[Progress in application of aspirin desensitization and maintenance therapy in aspirin-exacerbated respiratory disease]

Aspirin-exacerbated respiratory disease (AERD) is a clinical syndrome characterized by chronic rhinosinusitis with nasal polyps, asthma and the development of significant airway symptoms following the ingestion of aspirin and other nonsteroid anti-inflammatory drugs (NSAIDs). At present, aspirin challenge is the gold standard for diagnosis. Aspirin desensitization and aspirin therapy after desensitization (ATAD) is one of the classical therapies. This paper described the application of aspirin desensitization and ATAD in AERD and provided the reference for the comprehensive treatment of AERD.

[Definition of severe pulmonary tuberculosis: a scoping review]

Objective: To clarify the definition of severe pulmonary tuberculosis and its inclusion criteria by summarizing and analyzing the studies of severe pulmonary tuberculosis (TB). Methods: A systematic search of Medline (via PubMed), Cochrane Library, Web of Science, Web of Science, Epistemonikos, Embase, CNKI, WanFang database, and CBM database was conducted to collect studies published between 2017 and 2022 on patients with severe pulmonary TB. Searches were performed using a combination of subject terms and free words. The search terms included: tuberculosis, severe, serious, intensive care, critical care, respiratory failure, mechanical ventilation, hospitalization, respiratory distress syndrome, multiple organ failure, pulmonary heart disease, and pneumothorax. The definitions and inclusion criteria for severe pulmonary TB in the included studies were extracted. Results: A total of 19 981 studies were identified and 100 studies were finally included, involving 8 309 patients with severe pulmonary TB. A total of 8 (8.00%) studies explicitly mentioned the definition of severe pulmonary TB, and 53 (53.00%) studies clearly defined the inclusion criteria for patients with severe pulmonary TB. A total of 5 definitions and 30 inclusion criteria were extracted. A total of 132 dichotomous variables and 113 continuous variables were included in the outcome indicators related to patients with severe pulmonary TB of concern in the studies. Conclusions: The definition and diagnostic criteria for severe TB are unclear, and there is an urgent need to develop a clear definition and diagnostic criteria to guide clinical practice.

[Clinical observation and preliminary economic study of rush immunotherapy in patients with allergic rhinitis]

Objective: To observe the clinical efficacy, safety, compliance, and cost-effectiveness of rush immunotherapy (RIT) and conventional immunotherapy (CIT) in patients with allergic rhinitis (AR), so as to evaluate the clinical significance of CIT and preliminarily explore its economic value. Methods: A study was conducted on 72 AR patients who had received specific immunotherapy from Oct 2019 to Jun 2020 in the Department of Otorhinolaryngology, the First Affiliated Hospital of Chongqing Medical University, including 39 males and 33 females, aging 8 to 60 years. RIT or CIT was performed respectively according to the patients' wishes. There were 35 cases in the RIT group and 37 cases in the CIT group, all subjects were followed up for 1 year. Visual analysis scale (VAS) and effectiveness were used to evaluate the clinical efficacy. Systemic adverse reactions were used to assess safety. Failure rate was calculated to evaluate the compliance. The cost and cost-effectiveness ratio (CER) were conducted to evaluate the health economics preliminarily. Results: After half a year and one year's treatment, both RIT and CIT groups had significant clinical efficacy and RIT group had more significant clinical efficacy than CIT group at half a year (76.67% vs 46.67%, χ²=7.37, P=0.007). During the dose accumulation phase, there was no significant difference in the incidence of systemic adverse reactions between the two groups (8.57% vs 8.10%, χ²=0.05, P=0.943), while the drop-out rate in the RIT group was significantly lower than that in the CIT group (0 vs 13.51%, χ²=5.08, P=0.024). After one year, the costs in RIT group were significantly higher ((8 163.08±452.67) yuan vs (7 385.87±369.92) yuan, t=-2.78, P=0.009), while there was no statistical differences in CER between the two groups ((3 298.06±1 374.09) yuan/point vs (3 154.38±1 532.51) yuan/point, t=-0.36, P=0.418). Conclusions: Both RIT and CIT are beneficial for AR, and they have similar clinical efficacy, safety, and CER. RIT is more effective in the early stage, with higher patient compliance. Thus, RIT is worth promoting and exploring in clinic.

