophagus 48.0±1.9 Gy and 14.7± 6.1 Gy, AE 45.1±2.4 Gy and 9.8± 4.2 Gy, respectively) in the non-SAES plan. After the follow-up of more than 7 months (range, 7.0-18.1 months) for all patients, only one patient (3.3%, 95% CI 0.1%-17.2%) experienced grade 3 acute esophagitis and no grade 4-5 acute esophagitis happened (Table 3). For late toxicities, one patient suffered sustained grade 1 late esophagitis and all others had no symptoms of esophagitis. The rate of radiation pneumonitis was very low, with one grade 3 event and no grade 4-5 event. Twelve (40.0%) patients had G3+ hematologic toxic events, including 2 patients with febrile neutropenia. The 1-year OS, LRFS, DMFS and PFS was 96.4%, 88.7%, 78.4% and 64.3%, respectively. No patient developed local recurrence in the abutting esophagus-sparing region.

CONCLUSION

SAES radiotherapy has significant dosimetric advantages compared with standard radiotherapy, which are successfully translated into clinical benefits for patients with LS-SCLC treated with 45 Gy in 3 Gy daily fractions. This may facilitate dose escalation for TRT in LS-SCLC patients.

Tumor Treatment Response Assessed During the Chemo-Radiotherapy for Locally Advanced NSCLC

PURPOSE/OBJECTIVE(S)

To evaluate the capability of assessing intratumoral treatment response distribution with using FDG-PET/CT during the chemoradiotherapy of locally advanced NSCLC.

MATERIALS/METHODS

Twelve of total 50 patients with stage III NSCLC were enrolled in the institutional protocol for concurrent chemoradiotherapy with treatment dose of 54-60 Gy in 27-30 fractions. For each patient, a pre-treatment FDG-PET/CT image (SUV0) and a mid-treatment image (SUVm) obtained within the treatment dose of 24 ∼ 46 Gy were obtained. Followed by deformable PET/CT registration between SUV0 and SUVm, the tumor voxel SUV reduction ratio was obtained to construct a tumor dose response matrix (DRM). Tumor SUVavid was also constructed by limiting tumor voxel SUVm > a given value. Spatial correlations of the tumor SUV0, SUVm, SUVavid and DRM were determined.

RESULTS

The mean and coefficient variation (CV) of the SUV0, SUVm and DRM for all tumors were 6.56(64%), 2.82(59%) and 0.52(70%) (Table contains the individual data), which were like those on the SUVs and the mean DRM of head-neck HPV- patients reported previously, but much larger on the DRM variation. The inter-tumoral CVs of SUV0 and DRM were 17% and 43%, which were much smaller than those of the intra-tumoral CVs 61% and 55%. Meanwhile, the intra-tumoral variations on both SUV0 and DRM were much larger than those of head-neck HPV- patients. There was a weak correlation between SUV0 and SUVm with the correlation coefficient 0.32, a medium correlation of -0.51 between SUV0 and DRM; 0.58 between SUVm and DRM. It implies that the rule of tumor dose response DRM on treatment modification decision cannot be fully replaced by either SUV0 or SUVm. The spatial correlation between tumor DRM and SUVavid was 0.23 with SUVavid value > 3, which was getting weaker when increasing SUVavid value.

CONCLUSION

Spatial dose response for NSCLC assessed using FDG-PET/CT feedback demonstrated high treatment resistant patterns, which had a large intra-tumoral variation. In addition, the medium correlations of DRM vs SUV0 and DRM vs SUVm imply that all these factors could be used to guide adaptive modification of NSCLC treatment.

Ten-Year Outcomes of Hypofractionated (45 Gy in 9 Fractions) Intensity Modulated Radiotherapy for Localized Prostate Cancer

PURPOSE/OBJECTIVE(S)

We reported 10-year outcomes of localized prostate cancers treated with hypofractionated intensity-modulated radiotherapy of 45 Gy in 9 consecutive fractions.

MATERIALS/METHODS

From October 2011 to April 2017, thirty patients with localized prostate cancer were enrolled in this prospective trial. The median age of the patients was 72.5 years. According to NCCN recurrence risk criteria, eight patients were at low-risk group, 17 at intermediate risk group, 5 at high-risk group. All patients were treated with hypofractionated intensity-modulated radiotherapy (IMRT) of 45 Gy in 9 consecutive fractions to their prostate with or without seminal vesicles. Before radiotherapy, three gold fiducials were implanted into the prostate. In order to reduce the rectal high dose irradiation volume, an inflated rectal balloon was placed in the rectum at simulation and every treatment and patients were treated with comfortable full bladder. Static Intensity-modulated radiotherapy (SIMRT) was applied in 1 patient, Volumetric Modulated Arc Therapy (VMAT) in 27 patients, and tomotherapy in 2 patients. Image guided radiotherapy (IGRT) with gold fiducial registration was adopted. Twenty-six patients also received androgen deprivation therapy (ADT). The median time of ADT was 6 months. Progression⁃free survival (PFS) and overall survival (OS) were analyzed using Kaplan-Meier analysis. All grade ≥1 genitourinary (GU) and gastrointestinal (GI) toxicities were recorded using Common Terminology Criteria for Adverse Event version 5.0 (CTCAE 5.0) and Radiation Therapy Oncology Group (RTOG) late morbidity criteria, and GU and GI toxicities were cumulatively calculated.

RESULTS

After a median follow-up of 102 months (65∼131 months), the 10-year OS was 90.0% (95% confidence interval, 83.3%-96.7%), and the 10-year PFS was 86.5% (95% confidence interval, 79.1%-93.9%). According to CTCAE 5.0, grade 1 acute gastrointestinal (GI) toxicity developed in 12 patients, grade 2 in 2 patients, grade 3 in 2 patients, and grade 1 acute genitourinary (GU) toxicity developed in 12 patients, grade 2 in 2 patients, and no grade 3 or higher toxicity occurred. According to RTOG late morbidity criteria, late (≥3 months after radiotherapy) grade 1 GI toxicity developed in 4 patients (13.3%), grade 2 in 1 (3.3%), grade 3 in 1 (3.3%), and late grade 1 GU toxicity occurred in 1 patient (3.3%), grade 2 in 1 (3.3%), grade 3 in 1 (3.3%). No grade 4 or higher GI and GU toxicities developed. Only one grade 3 GI and one grade 2 GU toxicities were observed for the maximum toxicity at the last follow-up. The potency was not evaluated.

CONCLUSION

The 10-year oncologic outcomes of this shortened hypofractionated IMRT regimen for mainly low/intermediate risk prostate cancer patients is favorable with acceptable acute and late toxicities.

