Biomaterial-based scaffolds for direct in situ programming of tumor-infiltrating T lymphocytes

Adoptive cell therapy with tumor-infiltrating T cells (TILs) has generated exciting clinical trial results for the treatment of unresectable solid tumors. However, solid tumors remain difficult targets for adoptively transferred T cells, due in part to poor migration of TILs to the tumor, physical barriers to infiltration, and active suppression of TILs by the tumor. Furthermore, a highly skilled team is required to obtain tumor tissue, isolate and expand the TILs ex vivo, and reinfuse them into the patient, which drives up costs and limits patient access. Here, we describe a cell-free polymer implant designed to recruit, genetically reprogram and expand host T cells at tumor lesions in situ. Importantly, the scaffold can be fabricated on a large scale and is stable to lyophilization. Using a mouse breast cancer model, we show that the implants quickly and efficiently amass cancer-specific host lymphocytes at the tumor site in quantities sufficient to bring about long-term tumor regression. Given that surgical care is the mainstay of cancer treatment for many patients, this technology could be easily implemented in a clinical setting as an add-on to surgery for solid tumors. Furthermore, the approach could be broadened to recruit and genetically reprogram other therapeutically desirable host cells, such as macrophages, natural killer cells or dendritic cells, potentially boosting the antitumor effectiveness of the implant even more.

Organizational climate of kindergartens and teacher professional learning: mediating effect of teachers' collective efficacy and moderating effect of mindfulness in teaching

Introduction

This study was aimed at testing a moderated mediation model of teaching mindfulness and teachers' collective efficacy in the relationships between the organizational climate of kindergartens and teacher professional learning.

Methods

A sample of 1,095 kindergarten teachers completed self-report questionnaires assessing their perceptions of the organizational climate of kindergartens, collective efficacy, teaching mindfulness, and professional learning.

Results

Controlling for teaching experience and kindergarten level, the results show that kindergarten organizational climate significantly and positively predicted teacher professional learning and the collective efficacy of teachers played a partial mediating role between them.Furthermore, moderation analysis revealed that teaching mindfulness moderated the relationship between kindergarten organizational climate and teacher professional learning.

Discussion

These results expand our understanding of how the organizational climate of kindergartens affects teacher professional learning. In practice, professional learning of kindergarten teachers can be facilitated by creating an open organizational climate and improving their ability to perceive the collective. Furthermore, the moderating role of teaching mindfulness suggests that intervening in teachers' teaching mindfulness possibly is an influential way to maximize the impact of kindergarten organizational climate on professional learning.

Exfoliated MXene/poly-melamine-formaldehyde composite membranes for removal of heavy metals and organics from aqueous solutions

Heavy metal ions and organic pollutants discharged into various water bodies have caused serious water pollution, and the efficient removal of these contaminants remains a challenge. Here, we report a novel MXene/poly-melamine-formaldehyde (PMF) composite membrane, in which the PMF particles serve as spacers, and the -NH2 groups of PMF and the hydroxyl groups of MXene nanosheets have a synergistic effect on the adsorption of pollutants, and the crosslinking of glutaraldehyde inhibits the swelling of the composite membrane. The MXene/PMF composite membrane with 83.7% PMF particle loading displays a water permeability of 381.2 L m-2 h-1 bar-1 (405% that of MXene membrane) and excellent adsorption ability. In static adsorption, the removal rates of Zn2+, Pb2+, phenol, and crystal violet reach 96.2%, 91.7%, 99.1%, and 96.4% respectively, 20∼100% higher than those of MXene membranes. In dynamic adsorption, the breakthrough volumes of the membrane for 2 ppm p-nitrophenol solution and methyl blue solution reach 75 mL (about 8500 times membrane volume) and 350 mL (about 39800 times membrane volume), and the saturation volumes are 1500 mL and 5000 mL, respectively. After cyclic adsorption/desorption for four times, the removal rate of the membranes still maintains above 90%. This work provides an efficient composite membrane for removing pollutants from wastewater.

Secretory breast carcinoma: clinicopathological features and prognosis of 52 patients

PURPOSE

Secretory breast carcinoma is a rare histological subtype of invasive breast cancer and considered with an indolent clinical behavior. This study was conducted to analyze the clinicopathological features of patients with secretory breast carcinoma (SBC), explore the outcome, and compare the prognostic difference with invasive ductal breast carcinoma (IDC). METHODS AND MATERIALS: Patients with SBC diagnosed between 2006 and 2017 from Fudan University Shanghai Cancer Center were included in the study, excluding patients with previous malignant tumor history and incomplete clinical data or follow-up records. Peculiar clinicopathological and immunohistochemical features of the cases were fully described. Clinical data of 4979 cases of IDC were also evaluated during this period. After propensity score matching, prognostic analysis of SBCs and IDCs was calculated by Kaplan-Meier method and landmark analysis method.

RESULTS

The data of 52 patients diagnosed with SBC were identified from the pathological files. Among them, 47 patients were women, and 5 were men. The median age of the 52 SBCs was 46 years (mean, 48.1 years; range, 10-80 years). The tumor sizes ranged from 0.3 to 6.8 cm, with a mean of 3.5 cm. Eight patients (15.4%) had positive axillary lymph node involvement. The molecular classification was mostly triple-negative breast cancer (65.4%). Fluorescence in situ hybridization confirmed the presence of ETV6::NTRK3 rearrangement in 16 of 18 cases (88.9%). Furthermore, Kaplan-Meier survival analysis and landmark analysis demonstrated that there were no statistically significant differences in DFS and OS between SBC and IDC patients.

CONCLUSION

Although SBCs are generally associated with a favorable prognosis, our work exhibited that the clinicopathological features of SBC were partly different from former understandings, indicating that therapeutic procedure should be prudent. Further studies are necessary to fully identify the clinical behavior and predictive markers to improve diagnosis and management in this unique subtype of breast cancer.

A Comprehensive Comparison between Primary Liver Cancer and Liver Metastases through scRNA-Seq Data Analysis

Metastasis is one of the leading causes of cancer-related deaths. A comprehensive comparison of the differences between primary and metastatic cancers within the same organ can aid in understanding the growth mechanisms of cancer cells at metastatic sites, thereby helping to develop more effective targeted treatment strategies. Primary liver cancer is one of the most common types of cancer, and the liver is also one of the main metastatic sites. In this paper, we utilize single-cell RNA-Seq data to compare primary liver cancer and colorectal liver metastases from multiple perspectives, including cell types and proportions, activity of various cell types, cell-cell communication, mRNA expression differences within the same types of cells, key factors associated with cell proliferation, etc. Our analysis results show the following: (i) Compared to primary tissue, metastatic tissue contains more cytotoxic T cells and exhausted T cells, and it retains some specific characteristics of the primary site. (ii) Cells of the same type exhibit functional differences between primary and metastatic cancers, with metastatic cancer cells showing lower metabolism levels and immune cells exhibiting stronger immune activity. (iii) Interactions between monocytes and hepato-associated cells are strong in primary cancer, while depleted T cells frequently communicate with hepatocytes in metastatic cancer. (iv) Proliferation-related genes in primary and metastatic cancers are mainly involved in cell energy supply and basic metabolism activity, respectively.

A prospective comparison of a modified miniaturised hand-held epifluorescence microscope and touch imprint cytology for evaluation of axillary sentinel lymph nodes intraoperatively in breast cancer patients

BACKGROUND

The management of axillary lymph nodes in early-stage breast cancer patients has changed considerably, with the primary focus shifting from the examination of sentinel lymph nodes (SLNs) to toward the detection of all macro-metastases. However, current methods, such as touch imprint cytology (TIC) and frozen sections, are inadequate for clinical needs. To address this issue, we proposed a novel miniaturised epifluorescence widefield microscope (MEW-M) to assess SLN status intraoperatively for improved diagnostic efficiency.

METHODS

A prospective, side-by-side comparison of intraoperative SLN evaluation between MEW-M and TIC was performed.

RESULTS

A total of 73 patients with 319 SLNs consecutive enrolled in this study. MEW-M showed significantly superior image quality compared to TIC (median score 3.1 vs 2.1, p < 0.0001) and had a shorter time to issue results (10.3 vs 19.4 min, p < 0.0001). Likelihood ratio analysis illustrated that the positive likelihood ratio value of MEW-M compared with TIC was infinitely great vs 52.37 (95% CI, 21.96-124.90) in model 1 (classifying results into negative/positive), infinitely great vs 52.37 (95% CI, 21.96-124.90) in model 2 (classifying results into macro-metastasis/others, and TIC results followed the same classification as model 1), respectively. Similarly, the negative likelihood ratio values of MEW-M compared with TIC were 0.055 (95% CI, 0.018-0.160) and 0.074 (95% CI, 0.029-0.190) in model 1; and 0.019 (95% CI, 0.003-0.130) vs 0.020 (95% CI, 0.003-0.140) in model 2, respectively.

CONCLUSIONS

MEW-M is a promising technique that can be utilised to provide a rapid and accurate intraoperative assessment of SLN in a clinical setting to help improve decision-making in axillary surgery.

Bascom II combined with VSD treatment involving the preservation of tissue bridges for recurrent complex pilonidal sinuses with a literature review

INTRODUCTION

For patients with large and deep-seated recurrent complex pilonidal sinuses, the use of traditional open excision or flap reconstruction surgery may lead to high surgical difficulty, significant local damage, numerous complications, slow healing, and a high risk of recurrence. This article reports a case of recurrent complex pilonidal sinus and discusses the advantages of Bascom II combined with VSD treatment involving the preservation of tissue bridges.

CASE PRESENTATION

The patient, a 31-year-old male, presented with recurrent swelling, pain, and purulent discharge from the sacrococcygeal region for over a year. Upon physical examination, extensive lumps and sinus tracts were observed in the lumbosacral tail area, with the lesion extending from L4 to the tip of the coccyx. Under general anesthesia, a segmental resection was performed, and the lumbosacral mass lesion was excised, preserving normal tissue bridges. The mature sinus tract at the upper part of the coccyx was removed, and Bascom II reconstruction surgery was performed. In the late stage at the site of lumbar sacral lesion excision, VSD was applied to promote wound healing.

DISCUSSION

The combination of Bascom II with lesion tunnel-like removal can reduce the damage, elevate gluteal cleft, and lower the recurrence rate. Subsequently, with the addition of VSD, it can accelerate the elimination of necrotic tissue, reduce infection risk, and expedite wound healing.

