Prognostic implication of UBE2C + CD8 + T cell in neoadjuvant immune checkpoint blockade plus chemotherapy for locally advanced esophageal cancer

BACKGROUND

Immune checkpoint blockers (ICBs) plus chemotherapy as neoadjuvant therapy for patients with esophageal cancer (EC) has gained substantial attention. This study aimed to investigate the early and mid-term outcome of neoadjuvant ICBs plus chemotherapy and discover immune-associated predictors of major pathological response (MPR) for locally advanced EC.

METHOD

Patients with locally advanced EC who received neoadjuvant ICBs plus chemotherapy were retrospectively included between June 2019 to December 2021. Conjoint analysis of Bulk-RNA seq (GSE165252) and scRNA seq (GSE188900) were used to investigate potential prognostic factors and immunological mechanisms, then multiplexed immunofluorescence was applied to validate.

RESULTS

76 patients were included. A total of 21 (27.6 %) patients achieved MPR, with 13 (17.1 %) attaining a pathological complete response. Over a median follow-up of 1.8 years, 6 (7.9 %) patients died and 21 (27.6 %) experienced disease recurrence within 0.6 to 2.1 years after surgery. The overall survival rate and recurrence-free survival rate were 93.3 + 2.9 % and 84.8 + 4.2 % at 12 months, 90.8 + 3.7 % and 67.1 + 6.4 % at 24 months, and 90.8 + 3.7 % and 62.9 + 7.2 % at 36 months, respectively. Patients achieving MPR had a significantly lower risk of recurrence compared to non-responders (9.5 % vs 34.5 %, P = 0.017). Analysis of bulk-RNA seq and scRNA-seq revealed that UBE2C and UBE2C + CD8 + T cells were adverse prognostic factors. Immunohistochemistry demonstrated that the non-MPR group had a higher infiltration of UBE2C + immune cells than MPR group after neoadjuvant treatment. Multiplexed immunofluorescence confirmed that infiltrating UBE2C + CD8 + T cells in MPR group were significantly fewer than non-MPR group after neoadjuvant treatment, indicating their poor prognostic role for EC.

CONCLUSIONS

Neoadjuvant ICBs plus chemotherapy shows promising efficacy in locally advanced EC, with MPR being a significant predictor of lower recurrence risk. Immunological analyses identified UBE2C + CD8 + T cells as adverse prognostic factors, suggesting their potential as biomarkers for patient stratification and treatment response.

Construction of a New Ferroptosis-related Prognosis Model for Survival Prediction in Colorectal Cancer

AIM

This study was designed to develop a ferroptosis-related gene signature for guiding the prognostic prediction in colorectal cancer (CRC) and to explore the potential in the molecular functions of the gene signature.

BACKGROUND

Ferroptosis is mainly characterized by lipid peroxide accumulation on the cell membranes in an iron-dependent manner, resulting in cellular oxidative stress, metabolic disorders, and, ultimately, cell death. This study aimed to develop a prognostic ferroptosis signature in CRC and explore its potential molecular function.

OBJECTIVE

The present work was designed to devise a ferroptosis signature for CRC prognosis and explore its potential molecular function.

METHODS

Single-cell RNA sequencing data GSE161277 and transcriptome sequencing data GSE17537 and TCGA-CRC from the Gene Expression Omnibus (GEO) and the Cancer Genome Atlas (TCGA) databases were downloaded, respectively. Quality control, dimension reduction, clustering, and clustering of single-cell RNA sequencing (scRNA- seq) data were performed using the Seurat package. A total of 259 ferroptosis-correlated genes from the FerrDb database were acquired. The single sample gene set enrichment analysis (ssGSEA) was performed to calculate the scores of genes related to ferroptosis. ESTIMATE was used to calculate immune infiltration. Independent prognostic factors were determined by performing Weighted Gene Co-Expression Network Analysis (WGCNA), univariate and Cox analyses, and Lasso analyses were used to search for independent prognostic factors.

RESULTS

From the scRNA-seq (GSE161277) dataset, 22 cell clusters were initially identified, and according to immune cell markers, only 8 types of cells (Follicular B, central memory T cell, Epithelial, Natural killer T cell, Plasma B, M1 macrophage, Fibroblasts, and Mast cell) were finally determined to be related to CRC prognosis. The results of the scRNA-seq analysis showed that the score of ferroptosis-related genes was higher in tumour tissues and in 8 types of cells in tumour samples. In the TCGA dataset, CRC samples were divided into ferroptosis-related high scores, ferroptosis-related median scores, and ferroptosis-related low scores. Immune cell analysis revealed that ferroptosis- related high scores had the highest abundance of immune cells. An 11-gene signature was developed by WGCNA, univariate Cox, and Lasso Cox regression. The prediction ability of the signature was successfully validated in the GSE17537 dataset. A comprehensive nomogram combining the 11 signature genes and clinical parameters could effectively predict the overall survival of CRC patients.

CONCLUSIONS

The present molecular signature established based on the 11 ferroptosis-related genes performed well in assessing CRC prognosis. The present discoveries could inspire further research on ferroptosis, providing a new direction for CRC management.

Identification of antigen-presentation related B cells as a key player in Crohn's disease using single-cell dissecting, hdWGCNA, and deep learning

Crohn's disease (CD) arises from intricate intercellular interactions within the intestinal lamina propria. Our objective was to use single-cell RNA sequencing to investigate CD pathogenesis and explore its clinical significance. We identified a distinct subset of B cells, highly infiltrated in the CD lamina propria, that expressed genes related to antigen presentation. Using high-dimensional weighted gene co-expression network analysis and nine machine learning techniques, we demonstrated that the antigen-presenting CD-specific B cell signature effectively differentiated diseased mucosa from normal mucosa (Independent external testing AUC = 0.963). Additionally, using MCPcounter and non-negative matrix factorization, we established a relationship between the antigen-presenting CD-specific B cell signature and immune cell infiltration and patient heterogeneity. Finally, we developed a gene-immune convolutional neural network deep learning model that accurately diagnosed CD mucosa in diverse cohorts (Independent external testing AUC = 0.963). Our research has revealed a population of B cells with a potential promoting role in CD pathogenesis and represents a fundamental step in the development of future clinical diagnostic tools for the disease.