[Evaluation of the determination of hydrogen sulfide in the air of workplace by the detection tube method]

Objective: To evaluate the accuracy and applicability of detection tube method for quantitative detection of hydrogen sulfide in workplace air. Methods: In September 2021, the lower limit of quantification, accuracy, precision, environmental factors, interfering gases and other performance indicators of the method for determining hydrogen sulfide in the air of workplace were verified by the detection tube, and the results were compared with those of GB 11742-89 "Standard method for hygienic examination of hydrogen sulfide in air of residential areas-methylene blue spectrophotometric method" to evaluate the application effect of the detection tube method for quantitative detection of hydrogen sulfide in workplace air. Results: There was no significant difference in the results of 2.83 mg/m(3), 4.25 mg/m(3) and 17.00 mg/m(3) hydrogen sulfide concentration between the two methods (P>0.05) , but there was significant difference in the results of 8.50 mg/m(3) concentration (P<0.05) . The lower limit of quantification of hydrogen sulfide in workplace air was 2.83 mg/m(3), the accuracy was 96.0%-111.0%, and the precision was 0.70%-6.64%. Under the condition of 4 ℃, the measured results decreased by 3.39%-13.10%. When the humidity was 50%-80%, the relative error of the average measured value was -1.67%-4.44%. Interference gases that may exist in the workplace (including carbon dioxide, carbon monoxide, mercaptans, nitrogen oxides, sulfur dioxide, etc.) did not interfere with the results of the test tube. Conclusion: The accuracy and precision of the detection tube method meet the detection requirements. The method is simple, rapid and easy to be popularized, and can be used for the rapid detection of hydrogen sulfide gas concentration in the workplace.

MoS2 @Polyaniline for Aqueous Ammonium-Ion Supercapacitors

Ammonium-ion aqueous supercapacitors are raising notable attention owing to their cost, safety, and environmental advantages, but the development of optimized electrode materials for ammonium-ion storage still lacks behind expectations. To overcome current challenges, here, a sulfide-based composite electrode based on MoS2 and polyaniline (MoS2 @PANI) is proposed as an ammonium-ion host. The optimized composite possesses specific capacitances above 450 F g-1 at 1 A g-1 , and 86.3% capacitance retention after 5000 cycles in a three-electrode configuration. PANI not only contributes to the electrochemical performance but also plays a key role in defining the final MoS2 architecture. Symmetric supercapacitors assembled with such electrodes display energy densities above 60 Wh kg-1 at a power density of 725 W kg-1 . Compared with Li+ and K+ ions, the surface capacitive contribution in NH4 + -based devices is lower at every scan rate, which points to an effective generation/breaking of H-bonds as the mechanism controlling the rate of NH4 + insertion/de-insertion. This result is supported by density functional theory calculations, which also show that sulfur vacancies effectively enhance the NH4 + adsorption energy and improve the electrical conductivity of the whole composite. Overall, this work demonstrates the great potential of composite engineering in optimizing the performance of ammonium-ion insertion electrodes.

Role of interferon alpha-inducible protein 6 in modulating the proliferation, apoptosis and senescence of oesophageal squamous cell carcinoma cells

Oesophageal cancer is one of the most malignant tumors worldwide. Dysfunction of interferon alpha-inducible protein 6 (IFI6) has been implicated in numerous human diseases, including cancer. We performed the study to investigate the function and potential molecular pathways of IFI6 in oesophageal squamous cell carcinoma (ESCC) cells. IFI6 expression was analysed using databases-derived data and paraffin-embedded tissue samples. CCK-8-based analyses and EdU staining, colony formation, β-galactosidase staining and Annexin V/PI double-staining assays were used to determine the influence of IFI6 on cell growth, senescence and apoptosis. Tumor growth in vivo was investigated in mouse xenograft models. RNA sequencing (RNA-seq) was performed to identify the transcripts and pathways affected by IFI6. The results showed that IFI6 expression was elevated in ESCC and correlated with poor clinical prognosis (P<0.05). IFI6 was overexpressed and silenced in TE-1 and TE-10 cells using lentiviruses. Upregulation of IFI6 promoted cell growth both in vitro and in vivo, whereas downregulation induced opposite effects. IFI6 overexpression inhibited cell senescence and apoptosis but did not influence cell cycle progression, while IFI6 downregulation increased cell senescence and apoptosis. RNA-seq revealed that 3 mRNAs (EPHA5, CLIP1 and GTF2F2) were consistently associated with both IFI6 overexpression and silencing. IFI6 appeared to modulate TE-1 cells via complex mechanisms. In conclusion, IFI6 plays a positive role in the proliferation of ESCC cells both in vitro and in vivo, which could be a novel therapeutic target for treating ESCC.

Hydrogen sulfide protects against ischemic heart failure by inhibiting RIP1/RIP3/MLKL-mediated necroptosis

The aim of the present study was to explore whether hydrogen sulfide (H2S) protects against ischemic heart failure (HF) by inhibiting the necroptosis pathway. Mice were randomized into Sham, myocardial infarction (MI), MI + propargylglycine (PAG) and MI + sodium hydrosulfide (NaHS) group, respectively. The MI model was induced by ligating the left anterior descending coronary artery. PAG was intraperitoneally administered at a dose of 50 mg/kg/day for 4 weeks, and NaHS at a dose of 4mg/kg/day for the same period. At 4 weeks after MI, the following were observed: A significant decrease in the cardiac function, as evidenced by a decline in ejection fraction (EF) and fractional shortening (FS); an increase in plasma myocardial injury markers, such as creatine kinase-MB (CK-MB) and cardiac troponin I (cTNI); an increase in myocardial collagen content in the heart tissues; and a decrease of H2S level in plasma and heart tissues. Furthermore, the expression levels of necroptosis-related markers such as receptor interacting protein kinase 1 (RIP1), RIP3 and mixed lineage kinase domain-like protein (MLKL) were upregulated after MI. NaHS treatment increased H2S levels in plasma and heart tissues, preserving the cardiac function by increasing EF and FS, decreasing plasma CK-MB and cTNI and reducing collagen content. Additionally, NaHS treatment significantly downregulated the RIP1/RIP3/MLKL pathway. While, PAG treatment aggravated cardiac function by activated the RIP1/RIP3/MLKL pathway. Overall, the present study concluded that H2S protected against ischemic HF by inhibiting RIP1/RIP3/MLKL-mediated necroptosis which could be a potential target treatment for ischemic HF.