Lattice distortions and the metal-insulator transition in pure and Ti-substituted Ca3Ru2O7

We report pair distribution function studies on the relationship between the metal-insulator transition (MIT) and lattice distortions in pure and Ti-substituted bilayer Ca₃Ru₂O₇. Structural refinements performed as a function of temperature, magnetic field and length scale reveal the presence of lattice distortions not only within but also orthogonal to the bilayers. Because of the distortions, the local and average crystal structure differ across a broad temperature region extending from room temperature to temperatures below the MIT. The coexistence of distinct lattice distortions is likely to be behind the marked structural flexibility of Ca₃Ru₂O₇under external stimuli. This observation highlights the ubiquity of lattice distortions in an archetypal Mott system and calls for similar studies on other families of strongly correlated materials.

A study on serum pro-neurotensin (PNT), furin, and zinc alpha-2-glycoprotein (ZAG) levels in patients with acromegaly

PURPOSE

Acromegaly caused by growth hormone cell adenoma is commonly associated with abnormal glucolipid metabolism, which may result from changes in adipocytokine secretion. This study aims to investigate serum adipokine levels, including pro-neurotensin (PNT), furin, and zinc alpha-2-glycoprotein (ZAG), in acromegalic patients and the correlation between the levels of these three adipokines and GH levels and glucolipid metabolism indices.

METHODS

Sixty-eight acromegalic patients and 121 controls were included, and their clinical data were recorded from electronic medical record system. Serum PNT, furin and ZAG levels were measured by ELISA.

RESULTS

Serum PNT levels in acromegalic patients were significantly higher than controls (66.60 ± 12.36 vs. 46.68 ± 20.54 pg/ml, P < 0.001), and acromegaly was an independent influencing factor of PNT levels (P < 0.001). Moreover, subjects with the highest tertile of PNT levels had a close correlation with acromegaly (OR = 22.200, 95% CI 7.156 ~ 68.875, P < 0.001), even in Model 1 adjusted for gender and age and Model 2 adjusted for gender, age and BMI. Additionally, serum PNT levels were positively correlated with BMI (r = 0.220, P = 0.002) and triglycerides (TGs, r = 0.295, P < 0.001), and TGs were an independent influencing factor of serum PNT levels in acromegalic subjects (P < 0.001). Furthermore, serum PNT levels in obese acromegalic patients were significantly higher than those with normal BMI (P < 0.05). However, serum furin levels were lower in acromegalic patients than controls (0.184 ± 0.036 vs. 0.204 ± 0.061 ng/ml, P < 0.001).

CONCLUSION

This study is the first to demonstrate that acromegalic patients have increased serum PNT levels. Moreover, serum PNT plays a potential role in abnormal lipid metabolism of acromegalic patients.

Mussel-Inspired Hydrogels for Fluoride Delivery and Caries Prevention

Fluoride agents hold promise for the repair and prevention of caries lesions, but their interaction with enamel is often hampered and diminished because of the dynamic wet environment in the oral cavity, which affects the efficacy of fluoride delivery and limits treatment success. We herein developed a mussel-inspired wet adhesive fluoride system (denoted TS@NaF) fabricated by the self-assembly of tannic acid (TA), silk fibroin (SF), and sodium fluoride (NaF). TS@NaF demonstrated remarkable biological stability and biocompatibility, showed reliable wet adhesion, released fluoride ions (F−) topically, and induced significant deposition of calcium fluoride (CaF2) onto enamel in vitro. Furthermore, TS@NaF provided an anticaries effect in vitro and induced a detectable increase in enamel mineral density. Advanced fluoride-releasing bioadhesives are therefore promising candidates for caries prevention and highlight the great potential of mussel-inspired dental materials in clinical applications.

Bone microarchitecture impairment in prolactinoma patients assessed by HR-pQCT

PURPOSE

Prolactinoma may reduce bone mineral density (BMD) and increase fracture risk, but its influence on bone microarchitecture remains to be elucidated. The purpose of this study is to evaluate bone microarchitecture parameters by high-resolution peripheral quantitative computed tomography (HR-pQCT) in prolactinoma patients.

METHODS

31 prolactinoma patients and 62 age- and sex-matched healthy controls in our center were included, and HR-pQCT was used to evaluate their bone microarchitecture at the radius and tibia. Z-scores for bone microarchitecture parameters were calculated based on previously published reference.