Single-cell dissection, hdWGCNA and deep learning reveal the role of oxidatively stressed plasma cells in ulcerative colitis

Ulcerative colitis (UC) develops as a result of complex interactions between various cell types in the mucosal microenvironment. In this study, we aim to elucidate the pathogenesis of ulcerative colitis at the single-cell level and unveil its clinical significance. Using single-cell RNA sequencing and high-dimensional weighted gene co-expression network analysis, we identify a subpopulation of plasma cells (PCs) with significantly increased infiltration in UC colonic mucosa, characterized by pronounced oxidative stress. Combining 10 machine learning approaches, we find that the PC oxidative stress genes accurately distinguish diseased mucosa from normal mucosa (independent external testing AUC=0.991, sensitivity=0.986, specificity=0.909). Using MCPcounter and non-negative matrix factorization, we identify the association between PC oxidative stress genes and immune cell infiltration as well as patient heterogeneity. Spatial transcriptome data is used to verify the infiltration of oxidatively stressed PCs in colitis. Finally, we develop a gene-immune convolutional neural network deep learning model to diagnose UC mucosa in different cohorts (independent external testing AUC=0.984, sensitivity=95.9%, specificity=100%). Our work sheds light on the key pathogenic cell subpopulations in UC and is essential for the development of future clinical disease diagnostic tools.

Development and validation of CT-based radiomics deep learning signatures to predict lymph node metastasis in non-functional pancreatic neuroendocrine tumors: a multicohort study

Background

Lymph node status is an important factor for the patients with non-functional pancreatic neuroendocrine tumors (NF-PanNETs) with respect to the surgical methods, prognosis, recurrence. Our aim is to develop and validate a combination model based on contrast-enhanced CT images to predict the lymph node metastasis (LNM) in NF-PanNETs.

Methods

Retrospective data were gathered for 320 patients with NF-PanNETs who underwent curative pancreatic resection and CT imaging at two institutions (Center 1, n = 236 and Center 2, n = 84) between January 2010 and March 2022. RDPs (Radiomics deep learning signature) were developed based on ten machine-learning techniques. These signatures were integrated with the clinicopathological factors into a nomogram for clinical applications. The evaluation of the model's performance was conducted through the metrics of the area under the curve (AUC).

Findings

The RDPs showed excellent performance in both centers with a high AUC for predicting LNM and disease-free survival (DFS) in Center 1 (AUC, 0.88; 95% CI: 0.84-0.92; DFS, p < 0.05) and Center 2 (AUC, 0.91; 95% CI: 0.85-0.97; DFS, p < 0.05). The clinical factors of vascular invasion, perineural invasion, and tumor grade were associated with LNM (p < 0.05). The combination nomogram showed better prediction capability for LNM (AUC, 0.93; 95% CI: 0.89-0.96). Notably, our model maintained a satisfactory predictive ability for tumors at the 2-cm threshold, demonstrating its effectiveness across different tumor sizes in Center 1 (≤2 cm: AUC, 0.90 and >2 cm: AUC, 0.86) and Center 2 (≤2 cm: AUC, 0.93 and >2 cm: AUC, 0.91).

Interpretation

Our RDPs may have the potential to preoperatively predict LNM in NF-PanNETs, address the insufficiency of clinical guidelines concerning the 2-cm threshold for tumor lymph node dissection, and provide precise therapeutic strategies.

Funding

This work was supported by JSPS KAKENHI Grant Number JP22K20814; the Rare Tumor Research Special Project of the National Natural Science Foundation of China (82141104) and Clinical Research Special Project of Shanghai Municipal Health Commission (202340123).

A precise molecular subtyping of ulcerative colitis reveals the immune heterogeneity and predicts clinical drug responses

BACKGROUND AND AIMS

We sought to identify novel molecular subtypes of ulcerative colitis (UC) based on large-scale cohorts and establish a clinically applicable subtyping system for the precision treatment of the disease.

METHODS

Eight microarray profiles containing colon samples from 357 patients were utilized. Expression heterogeneity was screened out and stable subtypes were identified among UC patients. Immune infiltration pattern and biological agent response were compared among subtypes to assess the value in guiding treatment. The relationship between PRLR and TNFSF13B genes with the highest predictive value was further validated by functional experiments.

RESULTS

Three stable molecular subtypes were successfully identified. Immune cell infiltration analysis defined three subtypes as innate immune activated UC (IIA), whole immune activated UC (WIA), and immune homeostasis like UC (IHL). Notably, the response rate towards biological agents (infliximab/vedolizumab) in WIA patients was the lowest (less than 10%), while the response rate in IHL patients was the highest, ranging from 42 to 60%. Among the featured genes of subtypes, the ratio of PRLR to TNFSF13B could effectively screen for IHL UC subtype suitable for biological agent therapies (Area under curve: 0.961-0.986). Furthermore, we demonstrated that PRLR expressed in epithelial cells could inhibit the expression of TNFSF13B in monocyte-derived macrophages through the CXCL1-NF-κB pathway.

CONCLUSIONS

We identified three stable UC subtypes with a heterogeneous immune pattern and different response rates towards biological agents for the first time. We also established a precise molecular subtyping system and classifier to predict clinical drug response and provide individualized treatment strategies for UC patients.