In Situ Generation of Ultrathin MoS2 Nanosheets in Carbon Matrix for High Energy Density Photo-Responsive Supercapacitors

Stimuli-responsive supercapacitors have attracted broad interest in constructing self-powered smart devices. However, due to the demand for high cyclic stability, supercapacitors usually utilize stable or inert electrode materials, which are difficult to exhibit dynamic or stimuli-responsive behavior. Herein, this issue is addressed by designing a MoS₂ @carbon core-shell structure with ultrathin MoS₂ nanosheets incorporated in the carbon matrix. In the three-electrode system, MoS₂ @carbon delivers a specific capacitance of 1302 F g^-1 at a current density of 1.0 A g^-1 and shows a 90% capacitance retention after 10 000 charging-discharging cycles. The MoS₂ @carbon-based asymmetric supercapacitor displays an energy density of 75.1 Wh kg^-1 at the power density of 900 W kg^-1 . Because the photo-generated electrons can efficiently migrate from MoS₂ nanosheets to the carbon matrix, the assembled photo-responsive supercapacitor can answer the stimulation of ultraviolet-visible-near infrared illumination by increasing the capacitance. Particularly, under the stimulation of UV light (365 nm, 0.08 W cm^-2 ), the device exhibits a ≈4.50% (≈13.9 F g^-1 ) increase in capacitance after each charging-discharging cycle. The study provides a guideline for designing multi-functional supercapacitors that serve as both the energy supplier and the photo-detector.

Toripalimab (anti-PD-1) versus High-Dose Interferon-α2b as Adjuvant Therapy in Resected Mucosal Melanoma: A Phase II Randomized Trial

BACKGROUND

No standard of care for mucosal melanoma (MM) in the adjuvant setting has been established. Meanwhile, relapse-free survival (RFS) is only about five months after surgery alone. This phase II trial aimed to compare toripalimab vs. high-dose interferon-α2b (HDI) as an adjuvant therapy for resected MM.

PATIENTS AND METHODS

From July 2017 to May 2019, 145 patients with resected MM were randomized (1:1) to receive HDI (N = 72) or toripalimab (N = 73) for one year until disease relapse/distant metastasis, unacceptable toxicity, or withdrawal of consent. The primary endpoint was RFS. The secondary endpoints included distant metastasis-free survival (DMFS), overall survival (OS), and safety.

RESULTS

After a median follow-up of 26.3 months, the numbers of RFS, OS, and DMFS events were 51 vs. 46, 33 vs. 29, and 49 vs. 44 in the toripalimab arm and the HDI arm, respectively. The median RFS were 13.6 (95%CI: 8.31-19.02) months and 13.9 (95%CI: 8.28-19.61) months in the toripalimab arm and HDI arm, respectively. The DMFS was not significantly different between the two arms (HR: 1.00, 95%CI: 0.65-1.54). The median OS was 35.1 months (95%CI: 27.93-NR) in the toripalimab arm, with no significant difference in all-cause death (HR: 1.11, 95% CI: 0.66-1.84) for the two arms. The median sums of the patients' actual infusion doses were 3672 mg and 1054.5 MIU in the toripalimab arm and HDI arm, respectively. The incidence of treatment-emergent adverse events with a grade ≥ 3 was much higher in the HDI arm than in the toripalimab arm (87.5% vs. 27.4%).

CONCLUSION

Toripalimab showed a similar RFS and a more favorable safety profile than HDI, both better than historical data, suggesting that toripalimab might be the better treatment option. However, additional translational studies and better treatment regimens are still warranted to improve the clinical outcome of MM.

Self-activatable carbon nanotube@ruthenium-catechol coordination complex for hydrogen evolution reaction

We report a simple metal ion-catechol coordination strategy to coat ruthenium-catechol polymer complex (TAC-Ru) on the surface of carbon nanotubes (CNT) to form a core-shell structure (abbreviated as CNT@TAC-Ru). This is achieved by firstly polymerizing catechol and boronic acid monomers on the surface of CNT to form a boronate ester polymer (BP) shell. Then, Ru³⁺is used to etch the BP shell, and cleave the dynamic boronate ester bond, leading to the formation of a CNT@ruthenium-catechol coordination complex based on the coordinative efficiency of the catechol group. The electrocatalytic property of the CNT@TAC-Ru composite can be activated through electrochemical cycling treatment. The as-activated CNT@TAC-Ru exhibits evidently improved hydrogen evolution reaction (HER) performance with an overpotential of 10 mV in 1.0 M KOH at a current density of 10 mA cm^-2, which is better than that of commercial Pt/C (32 mV). And the long-term stability is also desirable. This work provides a pyrolysis-free method to form metal-polymer-carbon composite with high HER performance under the alkaline condition.

P-060 Bubble-shaped Acrosome: Novel phenotype of Teratozoospermia Caused by Mutation in Actin-like 7A

Study question

What’s the etiology of severe teratozoospermia characteristic as bubble-shaped acrosome (BSA)?

Summary answer

Severe teratozoospermia characterized as BSA caused by mutation (c.1024G&gt;A) in actin-like 7A (ACTL7A).

What is known already

Teratozoospermia is a common cause of male infertility, defined by having a proportion of morphologically normal sperm at less than 4%. It exhibits aberrant sperm phenotypes in the head, neck, midpiece, and endpiece of sperm. Teratozoospermia with ephalic abnormalities are among the most severe and characteristic sperm defects. Some genetic factors are reported to be associated with ephalic abnormalities such as globozoospermia and macrozoospermia. However, other phenotypes and the causative genes of ephalic abnormalities, especially in acrosomal structure, and were largely unknown.

Study design, size, duration

Severe teratozoospermia were recruited from the Reproductive and Genetic Hospital of CITIC-Xiangya from Jan 2019 to Dec 2021.

Participants/materials, setting, methods

Whole-exome sequencing analysis was used to analyze the genetic factor of man. An Actl7a-mutated mouse model was generated by CRISPER-Cas9. Transmission electron microscopy was used to detect the abnormality of ultrastructure during acrosome biogenesis. Immunostaining was used to analyze the localization of ACTL7A and PLCζ. Immunoprecipitation followed by liquid chromatography-mass spectrometry (LC-MS) was used to select the differentially expressed proteins. ICSI with calcium ionophore exposure was performed in couple with ACTL7A mutation.

Main results and the role of chance

We found a man with severe teratozoospermia characterized as BSA carrying a mutation (c.1024G&gt;A) in ACTL7A. Homozygous Actl7a-mutated male mice were sterile, and all of sperm showed acrosomal abnormalities. During acrosomal biogenesis, it detected the acrosome detach from the nuclear in Actl7a-mutated mice. Furthermore, mutant ACTL7A failed to attach to the acroplaxome and was discharged by cytoplasmic droplets, which led to the absence of ACTL7A in mature sperm. The mutant sperm failed to activate the oocyte, and PLCζ discharge accompanied by ACTL7A was observed, leading to total fertilization failure (TFF). Immunoprecipitation followed by LC-MS showed that several differentially expressed proteins participate in acrosome assembly and actin filament organization. Furthermore, assisted oocyte activation by calcium ionophore exposure successfully overcame TFF in a couple with an ACTL7A mutation.