CONCLUSION

This case explores the advantages and characteristics of combining various techniques in the treatment of recurrent complex pilonidal sinuses, emphasizes the utility of VSD as an adjunctive therapy for large lesions.

Neuromechanism, recovery effect and case study of swimming training intervention in children with cerebral palsy: A case report

BACKGROUND

Cerebral palsy, hereinafter referred to as "cerebral palsy", refers to a non progressive injury that occurs during the development of brain tissue in fetuses or infants. The patients often have walking dysfunction, abnormal balance ability and abnormal body stability, which are mainly caused by Cranial nerves injury.

PATIENT CONCERNS

One child diagnosed with ataxia cerebral palsy by the hospital was recruited, aged 6 years and 9 months. The symptoms were: lower limb adduction and internal rotation, left neck tilt to the left due to insufficient muscle tension, and eyes squint to the right. The movement is clumsy and the coordination ability of limbs is poor; Its body balance function is poor, the sitting and standing position cannot keep the body upright and balanced for a long time, and the coordination of the random movement of hands and eyes is poor; Weak spatial cognition and orientation ability; Have persistent central motor dysfunction. When walking, the body leans forward and sideways, and the gait is staggered, which is easy to fall; In terms of expression, it shows vague language and unclear speech; Relatively retarded in intelligence.

DIAGNOSIS AND INTERVENTION

The study used swimming training intervention to report a twelve months training intervention program for a child with ataxic cerebral palsy, and evaluated it with Berg balance scale and modified Ashworth scale.

OUTCOMES

Swimming training has a significant effect on the rehabilitation of children with ataxic cerebral palsy; The forces from different directions in the water can improve the balance of children with cerebral palsy; Muscle endurance training with medium load intensity can help restore unilateral muscle tension deficiency to a certain extent, and make bilateral muscle tension gradually becomes.consistent, thus enhancing the balance ability, gait and body stability of children with cerebral palsy.

Effects of remittances on life expectancy and under-five mortality in sub-Saharan Africa: Evidence using Generalized Method of Moments analysis

The study examined the relationship between financial remittances and health outcomes in 45 sub-Saharan African countries (SSA) using data obtained from the World Development Indicator (WDI) over the period 1990 to 2021. Because of the issue of endogeneity, the System Generalized Method of Moments (SGMM) was adopted to analyze the impact of remittances on life expectancy and infant mortality respectively. The results showed that contrary to expectations, remittances did not significantly improve life expectancy and infant mortality rate in SSA. The life expectancy in the previous year, has a statically significant impact on life expectancy at birth for the current year. Also, the lagged value of infant mortality rate significantly increased under five mortality. Therefore, the study recommends that governments in SSA sub-region should evolve policies aimed at guiding recipients of remittances towards effective utilization with a view to improving social welfare and health outcomes.

Quantitatively Unveiling the Structure-Activity Relationship of Polyamide Nanofiltration Membranes with Complex Structures

Nanofiltration polyamide (NF PA) membranes are widely used in seawater desalination and wastewater treatment due to their excellent permeability. The structure-activity relationship of PA membranes has attracted extensive attention in decades. In this work, NF PA membranes with planar structure, nodular structure, and peak-valley structure were constructed, and the pure water permeance was calculated by nonequilibrium molecular dynamics simulation to quantitatively investigate the structure-activity relationship between the microstructure and water permeance. Results showed that the peak-valley structure had the highest effective utilization rate of the membrane surface, which had the highest number of water molecules that passed through membranes per unit cross-sectional area (7.09). Furthermore, with the increase of the specific surface area ratio, the water permeance of the NF PA with peak-valley increased at a rate about 2.5 times than that of the planar NF PA. Therefore, some molecular scale insights were supplied about the structure-activity relationship of NF PA membranes, which is helpful for the fabrication of high-performance NF PA membranes.

Isolation of an Insulin-Like Receptor Involved in the Testicular Development of the Mud Crab Scylla paramamosain

Insulin-like androgenic gland hormone (IAG) is a key regulator of male sexual differentiation in crustaceans that plays important roles in secondary sexual characteristics and testicular development. As a hormone, IAG interacts with its membrane receptor to initiate downstream signal pathways to exert its biological functions. In this study, we isolated a full-length cDNA of an insulin-like receptor (Sp-IR) from the mud crab Scylla paramamosain. Sequence analysis revealed that this receptor consists of a Fu domain, two L domains, three FN-III domains, a transmembrane domain, and a tyrosine kinase domain, classifying it as a member of the tyrosine kinase insulin-like receptors family. Our results also suggested that Sp-IR was highly expressed in the testis and AG in males. Its expression in the testis peaked in stage I but significantly decreased in stages II and III (p < 0.01). Next, both short- and long-term RNA interference (RNAi) experiments were performed on males in stage I to explore Sp-IR function in mud crabs. The results showed that Sp-vasa and Sp-Dsx expression levels in the testis were significantly down-regulated after the specific knockdown of Sp-IR by RNAi. Additionally, the long-term knockdown of Sp-IR led to a considerable decrease in the volume of seminiferous tubules, accompanied by large vacuoles and a reduced production of secondary spermatocytes and spermatids. In conclusion, our results indicated that Sp-IR is involved in testicular development and plays a crucial role in transitioning from primary to secondary spermatocytes. This study provided a molecular basis for the subsequent analysis of the mechanism on male sexual differentiation in Brachyuran crabs.

Forniceal deep brain stimulation in a mouse model of Rett syndrome increases neurogenesis and hippocampal memory beyond the treatment period

BACKGROUND

Rett syndrome (RTT), caused by mutations in the X-linked gene encoding methyl-CpG binding protein 2 (MeCP2), severely impairs learning and memory. We previously showed that forniceal deep brain stimulation (DBS) stimulates hippocampal neurogenesis with concomitant improvements in hippocampal-dependent learning and memory in a mouse model of RTT.

OBJECTIVES

To determine the duration of DBS benefits; characterize DBS effects on hippocampal neurogenesis; and determine whether DBS influences MECP2 genotype and survival of newborn dentate granular cells (DGCs) in RTT mice.

METHODS

Chronic DBS was delivered through an electrode implanted in the fimbria-fornix. We tested separate cohorts of mice in contextual and cued fear memory at different time points after DBS. We then examined neurogenesis, DGC apoptosis, and the expression of brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF) after DBS by immunohistochemistry.

RESULTS

After two weeks of forniceal DBS, memory improvements lasted between 6 and 9 weeks. Repeating DBS every 6 weeks was sufficient to maintain the improvement. Forniceal DBS stimulated the birth of more MeCP2-positive than MeCP2-negative DGCs and had no effect on DGC survival. It also increased the expression of BDNF but not VEGF in the RTT mouse dentate gyrus.

CONCLUSION

Improvements in learning and memory from forniceal DBS in RTT mice extends well beyond the treatment period and can be maintained by repeated DBS. Stimulation of BDNF expression correlates with improvements in hippocampal neurogenesis and memory benefits.

Latissimus dorsi flap - the main force in breast reconstruction for breast tumor in Chinese population

Background

The latissimus dorsi flap (LDF) is the most commonly used autologous flap for breast reconstruction (BR) in China. We conducted this study to explore the current status of BR using LDF with/without implants.

Methods

This study was a single-center retrospective study that included breast tumor patients who underwent LDF breast reconstruction at Fudan University Shanghai Cancer Center (FUSCC) between 2000 and 2021.

Results

We analyzed 4918 patients who underwent postmastectomy BR, including 1730 patients (35.2%) with autologous flaps. LDF was used for BR in 1093 (22.2%) patients, and an abdominal flap was used in 637 (13.0%) patients. The proportion of LDFs used in autologous BR patients decreased each year and dropped to approximately 65.0% after 2013 due to the increased use of abdominal flaps. Among these patients, 609 underwent extended LDF (ELDF) BR, 455 underwent LDF BR with implants, and 30 received a LDF as a salvage flap due to previous flap or implant failure. Patients who underwent ELDF reconstruction were older and had a higher BMI than those who received a LDF with implants. There was no significant difference in the mean postoperative hospital stay, neoadjuvant chemotherapy rates, or adjuvant radiotherapy rates between the two groups. Major complications requiring surgical intervention occurred in 25 patients (2.29%). There was no significant difference in the incidence of major complications between the two groups (P=0.542).

Conclusions

LDF breast reconstruction is a well-developed and safe procedure. The duration of postoperative hospitalization nor the incidence of major complications was affected by implant use.

The relationship between ensemble coding and individual representation of crowd facial emotion

In recent years, the processing mechanism of group expression has gradually gained the attention of researchers owing to its high ecological validity. However, research on the relationship between ensemble coding and individual representation is still in the early stage of the investigation, with many studies remaining at the behavioral level and findings varying widely. Based on our behavioral research (Experiment 1), we used EEG measures (Experiments 2A and 2B) to investigate the relationship between summary and object representations by manipulating the exposure time of crowd emotions. The behavioral results indicated that participants performed better in judging emotions of multiple faces compared to a single face during the shorter exposure time, whereas the reverse occurred during the long exposure time. Furthermore, ERP results revealed that the N2pc effect was not affected by the number of faces in the short exposure time; however, as the exposure time increased, the N2pc increased as a function of the number of faces. The findings of the current investigation align with time-dependent assumption, indicating that during short time of visual processing, although individual representations may not be fully developed, ensemble representations are initially established. With longer processing times, detailed individual representations become complete and take precedence.

A SYSTEMATIC REVIEW AND META-ANALYSIS OF COMPARING DRAINAGE ALONE VS. DRAINAGE WITH PRIMARY FISTULA TREATMENT FOR THE PERIANAL ABSCESS IN CHILDREN

Background This systematic review and meta-analysis of non-randomized studies (NRSs) aimed to evaluate the clinical efficacy and safety of two types of surgical interventions (respectively drainage alone and drainage with primary fistula treatment) for perianal abscesses (PAs) in children. Materials and Methods Studies from 1992 to July 2022 were searched in 10 electronic databases. All relevant NRSs with available data which compared surgical drainage with or without primary fistula treatment were included. Patients with underlying diseases which led to abscess formation were excluded. The Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias and quality of the included studies. The outcomes were the healing rate, fistula formation rate, fecal incontinence, and wound healing duration. Results A total of 16 articles with 1,262 patients were considered suitable for the final meta-analysis. Primary fistula treatment was associated with a significantly higher healing rate when compared with incision and drainage alone (OR 5.76, 95% CI 4.04-8.22). This aggressive procedure for PA resulted in an 86% reduction in the fistula formation rate (OR 0.14, 95% CI 0.06-0.32). Limited data showed patients who underwent primary fistula treatment have a minor effect on postoperative fecal incontinence. Conclusion Primary fistula treatment demonstrates a better clinical efficacy in promoting the healing rate and decreasing the formation of fistulas in PAs in children. The available evidence for a minor impact on anal function after this intervention is less strong.