Cell metabolism-based optimization strategy of CAR-T cell function in cancer therapy

Adoptive cell therapy (ACT) using chimeric antigen receptor (CAR)-modified T cells has revolutionized the field of immune-oncology, showing remarkable efficacy against hematological malignancies. However, its success in solid tumors is limited by factors such as easy recurrence and poor efficacy. The effector function and persistence of CAR-T cells are critical to the success of therapy and are modulated by metabolic and nutrient-sensing mechanisms. Moreover, the immunosuppressive tumor microenvironment (TME), characterized by acidity, hypoxia, nutrient depletion, and metabolite accumulation caused by the high metabolic demands of tumor cells, can lead to T cell "exhaustion" and compromise the efficacy of CAR-T cells. In this review, we outline the metabolic characteristics of T cells at different stages of differentiation and summarize how these metabolic programs may be disrupted in the TME. We also discuss potential metabolic approaches to improve the efficacy and persistence of CAR-T cells, providing a new strategy for the clinical application of CAR-T cell therapy.

Systematic single-cell dissecting reveals heterogeneous oncofetal reprogramming in the tumor microenvironment of gastric cancer

Oncofetal reprogramming of the tumor microenvironment is clinically relevant. This study used the non-negative matrix factorial (NMF) algorithm for single-cell RNA sequencing data of gastric cancer (GC) based on embryonic stem genes. Pseudotime analysis, cell-cell interaction analysis, and SCENIC analysis revealed that cancer-associated fibroblasts (CAFs), tumor-associated endothelial cells (TECs), and tumor-associated macrophages (TAMs) have different oncofetal reprogramming that affects cell function, enhances intercellular communication, and activates multiple transcription factors in these cells. Furthermore, based on the signatures of the newly defined oncofetal cell subtypes and expression profiles of large cohorts in GC patients, we determined that GJA1 + TEC-C2, IFITM1 + CAF-C3, PODXL + TEC-C1, SFRP2 + CAF-C2, and SRSF7 + CAF-C1 are crucial prognostic factors for GC patients and predictors of immune checkpoint blockade in GC. Cell subtypes were validated by immunohistochemical methods. Our novel, profound, and systematic analysis of the oncofetal reprogramming of GC may facilitate the development of improved drugs for treating GC.

Single-cell dissection reveals the role of DNA damage response patterns in tumor microenvironment components contributing to colorectal cancer progression and immunotherapy

Colorectal cancer (CRC) is one of the leading malignant cancers. DNA damage response (DDR), referring to the molecular process of DNA damage, is emerging as a promising field in targeted cancer therapy. However, the engagement of DDR in the remodeling of the tumor microenvironment is rarely studied. In this study, by sequential nonnegative matrix factorization (NMF) algorithm, pseudotime analysis, cell-cell interaction analysis, and SCENIC analysis, we have shown that DDR genes demonstrate various patterns among different cell types in CRC TME (tumor microenvironment), especially in epithelial cells, cancer-associated fibroblasts, CD8+ T cells, tumor-associated macrophages, which enhance the intensity of intercellular communication and transcription factor activation. Furthermore, based on the newly identified DDR-related TME signatures, cell subtypes including MNAT+CD8+T_cells-C5, POLR2E+Mac-C10, HMGB2+Epi-C4, HMGB1+Mac-C11, PER1+Mac-C5, PER1+CD8+T_cells-C1, POLR2A+Mac-C1, TDG+Epi-C5, TDG+CD8+T_cells-C8 are determined as critical prognostic factors for CRC patients and predictors of immune checkpoint blockade (ICB) therapy efficacy in two public CRC cohorts, TCGA-COAD and GSE39582. Our novel and systematic analysis on the level of the single-cell analysis has revealed the unique role of DDR in remodeling CRC TME for the first time, facilitating the prediction of prognosis and guidance of personalized ICB regimens in CRC.

Minimally invasive versus open McKeown esophagectomy for patients with esophageal squamous cell carcinoma after neoadjuvant PD-1 inhibitor plus chemotherapy

Introduction

The purpose of this study was to compare short and mid-term outcomes in esophageal squamous cell carcinoma (ESCC) patients undergoing open or minimally invasive McKeown esophagectomy (MIE) after neoadjuvant PD-1 inhibitor plus chemotherapy.

Methods

Patients with locally advanced ESCC underwent open or minimally invasive McKeown esophagectomy after neoadjuvant PD-1 inhibitor plus chemotherapy were retrospectively included from June 2019 to June 2021. The baseline characteristics, pathological data, short-and mid-term outcomes were collected and compared based on the surgical approach.

Results

A total of 35 patients were included in the study. An open procedure was performed for 13 patients (37.1%), and 22 (62.9%) patients underwent MIE after neoadjuvant therapy. Compared with open group, MIE group had shorter operative times (350.8± 117.8 vs. 277.9 ± 30.2 min, P = 0.009). The total number of resected lymph nodes was not significantly different, but more left recurrent laryngeal lymph nodes were harvested from the Open group (2.6 ± 3.2 vs. 0.9 ± 1.7, P = 0.047). The median follow-up time was 1.42 years (range, 0.35-2.59 years) from the first day of treatment. Three patients (8.6%) died during follow-up, one in the open surgery group and two in the MIE group. There were six (17.1%) patients developed recurrence, three in each group. The 2-year cumulative survival rates were 92.3 ± 7.4% and 89.5 ± 7.1% for the open and MIE groups, respectively. Overall survival was not different between the two surgical approaches.

Conclusions

MIE might be safe and feasible for patients with locally advanced ESCC undergoing neoadjuvant PD-1 inhibitor plus chemotherapy.