Limitations, reasons for caution

More cases are needed to demonstrate the relationship between mutation and phenotype.

Wider implications of the findings

Our study defined a novel phenotype of the acrosomal abnormality characterized as BSA and revealed the underlying mechanism of mutation in ACTL7A and provided a genetic marker and a therapeutic option for male infertility.

Trial registration number

Not Applicable

[Comparison and thoughts of the training system for thoracic surgeons]

There is no unified thoracic surgery training system in China, neither in the trainee selection or evaluation, nor in the training curriculum or the graduation requirements. A literature review was performed for available publications regarding international thoracic surgical training. A brief comparison was made regarding the thoracic surgery residency programs in China, Japan, United States and United Kingdom, including training pathway, recruitments, training content, performance assessment and academic experience. In conclusion, there are four key aspects worth noting. Firstly, an effective residency programme is invaluable to specialty training, and effort should be made to create a unified training programme that allows trainee to progress from residency to specialty training smoothly. Secondly, flexibility and personalization should be allowed in higher specialty training, so that trainee can develop their subspecialty interests. Thirdly, a unified clinical curriculum, selection and standardized income should be promoted to minimalize the variation of training outcome between provinces. Fourthly, additional training and time should be allowed for trainee who wants to pursue an academic career, and academic outcomes should be evaluated alongside with the standard clinical training.

[Association between the presence of solid or micropapillary components and survival outcome in stage ⅠA lung adenocarcinoma cases: a retrospective cohort study]

Objectives: To examine the influence of the proportion of pathological subtypes on the prognosis of stage ⅠA lung adenocarcinoma cases, and to explore the association between the presence/absence of solid or micropapillary (S/M) components and survival outcome. Methods: Totally 321 patients with stage ⅠA lung adenocarcinoma who received complete surgical resection at Department of Thoracic Surgery, Tongji University Affiliated Shanghai Pulmonary Hospital from January 2011 to December 2013 were retrospectively analyzed. There were 130 males and 191 females, aging 59(11) years (M(IQR)) (range: 55 to 66 years). The diagnostic value of the proportion of each pathological growth subtype on relapse-free survival (RFS) and overall survival (OS) were analyzed by using receiver operator characteristic curve. Patients were firstly divided into two groups according to the presence or absence of S/M components. And patients without S/M components were farther divided into two groups according to predominant growth pattern. There were three groups in total: with S/M components (group S/M⁺), without S/M components and lepidic growth pattern predominant (group S/M^-LPA), without S/M components and papillary or acinar growth pattern predominant (group S/M^-P/A). Kaplan-Meier method were used to draw the survival curves of the three groups, and Log-rank test were used to compare RFS and OS among the three groups. Cox proportional risk model was used to verify whether the presence of S/M components was a prognostic factor on RFS. Results: The proportion of S/M components had no diagnostic value for recurrence (solid: area under curve (AUC)=0.588, P=0.095; micropapillary: AUC=0.566, P=0.106) and death (AUC=0.589, P=0.104; AUC=0.607, P=0.056). The 5-year RFS rate of group S/M^-LPA, S/M^-P/A and S/M⁺ were 92.4%, 82.3% and 77.3%, respectively (all P<0.05), while the 5-year OS rate were 97.4%, 94.5% and 83.2%, respectively (all P<0.05). Multivariable analysis showed that the 3 groups were independent predictors of recurrence (S/M^-P/A vs. S/M^- LPA: HR=2.691, 95%CI: 1.249 to 5.799, P=0.011; S/M⁺ vs. S/M^-LPA, HR=6.763, 95%CI: 3.050 to 14.996, P<0.01). Conclusions: The proportion of S/M components in stage ⅠA lung adenocarcinoma with complete resection cases did not affect survival outcome. New grouping method based on the presence or absence of S/M components were significantly associated with patient survival outcomes: S/M⁺ patients had the worst prognosis and S/M^-LPA patients had the best prognosis.

Quantum Gaussian process model of potential energy surface for a polyatomic molecule

With gates of a quantum computer designed to encode multi-dimensional vectors, projections of quantum computer states onto specific qubit states can produce kernels of reproducing kernel Hilbert spaces. We show that quantum kernels obtained with a fixed ansatz implementable on current quantum computers can be used for accurate regression models of global potential energy surfaces (PESs) for polyatomic molecules. To obtain accurate regression models, we apply Bayesian optimization to maximize marginal likelihood by varying the parameters of the quantum gates. This yields Gaussian process models with quantum kernels. We illustrate the effect of qubit entanglement in the quantum kernels and explore the generalization performance of quantum Gaussian processes by extrapolating global six-dimensional PESs in the energy domain.

[HCV and Treponema pallidum infection status in HIV/AIDS cases in Yunnan province, January-June, 2020]

Objective: To understand the infection status of HCV and Treponema pallidum (TP) in HIV/AIDS cases in Yunnan province,and identify the risk factors. Methods: Between January 1 and June 30 in 2020,a cross-sectional survey was conducted in Yunnan. Two enzyme-linked immunosorbent assay (ELISA) kits were used to detect anti-HCV, the positive results of both two kits indicated HCV infection. ELISA and syphilis toluidine red untreated serum test were applied to identify TP infection. Both Excel 2016 and SPSS 22.0 software were used for statistical analysis, and logistic regression model was conducted to identify the relevant factors of HCV and TP infection. Results: A total of 5 922 HIV/AIDS cases were included in this study, the infection rates of HCV and TP were 6.5% (383/5 922) and 5.8% (344/5 922) respectively. The co-infection rate of HCV and TP was 0.4% (22/5 922). The risk for HCV infection in HIV/AIDS cases was higher in younger age groups compared with age group ≥50 years (15-19:aOR=3.53;20-29:aOR=3.02;30-39:aOR=2.91;40-49:aOR=3.61), in males than in females (aOR=2.31), in the married and unmarried than in the divorced or widowed (married:aOR=1.61;unmarried:aOR=1.63), in other ethnic groups than in Han ethnic group (aOR=1.70), in people with lower education level than in people with education level of college and above (primary school degree and below:aOR=4.69;middle school:aOR=3.96), in people living in the central and western Yunnan than in people living in eastern Yunnan (central Yunnan:aOR=2.46; western Yunnan:aOR=7.08), in injection drug users than in MSM (aOR=131.08). The risk of TP infection in HIV/AIDS cases was higher in people with education level of college and primary school than in middle school degree (primary school and below:aOR=1.73;college and above:aOR=1.77), in people with other occupations than in farmers (aOR=1.39), in people living in eastern Yunnan than in people living in western Yunnan (aOR=1.75); in MSM than in people with heterosex (aOR=9.75). Conclusions: A certain proportion of HIV/AIDS cases reported between January and June in 2020 in Yunnan were co-infected with HCV and TP, many factors were associated with the co-infection. It is suggested to strengthen HCV and TP tests in HIV/AIDS cases and conduct active treatment of the co-infection.