[Expression and clinical significance of plasma methylated SEPT 9 gene in patients with primary liver cancer]

Objective: To investigate the expression and clinical significance of plasma methylated SEPT9 (mSEPT9) gene in patients with primary liver cancer. Methods: 393 cases who visited our hospital from May 2016 to October 2018 were selected. Among them, 75 cases were in the primary liver cancer (PLC) group, 50 cases were in the liver cirrhosis (LC) group, and 268 cases were in the healthy control group (HC). The three groups' positive rates of mSEPT9 expression in the peripheral plasma were detected by the polymerase chain reaction (PCR) fluorescent probe method. The correlational clinical features of liver cancer were analyzed. At the same time, the electrochemiluminescence detection method was used to compare the AFP positive rate. Statistical analysis was conducted using chi-square tests or continuity-corrected chi-square tests. Results: 367 cases actually had valid samples. There were 64, 42, and 64 cases in the liver cancer group, cirrhosis group, and healthy control group, respectively. Among them, 34 cases of liver cancer were verified from pathological tissues. The positive rate of plasma mSEPT9 was significantly higher in the liver cancer group than that in the liver cirrhosis and healthy control groups [76.6% (49/64), 35.7% (15/42), and 3.8% (10/261), respectively], and the differences were statistically significant (χ (2) = 176.017, P < 0.001). The sensitivity of plasma mSEPT9 detection (76.6%) was significantly better in liver cancer (76.6%) than that of AFP patients (54.7%), and the difference was statistically significant (χ (2) = 6.788, P < 0.01). Compared with the single detection, the sensitivity and specificity of plasma mSEPT9 combined with AFP were significantly improved (89.7% vs. 96.3%, respectively). Patients with liver cancer aged≥50 years, with clinical stage II or above, and those with pathological signs of moderate to low differentiation had higher levels of plasma mSEPT9 positive expression, and the differences were statistically significant (χ (2) = 6.41, 9.279, 6.332, P < 0.05). During the follow-up period, the survival time of liver cancer patients with positive plasma mSEPT9 expression was significantly shorter than that of those with negative expression (310 ± 26 days vs. 487 ± 59 days, respectively), with statistically significant differences (Log Rank P = 0.039). Conclusion: In China, the positive rate of plasma mSEPT9 detection in liver cancer patients is higher than that of AFP in relation to age, clinical stage, and degree of tissue differentiation; additionally, it has certain survival predictive values. As a result, detecting this gene has important clinical significance and potential clinical application value in the non-invasive diagnosis and prognosis assessment of patients with primary liver cancer.

Abstract P1-05-31: A single center retrospective analysis of 259 cases of metaplastic breast cancer

Introduction: Metaplastic breast cancer (MBC) is a rare breast tumor.WHO histological classification of breast tumors in 2019 divided MBC into the following seven types: low-grade adenosquamous carcinoma, fibromatoid metaplastic carcinoma, squamous cell carcinoma, spindle cell carcinoma, metaplastic carcinoma with mesenchymal differentiation, mixed metaplastic carcinoma and myoepithelial carcinoma. Based on single center data, this study intends to conduct a detailed analysis of the clinicopathological features, treatment and prognostic factors of MBC. Methods:We collected 259 MBCs treated in our center from 2006 to 2022. The patient’s age, histological type, image feature, tumor size, lymph node metastasis, tumor stage, immunohistochemical information, surgical plan and systemic adjuvant therapy were summarized and considered to explore the factors affecting the overall survival rate (OS) and disease-free survival rate (DFS). T-test and chi-square test were performed on the data. P&lt; 0.05 showed that the difference was statistically significant. Kaplan-Meier survival was used to analyze the long-term efficacy. Results: The incidence rate of MBC in breast cancer patients in our center is about 0.5%. They included 105 cases of squamous cell carcinoma (40.5%), 49 cases of mixed metaplastic carcinoma (18.9%), 41 cases of spindle cell carcinoma (15.8%), 27 cases of metaplasia carcinoma secreting matrix (10.4%), 6 cases of metaplastic carcinoma with mesenchymal differentiation (2.3%), 6 cases of myoepithelial carcinoma (2.3%), 3 cases of low-grade adenosquamous carcinoma (1.2%), 1 case of fibromatoid metaplasia carcinoma (0.4%) and 21 cases of unknown (8.1%). MBC were mainly three negative subtypes, which were 204 cases (78.8%), 41 cases (15.8%) luminal subtypes and 14 cases (5.4%) HER2 positive subtypes. There was no significant difference in the distribution of breast cancer subtypes among different histological types of MBC. There were 63 cases (24.3%) in clinical stage I, 171 cases (66.0%) in stage II, 23 cases (8.9%) in stage III and 2 cases (0.8%) in stage IV. 58 patients underwent core needle biopsy, of which only 7 (12.1%) reported histological types consistent with MBC. Among 154 patients with molybdenum target reports, 59 of them (38.3%) had malignant calcifications. The diagnostic coincidence rates of MRI, ultrasound and molybdenum target were 90.0%, 85.1% and 74.7% respectively. 258 cases of MBC received surgical treatment, including 183 cases of total mastectomy (70.9%), 53 cases of breast conserving surgery (20.5%) and 22 cases of quadrant resection (8.5%); 132 patients (51.2%) underwent axillary lymph node dissection and 93 patients (36.0%) underwent sentinel lymph node biopsy. 24 patients (9.3%) received neoadjuvant chemotherapy, of which only 2 (8.3%) achieved pathological complete remission. 56 patients (21.6%) received adjuvant radiotherapy, with a median of 25 times. 167 patients (64.5%) received adjuvant chemotherapy, and anthracycline sequential paclitaxel was the most commonly used regimen. The median follow-up was 31 months. The five-year DFS was 82.0%, and the five-year OS was 89.4%. Through Cox regression analysis, it was found that patients’ N stage (P=0.036) and receiving anthracycline sequential paclitaxel adjuvant chemotherapy (P=0.004) were independent prognostic factors. Conclusion: The histological types of MBC are complex. MRI is of high value in diagnosis. Conventional CNB is difficult to meet the needs of pathological tissue classification. Patients without lymph node metastasis and receiving anthracycline sequential paclitaxel adjuvant chemotherapy are associated with better prognosis. Through multidisciplinary standardized diagnosis and treatment, there is no significant difference between the prognosis of MBC and the common types of breast cancer. Keyword: metaplastic breast cancer; pathological characteristics; imaging; treatment; prognosis.

Citation Format: Douwaner Liu, Jiajian Chen, Shuang Hao, Bingqiu Xiu, Qi Zhang, Liyi Zhang, Guangyu Liu, Zhimin Shao, Jiong Wu. A single center retrospective analysis of 259 cases of metaplastic breast cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-05-31.

Abstract P2-14-13: Propensity score matching for survival outcomes in breast cancer patients with nipple sparing mastectomy versus total mastectomy and breast-conserving surgery: a single-center retrospective study

Objective: With the development of the diagnosis and treatment of breast cancer, the pattern of multidisciplinary treatment has resulted a new tendency of breast conserving surgery and reconstruction. Nipple sparing mastectomy (NSM) preserves the aesthetically important nipple-areolar complex, improved appearance satisfaction and quality of life of patients after mastectomy, and had similar oncologic outcomes compared with traditional mastectomy techniques. The primary guiding principles of NSM are oncologic safety. Some studies have demonstrated its oncologic safety while others have demonstrated recurrent risk increasing because of the nipple-areolar complex. We sought to assess the overall survival and disease-free survival of NSM compared with breast-conserving surgery (BCS) and total mastectomy (TM). Key words: nipple sparing mastectomy, breast-conserving surgery, total mastectomy, the overall survival, the disease-free survival Methods: This retrospective matched-cohort study was conducted patients accepted breast surgery between January 2007 and December 2017 in the Department of Breast Surgery of Fudan University Shanghai Cancer Center. Cancer stages were identified depending on the American Joint Committee on Cancer [AJCC] TNM staging system. The inclusion criteria included (1) female breast cancer, (2) histopathology confirmed invasive breast cancer without distant metastasis or local relapses, (3) had complete clinical and pathological T&N stages. The exclusion criteria included in situ carcinoma, phylloides tumor, recurrent or metastatic breast cancer and pregnancy. The primary outcome was the overall survival (OS), the secondary outcome was the disease-free survival (DFS). Statistical methods included Kaplan-Meier survival analysis and COX regression analysis, all of which were completed by SPSS 20.0. Results: A total of 2757 patients were evaluated for eligibility, of which 430 were included (86 NSM vs 172 BCS vs 172 TM), the median follow-up is 61.57 months. Clinical T&N stage and other factors of the above three operations were balanced and comparable after matching. COX regression analysis reported that pT (pT3 vs pT1, P=0.00, HR 16.051, 95%CI:3.822-67.409) and pN (pN2 vs pN0, P=0.00, HR 16.626, 95%CI:4.581-60.337) were related factors for OS, and pT (pT3 vs pT1, P=0.021, HR 6.619, 95%CI:1.331-32.927) and pN (pN2 vs pN0, P=0.000; HR 13.320, 95%CI:3.250-54.591) are independent predictive factor of OS. In addition, pN (pN2 vs pN0, P=0.013; HR 3.448, 95%CI:1.304-9.118) was a related factor for DFS. Among 94.19% patients of the NSM group underwent breast reconstruction, 70 underwent implant-based breast reconstruction, 8 underwent autogenous flaps reconstruction, and 3 patients chose latissimus dorsi flap combined with prosthesis immediate breast reconstruction. Only 4 of 172 patients underwent autogenous flaps reconstruction in TM, and 1 chose implant-based breast reconstruction. Kaplan-Meier survival analysis found that the 5-year OS of NSM group, TM group and BCS group were respectively 100%, 95.8% and 99.2%. The 5-year DFS of three operations were respectively 95.2%, 92.1%, 93.5%. Patients who underwent NSM had no difference compared with BCS or TM regarding the OS (P=0.875, HR 0.938, 95%CI:0.421-2.090) and the DFS (P=0.882, HR 0.967, 95%CI:0.623-1.502). Conclusions: Patients undergoing NSM are not disadvantaged in terms of the OS and the DFS compared with patients who underwent BCS or TM. Patients with NSM tend to opt for breast reconstruction to keep good shape and it has the same prognostic outcome as patients with TM or BCS.