Machine Learning Model in Predicting Sarcopenia in Crohn's Disease Based on Simple Clinical and Anthropometric Measures

Sarcopenia is associated with increased morbidity and mortality in Crohn's disease. The present study is aimed at investigating the different diagnostic performance of different machine learning models in identifying sarcopenia in Crohn's disease. Patients diagnosed with Crohn's disease at our center provided clinical, anthropometric, and radiological data. The cross-sectional CT slice at L3 was used for segmentation and the calculation of body composition. The prevalence of sarcopenia was calculated, and the clinical parameters were compared. A total of 167 patients were included in the present study, of which 127 (76.0%) were male and 40 (24.0%) were female, with an average age of 36.1 ± 14.3 years old. Based on the previously defined cut-off value of sarcopenia, 118 (70.7%) patients had sarcopenia. Seven machine learning models were trained with the randomly allocated training cohort (80%) then evaluated on the validation cohort (20%). A comprehensive comparison showed that LightGBM was the most ideal diagnostic model, with an AUC of 0.933, AUCPR of 0.970, sensitivity of 72.7%, and specificity of 87.0%. The LightGBM model may facilitate a population management strategy with early identification of sarcopenia in Crohn's disease, while providing guidance for nutritional support and an alternative surveillance modality for long-term patient follow-up.

Single-nucleus RNA sequencing reveals the shared mechanisms inducing cognitive impairment between COVID-19 and Alzheimer’s disease

Alzheimer’s disease (AD)-like cognitive impairment, a kind of Neuro-COVID syndrome, is a reported complication of SARS-CoV-2 infection. However, the specific mechanisms remain largely unknown. Here, we integrated single-nucleus RNA-sequencing data to explore the potential shared genes and pathways that may lead to cognitive dysfunction in AD and COVID-19. We also constructed ingenuity AD-high-risk scores based on AD-high-risk genes from transcriptomic, proteomic, and Genome-Wide Association Studies (GWAS) data to identify disease-associated cell subtypes and potential targets in COVID-19 patients. We demonstrated that the primary disturbed cell populations were astrocytes and neurons between the above two dis-eases that exhibit cognitive impairment. We identified significant relationships between COVID-19 and AD involving synaptic dysfunction, neuronal damage, and neuroinflammation. Our findings may provide new insight for future studies to identify novel targets for preventive and therapeutic interventions in COVID-19 patients.

Construction and validation of a novel ten miRNA-pair based signature for the prognosis of clear cell renal cell carcinoma

BACKGROUND

Clear cell renal cell carcinoma (ccRCC) is the most predominate pathological subtype of renal cell carcinoma, causing a recurrence or metastasis rate as high as 20% to 40% after operation, for which effective prognostic signature is urgently needed.

METHODS

The mRNA and miRNA profiles of ccRCC specimens were collected from the Cancer Genome Atlas. MiRNA-pair risk score (miPRS) for each miRNA pair was generated as a signature and validated by univariate and multivariate Cox proportional hazards regression analysis. Functional enrichment was performed, and immune cells infiltration, as well as tumor mutation burden (TMB), and immunophenoscore (IPS) were evaluated between high and low miPRS groups. Target gene-prediction and differentially expressed gene-analysis were performed based on databases of miRDB, miRTarBase, and TargetScan. Multivariate Cox proportional hazards regression analysis was adopted to establish the prognostic model and Kaplan-Meier survival analysis was performed.

FINDINGS

A novel 10 miRNA-pair based signature was established. Area under the time-dependent receiver operating curve proved the performance of the signature in the training, validation, and testing cohorts. Higher TMB, as well as the higher CTLA4-negative PD1-negative IPS, were discovered in high miPRS patients. A prognostic model was built based on miPRS (1 year-, 5 year-, 10 year- ROC-AUC=0.92, 0.84, 0.82, respectively).

INTERPRETATION

The model based on miPRS is a novel and valid tool for predicting the prognosis of ccRCC.

FUNDING

This study was supported by research grants from the China National Natural Scientific Foundation (81903972, 82002018, and 82170752) and Shanghai Sailing Program (19YF1406700 and 20YF1406000).

ITGB1 as a prognostic biomarker correlated with immune suppression in gastric cancer

INTRODUCTION

Gastric cancer is one of the common malignant tumors with a high incidence and mortality in China. Prognostic biomarkers and potential predictors of the treatment efficacy of gastric cancer urgently need to be identified. Integrin-β (ITGB) is a superfamily of integrins and is involved in cell adhesion, tissue repair, immune response, and tumor metastasis.

METHODS

We analyzed ITGB1 expression in our hospital samples of the gastric cancer cohort. And the public data of The Cancer Genome Atlas stomach adenocarcinoma (TCGA-STAD), The Asian Cancer Research Group (ACRG)/GSE62254, and GSE15459 data sets were analyzed by using the bioinformatic methods. The relationships between ITGB1 expression and clinicopathological features, patient prognosis, activation of the Wnt/β-catenin signaling pathway, and tumor immunosuppressive factors were also explored.

RESULTS

The positive rate of ITGB1 expression in the Fudan University Shanghai Cancer Center gastric cancer tumor tissues was 61.4% (258/420) and correlated with deep invasion (p = 0.017), an advanced clinical stage (p = 0.011), and a poor prognosis (p < 0.05). The TCGA-STAD/ACRG/GSE15459 cohorts also showed similar results. ITGB1 is one of the upstream molecules of the Wnt/β-catenin signaling pathway and is correlated with tumor immune suppression. In gastric cancer, we found a correlation between ITGB1 expression and Wnt/β-catenin signaling pathway activity. In the TCGA-STAD/ACRG/GSE15459 cohorts, ITGB1 expression was positively associated with immunosuppressive factors and negatively associated with immunoactive factors. Patients with low ITGB1 expression exhibited a significantly high immunotherapy response ratio according to an analysis of tumor immune dysfunction and exclusion (TIDE), which may indicate that ITGB1 is a potential predictor of immunotherapy efficacy.