P–568 Homozygous Pathogenic Variants in ACTL9 Cause Fertilization Failure and Male Infertility in Human and Mouse

Study question

What are the other male factors that cause total fertilization failure (TFF) excepting for variants in PLCZ1?

Summary answer

Homozygous variants in ACTL9 (actin like 9) cause abnormal localization of PLCζ in a loosened perinuclear theca (PT) structure and leads to TFF.

What is known already

In previous studies, investigators have reported that the female factors in TFF after intracytoplasmic sperm injection (ICSI) include pathogenic variants in WEE2, TLE6, and TUBB8, whereas for male factors, pathogenic variants in PLCZ1 were reported to be the primary cause of TFF, which account for approximately 30% of couples with male factors in TFF excluding globozoospermia. Most recently, it was reported that pathogenic variants in ACTL7A led to reduced expression and abnormal localization of PLCζ, thereby identifying this genetic variant as a potential cause of TFF.

Study design, size, duration

Fifty-four infertile couples with TFF or poor fertilization (fertilization rate of &lt; 20%) at the Reproductive and Genetic Hospital of CITIC-Xiangya during January 2014 to June 2020 were recruited into this study.

Participants/materials, setting, methods

Male factors were identified in (MOAT). WES analysis was used to analyze the genetic factors of individuals with male factors. Sperm morphological study was conducted by H&E staining and TEM. Immunostaining of PLCζ was used to analyze the status of sperm-borne activation factor. A knock-in mouse model was generated by CRISPER-Cas9 technology. Sperm from homozygous Actl9 variant mice were analyzed by TEM and ICSI. ICSI with AOA was performed in couples with ACTL9 variants.

Main results and the role of chance

A total of 54 couples with TFF or poor fertilization were screened, with 21 couples determined to have a male infertility factor by MOAT. Whole-exome sequencing of these 21 male individuals identified three homozygous pathogenic variants in ACTL9 in three individuals. ACTL9 variations led to abnormal ultrastructure of the PT, with PLCζ absent in the head and present in the neck of the mutant sperm, which contributed to failed normal calcium oscillations in oocytes and subsequent TFF. The key roles of ACTL9 in the PT structure and TFF after ICSI were further confirmed in Actl9-mutated mouse model. Furthermore, assisted oocyte activation by calcium ionophore exposure successfully overcame TFF and achieved live births in a couple with an ACTL9 variant.

Limitations, reasons for caution

The mechanism of how ACTL9 regulate PLCζ remains unknown.

Wider implications of the findings: It provided a genetic marker and a therapeutic option for individuals who have undergone ICSI without successful fertilization.

Trial registration number

not applioable

TDP-43 maintains chondrocyte homeostasis and alleviates cartilage degradation in osteoarthritis

OBJECTIVE

Osteoarthritis (OA) is the most prevalent age-related disorder due to cartilage degradation. Previous studies have identified aberrant chondrocyte homeostasis under extracellular stress as a key pathological mechanism behind cartilage degradation in OA. TDP-43, a DNA/RNA-binding protein has been demonstrated to participate in processing many extracellular stress responses; however, understanding of the role of TDP-43 in OA is limited. This study aims to investigate the role of TDP-43 in chondrocyte homeostasis and cartilage degradation in OA.

METHODS

The role of TDP-43 during degradation of cartilage is examined by experimental posttraumatic OA animal models and human cartilage specimens. Cartilage degradation is assessed by histological analysis, qPCR, and Western blot. The molecular mechanisms are investigated in vitro using human primary chondrocytes.

RESULTS

TDP-43 decreases significantly in degenerated cartilage. TDP-43 concentration is positively correlated with IL-1β concentration in synovial fluid derived from OA patients (Pearson r = 0.95, CI (95%) [0.80, 0.99], P < 0.0001). Intra-articular injection of recombinant TDP-43 significantly alleviates cartilage degradation and subchondral bone remodeling in vivo. In vitro mechanistic analyses show that TDP-43 maintains chondrocyte homeostasis under oxidative stress through regulating stress granule dynamics via G3BP1.

CONCLUSION

The present study indicates that TDP-43 maintains chondrocyte homeostasis under oxidative stress and alleviates cartilage degeneration in osteoarthritis, identifying TDP-43 as a potential target for the diagnosis and treatment of knee OA.

Effect of morphology and phase engineering of MoS2 on electrochemical properties of carbon nanotube/polyaniline@MoS2 composites

This paper rationally designs the morphology and phase structure of carbon nanotube/polyaniline@MoS₂ (CNT/PANI@MoS₂) composites, with MoS₂ conductive wrapping growing vertically on the outer layer of the composites via hydrothermal method. The crystalline nature and chemical properties are characterized by X-ray diffraction (XRD), Flourier transformation infrared spectroscopy (FT-IR), Raman spectroscopy (Raman), X-ray photoelectron spectroscopy (XPS). Morphology and microstructures are determined by Scanning electric microscopy (SEM), Transmission electron microscope (TEM) and Brunauer-Emmett-Teller (BET). The developed composites possess excellent electrochemical properties (the specific capacitance is substantially increased by ~119%, reaching 700.0 F g^-1 after wrapping by MoS₂) and good cycling stability (after over 5000 cycles retains 80.8% capacitance) in three-electrode systems, which indicating that the unique morphology of MoS₂ shells endow the channels to composites for rapid charge transport and ionic diffusion. Furthermore, symmetric supercapacitors devices assembled with the CNT/PANI@MoS₂ composites achieve specific capacitance of 459.7 F g^-1 at 1 A g^-1, capacitance retention is 97.4% after 10,000 cycles and reach superior energy density of 40.9 Wh kg^-1 at the power density of 400 W kg^-1. This strategy of three-dimensional wrapping method may open up a new potential to relieve the dilemma of degraded performance of supercapacitor, while improving the capacitance and stability for supercapacitors.