Citation Format: Min Xiong, Shuang Hao, Jiajian Chen, Xiaoyan Huang, Guangyu Liu, Zhimin Shao, Jiong Wu. Propensity score matching for survival outcomes in breast cancer patients with nipple sparing mastectomy versus total mastectomy and breast-conserving surgery: a single-center retrospective study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-14-13.

Abstract P6-05-56: Current Status and Focus of Breast Reconstruction Research in China and Abroad-A Bibliometric Study

Objective: The aim of this study was to conduct a bibliometric and visual analysis of breast reconstruction related research at China and abroad published in the past five years, to understand the research status and development trend in this field, to discuss the focus of research in different countries and different disciplines, and to provide reference for other researchers. Methods: Relevant literatures about breast reconstruction were retrieved from the Web of Science Core Collection. The VOS viewer 1.6.15 software was used to extract the authors, countries, institutions and keywords to generate network maps of high-yield authors, institutions and high-frequency keywords clustering network. Results: 4,815 documents meeting the requirements were retrieved, which showed an upward trend in the past five years. Regarding the discipline, 838 documents (17.40%) were published by breast surgery and Cancer Surgery, 3308 (68.70%) were published by plastic surgery, and 669 (13.90%) were jointly published by both types of researchers. A total of 161 clinical trials were registered in the US clinical trial registry (ClinicalTrial.gov), of which intervention trials accounted for the highest proportion (107, 66.46%), followed by observational trials (54, 33.54%) and patient registry (4, 2.48%). Regarding country distribution, the United States conducted the largest number of breast reconstruction-related clinical trials (45, 27.95%), followed by China (22, 13.66%), Italy (12, 7.45%), France (11, 6.83%), the Netherlands (9, 5.59%). The top ten institutions contributed 983 articles (20.41%), and the institution with the highest number of publications was MD Anderson Cancer Center (144, 2.99%), followed by Harvard Medical School (139, 2.89%), Sloan-Kettering Cancer Center (125, 2.60%), Stanford University (113, 2.35%) and University of Michigan (102, 2.12%). The author with the largest number of documents was Bernard T. Lee of Beth Israel Deaconess Medical Center (BIDMC), with 56 papers and 540 citations. The most cited author was Andrea L. Pusic of Brigham and Women’s Hospital, with 48 papers and 1,332 citations. Chinese authors published 310 documents, accounting for 6.44%. There were differences in the disciplines of the main authors between China and abroad. In China, authors from breast surgery published a larger proportion of documents (138, 44.52%), while the number of documents published by authors of plastic surgery (129, 44.52%) and the joint publication of both types of authors (43, 13.87%) was relatively small. However, foreign documents mainly came from authors of plastic surgery (74.74%). There were more cooperative groups (155) formed by major foreign authors, and joint publishing between groups was more frequent; while Chinese author formed only 16 cooperative groups with less cooperation. Keyword cluster analysis showed that top five keywords were flap, implant, breast cancer, immediate breast reconstruction, tissue. In breast surgery publications, top five keywords were breast cancer, breast reconstruction, complications, implant, immediate breast reconstruction, while in plastic surgery publications top five keywords were flap, implant, tissue, breast cancer, infection. Authors from breast surgery focus more on oncology-related issues in breast reconstruction, while in plastic surgery, more attentions were paid on autologous tissue reconstruction. Conclusion: Breast reconstruction had gradually attracted the attention of Chinese and foreign researchers. Compared with foreign countries, there were problems such as lack of high-quality research and less cooperative research in China. There were differences in the research focus of breast reconstruction between China and abroad, which is mainly related to the differences in the disciplines of researchers.

Citation Format: Hengyu Ren, Shuang Hao, Jiajian Chen, Zhimin Shao, guangyu liu, A-Yong Cao, Jiong Wu. Current Status and Focus of Breast Reconstruction Research in China and Abroad-A Bibliometric Study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-56.

Effect of antioxidant procyanidin b2 (pcb2) on ovine oocyte developmental potential in response to in vitro maturation (ivm) and vitrification stress

BACKGROUND

It was demonstrated that external stress, such as in vitro maturation (IVM) and vitrification process can induce significantly reduced development capacity in oocytes. Previous studies indicated that antioxidants play a pivotal part in the acquisition of adaptation in changed conditions. At present, the role of the natural potent antioxidant PCB2 in response to IVM and vitrification during ovine oocyte manipulation has not been explored.

OBJECTIVE

To investigate whether PCB2 treatment could improve the developmental potential of ovine oocytes under IVM and vitrification stimuli.

MATERIALS AND METHODS

The experiment was divided into two parts. Firstly, the effect of PCB2 on the development of oocytes during IVM was evaluated. Un-supplemented and 5 ug per mL PCB2-supplemented in the IVM solution were considered as control and experimental groups (C + 5 ug per mL PCB2). The polar body extrusion (PBE) rate, mitochondrial membrane potential (MMP), ATP, reactive oxygen species (ROS) levels and early apoptosis of oocytes were measured after IVM. Secondly, we further determine whether PCB2 could improve oocyte quality under vitrification stress. The survival rate, PBE rate and early apoptosis of oocytes were compared between fresh group, vitrified group and 5 ug per mL PCB2-supplemented in the IVM solution after vitrification (V + 5 ug per mL PCB2).

RESULTS

Compared to the control group, adding PCB2 significantly increased PBE rate (79.4% vs. 62.8%, P < 0.01) and MMP level (1.9 +/- 0.08 vs. 1.3 +/- 0.04, P < 0.01), and decreased ROS level (47.1 +/- 6.3 vs. 145.3 +/- 8.9, P < 0.01). However, there was no significant difference in ATP content and early apoptosis. Compared to the fresh group, vitrification significantly reduced oocytes viability (43.0% vs. 90.8%, P < 0.01) as well as PBE rate (24.2% vs. 60.6%, P < 0.05). However, 5 ug per mL PCB2-supplemention during maturation had no effect on survival, PBE or early apoptosis in vitrified oocytes.

CONCLUSION

PCB2 could effectively antagonise the oxidative stress during IVM and promote oocyte development. DOI: 10.54680/fr23210110412.

Abstract P2-07-02: Effects of different duration of prophylactic antibiotic use on unplanned reoperation in breast cancer patients undergoing implant-based breast reconstruction: A retrospective study with overlap weighting analysis

Background: Some special consensus recommended the duration of perioperative antibiotic prophylaxis was within 24 hours postoperatively in breast cancer undergoing postmastectomy implant breast reconstruction. However, surgeons in practice favored to prolong the duration. The aim of this study was to estimate the effects of duration of antibiotics on major adverse outcomes in real clinical practice setting with diverse population using overlap weighting model. Methods: In this retrospective study, patients with breast cancer undergoing breast implant reconstructions were collected in Fudan University Shanghai Cancer Center from 1 January 2008 to 31 December 2021. Cases were divided into two groups according to the duration of perioperative antibiotic prophylaxis: short-term group (≤ 24 hours) and long-term group (&gt;24 and≤48 hours). The primary outcomes were unplanned reoperations and complication-related unplanned reoperations. Unplanned reoperation was defined as debridement, expander removal without prosthesis implantation, expander removal and expander implantation, prosthesis removal and prosthesis implantation, prosthesis removal, prosthesis removal and expander implantation. By reviewing the patients’ detailed medical history, all unplanned reoperations were divided into non-complication-related unplanned reoperations and complication-related unplanned reoperations. Non-complication-related unplanned reoperations included: patients voluntarily gave up continuing reconstruction, suspected recurrence of cancer, changed reconstruction methods, unsatisfactory appearance, and unknown reasons. Complication-related unplanned reoperations included: infection, exposure of prosthesis or expander, poor wound healing, rupture of expander, necrosis of skin flap, bleeding. The secondary outcomes were infections that required intervention. It was defined as both met with white blood cells elevation and physician antibiotic prescription during outpatient follow-up. To adjust confounders, propensity score overlap weighting was used, and subgroup analysis and sensitive test were conducted to demonstrate the robustness of results. A P value less than 0.05 was considered statistically significant. Results: In 4367 cases of unilateral implant reconstructions, 4128 (95%) were included in this study. Among them, 1689 were expander implantation, 1124 were prosthesis implantation and 1315 were expander removal and prosthetic implantation. At inclusion, only 283 cases (6.9%) received antibiotics prophylaxis ≤24 hours, 3090 cases (74.9%) with duration &gt;24 and≤48 hours, and 755 cases (18.3%) with duration &gt;48 hours. Of them, 230 cases (5.6%) underwent unplanned reoperation, including 131 (3.2%) complication-related unplanned reoperations, and 99 (2.4%) non-complication-related unplanned reoperations. And there were 110 cases (2.7%) with infections that required intervention. In unweighted or weighted data set, short-term antibiotic use did not significantly increase the risk of adverse outcomes, including unplanned reoperation, complication-related unplanned reoperation, and infection required intervention, compared with long-term antibiotic use with or without patients with duration more than 48 hours. Most subgroup analysis showed no evidence of heterogeneity of the effects of duration of antibiotic use on adverse outcomes. Conclusion: In clinical setting with diverse population, prolong antibiotic prophylaxis with more than 24 hours is not necessary to reduce major adverse outcomes, even in some critical conditions. Appropriating and accessible prophylactic initiatives should be developed and implemented with shorten the duration of antibiotic prophylaxis and minimized adverse outcomes. Key words: perioperative antibiotic prophylaxis, breast cancer, postmastectomy implant reconstruction, unplanned reoperation

Citation Format: Zeqing Li, Jiajian Chen, Shuang Hao, A-Yong Cao, Xiaoyan Huang, Zhiming Shao, Jiong Wu. Effects of different duration of prophylactic antibiotic use on unplanned reoperation in breast cancer patients undergoing implant-based breast reconstruction: A retrospective study with overlap weighting analysis [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-07-02.