CONCLUSIONS

ITGB1 affects the prognosis in gastric cancer patients and plays a core role in immune suppression in gastric cancer.

Transcriptomic Analysis and Novel Gene Pair-Based Signatures for Hepatitis B-Related Hepatocellular Carcinoma

Hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) misses the opportunity for surgery because it is not detected early. The molecular mechanism of hepatitis B-related liver cancer needs further understanding, and effective diagnostic and prognostic models are in urgent need. Expression profiles from the Cancer Genome Atlas (TCGA) Liver Hepatocellular Carcinoma (LIHC) and GSE121248, GSE94660, GSE76724 and GSE14520 from Gene Expression Omnibus (GEO) database were obtained. Differentially expressed genes (DEGs) between normal and tumor HBV-related HCC samples. Gene pairs are generated by comparing the expression levels of every two DEGs. The diagnostic signature of pairs of DEGs was built using cross-validation Lasso and Best Subset Selection regression. Hub genes and significant modules were screened by Cytoscape, and potential drugs were predicted by DGIdb. The gene-pair based prognostic signature was established by Cox proportional hazards regression model. xCell and ssGSEA were utilized to reveal the cell composition and cancer hallmarks to get an elucidation for the risk. A total of 457 DEGs were screened. A powerful diagnostic signature of two pairs of DEGs was built and validated in TCGA-LIHC and GEO datasets repeatedly with assured performance. Ten Hub genes were screened out. The prognostic signature of four gene pairs had good efficacy both in training and validation cohorts, with stromal score and several hallmarks related to the increasing of risk. Taken together, the study provided sight into the molecular mechanism as well as a novel strategy for the early diagnosis and prognosis for HBV-related HCC.

Construction of a Signature Composed of 14 Immune Genes to Judge the Prognosis and Immune Infiltration of Colon Cancer

Background: Colon cancer (CC) is an immunogenic tumor and immune-targeting disease. In this study, we analyzed differentially expressed genes (DEGs) from the expression profile data in CC of The Cancer Genome Atlas. Methods and Results: Using univariate and multivariate Cox regression analysis, an immune gene-risk model containing 14 immune genes was established. Four hundred seventeen CC samples were divided into high-risk and low-risk groups, and Kaplan-Meier analysis revealed that high-risk score predicted poor survival. Meanwhile, we found the model was an independent prognostic factor for CC. Weighted gene coexpression network analysis was used to identify key gene modules between high- and low-risk groups. The methods of CIBERSORT and single-sample Gene Set Enrichment Analysis were used to evaluate the correlation between immune cells and our model. Conclusion: Taken together, our study suggested that the immune gene-related risk model may be developed as a potential tool in the prognostic assessment of CC.

Open Abdomen Treated with Negative Pressure Wound Therapy: Indications, Management and Survival

BACKGROUND

Open abdomen treatment (OAT) is a significant burden for patients and is associated with considerable mortality. The primary aim of this study was to report survival and cause of mortality after OAT. Secondary aims were to evaluate length of stay (LOS) in intensive care unit (ICU) and in hospital, time to abdominal closure and major complications.

METHODS

Retrospective review of prospectively registered patients undergoing OAT between October 2006 and June 2014 at Trondheim University Hospital, Norway.

RESULTS

The 118 patients with OAT had a median age of 63 (20-88) years. OAT indications were abdominal compartment syndrome (ACS) (n = 53), prophylactic (n = 29), abdominal contamination/second look laparotomy (n = 22), necrotizing fasciitis (n = 7), hemorrhage packing (n = 4) and full-thickness wound dehiscence (n = 3). Eight percent were trauma patients. Vacuum-assisted wound closure (VAWC) with mesh-mediated traction (VAWCM) was used in 92 (78 %) patients, the remaining 26 (22 %) had VAWC only. Per-protocol primary fascial closure rate was 84 %. Median time to abdominal closure was 12 days (1-143). LOS in the ICU was 15 (1-89), and in hospital 29 (1-246) days. Eighty-one (68 %) patients survived the hospital stay. Renal failure requiring renal replacement therapy (RRT) (OR 3.9, 95 % CI 1.37-11.11), ACS (OR 3.1, 95 % CI 1.19-8.29) and advanced age (OR 1.045, 95 % CI 1.004-1.088) were independent predictors of mortality in multivariate analysis. The nine patients with an entero-atmospheric fistula (EAF) survived.

CONCLUSION

Two-thirds of the patients treated with OAT survived. Renal failure with RRT, ACS and advanced age were predictors of mortality, whereas EAF was not associated with increased mortality.

Advances in the treatment of portal hypertension in cirrhosis

Non-selective beta-blockers and handling of esophageal varices has been key elements in the treatment of portal hypertension in recent decades. Liver vein catheterization has been essential in diagnosis and monitoring of portal hypertension, but ongoing needs for noninvasive tools has led to research in areas of both biomarkers, and transient elastography, which displays promising results in discerning clinically significant portal hypertension. Novel research into the areas of hepatic stellate cell function and the dynamic components of portal hypertension has revealed promising areas of treatment modalities, targeting intestinal decontamination, angiogenesis, inflammation and oxidative stress. Future studies may reveal if these initiatives lead to developments of new drugs for treatment of portal hypertension.