Experimental Observation and Spin Texture of Dirac Node Arcs in Tetradymite Topological Metals

We report the observation of a nontrivial spin texture in Dirac node arcs, i.e., novel topological objects formed when Dirac cones of massless particles extend along an open one-dimensional line in momentum space. We find that such states are present in all the compounds of the tetradymite M_{2}Te_{2}X family (M=Ti, Zr, or Hf and X=P or As) regardless of the weak or strong character of the topological invariant. The Dirac node arcs in tetradymites are thus the simplest possible textbook example of a type-I Dirac system with a single spin-polarized node arc.

CircRNA UBAP2 facilitates the progression of colorectal cancer by regulating miR-199a/VEGFA pathway

OBJECTIVE

The aim of this study is to explore the regulatory mechanism of circRNA UBAP2 (circUBAP2) in colorectal cancer (CRC).

PATIENTS AND METHODS

The expression levels of circUBAP2, miR-199a, and VEGFA in tissues and cell lines were detected by RT-qPCR. The cell proliferation was examined by CCK-8 and colony formation assays. The migration and invasion abilities were evaluated by wound healing and transwell assays, respectively. Bioinformatics analysis and Luciferase activity assay were applied to determine the interaction between genes.

RESULTS

The expression of circUBAP2 was upregulated in CRC tissues and cell lines, and depletion of circUBAP2 suppressed the cell proliferation, migration, and invasion of CRC. Furthermore, miR-199a inhibitor abrogated the suppressive effect of circUBAP2 knockdown on CRC progression. Vascular endothelial growth factor A (VEGFA) was identified as a downstream target gene of miR-199a, and overexpression of VEGFA rescued the tumor phenotypes attenuated by circUBAP2 knockdown or miR-199a overexpression.

CONCLUSIONS

Our findings demonstrated that circUBAP2 facilitated CRC progression by sponging miR-199a to upregulate VEGFA. These findings implied that circUBAP2 may be a potential therapeutic biomarker for CRC.

Influence of miR-155 on behaviors of depression mice through regulating Wnt/β-catenin signaling pathway

OBJECTIVE

To study the influence of micro ribonucleic acid (miR)-155 on depression-like behaviors of depression mice, and to explore the role of Wnt/b-catenin signaling pathway in behavioral regulation of depression mice.

MATERIALS AND METHODS

The mouse model of depression was established via chronic unpredictable mild stress (CUMS). All mice were randomly divided into control group (n=12), model group (n=12), and fluoxetine group (n=12). The expression level of miR-155 in the hippocampus of mice in each group was detected via quantitative Polymerase Chain Reaction (qPCR). The changes in the behaviors of mice in each group were evaluated via behavioral experiments. The apoptosis level in the hippocampus of mice in each group was detected via terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining. Moreover, the content of inflammatory factors in the hippocampus of mice in each group was detected using the enzyme-linked immunosorbent assay (ELISA) kits. The expression levels of Wnt/b-catenin signaling pathway-related proteins in each group were detected via Western blotting.

RESULTS

The expression level of miR-155 in the hippocampus was significantly higher in model group than that in control group (p<0.01). Meanwhile, the expression level of miR-155 was significantly lower in fluoxetine group than that in model group (p<0.01). There were no statistically significant differences in the crossing score and rearing score in the open field test among groups (p>0.05). Compared with those in control group, the immobility time in tail suspension test and forced swimming test were significantly increased (p<0.01), while the sucrose preference degree significantly declined (p<0.01) in model group. Fluoxetine could significantly reduce the immobility time in tail suspension test and forced swimming test (p<0.01) and increase the sucrose preference degree (p<0.01) in model group. The number of TUNEL-positive cells in the hippocampus of mice in model group was significantly larger than that in control group (p<0.01). Fluoxetine could effectively reduce the number of TUNEL-positive cells in the hippocampus (p<0.01). Compared with those in control group, the content of tumor necrosis factor-α (TNF-a), interleukin-1b (IL-1b), and IL-6 in the hippocampus was significantly increased (p<0.01), while the content of IL-10 was significantly decreased (p<0.01) in model group. Fluoxetine could effectively reduce the content of TNF-a, IL-1b, and IL-6 (p<0.01) and increase the content of IL-10 (p<0.01). Besides, in model group, the expression levels of dishevelled-1 (DVL-1) and b-catenin in hippocampus remarkably declined (p<0.01), while the expression levels of glycogen synthase kinase-3b (GSK-3b) and adenomatous polyposis coli (APC) were remarkably increased (p<0.01) compared with those in control group. Fluoxetine could effectively lower the expressions of GSK-3b and APC in the hippocampus (p<0.01) and increase the expressions of DVL-1 and b-catenin (p<0.01) in model group.

CONCLUSIONS

MiR-155 is involved in regulating the depression-like behaviors of depression mice through promoting the release of inflammatory factors and the apoptosis of hippocampal neurons. Its mechanism may be related to the inhibition of the Wnt/b-catenin signaling pathway.

MicroRNA-596 is epigenetically inactivated and suppresses prostatic cancer cell growth and migration via regulating Wnt/β-catenin signaling

OBJECTIVES

Although studies have reported that miR-596 extensively participates in multiple cancer progression, the biological mechanisms and effects of miR-596 in prostatic cancer remain unclear. The literature is aimed to reveal the function and possible molecular mechanisms of miR-596 in prostatic cancer carcinogenesis.

MATERIALS AND METHODS

qRT-PCR was applied to examine miR-596 expression in prostatic cancer cell lines and samples, also methylation-specific PCR was used to detect the methylation status of the promoter CpG islands in prostatic cancer samples. Meanwhile, the tumor-related effects of miR-596 were detected via cell viability, clone formation assay, migration assay, flow cytometric and AO/EB assay. qRT-PCR and Western blots were applied to investigate the function of miR-596 on malignant behavior in prostatic cancer cells.

RESULTS

We found that miR-596 mRNA was decreased in prostatic cancer samples and cell lines. miR-596 mRNA level was also correlated to cancer stage, Gleason scores, while miR-596 promoter methylation was related to cancer tumor stage, Gleason score and preoperative PSA levels. miR-596 inhibited the cell growth and activity by causing cell apoptosis, and also suppressed the migration of prostatic cancer cells by revealing the epithelial-mesenchymal transition process. In addition, Western blot indicates that miR-596 overexpression deregulated Wnt/β-catenin signaling, by restraining phosphorylation levels of β-catenin and expression levels of downstream targets.

CONCLUSIONS

In summary, this research indicates that miR-596 overexpression could be potentially useful in the cell growth and migration of prostatic cancer and serves as a potential molecular marker in prostatic cancer.