RESULTS

After adjusting for height and weight, prolactinoma patients had lower trabecular (- 0.011 mm, p = 0.005) and cortical thickness (- 0.116 mm, p = 0.008) and cortical area (- 6.0 mm2, p = 0.013) at radius, as well as lower trabecular (- 0.014 mm, p = 0.008) and cortical (- 0.122 mm, p = 0.022) thickness at tibia compared with the controls. Patients with higher prolactin level had more severe bone microarchitecture impairments. After adjusting for prolactin level and age, male patients had lower trabecular volumetric BMD (vBMD), trabecular number, trabecular thickness, and cortical porosity at radius, as well as lower trabecular vBMD, trabecular bone volume fraction, trabecular number, and cortical area, and higher trabecular separation at tibia compared with female patients. Z-score for radius vBMD was correlated with Z-score for areal BMD (aBMD) at lumbar and femoral neck, while Z-score for tibia vBMD was correlated with Z-score for lumbar aBMD, and some patients with vBMD Z-score below - 2.0 had aBMD Z-score within normal range.

CONCLUSION

Peripheral bone microarchitecture was impaired in prolactinoma patients, especially in patients with higher prolactin level. We compared the bone microarchitecture of prolactinoma patients and healthy controls by high-resolution peripheral quantitative computed tomography (HR-pQCT), and found that many bone microarchitecture parameters were impaired among prolactinoma patients. Such impairment was more prominent among patients with higher prolactin level.

[Progress in the traceability of tumor marker detection]

Tumor markers (TM) detection is of great significance in tumor screening, monitoring and treatment intervention, which puts forward higher requirements for its detection quality. TM traceability is very important in the process of reagent production and clinical laboratory testing, which can help improving the reliability and comparability of TM testing. Based on the current principles and classification system of metrology traceability in the world, this paper reviews the quality requirements of reference materials and reference measurement methods related to protein and nucleic acid of TM, as well as the problems existing in the international convention reference measurement procedure and traceability system of TM, so as to provide a new idea for the quality assurance work of TM detection.

[Development and application of a fundus image quality assessment system based on computer vision technology]

Objective: To develop a fundus image quality assessment system based on computer vision technology and to verify its accuracy by comparing the results of artificial discrimination and using this system. Methods: The process of image evaluation was divided into four modules: fundus image preprocessing, fundus image quality evaluation, fundus image content detection and evaluation result output. The system was designed to automatically evaluate the image quality of each fundus image, identify the optic disc and macula, and judge whether the image was qualified or not according to the image quality discrimination rules. A total of 2 397 fundus images of 787 type 2 diabetes patients were selected as the test data set. The average age of the patients, including 384 males and 403 females, was (69.65±19.09) years old. The images were taken by the staff of community health service centers in Shanghai with a fundus camera. The fundus image quality assessment system was used to conduct quality control and classification of the data set. At the same time, 12 professional fundus picture readers were employed to conduct manual quality control and classification of this data set. The system quality control results and artificial quality discrimination results were compared and analyzed. Results: The fundus image quality assessment system automatically recognized left and right eyes and eye positions on the input fundus images. The quality control interface included four indicator lights, which respectively corresponded to the images with the optic disc or macula as the center of the left or right eye. Evaluation of each fundus image was completed within 1 second, and the results were automatically displayed on the user interface. The 2 397 fundus photos were identified manually as 1 846 qualified photos and 551 unqualified photos. Among the unqualified images, 62 (11.27%) were too dark, 51 (9.27%) were too bright, 59 (10.73%) were not clear in the macular area, 36 (6.54%) showed no macula or optic disc, 125 (22.73%) could not present the fundus structure, 175 (31.82%) were blurred, and 42 (7.64%) were blocked. The results of the system and manual assessment were consistent in 1 788 qualified images (96.86%) and 550 unqualified images (99.82%), with an overall consistency rate of 97.54%. Conclusion: The fundus image quality assessment system can achieve highly consistent results with the professional judgment of ophthalmologists and has the characteristics of objectivity. (Chin J Ophthalmol, 2020, 56:920-927).