Clinical reappraisal of SHORT syndrome with PIK3R1 mutations: toward recommendation for molecular testing and management

SHORT syndrome has historically been defined by its acronym: short stature (S), hyperextensibility of joints and/or inguinal hernia (H), ocular depression (O), Rieger abnormality (R) and teething delay (T). More recently several research groups have identified PIK3R1 mutations as responsible for SHORT syndrome. Knowledge of the molecular etiology of SHORT syndrome has permitted a reassessment of the clinical phenotype. The detailed phenotypes of 32 individuals with SHORT syndrome and PIK3R1 mutation, including eight newly ascertained individuals, were studied to fully define the syndrome and the indications for PIK3R1 testing. The major features described in the SHORT acronym were not universally seen and only half (52%) had four or more of the classic features. The commonly observed clinical features of SHORT syndrome seen in the cohort included intrauterine growth restriction (IUGR) <10th percentile, postnatal growth restriction, lipoatrophy and the characteristic facial gestalt. Anterior chamber defects and insulin resistance or diabetes were also observed but were not as prevalent. The less specific, or minor features of SHORT syndrome include teething delay, thin wrinkled skin, speech delay, sensorineural deafness, hyperextensibility of joints and inguinal hernia. Given the high risk of diabetes mellitus, regular monitoring of glucose metabolism is warranted. An echocardiogram, ophthalmological and hearing assessments are also recommended.

Prevalence and diversity of Synergistetes taxa in periodontal health and disease

BACKGROUND AND OBJECTIVE

Members of the phylum Synergistetes have previously been identified within periodontitis subgingival plaque and are considered putative periodontopathogens. This study compared the diversity of subginigval Synergistetes in a cohort of subjects with periodontitis (n = 10) vs. periodontitis-free controls (n = 10).

MATERIAL AND METHODS

Pooled subgingival plaque samples from all deep periodontal pockets or all sulci were collected from the periodontitis and periodontitis-free subjects, respectively. Bacterial 16S rRNA genes were PCR-amplified from purified subgingival plaque DNA using a Synergistetes 'selective' primer set. PCR products were cloned and sequenced to analyze the prevalence and diversity of Synergistetes operational taxonomic units (OTUs) present in plaque samples of both subject groups.

RESULTS

A total of 1030 non-chimeric 16S rRNA clones were obtained, of which 162 corresponded to members of the phylum Synergistetes. A significantly larger number of Synergistetes clones were obtained from periodontitis subgingival plaque than from periodontitis-free controls (25.4% vs. 5.9%, p < 0.001). All Synergistetes clones corresponded to cluster A oral Synergistetes, and fell into 31 OTUs (99% sequence identity cut-off). Twenty-nine Synergistetes OTUs were detected in the periodontitis group while eight were detected in the periodontitis-free group (p < 0.001). Five Synergistetes OTUs; including one OTU corresponding to the recently-characterized species Fretibacterium fastidiosum, were more prevalent in the periodontitis subjects (p < 0.05).

CONCLUSION

OTUs belonging to oral Synergistetes cluster A were more readily detectable and were more diverse in subgingival plaque from periodontitis subjects compared with periodontitis-free controls. Specific Synergistetes OTUs appear to be associated with periodontitis.

Prognostic analysis for carcinoid tumours of the rectum: a single institutional analysis of 106 patients

AIM

Rectal carcinoid is a rare rectal tumour with a good prognosis. The aim of this study was to assess its clinicopathological characteristics and prognostic factors in a single institution.

METHOD

Clinical and pathological information was retrospectively collected in a single institution, and patients' outcomes were determined. Multivariate analyses were performed to find independent prognostic factors attributed to overall survival.

RESULTS

A total of 106 patients with rectal carcinoid were included. In all, 66% of the patients underwent transanal local excision and 34% had transabdominal surgery. The 5-year survival rate was 87%. Muscularis invasion was the only independent prognostic factor for predicting 5-year survival (P = 0.00046). Tumour size was found to be significantly associated with muscular invasion (P = 0.00003). The area under the curve of tumour size in the receiver operating characteristic curve for predicting muscular invasion was 0.92.

CONCLUSION

Patients with rectal carcinoid have a good prognosis. Muscular invasion is an independent risk factor of survival.

[Clinicopathological and molecular genetic analysis in Chinese typical hereditary nonpolyposis colorectal cancer pedigrees]

OBJECTIVE

To investigate the clinicopathological and molecular genetic characteristics of Chinese hereditary nonpolyposis colorectal cancer (HNPCC) pedigrees.

METHODS

Four Chinese HNPCC pedigrees were studied using microdissection, microsatellite instability analysis, immunohistochemistry staining and direct DNA sequencing for hMSH2 and hMLH1 genes.

RESULTS

All five tumor tissues from 4 probands showed high level of microsatellite instability at more than 2 loci(RER + phenotype). Three of 4 cases lost hMSH2 protein expression and one case showed no hMLH1 protein expression. Three pathological germline mutations (2 on hMSH2 and 1 on hMLH1) were identified.

CONCLUSIONS

Chinese typical HNPCC kindreds showed relatively frequent germline mutations of mismatch repair genes. Microsatellite instability analysis and immunohistochemistry staining might be the effective screening methods before direct DNA sequencing for the detection of mismatch repair genes. It is necessary to establish clinical criteria and molecular diagnostic strategies more suitable for Chinese HNPCC kindreds.

[Clinical study on treatment 82 cases of chronic primary glomerulopathy with deficiency of yin with damp-heat symptom with dan shao tang]

OBJECTIVE

To investigate the treatment effect of Dan Shao Tang on chronic primary glomerulopathy with deficiency of Yin with damp-heat symptom.

METHODS

132 cases of chronic glomerulopathy with deficiency of Yin with damp-heat symptom, which divided into two groups at random, the 82 cases which were the therapy group using Dan Shao Tang and west medicine, and the other 50 cases which treated only by west medicine. We observed the effect and indexes change including renal function, proteinuria, hematuria.

RESULTS

The effective rate of the therapy group is 90.24%, and the effective rate of the control group is 66% (P < 0.05), The therapy group is superior to the control group in improving renal function, decreasing proteinuria and hematuria in evidence(P < 0.05).

CONCLUSION

Dan Shao Tang is effective to treatment on chronic primary glomerulopathy with deficiency of Yin with damp-heat symptom.