[The diagnostic value of flow cytometry in patients with lymphoma associated hemophagocytic syndrome]

Objective: To evaluate the reliability of flow cytometry (FCM) for diagnosing lymphoma associated hemophagocytic syndrome (LAHS). Method: The clinical data in 57 patients with hemophagocytic lymphohistiocytosis (HLH)were retrospective analyzed at Peking University Shenzhen Hospital from July 2010 to July 2019. All patients were performed bone marrow FCM and bone marrow pathological examination before final diagnoses were made. The golden diagnosis criterion was based on clinical, biochemical and histopathological evidence, which was regarded as the standard to evaluate the sensitivity and specificity of FCM analysis in diagnosing LAHS. Results: Among 57 cases, 36 cases were eventually diagnosed with LAHS, including 15 B-cell lymphoma(14 diffuse large B-cell lymphoma, 1 B-cell lymphoma with reactive T-cell hyperplasia), 13 aggressive NK/T cell lymphoma/leukemia, 2 cases of gamma-delta T-cell lymphoma, 4 angioimmunoblastic T-cell lymphoma, 1 enteropathy-associated peripheral T-cell lymphoma and 1 anaplastic T-cell lymphoma. Lymphoma cells in bone marrow were detected in all patients by FCM except one ENTCL patient. The sensitivity and the specificity of FCM in LASH compared to bone marrow biopsy were 97.2%(P=0.014)and 90.5%(P=0.488) respectively. In the other 21 non-LAHS patients, T cell receptor Vβ (TCRVβ) rearrangement was detected in 2 patients with Epstein-Barr virus (EBV) associated primary HLH. Conclusions: FCM effectively detects lymphoma cells in bone marrow of lymphoma patients with LHL, suggesting that FCM could be an important indicator for the diagnosis of LAHS. FCM also has the advantage in differentiating LAHS from other HLH.

Predictors of plaque erosion in current smokers and non-current smokers presented with ST-segment elevation myocardial infarction: an optical coherence tomography study

Background

Plaque erosion with subsequent coronary thrombosis is considered as an important cause of ST-segment elevation myocardial infarction (STEMI). Smoking is a major risk factor for acute coronary thrombosis. However, the relationship between current smoking status and plaque erosion has not been systematically investigated.

Purpose

The present study aimed to investigate predictors of plaque erosion in current smokers and non-current smokers with STEMI by using optical coherence tomography (OCT).

Methods

Between January 2015 to December 2017, a total of 1313 STEMI patients underwent pre-intervention OCT of culprit lesion were enrolled and divided into two groups based on current smoking status: current smoking group (n=713) and non-current smoking group (n=600). Using established criteria, quantitative and qualitative underlying plaque characteristics were assessed by OCT. Clinical, angiographic and OCT characteristics of all enrolled patients were recorded. Univariable and multivariable logistic regression analyses were used to identify predictors of plaque erosion in two groups.

Results

Plaque erosion were found in 30.9% (220/713) culprit lesions in current smoking group and 20.8% (125/600) of those in non-current smoking group detected by OCT. In multivariate regression analysis, the predictors that strongly related to plaque erosion in the current smoking group were nearby bifurcation (OR: 4.84; 95% CI:2.38–9.87; p&lt;0.001); the minimum fiber cap thickness (FCT, OR:1.05; 95% CI:1.03–1.08; p&lt;0.001); thin-cap fibroatheroma (TCFA, OR: 0.22; 95% CI: 0.07–0.67; p=0.007) and lipid core length (OR: 0.91; 95% CI: 0.84–0.97; p=0.007). The predictors in the non-current smoking group were nearby bifurcation (OR: 4.84; 95% CI: 2.38–9.87; p=0.006); the minimal FCT (OR: 1.09; 95% CI: 1.06–1.13; p&lt;0.001); multi-vessel disease (MVD, OR: 0.43; 95% CI: 0.19–0.97; p=0.042) and dyslipidemia (OR: 0.34; 95% CI: 0.14–0.84; p=0.020).

Conclusions

Predictors of plaque erosion causing STEMI onset are different between current smokers and non-current smoker, with nearby bifurcation and thicker minimal FCT both predicting plaque erosion in two groups of patients.

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Key Research and Development Program of China, National Natural Science Foundation of China.

Coronary plaque characteristics associated with reduced thrombolysis in myocardial infarction flow in st-segment elevation myocardial infarction patients with plaque erosion

Background

It has been reported that the lumen factors of the culprit lesions are related to Thrombolysis in Myocardial Infarction (TIMI) flow grade in ST-Segment–Elevation Myocardial Infarction (STEMI) patients, but the factors of reduced TIMI flow in plaque erosion have not been studied.

Methods

329 STEMI patients with plaque erosion who underwent pre-intervention optical coherence tomography after thrombectomy were included and divided into 2 groups according to preprocedural TIMI flow grade [TIMI 0–1 (n=219) and TIMI 2–3 (n=110)].

Results

The patients with older age (55.7±11.1yrs vs. 51.8±10.6yrs, P=0.003) and diabetes patients (18.3% vs. 8.2%, P=0.015) had poorer TIMI flow, and the patients with reduced TIMI flow grade have lower initial cTnI (1.2ng/mL vs. 2.1ng/mL, P=0.023). The lesion in the LAD had better blood flow than the lesion in RCA (P=0.003), and the patients in TIMI 0–1 grade had more lipid plaques (53.9% vs. 41.8%, P=0.039), more macrophage (59.8% vs. 41.8%, P=0.002), and more calcification (34.2% vs. 21.8%, P=0.020). There was no statistically significant difference in the descriptive indicators of lipid or lumen between the two groups. And In a multivariate logistic regression model, the independent correlation factors of reduced TIMI flow grade in erosion patients were age, diabetes mellitus, lesion vessel, and macrophage.

Conclusions

In STEMI patients with plaque erosion non-lumen factors greatly affect flow, which suggests that systemic treatment is as important as local treatment for plaque erosion.

Flow Chart

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): National Natural Science Foundation of China (81827806, 81801861), National Key R&D Program of China (2016YFC1301100)

Morphological characteristics of plaque erosion with noncritical coronary stenosis: an optical coherence tomography study

Background

Plaque erosion is a frequent and important mechanism of acute coronary thrombosis only secondary to plaque rupture. Recent studies suggested plaque erosion with noncritical stenosis could be treated conservatively that distinct from those with critical stenosis. However, characteristics of plaque erosions with different coronary stenosis remain unknown.

Purpose

The present study aimed to investigate morphological features of plaque erosions with different coronary stenosis using optical coherence tomography (OCT).