[The correlation between the degree of anxiety/depression and the improvement of subjective and objective symptoms after functional endoscopic sinus surgery in chronic sinusitis]

Objective: To explore whether the improvement of subjective symptoms and objective grades after endoscopic sinus surgery in patients with chronic sinusitis (CRS) are related to the degree of preoperative anxiety or depression and to provide reference for improving the effects of clinical treatment. Methods: The clinical data of one hundred and sixty patients with CRS treated by endoscopic sinus surgery in the First Affiliated Hospital of Chongqing Medical University from April 2018 to August 2019 were collected prospectively. The visual analogue scale (VAS) scores, self-rating anxiety scale (SAS) scores, self-rating depression scale (SDS) scores, Lund-Kennedy scores of nasal endoscopy and the Lund-Mackay scores of CT before and 6 months after surgery were used to analyse the correlation between the scores of anxiety or depression and the subjective and objective scores of patients before and after operation by grouping and layering. One hundred and one males (63.1%) and 59 females (36.9%) with an average age of 47.3 years (18-75 years) were included. Single-sample, independent or paired t-test, one-way ANOVA and rank-sum test were used for comparison and Pearson correlation analysis was used for the correlation between groups. Results: There was no statistical difference of anxiety or depression between different groups in terms of age, gender and course in the 160 effective patients (t values were -0.151, -0.487, -0.846, all P values>0.05; t values were -0.473, -1.302, -1.069, all P values>0.05). And the degree of preoperative anxiety or depression was positively correlated with the subjective scores, including overall discomfort, nasal obstruction, runny nose and olfactory decline (r values were 0.515, 0.606, 0.424, 0.306, all P values<0.01; r values were: 0.518, 0.584, 0.448, 0.308, all P values<0.01), but not significantly correlated with objective scores of Lund-Mackay and Lund-Kennedy (all P value>0.05). Moreover, as far as the symptoms of overall discomfort, nasal obstruction, headache and runny nose, the results of one-way ANOVA showed that the improvement of symptoms in patients with serious anxiety or depression was worse than that of the normal, mild and moderate patients (all P values<0.05). However, there was no significant difference in the scores of Lund-Kennedy 6 months after surgery between them (both P values>0.05). Conclusion: The state of anxiety or depression affects the improvement of symptoms after endoscopic sinus surgery for CRS patients. Compared with the patients with normal and mild to moderate anxiety or depression, the improvement of symptoms in patients with severe anxiety and depression is worse. It is necessary to evaluate the anxiety or depression of the patients with CRS who are going to undergo endoscopic sinus surgery.

The clinical impact of serum sLOX-1 level in coronary artery disease patients as inferred from its implication in the in vitro protective effects of metoprolol against hypoxic injury of HUVECs

Background

Ischemic coronary artery disease (CAD) is a major public health problem across the world. Early detection and appropriate management significantly reduced CAD-induced morbidities and death. Endothelial cells are pathogenically implicated.

Purpose

Our study was designed to investigate the role of the soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) in the in vitro protective effect of Metoprolol against hypoxia-induced injury of Human umbilical vein endothelial cells (HUVECs). Secondly, the clinical significance of variations in serum levels of sLOX-1 in patients with CAD was assessed.

Methods

In vitro, hypoxic injury model of HUVECs was established in an atmosphere of 1% O2, 95% N2, and 5% CO2 for 24 hours. The protective effect and mechanism of action of the cardio-selective beta-blocker Metoprolol at 10–6 μM concentration was investigated.

Consented stable atherosclerotic CAD (n=150) and unstable angina pectoris patients (n=75) along with 150 healthy volunteer subjects were voluntarily enrolled in this ethically approved study. Invasive coronary angiogram with ≥50% stenosis at least in one major coronary artery was used for diagnosis. ESC/ACC/AHC/practical protocols were used for categorizing patients into stable or unstable CAD. Serum sLOX-1 level was measured using specific ELISA kit. The diagnostic significance of serum sLOX-1 levels was assessed by analyzing its area under the curve (AUC).

Results

In vitro hypoxic conditions induced high rate of cellular apoptosis, high levels of LOX-1 expression, reactive oxygen species (ROS) generation and LDH release from HUVECs after 24 hours incubation, compared to normoxic control cells. Metoprolol significantly decreased LOX-1 levels, and prevented the release of LDH and generation of ROS. This culminated into marked improvement in cellular viability of hypoxia-exposed HUVECs (p&lt;0.001).

Compared to healthy subjects, serum levels of sLOX-1s were significantly elevated in atherosclerotic stable and unstable CAD patients (p&lt;0.001). Serum sLOX-1 levels were increased by 4.21 folds in stable CAD patients and by 6.373 folds in atherosclerotic unstable angina patients vs. healthy participants. Moreover, the levels in the two patients' groups were significantly different (p&lt;0.001). In stable angina CAD patients, sLOX-1 AUC = 0.929; and in unstable CAD patients, AUC = 0.944, indicating that serum sLOX-1 levels clearly differentiated patients from healthy participants with high specificity and sensitivity.