Abstract P2-14-02: Surgical options of the breast and clinical outcomes in breast cancer patients after neoadjuvant chemotherapy: a single-center retrospective study

Background: Neoadjuvant chemotherapy (NAC) has evolved significantly and has been widely accepted for downstaging disease in early-stage and locally advanced breast cancer patients. Since the optimal surgical intervention of the breast for patients receiving NAC remains controversial, we aim to investigate the survival outcome of patients treated with different surgical management.

Methods: Patients with invasive breast cancer that underwent NAC in Fudan University Shanghai Cancer Center from January 2010 to June 2019 were involved in this study. Based on surgical intervention of the breast following NAC, patients were divided into mastectomy and breast conservation groups. To be specific, the mastectomy group involved patients who received mastectomy alone or mastectomy plus immediate breast reconstruction (M+IBR), while the breast conservation group evolved patients who underwent conventional breast-conserving surgery (CBCS) and oncoplastic surgery (OPS). Surgical interventions were performed by breast surgeons. Propensity scores matching was utilized for group matching.

Results: A total of 2080 patients were enrolled in this study. Among them, 1819 (87.5%) patients were categorized as mastectomy group, and 261 (12.5%) patients were classed as breast conservation group. In the mastectomy group, mastectomy alone and M+IBR accounted for 82.5% (1715/2080) and 5% (104/2080) patients respectively. As for breast conservation, 170 (8.2%) and 91 (4.4%) patients were treated with CBCS and OPS after NAC. Over 9-years of research, the proportion of breast conservation steadily increased in patients after NAC. Notably, the percentage of patients undergoing OPS increased from 0.43 % to 7.60 % throughout the 9 years. Moreover, increasing rate of M+IBR was also observed in the study cohort, whereas fewer patients opted for mastectomy alone as surgical intervention after NAC. Compared with mastectomy group, patients underwent BCS showed younger age (P &lt; 0.001), as well as higher proportion of normal BMI (P = 0.022), pre-menopausal status (P &lt; 0.001), and triple-negative breast cancer (P &lt; 0.008). Additionally, patients with tumors of advanced clinical T stage (P &lt; 0.001) and TNM stage (P = 0.002) were more often to be treated with mastectomy (Table 1). After propensity score matching, 460 patients were matched successfully (Table 2). Compared with the mastectomy group, significant benefits in overall survival (Hazard ratio 0.51, [95% confidence interval: 0.27-0.96]; p=0.044) and disease-free survival (Hazard ratio 0.62, [95% confidence interval: 0.39-0.99]; p&lt;0.05) were observed in the breast conservation group (Table 3A and 3B). Moreover, there was no statistical difference in locoregional recurrence among the surgical groups (Table 3C).

Conclusions: Tumor biology can significantly impact the surgical decision in patients administrated with NAC. Breast conservation was a safe alternative for mastectomy in the NAC setting without compromising survival outcomes.

Table 1. Clinicopathologic characteristics of patients in mastectomy and breast conservation groups.

Table 2. Balanced statistics of patients receiving mastectomy and breast conservation after propensity score matching.

Table 3. Survival analysis between matched cohort of patients receiving mastectomy (n=230), breast-conserving therapy (n=230).

Citation Format: Yuting Sang, Jiajian Chen, Benlong Yang, Shuang Hao, Xiaoyan Huang, Guangyu Liu, Zhimin Shao, Jiong Wu. Surgical options of the breast and clinical outcomes in breast cancer patients after neoadjuvant chemotherapy: a single-center retrospective study. [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-14-02.

Abstract P2-15-07: Current status of latissimus dorsi flaps with or without implants for breast reconstruction in patients with breast tumor: A single-center retrospective study

Background: Asian women have relatively small breast sizes compared to European American women, so the latissimus dorsi flap (LDF) is the most commonly used autologous flap for breast reconstruction in Chinese patients with breast tumor. To explore the current status of LDF with or without implants (IMP) breast reconstruction in China, we conducted this study. Methods: This study was a single-center retrospective study that included breast tumor patients who underwent LDF breast reconstruction in Fudan University Shanghai Cancer Center (FUSCC) from 2000 to 2019. The basic clinicopathological information, the timing and type of reconstruction, postoperative hospitalization time and serious complications requiring surgical intervention were analyzed. Continuous variables were expressed as mean values or median values, while categorical variables were expressed as frequencies. Data were analyzed by using Chi-square and Kruskal-Wallis tests. All P values reported were two-sided and were calculated at a significance level of 0.05. Results: A total of 2868 patients who underwent breast reconstruction for breast tumor were analyzed in this study, 785 (27.4%) patients used LDF for breast reconstruction, and 397 (13.8%) patients underwent autologous breast reconstruction utilizing abdominal flap. The number of breast reconstruction patients and the diversity of reconstruction procedures were increasing year by year. Breast reconstructions utilizing LDF have decreased as a percentage of breast reconstructions, but have increased in number in the past few years. Among patients with LDF breast reconstruction, the majority (97.3%) underwent immediate reconstruction, 11 patients underwent delay reconstruction, and 10 patients underwent immediate-delay reconstruction. 448 patients underwent expanded LDF breast reconstruction, and 337 (42.9%) patients underwent LDF combined with IMP breast reconstruction. 13 patients underwent restoration of reconstructed breast with LDF, 12 of which were changed to LDF±IMP reconstruction due to unsatisfactory outcome of expander reconstruction or failed implant reconstruction, and one patient was changed to LDF reconstruction from failed abdominal flap reconstruction. In terms of pathological type, 629 (80.1%) patients had invasive carcinoma, 129 (16.4%) had carcinoma in situ, 18 (2.3%) patients had phyllodes tumor and 9 (1.1%) patients had other malignancies. The median reconstruction age of the patients was 37 years old, the mean BMI was 21.76kg/cm2, and the mean postoperative length of stay was 11.13 days. There were no significant differences in postoperative hospitalization time, reconstruction age, BMI, pT, ER, PR, HER2, Ki67, and radiotherapy between patients with expanded LDF and LDF combined with IMP breast reconstruction. Patients with neoadjuvant therapy (P=0.045), phyllodes tumors or other malignant tumors (P=0.023), and those with more metastatic lymph nodes (P=0.031) were tent to expanded latissimus dorsi flap reconstruction. Serious complications requiring surgical intervention occurred in 13 patients (1.65%), including 7 patients who underwent surgical debridement or scar repair due to wound infection and poor healing, and 3 patients who removed the implant due to implant infection. The reconstructed latissimus dorsi flaps necrosis occurred in 3 patients, and the reconstructed breasts were removed in these patients. There was no significant difference in the incidence of serious complications requiring surgical intervention between patients with expanded LDF and those with LDF combined with implant reconstruction, P=0.79. Conclusions: LDF±IMP breast reconstruction is a mature breast reconstruction procedure in our center with high safety. Whether combined with implant reconstruction did not affect the postoperative hospitalization time and the incidence of serious complications.

Citation Format: Shuyue Zheng, Jiajian Chen, Shuang Hao, Benlong Yang, Xiaoyan Huang, Guangyu Liu, Jiong Wu. Current status of latissimus dorsi flaps with or without implants for breast reconstruction in patients with breast tumor: A single-center retrospective study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-15-07.

LOWER LIMB STRENGTH TRAINING AND MOBILITY IN TABLE TENNIS

ABSTRACT Introduction: Between the existing fast movement ability training program and the real situation of the athletes, there is a discrepancy, which needs to be solved. Objective: Study the effects of lower limb strength training on fast movement ability in table tennis. Methods: A total of 40 volunteers were recruited and divided into the experimental and control groups, with 20 people in each group. The control group followed the traditional table tennis fast-movement training program. In contrast, the experimental group added lower limb strength training based on the traditional table tennis fast movement training program. The experimental and control groups conducted training experiments twice a week, one hour at a time, for a total of 8 weeks. Results: In the specific fast movement fitness test, the number of upper stages before training in the experimental group was 55.91, and after training was 61.25 (P<0.01). In the whole platform turning speed test, the number in the experimental group before training was 61.40, and after training was 64.28 (P<0.01). Conclusion: Fitness in the rapid movement ability of table tennis players was optimized after the addition of the lower limb strength training program. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Quantitative analysis of lake-cooling effect in Hefei City, China, based on multispectral remote sensing and its response to urban expansion

Urban expansion has intensified the heat-island effect, and the negative impact on the natural environment has gradually become considerable. However, urban lakes can significantly alleviate the heat-island effect caused by urbanization. Based on four-phase multispectral remote-sensing images during 2005-2020, 17 lakes in the main and surrounding urban areas of Hefei, China, were selected as the objects of our research. Each lake's cooling intensity and distance were calculated; cooling-efficiency data for different lakes were compared and analyzed considering lake areas and regional differences. The following conclusions were drawn: (1) The mean temperature of the lake had a strong positive correlation with the cooling-intensity efficiency and the cooling-distance efficiency, and it was the leading influencing factor of the cooling-intensity efficiency and the cooling-distance efficiency. The mean explanation degree was as high as 63.33% and 51.70%, respectively. (2) The lake area and the distance from the lake to the city center had a negative correlation with the cooling-intensity efficiency and cooling-distance efficiency and were the secondary factors that affect the cooling-intensity efficiency and cooling-distance efficiency. (3) The lakes around the urban area were far away from the main urban area where the heat-island effect was most concentrated, the ability of absorbing the high surface temperature caused by the heat-island effect was limited, and the cooling-intensity efficiency and cooling-distance efficiency were reduced by ~ 6.6 °C/km² and ~ 607.47 m/km², respectively, compared with the lakes in the main urban area. (4) With urban expansion and the intensified urban heat-island effect, the cooling-intensity efficiency of lakes in the main urban area gradually increased, whereas the cooling-distance efficiency of lakes decreased.