Methods

Consecutive ST-segment elevated myocardial infarction (STEMI) patients with OCT images of culprit lesion between August 2014 and December 2017 were enrolled and 348 cases presented with plaque erosion identified by OCT. Based on the severity of lumen area stenosis [calculated by (1-minimal lumen area/reference lumen area) * 100%], all culprit plaque erosions were divided into three groups: Group A (area stenosis&lt;50%, n=50, 14.4%); Group B (50%≤area stenosis&lt;75%, n=146, 42.0%); Group C (area stenosis≥75%, n=152, 43.7%). Clinical characteristics, lesion features detected by coronary angiography and OCT were compared among three groups.

Results

Of all 348 STEMI patients with plaque erosions, patients in Group A were youngest (p=0.008) and had the lowest frequency of hypertension (p=0.029) as compared with those in Group B and C. Angiographic analysis showed 72.0% of plaque erosions in Group A located in LAD, while 67.8% in Group B and 53.9% in Group C (p=0.039). OCT findings (Figure 1-A) showed the prevalence of fibrous plaque was significantly highest in Group A than those in Group B and C (82.0% vs. 54.8% vs. 34.9%, p&lt;0.001), whereas lipid rich plaque was most frequent in Group C (16.0% vs. 43.8% vs. 62.5%, p&lt;0.001). The prevalence of macrophage (p&lt;0.001), microvessel (p=0.009) and cholesterol crystals (p&lt;0.001) increased gradually from plaque erosion with lumen area stenosis &lt;50% to 50–75% to ≥75%. Notably, compared with Group B and C, nearby bifurcation was most common in Group A (72.0% vs. 67.1% vs. 55.3%, p=0.036). Multivariable regression analyses (Figure 1-B) showed fibrous plaque and nearby bifurcation were independently associated with plaque erosion with noncritical stenosis (area stenosis&lt;75%).

Conclusion

56.3% plaque erosion in STEMI patients presented with noncritical stenosis, having distinct morphological features from erosion with critical stenosis. Fibrous plaque and nearby bifurcation were independently associated with the presence of noncritically stenotic plaque erosion, remaining a desire to tailor treatment therapy to individual patients.

Figure 1

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): National Key R&D Program of China

Relation of microchannel identified by optical coherence tomography to clinical, angiography and other plaque morphological characteristics in ST-segment Elevation myocardial infarction patients

Background

Previous studies have suggested that Microchannel (MC) is associated with plaque progression and vulnerability. Optical coherence tomography (OCT) could provide a chance to directly visualize plaque neovascularization in vivo.

Methods

1268 STEMI patients who underwent OCT examination of culprit lesion were included and divided into MC group (the culprit plaque with MC, n=560) and no-MC group (the culprit plaque without MC, n=708). MC was defined as a no-signal tubuloluminal structure on the cross-sectional optical coherence tomographic image. Clinical, angiography and other plaque morphological characteristics were compared between the two groups. Logistic regression analysis was used to identify independent predictors of MC in overall. In addition, the difference of predictors on MC was found in plaque rupture (PR) and plaque erosion (PE).

Results

Significant differences between MC group and no-MC group were found in the frequency of thin-cap fibroatheroma (74.6% vs 64.4%, p&lt;0.001), lipid plaque (91.8% vs 82.9%, p&lt;0.001), lipid core length (13.7±6.5mm vs 12.6±6.3mm, p=0.006) and the minimal lumen area (MLA, 1.95±0.98mm2 vs 2.10±1.58mm2, p=0.046). In MC group, the other vulnerable plaque morphological characteristics, such as macrophage (88.8% vs 75.1%, p&lt;0.001), cholesterol crystal (39.6% vs 32.9%, p=0.013), spotty calcification (38.6% vs 29.5%, p&lt;0.001) were more frequent. And compared with MLA the more locations of the culprit lesion in MC group was proximal (proximal, 47.3% vs 38.1%, at MLA, 38.2% vs 44.2%, distal, 14.5% vs 17.7%, p=0.004).The difference of Hemoglobin (Hb, 147.5±16.9g/L vs 144.1±18.2g/L, p&lt;0.001), lipidemia (TC, 188.7±43.6mmol/L vs 180.8±40.0mmol/L, p&lt;0.001, LDL-C, 121.5±37.4mmol/L vs 115.7±36.8mmol/L, p=0.005, and TC/HDL, 4.0±1.6 vs 3.8±1.0, p&lt;0.001), and hypertension (50.7% vs 44.2%, p=0.021) between 2 groups was statistically significant. Multivariable logistic regression models showed 7 independent parameters associated with MC in culprit plaque of overall: hypertension, Hb, TC, MLA, lesion location (compared with MLA), lipid core length, macrophage, spotty calcification. In addition, Hb, TC and MLA were common predictors of MC in PR and PE, however, the predictive effect of MLA on MC was opposite in PR [OR (95% CI)=1.266 (1.095–1.463), p=0.001] and PE [OR (95% CI)=0.742 (0.597–0.922), p=0.007].

Conclusions

MC in culprit plaque is associated with more lipid (especially cholesterol), higher Hb, hypertension, lesion location (compared with MLA) and the other vulnerable plaque morphological characteristics. The predictors of MC were different in plaque rupture and plaque erosion.

Flow chart

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): National Natural Science Foundation of China (81827806, 81801861); National Key R&D Program of China (2016YFC1301100)

[One case of extremely severe burn combined with stillbirth and multiple organ dysfunction syndrome in the third trimester of pregnancy]

One 24 years old female patient who suffered extremely severe burn in the third trimester of pregnancy was admitted to the Department of Burns and Skin Repair Surgery of the Third Affiliated Hospital of Wenzhou Medical University on 9th May, 2015. Intrauterine distress occurred after injury and stillbirth was confirmed within 12 hours. In cooperation with the obstetrician, the labor was induced on post injury day (PID) 5. Septic shock and multiple organ dysfunction syndrome occurred on PID 8. Through treatments including anti-infection, ventilator-assisted ventilation, cardiotonic diuresis, and escharectomy and skin grafting, the patient was finally cured. This case indicates that it is crucial to grasp the right time and choose a reasonable induction of labor to deal with stillbirth. The scheme of transvaginal induction of labor after shock is a worthy question to explore. The main characteristics of this patient include the extreme paroxysmal changes in breath, circulation, and urine volume within 24 hours after induced labor, which should be monitored dynamically for effective and timely adjustment of respiratory circulation support. This may be another key point for the rescue of this type of patient. To seize the opportunities to perform escharectomy, cover the wound with xenogenic skin graft, and perform skin grafting in time for wound repair remain the top priority.