Conclusions

Extrapolated from HUVECs hypoxia-induced injury model and the protective effect of Metoprolol, elevation of the circulating levels of sLOX-1 correlated with increased risks for atherosclerotic CAD and is a highly sensitive and specific biomarker for early detection of the disease.

Funding Acknowledgement

Type of funding source: None

[Application of the subjective and objective evaluation in functional rhinoplasty]

Objective: To explore the subjective and objective evaluation methods in functional rhinoplasty. Methods: Sixty-four patients who underwent rhinoplasty in the Department of Otorhinolaryngology, the First Affiliated Hospital of Chongqing Medical University were included in this study from January 2017 to October 2018. There were 32 males and 32 females, with the age ranging from 18 to 45 years old. Before and 6 months after operation, nasal ventilation function was evaluated by Visual Analogue Scale (VAS), Nasal Obstruction Symptom Evaluation (NOSE), nasal acoustic reflex and nasal resistance. Satisfaction with nasal appearance was evaluated by VAS, Rhinoplasty Outcome Evaluation (ROE) and facial proportions evaluation. Psychological state was assessed by Emotional Balance Scale and Rosenberg Self-esteem Scale. Finally, the Pearson correlation analysis of patient satisfaction was performed. SPSS 23.0 software was used for statistical analysis. Results: Compared with pre-operation, nasal obstruction VAS, NOSE scores, total nasal resistance and difference ratio of nasal resistance showed significantly decline after surgery (1.62±0.85 vs 7.56±1.44, 22.62±3.54 vs 69.75±7.85, (0.16±0.08) Pa·s/ml vs (0.31±0.43) Pa·s/ml, 0.33±0.28 vs 0.71±0.32, all P<0.05). VAS of appearance and ROE scores showed an increase after surgery (11.20±3.66 vs 2.70±0.97, 17.80±2.71 vs 7.50±1.12, all P<0.05). The measurement of the external nasal subunits showed that the length of the dorsum of the nose, the angle of the face to the nose, the angle of the frontal and the angle of the alar of the nose were obviously reduced ((29.33±4.26) mm vs (33.61±5.24) mm, (135.11±3.81)° vs (139.91±6.30)°, (130.63±2.88)° vs (136.74±5.72)°, (99.71±4.02)° vs (106.27±5.60)°, all P<0.05). The scores of postoperative Emotional Balance Scale and Rosenberg Self-esteem Scale increased significantly (5.88±1.54 vs 4.31±1.85, 28.31±2.64 vs 22.13±2.77, all P<0.05). The Pearson correlation analysis showed that patients' satisfaction was positively correlated with subjective score of nasal ventilation (VAS, NOSE), subjective score of nasal appearance (VAS, ROE) and emotional balance scale, while negatively correlated with nasal resistance, and not correlated with the measurement of external nasal subunit. There was a significant positive correlation between the subjective score of nasal ventilation and the measurement of nasal resistance, but there was no significant correlation between the subjective score of nasal appearance and the measurement of external nasal subunit. Conclusion: The subjective and objective evaluation of nasal ventilation function, aesthetics of nasal appearance and psychological state can evaluate the effect of functional rhinoplasty effectively.

Coexistence and Interaction of Spinons and Magnons in an Antiferromagnet with Alternating Antiferromagnetic and Ferromagnetic Quantum Spin Chains

In conventional quasi-one-dimensional antiferromagnets with quantum spins, magnetic excitations are carried by either magnons or spinons in different energy regimes: they do not coexist independently, nor could they interact with each other. In this Letter, by combining inelastic neutron scattering, quantum Monte Carlo simulations, and random phase approximation calculations, we report the discovery and discuss the physics of the coexistence of magnons and spinons and their interactions in Botallackite-Cu_{2}(OH)_{3}Br. This is a unique quantum antiferromagnet consisting of alternating ferromagnetic and antiferromagnetic spin-1/2 chains with weak interchain couplings. Our study presents a new paradigm where one can study the interaction between two different types of magnetic quasiparticles: magnons and spinons.