Hausdorff dimension of critical fluctuations in abelian gauge theories

The geometric properties of the critical fluctuations in Abelian gauge theories such as the Ginzburg-Landau model are analyzed in zero background field. Using a dual description, we obtain scaling relations between exponents of geometric and thermodynamic nature. In particular, we connect the anomalous scaling dimension eta of the dual matter field to the Hausdorff dimension D(H) of the critical fluctuations, which are fractal objects. The connection between the values of eta and D(H), and the possibility of having a thermodynamic transition in finite background field, is discussed.

[X-ray photoelectron spectroscopy (XPS) of carbon nitride (CN) films]

The chemical structure of carbon nitride thin films, prepared by rf-dc plasma enhanced chemical vapor deposition (PECVD) was studied by XPS. Analyzing the C(1s) and N(1s) core level lines indicated two types of chemical structure N-sp3C and N-sp2C binding states existed in the CN films. There is also little N-spC binding state in the CN film with a nitrogen content of 22%. The ratio of N/C in N-sp3C binding state is 1.28 which is near 4 : 3, thus demonstrated the existence of C3N4-like phase. High nitrogen content in the CN films is useful to increase the content of beta-C3N4 phase. Light changes of the chemical structure of the CN films can be observed under ion irradiation. With the increase of ion dose, the ratio of N-sp3C/N-sp2C increase, while the N/C ratio in the films decrease.

[Study on the determination method of Mo in the internal organs of body by graphite furnace atomic absorption spectrophotometry]

A new method for the determination of Mo in the heart by tantalum-lining graphite tube was developed. The tantalum-lining graphite tube can entirely eliminate effects of stable carbide formed. The sensitivity was enhanced to compare with the conventional graphite tube. At the same time, it also climinates memory effect completely and reduces the interferences of coexistent elements such as Fe, Na, K etc. The method is simple, accurate and rapid.

[Influence of functional groups of huatanyuxin decoction on Ca2+ transmembrane influx in rat aorta]

OBJECTIVE

To study the Ca2+ antagonistic effect of functional groups of Huatanyuxin decoction.

METHOD

The 45Ca transmembrane influx technique was used to measure the Ca2+ blocking effect of leak, receptor-operated Ca2+ channel (ROC) and potential-dependent Ca2+ channel (PDC) in rat aorta.

RESULT

ROC and PDC could be blocked when the complex prescription was used at concentrations of 0.5-5 mg/ml. Among the functional groups, Huoxue group (activating blood) and Xinqi group (promoting and normalizing flow of vital energy) showed better Ca2+ antagonistic effect.

CONCLUSION

The mechanism of therapeutic effect of Huatanyuxin decoction may be related to its Ca2+ blocking effect similar to verapamil.

[Study of the background absorption of ErCl3 and Er(NO3) matrices in GFAAS]

The investigation shows that the background absorption of Er matrices is significantly wavelength dependent. The effects of ashing temperature, heating mode, atomization temperature, recording time and matrix modifiers on the non-specific absorption of Er matrices have also been studied.

Adaptive, quadratic preprocessing of document images for binarization

This paper presents an adaptive algorithm for preprocessing document images prior to binarization in character recognition problems. Our method is similar in its approach to the blind adaptive equalization of binary communication channels. The adaptive filter utilizes a quadratic system model to provide edge enhancement for input images that have been corrupted by noise and other types of distortions during the scanning process. Experimental results demonstrating significant improvement in the quality of the binarized images over both direct binarization and a previously available preprocessing technique are also included.

[A study on the treatment and restoration of the complete fractured teeth]

In order to keep the fractured teeth with their important function of mastication the authors had adopted a kind of improved calvital preparation to carry out the pulp treatment for 56 cases, 63 teeth, together with periodontal washing, the application of medicine and the periodontal treatment of gingivectomy and flap operation, etc. from Jan. 1989 to Jan. 1993. The regularization of the filling of the fragmental area, the combination and the fixation of the split tooth were strengthened with spiral root post and dentin retaining nails, and then the full cast crown was restorated. The results were satisfied. It turns out that complete fracture of posterior teeth, thought to be pulled out in the past because they had split well below the gum, or even affected the pulp chamber floor, can be kept if given treatment and proper restoration.

[Management and prognosis of patients with locally recurrent soft tissue sarcomas]

OBJECTIVE

The results and prognositic factors in treating locally recurrent soft tissue sarcoma (STS) of the extremities and trunk were identified.

METHODS

The clinical, pathologic, and therapeutic characteristics of 96 STS patients were investigated using univariate and multivariate analyses. Seventy-six patients (79.2%) had high grade sarcoma and 20 patients (20.8%) had low grade sarcoma. Operative procedures were wide excision (surgical margin > or = 2 cm) in 66, local excision (surgical margin < 2 cm) in 6, and amputation in 24 patients. Adjuvant radiotherapy and chemotherapy was administered in 24 and 36 patients respectively.

RESULTS

After reoperation of the recurrent tumor, the 5-year local control and overall survival rates were 70.1% and 59.1%, respectively. High grade, large size, and tumor in the upper extremities were associated with decreased overall survival.

CONCLUSION

The authors emphasize that the initial management of primary STS should be adequate and suggest that safty margin of > or = 2 cm should be adhered to. In patients with local recurrence only, the overall survival may not be adversely affected if the recurrent lesion is properly treated. Investigations of more effective multimodality therapy needs to be done.