Cost-effectiveness of Prostate Cancer Screening Using Magnetic Resonance Imaging or Standard Biopsy Based on the STHLM3-MRI Study

Importance

The combination of prostate-specific antigen (PSA) testing with magnetic resonance imaging (MRI) for prostate cancer detection has rarely been evaluated in a screening context. The STHLM3-MRI screening-by-invitation study (NCT03377881) has reported the benefits of using MRI with subsequent combined targeted and standard biopsies compared with using standard biopsies alone.

Objective

To investigate the cost-effectiveness of prostate cancer screening using MRI with combined targeted and standard biopsies compared with standard biopsies alone among men aged 55 to 69 years in Sweden, based on evidence from the STHLM3-MRI study.

Design, Setting, and Participants

This economic evaluation study was conducted from a lifetime health care perspective using a microsimulation model to evaluate no screening and screening strategies among adult men in Sweden. Men aged 55 to 69 years in Sweden were simulated for no screening and screening strategies. Input parameters were obtained from the STHLM3-MRI study and recent reviews. One-way and probabilistic sensitivity analyses were performed in May 2022.

Interventions

No screening, quadrennial PSA screening using standard biopsies alone, and MRI-based screening using combined targeted and standard biopsies.

Main Outcomes and Measures

The number of tests, incidence, deaths, costs, quality-adjusted life-years (QALY), and incremental cost-effectiveness ratios (ICERs) were estimated.

Results

A total 603 men were randomized to the standard arm, 165 of these participants (27.4%) did not undergo standard biopsy; 929 men were randomized to the experimental arm, 111 (11.9%) of whom did undergo MRI or any biopsy. Compared with no screening, the screening strategies were associated with reduced lifetime prostate cancer-related deaths by 6% to 9%. Screening with MRI and the combined biopsies resulted in an ICER of US $53 736, which is classified as a moderate cost per QALY gained in Sweden. Relative to screening with standard biopsies alone, MRI-based screening reduced the number of both lifetime biopsies and overdiagnosis by approximately 50% and had a high probability of being cost-effective than the traditional PSA screening.

Conclusions and Relevance

For prostate cancer screening, this economic evaluation study found that PSA testing followed by MRI with subsequent combined targeted and standard biopsies had a high probability to be more cost-effective compared with the traditional screening pathway using PSA and standard biopsy. MRI-based screening may be considered for early detection of prostate cancer in Sweden.

Surgical options of the breast and clinical outcomes of breast cancer patients after neoadjuvant chemotherapy: A single-center retrospective study

Background

Neoadjuvant chemotherapy (NAC) has evolved significantly and has been widely accepted for downstaging disease in early-stage and locally advanced breast cancer patients. Since the optimal surgical intervention for patients receiving NAC remains controversial, we aim to investigate the survival outcome of patients treated with different surgical management.

Methods

A retrospective, nested case-control study was conducted in patients with invasive breast cancer that underwent NAC at Fudan University Shanghai Cancer Center from January 2010 to June 2019. Based on surgical intervention, patients were divided into mastectomy and breast conservation groups. Patients were matched on age at diagnosis, menopausal status, the year of the surgery, post neoadjuvant therapy pathological tumor (ypT) stage, post neoadjuvant therapy pathological node (ypN) stage, molecular subtypes, and axillary surgery by propensity score matching.

Results

A total of 2080 patients were enrolled in this study. Among them, 1819 (87.5%) patients were categorized as mastectomy group, and 261 (12.5%) patients were classed as breast conservation group. Over 9-years of research, the proportion of breast conservation steadily increased in patients after NAC. Data showed that younger (P&lt;0.001) and pre-menopausal (P&lt;0.001) patients with normal BMI (P=0.022) were more likely to receive breast conservation. Patients at advanced ypT stage (P&lt;0.001), ypN stage (P&lt;0.001), and clinical TNM stage (P&lt;0.001) were more often to undergo mastectomy, while breast conservation rate was significantly higher in patients with triple-negative tumors (P=0.023). Compared with the mastectomy group, significant benefits in overall survival were observed in patients who received breast conservation (Hazard ratio 0.41, [95% confidence interval: 0.18-0.97]; p=0.049) in the matched cohort. There was no statistical difference between groups related to disease-free survival and locoregional recurrence.

Conclusions

Tumor biology can significantly impact the surgical decision in patients administrated with NAC. Breast conservation was a safe alternative for mastectomy in the NAC setting without compromising survival outcomes and locoregional control.

Treatment and survival outcomes in older women with primary breast cancer: A retrospective propensity score-matched analysis

PURPOSE

Changes in biological features and functional status make management decisions in older women with primary breast cancer complicated. We aimed to provide an overview of the clinicopathological characteristics and survival outcomes of older breast cancer patients based on the current treatment strategies.

METHODS

Female patients diagnosed with primary invasive breast cancer at Fudan University Shanghai Cancer Centre from 2008 to 2016 were included. Patients were divided into a younger group (<65 years) and older group (≥65 years). Propensity score matching was utilised to generate balanced cohorts.

RESULTS

A total of 13,707 patients met the study criteria. Compared with younger patients, older patients had a higher Charlson Comorbidity Index (p < 0.001), less lymph node metastasis (p = 0.009), more advanced tumour stage (p = 0.038), and a larger proportion of estrogen receptor-positive (p < 0.001) and epidermal growth factor receptor 2-negative (p < 0.001) tumours. Older patients were likely to receive mastectomy and axillary lymph node dissection in addition to a lower proportion of adjuvant chemotherapy. Adjuvant chemotherapy (HR [hazard ratio] 0.69, p = 0.039) was independently correlated with better overall survival in the older patients. This survival benefit (HR 0.58, p = 0.041) was confirmed in matched cohorts. Among the older patients with larger tumours (HR 0.48, p = 0.038) and more lymph node involvement (HR 0.44, p = 0.040), adjuvant chemotherapy was associated with a significant survival benefit.

CONCLUSION

Older breast cancer patients showed less aggressive biological characteristics, intensive surgical and moderate medical preferences. The addition of adjuvant chemotherapy should be considered for older patients, especially for patients with large tumours and more lymph node involvement.

Reorganization of 3D chromatin architecture in doxorubicin-resistant breast cancer cells

Background: Doxorubicin resistance remains a major therapeutic challenge leading to poor survival prognosis and treatment failure in breast cancer. Although doxorubicin induces massive changes in the transcriptional landscape are well known, potential diagnostic or therapeutic targets associated with the reorganization of three-dimensional (3D) chromatin architecture have not yet been systematically investigated.

Methods: Here we performed in situ high-throughput chromosome conformation capture (Hi-C) on parental and doxorubicin-resistant MCF7 (MCF7-DR) human breast cancer cells, followed by integrative analysis of HiC, ATAC-seq, RNA-seq and TCGA data.

Results: It revealed that A/B compartment switching was positively correlated to genome-wide differential gene expression. The genome of MCF7-DR cells was spatially reorganized into smaller topologically associating domains (TADs) and chromatin loops. We also revealed the contribution of increased chromatin accessibility and potential transcription factor families, including CTCF, AP-1 and bHLH, to gained TADs or loops. Intriguingly, we observed two condensed genomic regions (∼20 kb) with decreased chromatin accessibility flanking TAD boundaries, which might play a critical role in the formation or maintenance of TADs. Finally, combining data from TCGA, we identified a number of gained and lost enhancer-promoter interactions and their corresponding differentially expressed genes involved in chromatin organization and breast cancer signaling pathways, including FA2H, FOXA1 and JRKL, which might serve as potential treatment targets for breast cancer.

Conclusion: These data uncovered a close connection between 3D genome reorganization, chromatin accessibility as well as gene transcription and provide novel insights into the epigenomic mechanisms involving doxorubicin resistance in breast cancer.

[Factors analysis of worsening renal function in patients with acute right ventricular myocardial infarction during hospitalization]

Objective: To analyze the related factors of worsening renal function (WRF) in patients with acute right ventricular myocardial infarction (RVMI) during hospitalization. Methods: A total of 98 patients with acute RVMI admitted to the emergency comprehensive ward of Beijing Anzhen Hospital from August 2011 to January 2020 were enrolled in this cross-sectional study. According to the situation of WRF, the patients were divided into non-WRF group (76 cases) and WRF group (22 cases). WRF was defined as ≥0.3 mg/dL increase in serum creatinine level from baseline on day 6 of hospitalization (if hospital stay<6 days, it was at discharge). Baseline data, intravenous fluid infusion, diuretic and significant positive balance of patients' intake and output volume [any 24 h intakes and outputs ≥1 000 ml or any consecutive 72 h intakes and outputs ≥2 000 ml within 6 d of hospitalization (if hospitalization<6 d, it was from admission to discharge)] were obtained, and the differences of above indicators between the two groups were analyzed. Multiple logistic regression model was used to analyze the related factors of WRF. Results: The ages of patients in WRF group and non-WRF group were 60 (50, 68) and 63 (52, 72) years, and the male proportions were 63.6% (14 cases) and 76.3% (58 cases), respectively, and there was no significant difference (all P>0.05). The proportion of positive balance was 31.8% (7 cases) in WRF group, which was higher than 14.5% (11 cases) in non-WRF group (P=0.034). The rate of loop diuretic use in WRF group was 4.5% (1 case), lower than that in non-WRF group 10.5% (8 cases) (P=0.027). After adjusting for age, sex, baseline estimated glomerular filtration rate (eGFR), preoperative isoproterenol/temporary pacemaker/atropine use, significant positive balance of intake and output volume, and loop diuretic use, it was found that eGFR≥60 ml·min^-1·1.73 m^-2 and significant positive balance were associated with WRF, the OR (95%CI) were 0.71 (0.62-0.86) and 1.21 (1.02-1.43) (both P<0.05); After eliminating the variable of significant positive balance in the above model, loop diuretic use was found to be a correlation factor for WRF, with an OR (95%CI) of 0.89 (0.72-0.97) (P<0.05). Conclusions: Significant positive balance of intake and output volume during hospitalization in patients with acute RVMI is a risk factor for WRF on day 6 or at discharge. In the presence of a significant positive balance, loop diuretic use is a protective factor for WRF.