Applications of Ultrafine Limestone Sorbents for the Desulfurization Process in CFB Boilers

With the stringent emission regulation taking effect, it is difficult for the conventional desulfurization technology in circulating fluidized bed (CFB) boilers to meet the requirements of ultralow SO₂ emission. Therefore, in this paper, the application of natural ultrafine limestone, with a Sauter mean diameter of less than 20 μm, was tested by conducting bench-scale, pilot-scale, and commercial-scale experiments to realize highly efficient desulfurization in CFB furnaces. In the past, such small-size limestone was considered unsuitable for CFB boilers. However, as demonstrated by bench-scale results, the desulfurization performance was clearly superior to that of coarse limestone, especially at low SO₂ concentrations. In a 3 MW_th pilot-scale CFB boiler, the ultrafine limestone exhibited competent desulfurization efficiency to that of the coarse limestone but clearly less significant catalytic effects on NOx formation. As revealed by field tests in four commercial-scale CFB boilers, when high-efficiency cyclones were applied to CFB boilers, the mass inventory of ultrafine particles was significantly increased and the residence time would be extended accordingly; thus, the ultrafine limestone can be used to achieve high desulfurization efficiency and even ultralow SO₂ emission with a favorable Ca/S ratio. Furthermore, a technical roadmap was drawn for the cost-effective control of SO₂ emission.

Crocin Protects Human Umbilical Vein Endothelial Cells from High Glucose-Induced Injury Via Inhibiting the Endoplasmic Reticulum Stress Response

BACKGROUND

Endothelial dysfunction plays a key role in diabetic atherosclerosis. High glucose (HG) is considered a stimulator in the development of diabetic atherosclerosis. The endoplasmic reticulum (ER) stress response is involved in HG-induced vascular injury. Crocin has antioxidative and antiapoptotic properties.

OBJECTIVE

The current study was to evaluate whether crocin can protect human umbilical vein endothelial cells (HUVECs) from HG-induced injury and explored the associated mechanism.

METHODS

HUVECs were treated with 33 mmol/L glucose as the HG condition. The endothelial protective effects of crocin were evaluated by comparison with the control groups.

RESULTS

The exposure of HUVECs to HG for 24 h remarkably induced the ER stress response and a sequence of injuries, as demonstrated an increase in the apoptotic cell number, the reactive oxygen species level and inflammatory cytokine generation, as well as a decline in vascular endothelial growth factor A expression. These changes were markedly alleviated by pretreating the HUVECs with either crocin or 4-phenylbutyrate (ER stress inhibitor) before exposure to HG.

CONCLUSION

Crocin exerted antioxidative, antiapoptotic, anti-inflammatory and proangiogenic effects in the HG-induced HUVEC injury model, which were probably mediated by a favorable modification of ER stress that requires further investigation.

Insulator-metal transition induced by electric voltage in a ruthenate Mott insulator

We report the observation of electric-voltage induced insulator-metal phase transition in a ruthenate Mott insulator Ca₃(Ru_0.9Ti_0.1)₂O₇. We show that the electric field effect dominates and leads to a sharp phase transition at measurement temperatures far below the Mott transition, whereas the thermal effect becomes more significant and broadens the phase transition as the measurement temperature approaches the insulator-metal transition. The electric field induced insulator-metal transition is presumably attributed to the avalanche breakdown of the correlated insulating state when driven out of equilibrium. This work highlights the strategy of using electric voltage to control the phase transition of this system in addition to other nonthermal parameters such as magnetic field and pressure reported previously.

[Rosai-Dorfman disease with nasal septum involvement:two cases report]

Clinical data of 2 cases with Rosai-Dorfman disease(RDD) originating from nasal septal mucosa were reported retrospectively,and the pertinent literature was reviewed. Without specific clinical features,RDD in nasal cavity could be misdiagnosed easily. Pathology revealed different morphologies of cell proliferation with engulfed lymphocytes,plasma cells and neutrophils. Immunohistochemical staining showed S-100(+),CD68(+)，CD1(-).RDD disease generally has a benign course and is self-limited. Its diagnosis depends mainly on biopsy．As for the treatment of this disease,the strategies are not systemic and standard. Surgical treatment is used to excise the mass in nasal cavity,glucocorticoids treatment after surgery is inconclusive. The long-term effect need to be further observed．.