Na(+)-H+ and Na(+)-Li+ exchange are mediated by the same membrane transport protein in human red blood cells: an NMR investigation

Na(+)-H+ exchange is a transport system present in erythrocytes which plays an important role in the regulation of intracellular pH, cellular volume, and transmembrane ion transport. Na(+)-Li+ exchange has received much attention and has been investigated in more detail than have any of the other ion transport systems, because of its high reproducibility. Both red blood cell (RBC) Na(+)-H+ and Na(+)-Li+ exchange are elevated in essential hypertensive patients relative to normotensive individuals. RBC Na(+)-Li+ exchange may be a mode of operation of Na(+)-H+ exchange. Amiloride and its analogue, 5-(N,N-hexamethylene)amiloride (HMA), are well-known inhibitors of Na(+)-H+ exchange, whereas phloretin strongly inhibits Na(+)-Li+ exchange. In this study, we tested the effects of amiloride, HMA, and phloretin on Na(+)-Li+ exchange activity in intact RBCs by using atomic absorption. We investigated by using 7Li nuclear magnetic resonance (NMR) spectroscopy the effects of HMA and phloretin inhibition on Li+ efflux across resealed H(+)- and Li(+)-loaded RBC ghosts in the absence and presence of pH gradients. Amiloride inhibitory activities on both Na+ and Li+ binding to exposed RBC membranes under different pH conditions were also studied by 23Na and 7Li NMR relaxation time measurements. We found that Na(+)-Li+ exchange activity was inhibited by amiloride, HMA, and phloretin in suspensions of intact RBCs and of resealed RBC ghosts. Li+ efflux rates across resealed H(+)- and Li(+)-loaded RBC ghosts were significantly lower when a pH gradient was present, presumably because of the competition between Li+ and H+ for transport by the same transport protein. Amiloride had similar inhibitory constants on both Na+ and Li+ binding to RBC membranes (1021 +/- 48 M-1 vs 964 +/- 40 M-1 at pH 8.0; 731 +/- 147 M-1 vs 716 +/- 27 M-1 at pH 7.0). These results suggest that Na(+)-H+ exchange and Na(+)-Li+ exchange are mediated by the same RBC membrane transport protein.

Reinvestigation of the transmembrane difference in 7Li NMR T1 values in Li(+)-loaded human erythrocyte suspensions

In contrast to the findings in a recent study (R. P. Gullapalli, R. M. Hawk, R. A. Komoroski, Magn. Reson. Med. 20, 240 (1991)), we found that, even at high hematocrits, the T1 values for extracellular 7Li were at least three times longer than those for intracellular Li+. We conclude that a transmembrane difference in T1 values can be used for separate observation of intracellular and extracellular Li+ in human red blood cell suspensions.

Plasminogen activator activity in human prostate and breast tumors: relationship to steroid receptors

Using a fluorometric assay based on the activation of human plasminogen, plasminogen activator (PA) activity was measured in cytosolic and lysosomal extracts prepared from normal, benign hyperplastic (BPH), and carcinomatous human prostates. In all three types of prostatic tissue, the lysosomal extracts had much higher concentrations of PA activity than did the cytosolic extracts. The mean PA activity in lysosomal extracts of the carcinomatous prostates was 170% and 85% higher than that measured in normal and BPH prostates, respectively (Student's t-test, p less than .05). With prostatic carcinoma and BPH specimens there was an inverse (negative) relationship between lysosomal PA activity and the nuclear concentration of androgen-receptors (correlation coefficient, -0.84). By comparison in specimens of human breast tumors, there were weakly positive correlations between PA activity and either estrogen (ER) or progestin (PR) receptors (correlation coefficients of + 0.23 and + 0.54, respectively). While as a group ER+, PR+ breast tumors had higher PA activity that ER+, PR- or ER-, PR- tumors, the differences were not statistically significant (Student's t-test, p greater than .05). Thus in breast tumors, it is uncertain whether high levels of PA activity are indicative of hormonal dependence. However, our findings with prostatic tumors infer that in contrast, high concentrations of this enzyme may reflect a malignant phenotype characterized by a decrease in both androgen responsiveness and differentiation.

Plasminogen activator in prostatic tumors of Nb rats

Using a fluorometric assay, nonspecific proteolytic activity and plasminogen activator were measured in transplantable tumors of the dorsal prostate of Nb rats. Nonspecific proteolytic activity in prostatic tumors did not differ significantly from that measured in normal dorsal prostate, whereas plasminogen activator activity, undetectable in the latter tissue, was readily measurable in the tumors. Furthermore, plasminogen activator activity in prostatic tumors characterized by hormone-insensitive growth was 8-fold higher than in tumors characterized by androgen-stimulated growth. In both typess of tumors, the plasminogen activator activity per mg protein was highest in the lysosomal fractions. The results indicate that plasminogen activator may be a useful marker for discriminating between androgen-stimulated and autonomous prostatic tumors.

Nuclear binding of androgens and acid phosphatase activity in prostatic tumors of Nb rats

A transplantable prostatic adenocarcinoma derived from the dorsal lobe of the prostate gland of an Nb rat was analyzed for the concentration of nuclear androgen-binding sites and the presence of acid phosphatase activity. When extracts of nuclei from normal prostatic tissue were labelled with [1,2-3H]dihydrotestosterone in the absence and presence of competitor, two types of specific binding were observed: type 1 was characterized by an association constant (Ka) of 6 x 10(7) M-1 and involved a molecule that was excluded from Sephadex G-200; type 2 was characterized by a Ka of 3 x 10(8) M-1 and depended on a binding component that was retained by Sephadex G-200. Nuclei from androgen-stimulated tumors contained reduced concentrations of both androgen-binding components, whereas nuclei from autonomous tumors had only a trace amount of type 1 sites and were entirely devoid of type 2 sites. In all tumors the acid phosphatase activity per mg of protein was markedly elevated. Relative to normal, the activity of this enzyme was 140% and 350% higher in androgen-stimulated and autonomous tumors, respectively. These findings indicate that prostatic tumors are characterized by a decrease in nuclear androgen-binding, and an increase in specific activity of acid phosphatase, and also that such changes are more pronounced in autonomous than in androgen-stimulated tumors.