[Clinical phenotype analysis of 6 cases of TTC21B gene related nephronophthisis]

Objective: To analyze the clinical characteristics of 6 children with TTC21B-related nephronophthisis to provide reference for early clinical diagnosis. Methods: The general condition, clinical manifestations, laboratory tests and other clinical data of 6 children from 4 families diagnosed with nephronophthisis by genetic testing in Shanghai Children's Hospital from January 2015 to December 2020 were analyzed retrospectively. Results: A total of 6 children (3 males and 3 females) developed proteinuria and progressive renal dysfunction in early infancy. The onset age of proteinuria was 18 (6, 25) months. The age at the onset of renal impairment was 22 (10, 36) months. All 6 children progressed to end-stage renal disease (ESRD) within 10 (4, 65) months of onset. Five children had hypertension, 3 children with abnormal liver function, 2 children with visceral translocation and 1 child with growth retardation. The genetic results suggested that all children carried variations TTC21B gene p.C518R. Conclusions: Children with TTC21B gene p.C518R nephronophthisis had proteinuria and progressed to ESRD at the early stage of life. These nephronophthisis patients commonly presented with liver and renal dysfunction.

Prolonged low-salt immersion effectively controls Flavobacterium columnare infection in Murray cod Maccullochella peelii peelii

A disease outbreak occurred in Murray cod Maccullochella peelii peelii in a recirculating aquaculture farm in Tianjin city, China, in 2019. Strain MRX-2019 was isolated and considered to be the etiological pathogen; it was identified as Flavobacterium columnare based on a 16S rDNA gene sequence analysis and physiological and biochemical tests. The effect of salinity on the growth of MRX-2019 was investigated in vitro. Salinity >4‰ (i.e. 6‰) inhibited MRX-2019 growth, whereas 8 and 10‰ salinity killed it. The effect of 4‰ salinity on F. columnare was not significant (p > 0.05). When MRX-2019-infected Murray cod were treated with 4, 6, or 8‰ salinity, the mortality rate was reduced by 8.9, 67.76, or 75.56%, respectively, compared with that of the control. However, the mortality rate increased by 7.77% at 10‰ salinity. In this study, we found that maintaining the fish in freshwater with 6-8‰ salinity effectively reduced the mortality of these fish when infected with F. columnare. The findings provide an environmentally friendly control strategy for columnaris disease in Murray cod.

Pectin methyltransferase QUASIMODO2 functions in the formation of seed coat mucilage in Arabidopsis

Pectin, cellulose, and hemicelluloses are major components of primary cell walls in plants. In addition to cell adhesion and expansion, pectin plays a central role in seed mucilage. Seed mucilage contains abundant pectic rhamnogalacturonan-I (RG-I) and lower amounts of homogalacturonan (HG), cellulose, and hemicelluloses. Previously, accumulated evidence has addressed the role of pectin RG-I in mucilage production and adherence. However, less is known about the function of pectin HG in seed coat mucilage formation. In this study, we analyzed a novel mutant, designated things fall apart2 (tfa2), which contains a mutation in HG methyltransferase QUASIMODO2 (QUA2). Etiolated tfa2 seedlings display short hypocotyls and adhesion defects similar to qua2 and tumorous shoot development2 (tsd2) alleles, and show seed mucilage defects. The diminished uronic acid content and methylesterification degree of HG in mutant seed mucilage indicate the role of HG in the formation of seed mucilage. Cellulosic rays in mutant mucilage are collapsed. The epidermal cells of seed coat in tfa2 and tsd2 display deformed columellae and reduced radial wall thickness. Under polyethylene glycol treatment, seeds from these three mutant alleles exhibit reduced germination rates. Together, these data emphasize the requirement of pectic HG biosynthesis for the synthesis of seed mucilage, and the functions of different pectin domains together with cellulose in regulating its formation, expansion, and release.

PROTACs: great opportunities for academia and industry (an update from 2020 to 2021)

PROteolysis TArgeting Chimeras (PROTACs) technology is a new protein-degradation strategy that has emerged in recent years. It uses bifunctional small molecules to induce the ubiquitination and degradation of target proteins through the ubiquitin–proteasome system. PROTACs can not only be used as potential clinical treatments for diseases such as cancer, immune disorders, viral infections, and neurodegenerative diseases, but also provide unique chemical knockdown tools for biological research in a catalytic, reversible, and rapid manner. In 2019, our group published a review article “PROTACs: great opportunities for academia and industry” in the journal, summarizing the representative compounds of PROTACs reported before the end of 2019. In the past 2 years, the entire field of protein degradation has experienced rapid development, including not only a large increase in the number of research papers on protein-degradation technology but also a rapid increase in the number of small-molecule degraders that have entered the clinical and will enter the clinical stage. In addition to PROTAC and molecular glue technology, other new degradation technologies are also developing rapidly. In this article, we mainly summarize and review the representative PROTACs of related targets published in 2020–2021 to present to researchers the exciting developments in the field of protein degradation. The problems that need to be solved in this field will also be briefly introduced.

Natural Compound Library Screening Identifies Oroxin A for the Treatment of Myocardial Ischemia/Reperfusion Injury

Myocardial ischemia/reperfusion injury (MI/RI) is a serious pathophysiological process relating to cardiovascular disease. Oroxin A (OA) is a natural flavonoid glycoside with various biological activities. However, its effect on the pathophysiological process of MI/RI has not yet been reported. The aim of this study was to determine whether OA could alleviate MI/RI induced inflammation and pyroptosis in vivo and in vitro, providing a novel therapeutic regimen for the treatment of MI/RI. A high-throughput drug screening strategy was employed to test 2,661 natural compound libraries that can alleviate MI/RI in vivo and in vitro. The rat model of MI/RI was established by ligating the left anterior descending (LAD) coronary artery. H9c2 cells were subjected to oxygen-glucose deprivation/reperfusion (OGD/R) to simulate MI/RI. The results show that OA is able to significantly inhibit apoptosis, pyroptosis and the inflammation response (TNF-α, IL-6, IL-8, IL-10, IL-1β, IL-18) in vivo and in vitro, and reduce the release of myocardial enzymes (cTnI, cTnT, CK-MB, LDH, AST). In the rat MI/RI model, OA can not only improve cardiac function and reduce inflammatory cell infiltration but also reduce myocardial infarct size. The results revealed that OA is an effective remedy against MI/RI as it reduces the inflammatory response and inhibits pyroptosis. This may provide a new therapeutic target for the clinical treatment of MI/RI.

The Root Hair Development of Pectin Polygalacturonase PGX2 Activation Tagging Line in Response to Phosphate Deficiency

Pectin, cellulose, and hemicellulose constitute the primary cell wall in eudicots and function in multiple developmental processes in plants. Root hairs are outgrowths of specialized epidermal cells that absorb water and nutrients from the soil. Cell wall architecture influences root hair development, but how cell wall remodeling might enable enhanced root hair formation in response to phosphate (P) deficiency remains relatively unclear. Here, we found that POLYGALACTURONASE INVOLVED IN EXPANSION 2 (PGX2) functions in conditional root hair development. Under low P conditions, a PGX2 activation tagged line (PGX2^AT ) displays bubble-like root hairs and abnormal callose deposition and superoxide accumulation in roots. We found that the polar localization and trafficking of PIN2 are altered in PGX2^AT roots in response to P deficiency. We also found that actin filaments were less compact but more stable in PGX2^AT root hair cells and that actin filament skewness in PGX2^AT root hairs was recovered by treatment with 1-N-naphthylphthalamic acid (NPA), an auxin transport inhibitor. These results demonstrate that activation tagging of PGX2 affects cell wall remodeling, auxin signaling, and actin microfilament orientation, which may cooperatively regulate root hair development in response to P starvation.

Radix Astragalus Polysaccharide Accelerates Angiogenesis by Activating AKT/eNOS to Promote Nerve Regeneration and Functional Recovery

Peripheral nerve injury (PNI) results in loss of neural control and severe disabilities in patients. Promoting functional nerve recovery by accelerating angiogenesis is a promising neuroprotective treatment strategy. Here, we identified a bioactive Radix Astragalus polysaccharide (RAP) extracted from traditional Chinese medicine (TCM) as a potent enhancer of axonal regeneration and remyelination. Notably, RAP promoted functional recovery and delayed gastrocnemius muscle atrophy in a rat model of sciatic nerve crush injury. Further, RAP treatment may induce angiogenesis in vivo. Moreover, our in vitro results showed that RAP promotes endothelial cell (EC) migration and tube formation. Altogether, our results show that RAP can enhance functional recovery by accelerating angiogenesis, which was probably related to the activation of AKT/eNOS signaling pathway, thereby providing a polysaccharide-based therapeutic strategy for PNI.

The early-stage triple-negative breast cancer landscape derives a novel prognostic signature and therapeutic target

PURPOSE

Triple-negative breast cancer (TNBC) is a highly heterogeneous disease. Patients with early-stage TNBCs have distinct likelihood of distant recurrence. This study aimed to develop a prognostic signature of early-stage TNBC patients to improve risk stratification.

METHODS

Using RNA-sequencing data, we analyzed 189 pathologically confirmed pT1-2N0M0 TNBC patients and identified 21 mRNAs that were highly expressed in tumor and related to relapse-free survival. All-subset regression program was used for constructing a 7-mRNA signature in the training set (n = 159); the accuracy and prognostic value were then validated using an independent validation set (n = 158).

RESULTS

Here, we profiled the transcriptome data from 189 early-stage TNBC patients along with 50 paired normal tissues. Early-stage TNBCs mainly consisted of basal-like immune-suppressed subtype and had higher homologous recombination deficiency scores. We developed a prognostic signature including seven mRNAs (ACAN, KRT5, TMEM101, LCA5, RPP40, LAGE3, CDKL2). In both the training (n = 159) and validation set (n = 158), this signature could identify patients with relatively high recurrence risks and served as an independent prognostic factor. Time-dependent receiver operating curve showed that the signature had better prognostic value than traditional clinicopathological features in both sets. Functionally, we showed that TMEM101 promoted cell proliferation and migration in vitro, which represented a potential therapeutic target.

CONCLUSIONS

Our 7-mRNA signature could accurately predict recurrence risks of early-stage TNBCs. This model may facilitate personalized therapy decision-making for early-stage TNBCs individuals.