[Analysis of the clinical characteristics of fungus ball sphenoid sinusitis]

Objective:To analyze the clinical characteristics of fungus ball sphenoid sinusitis(FBSS) and its differences from fungus ball maxillary sinusitis(FBMS). Method:A retrospective analysis was made for 50 patients with FBSS and 273 patients with FBMS in the corresponding period, which were confirmed by postoperative pathological diagnosis. And the related factors and clinical characteristics of them were analyzed. Result:FBSS were common disease in women around 50 years old. The left side FBSS was more common than the right side. About 40 percent of patients' disease course was less than half a year.FBSS had many presenting symptoms such as headache, nasal obstruction, nasal mucus with blood, smelly nasal secretions, eye ache bilges or nasion acheand tears spill. However, headache, eye ache bilges and tears spill were more common in FBSS compared with FBMS(P<0.05). The CT scan showed that there were calcification shadows in the diseased softtissue of sinus cavity.It could be accompanied by local bone thickening, sclerosis and coloboma. Only one case had a secondary surgery in 50 cases of FBSS. The surgery cure rate was as high as 98 percent. Conclusion:FBSS had various of clinical symptoms.Some presenting symptoms such as headache, eye ache bilges, and tears spill had relative specificity. CT diagnosis was more specific, and the endoscopic sphenoidotomy was the most effective treatment.

Thickness evolution of transport properties in exfoliated Fe1+y Te nanoflakes

We report the evolution of transport properties in exfoliated Fe_1+y Te (y  =  0.04) nanoflakes of various thickness. In contrast to the sharp semiconducting-to-metallic phase transition observed in both bulk and thicker flakes, this transition becomes broadened for flakes with an intermediate thickness followed by the appearance of a superconducting-like feature upon further cooling. With the thickness further decreased, the flakes exhibit insulating transport behavior with significantly enhanced positive magnetoresistance, which can be explained using a variable range hopping mechanism, suggesting the nature of a highly disordered 2D system.

Association of functional MMP-2 gene variant with intracranial aneurysms: case-control genetic association study and meta-analysis

INTRODUCTION

Abnormalities in Matrix Metalloproteinase (MMP) genes, which are important in extracellular matrix (ECM) maintenance and therefore arterial wall integrity are a plausible underlying mechanism of intracranial aneurysm (IA) formation, growth and subsequent rupture. We investigated whether the rs243865 C > T SNP (single nucleotide polymorphism) within the MMP-2 gene (which influences gene transcription) is associated with IA compared to matched controls.

MATERIALS AND METHODS

We conducted a case-control genetic association study, adjusted for known IA risk factors (smoking and hypertension), in a UK Caucasian population of 1409 patients with intracranial aneurysms (IA), and 1290 matched controls, to determine the association of the rs243865 C > T functional MMP-2 gene SNP with IA (overall, and classified as ruptured and unruptured). We also undertook a meta-analysis of two previous studies examining this SNP.

RESULTS

The rs243865 T allele was associated with IA presence in univariate (OR 1.18 [95% CI 1.04-1.33], p = .01) and in multi-variable analyses adjusted for smoking and hypertension status (OR 1.16 [95% CI 1.01-1.35], p = .042). Subgroup analysis demonstrated an association of the rs243865 SNP with ruptured IA (OR 1.18 [95% CI 1.03-1.34] p = .017), but, not unruptured IA (OR 1.17 [95% CI 0.97-1.42], p = .11).

CONCLUSIONS

Our study demonstrated an association between the functional MMP-2 rs243865 variant and IAs. Our findings suggest a genetic role for altered extracellular matrix integrity in the pathogenesis of IA development and rupture.

Association of prenatal organochlorine pesticide-dichlorodiphenyltrichloroethane exposure with fetal genome-wide DNA methylation

AIMS

To investigate whether intrauterine organochlorine pesticide (OCP)-dichlorodiphenyltrichloroethane (DDT) exposure could lead to epigenetic alterations by DNA methylation with possible important lifetime health consequences for offspring.

MAIN METHODS

We used Illumina Infinium HumanMethylation 450 K BeadChip to explore the pattern of genome-wide DNA methylation containing >485,000 gene sites in cord blood of 24 subjects in a 12 mother-newborn pairs birth cohort. Based on the genome-wide DNA methylation data, we chose one potential gene, BRCA1, to verify the results in another group comprising 126 subjects.

KEY FINDINGS

We identified 1,131 significantly different CpG sites which included 690 hypermethylation sites and 441 hypomethylation sites in the DNA methylation level between case and control group. The identified sites were located in 598 unique genes. In subsequent validation studies, we found that the DNA methylation level of the identified CpGs of BRCA1 increased with increased exposure to dichlorodiphenyltrichloroethane (DDT) and the level of gene expression in the identified CpGs of BRCA1 decreased with increased exposure to dichlorodiphenyltrichloroethane (DDT).

SIGNIFICANCE

The results indicated that epigenetic processes played a possible role in the development of fetuses affected by maternal OCP-DDT exposure. Early prenatal exposure to DDT may affect fetal BRCA1 gene methylation, and increased exposure leads to a higher DNA methylation level and lower gene expression level.