[Application of bionics in spinal surgery]

Spinal bionic therapy is the application of bionics concept, by imitating the natural anatomical structure and physiological function of the spine, to treat spinal diseases using various modern technology, materials and equipment .How to repair or preserve the anatomical structure and function of spine to the maximum extent while treating spinal diseases is an important content of spinal bionic therapy.Firstly, the use of movable spinal implants not only preserves the spinal mobility function to a certain extent, reduces the degeneration of adjacent segments, but also reduces the incidence of internal fixation fracture and improves the long-term efficacy.Secondly, with the help of the development of three dimensional printing technology, personalized artificial prostheses can be made to fill the spinal structure with complex defects, and biological scaffolds and functional prostheses with anti-tumor drugs can not only realize the biomimetic and functional spine anatomy, but also become a multiplier of the efficacy of anti-tumor drugs.Thirdly, in the design and manufacture of spinal orthopaedic braces, computer aided design and manufacturing technology can make spinal orthopaedic braces more comfortable with better orthopaedic effect and ergonomic characteristics.How to apply bionics concepts and relate technologies to spinal surgery have not been determined yet, and no relevant diagnosis and treatment guidelines have been formulated.It is foreseeable that with the continuous development of medical technology, the content of spinal bionic therapy will be gradually enriched and improved, and become a powerful measure to overcome difficulties in the diagnosis and treatment of spinal surgery diseases.

Syntheses and applications of N-halamines antimicrobial agents

Abstract:

Harmful microorganisms are widely present in the surrounding environment, causing a large number of infectious diseases in human society and serious negative effects on human life. In order to resist the damage of harmful microorganisms, antimicrobial agents that inhibit the growth of microorganisms came into being. This review is aiming to encompass current syntheses and applications of N-halamines antimicrobial agents in the past five years, with highlights on the recent significant breakthroughs. This review includes an introduction of the classification of antimicrobial agent, antimicrobial mechanisms, syntheses and applications of small molecular N-halamines and N-halamines polymers. And finally the conclusions and outlooks of N-halamines antimicrobial agents were given

Immunomodulatory role of crustacean cardioactive peptide in the mud crab Scylla paramamosain

Crustacean cardioactive peptide (CCAP) is a pleiotropic neuropeptide, but its immunomodulatory role is not clear. Herein, the mud crab Scylla paramamosain provides a primitive model to study crosstalk between the neuroendocrine and immune systems. In this study, in situ hybridization showed that Sp-CCAP positive signal localized in multiple cells in the nervous tissue, while its conjugate receptor (Sp-CCAPR) positive signal mainly localized in the semigranular cells of hemocytes. The Sp-CCAP mRNA expression level in the thoracic ganglion was significantly up-regulated after lipopolysaccharide (LPS) stimulation, but the Sp-CCAP mRNA expression level was up-regulated firstly and then down-regulated after the stimulation of polyriboinosinic polyribocytidylic acid [Poly (I:C)]. After the injection of Sp-CCAP synthesis peptide, the phagocytosis ability of hemocytes was significantly higher than that of synchronous control group. Simultaneously, the mRNA expression of phagocytosis related gene (Sp-Rab5), nuclear transcription factor NF-κB homologues (Sp-Relish), C-type lectin (Sp-CTL-B), prophenoloxidase (Sp-proPO), pro-inflammatory cytokines factor (Sp-TNFSF, Sp-IL16) and antimicrobial peptides (Sp-ALF1 and Sp-ALF5) in the hemocytes were also significantly up-regulated at different time points after the injection of Sp-CCAP synthetic peptide, but Sp-TNFSF, Sp-ALF1 and Sp-ALF5 were down-regulated significantly at 24h. In addition, RNA interference of Sp-CCAP suppressed the phagocytic activity of hemocytes and inhibited the mRNA expression of Sp-Rab5, Sp-Relish, Sp-CTL-B, Sp-TNFSF, Sp-IL16 and Sp-ALF5 in the hemocytes, and ultimately weakened the ability of hemolymph bacteria clearance of mud crab. Taken together, these results revealed that CCAP induced innate immune and increased the anti-infection ability in the mud crab.

A Retrospective Cohort Study Comparing Traditional Breast Conservation With Oncoplastic Surgery in Breast Cancer Patients After Neoadjuvant Chemotherapy

BACKGROUND

To better understand the difference between traditional breast-conserving surgery (BCS) and oncoplastic surgery (OPS), we conducted a retrospective cohort study involving breast cancer patients who received neoadjuvant chemotherapy (NAC) and then underwent breast conservation at the Fudan University Shanghai Cancer Center.

METHODS

A retrospective chart review was conducted. All breast cancer patients who received NAC and then underwent traditional BCS or OPS at the Fudan University Shanghai Cancer Center from January 1, 2008, to December 31, 2019, were included.

RESULTS

Three hundred ninety-nine breast cancer patients received NAC and underwent traditional BCS, and 99 patients underwent OPS. The average age of the patients in the OPS group was younger than that in the BCS group (43 vs 48 years, P = 0.017). The size of the tumor assessed by ultrasonography at baseline in the OPS group was larger than that in the BCS group (31.3 vs 28.1 mm, P = 0.013). The same trend was observed in the clinical T stage and overall staging assessments before the administration of NAC in these 2 groups. Oncoplastic techniques were more frequently applied when tumors were located in areas with relatively few glands, such as the upper inner quadrant. There were no significant differences in the margins and distributions of pathological types and molecular subtypes between these 2 groups. The rates of pathological complete response were similar in the traditional BCS and OPS groups.

CONCLUSIONS

Unlike traditional BCS, in breast cancer patients after NAC, the adoption of oncoplastic techniques makes breast conservation feasible, even in patients with large tumors, late stages, and unfavorable tumor locations.

BiTE secretion from in situ-programmed myeloid cells results in tumor-retained pharmacology

Bispecific T-Cell Engagers (BiTEs) are effective at inducing remission in hematologic cancers, but their use in solid tumors has been challenging due to their extreme potency and on-target, off-tumor toxicities in healthy tissue. Their deployment against solid tumors is further complicated by insufficient drug penetration, a hostile tumor microenvironment, and immune escape. To address these challenges, we developed targeted nanocarriers that can deliver in vitro-transcribed mRNA encoding BiTEs to host myeloid cells – a cell type that is actively recruited into the tumor microenvironment. We demonstrate in an immunocompetent mouse model of ovarian cancer, that infusion of these nanoparticles directs BiTE expression to tumor sites, which reshapes the microenvironment from suppressive to permissive and triggers disease regression without systemic toxicity. In contrast, conventional injections of recombinant BiTE protein at doses required to achieve anti-tumor activity, induced systemic inflammatory responses and severe tissue damage in all treated animals. Implemented in the clinic, this in situ gene therapy could enable physicians – with a single therapeutic – to safely target tumor antigen that would otherwise not be druggable due to the risks of on-target toxicity and, at the same time, reset the tumor milieu to boost key mediators of antitumor immune responses.

Cost-Effectiveness of the Stockholm3 Test and Magnetic Resonance Imaging in Prostate Cancer Screening: A Microsimulation Study

BACKGROUND

Stockholm3 is a risk model that combines the prostate-specific antigen (PSA) test, other plasma protein biomarkers, single nucleotide polymorphisms, and clinical variables. The STHLM3-MRI study (NCT03377881) found that the Stockholm3 test with magnetic resonance imaging (MRI) and combined targeted and systematic biopsies maintained the sensitivity for clinically significant cancers, and reduced the number of benign biopsies and clinically insignificant cancers.

OBJECTIVE

To assess the cost-effectiveness of MRI-based screening for prostate cancer using either Stockholm3 as a reflex test or PSA alone.

DESIGN, SETTING, AND PARTICIPANTS

A cost-utility analysis was performed from a lifetime societal perspective using a microsimulation model for men aged 55-69 yr in Sweden. Test characteristics were estimated from the STHLM3-MRI study.

INTERVENTION

No screening and three quadrennial screening strategies, including either PSA ≥3 ng/ml or Stockholm3 with reflex test thresholds of PSA ≥1.5 or 2 ng/ml as criteria for referral to MRI, were performed, and those who were MRI positive had combined targeted and systematic biopsies.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

Predictions included the number of tests, cancer incidence and mortality, costs, and quality-adjusted life-years. Uncertainties in key parameters were assessed using sensitivity analyses.

RESULTS AND LIMITATIONS

Compared with no screening, the screening strategies were predicted to reduce prostate cancer deaths by 7-9% across a lifetime. The use of Stockholm3 with PSA ≥2 ng/ml resulted in a 60% reduction in MRI compared with screening using PSA. This Stockholm3 strategy was cost-effective with a probability of 70% at a cost-effectiveness threshold of €47 218 (500 000 Swedish Kronor). As a potential limitation, the economic perspective was specific to Sweden.

CONCLUSIONS

Screening with the Stockholm3 test at a reflex threshold of PSA ≥2 ng/ml and MRI was predicted to be cost-effective in Sweden.

PATIENT SUMMARY

The Stockholm3 test with image-based screening may reduce screening-related harms and costs, while maintaining the health benefits from early detection of prostate cancer.

Deep learning-based remote sensing estimation of water transparency in shallow lakes by combining Landsat 8 and Sentinel 2 images

Water transparency is a key indicator of water quality as it reflects the turbidity and eutrophication in lakes and reservoirs. To carry out remote sensing monitoring of water transparency rapidly and intelligently, deep learning technology was used to construct a new retrieval model, namely, point-centered regression convolutional neural network (PSRCNN) suitable for Sentinel 2 and Landsat 8 images. The impact of input feature variables on the accuracy of the inversion model was examined, and the performance of an optimized PSRCNN model was also assessed. This model was applied to remote sensing images of three shallow lakes in the eastern China plain acquired in summer. The PSRCNN model, constructed using five identical bands from Landsat 8 and Sentinel 2 images and 20 band combinations as the input variables, the input window size of 5 × 5 pixels, proves a good predictive ability, with a verification accuracy of R² = 0.85, the root mean squared error (RMSE) = 13.0 cm, and the relative predictive deviation (RPD) = 2.58. After the sensitive spectral analysis of water transparency, the band combinations that had correlation coefficients higher than 0.6 were selected as the new input feature variables to construct an optimized PSRCNN model (PSRCNN_opt) for water transparency. The PSRCNN_opt model has an excellent predictive ability, with a verification accuracy of R² = 0.89, RMSE = 11.48 cm, and RPD =3.0. It outperforms the commonly retrieval models (band ratios, random forest, support vector machine, etc.), with higher accuracy and robustness. Spatial variations in water transparency of three lakes from the retrieval results by PSRCNN_opt model are consistent with the field observations.