Epigenome-wide study for the offspring exposed to maternal HBV infection during pregnancy, a pilot study

BACKGROUND & AIM

Hepatitis B virus (HBV) can be transmitted to infants, and is related to infants' later disease risk. Epigenetic change (such as DNA methylation) may be mechanism underlying the relationship. In this study, we aimed to investigate whether prenatal HBV infection could alter DNA methylation status in newborns.

METHOD

We selected 12 neonates with intrauterine HBV infection whose mothers were HBsAg-positive during pregnancy, relative to 12 HBV-free neonates with HBsAg-negative mothers. The pattern of genome-wide DNA methylation in the umbilical cord blood was investigated by Illumina Infinium Human Methylation 450K BeadChip.

RESULT

The average level of global methylation in infected neonates exposed to maternal HBV infection was not significantly different from controls. However, after adjusting for multiple comparisons, we found differential significance in the cases group compared to the controls for 663 CpG sites, associated with 534 genes. Among these sites, 53.85% (357/663) had decreased methylation (ΔM < 0) and 46.15% (306/663) had increased methylation (ΔM > 0). The average percentage change (Δβ) in methylation ranged from -46% to 36%. Validated by pyrosequencing, we identified 4 significantly differentially methylated CpG sites in the KLHL35 gene and additional CpGs for the CPT1B gene. These genes play a role in the development of hepatocellular and colorectal carcinoma and fatty acid oxidation, suggesting the candidature of these genes in HBV related disease.

CONCLUSION

Prenatal HBV exposure, even without malformation or preterm birth, may alter the epigenome profile in newborns. We identified a set of genes with differentially methylated CpG sites presented in the cord blood of HBV-infected newborns with HBsAg-positive mothers, demonstrating that DNA methylation status at birth can be used as a biomarker of prenatal exposure. These DNA methylation differences suggest a possible role for epigenetic processes in neonatal development in response to prenatal HBV exposure.

Temperature- and field-driven spin reorientations in triple-layer ruthenate Sr4Ru3O10

Sr₄Ru₃O₁₀, the n = 3 member of the Ruddlesden-Popper type ruthenate Sr_n+1Ru_nO_3n+1, is known to exhibit a peculiar metamagnetic transition in an in-plane magnetic field. However, the nature of both the temperature- and field-dependent phase transitions remains as a topic of debate. Here, we have investigated the magnetic transitions of Sr₄Ru₃O₁₀ via single-crystal neutron diffraction measurements. At zero field, we find that the system undergoes a ferromagnetic transition with both in-plane and out-of-plane magnetic components at T_c ≈ 100 K. Below T ^* = 50 K, the magnetic moments incline continuously toward the out-of-plane direction. At T = 1.5 K, where the spins are nearly aligned along the c axis, a spin reorientation occurs above a critical field B_c, giving rise to a spin component perpendicular to the plane defined by the field direction and the c axis. We suggest that both the temperature- and field-driven spin reorientations are associated with a change in the magnetocrystalline anisotropy, which is strongly coupled to the lattice degrees of freedom. This study elucidates the long-standing puzzles on the zero-field magnetic orders of Sr₄Ru₃O₁₀ and provides new insights into the nature of the field-induced metamagnetic transition.

Field-induced magnetic phase transitions and memory effect in bilayer ruthenate Ca3Ru2O7 with Fe substitution

Bilayer ruthenate Ca3(Ru1-x Fe x )2O7 (x  =  0.05) exhibits an incommensurate magnetic soliton lattice driven by the Dzyaloshinskii-Moriya interaction. Here we report complex field-induced magnetic phase transitions and memory effect in this system via single-crystal neutron diffraction and magnetotransport measurements. We observe first-order incommensurate-to-commensurate magnetic transitions upon applying the magnetic field both along and perpendicular to the propagation axis of the incommensurate spin structure. Furthermore, we find that the metastable states formed upon decreasing the magnetic field depend on the temperature and the applied field orientation. We suggest that the observed field-induced metastability may be ascribable to the quenched kinetics at low temperature.

Final kissing balloon inflation for coronary bifurcation lesions treated with single-stent technique : A meta-analysis

BACKGROUND

The efficacy of final kissing balloon (FKB) inflation in one-stent techniques for bifurcation lesions is controversial. The goal of the present study was to investigate the impact of FKB on long-term clinical outcomes in one-stent strategies.

METHODS

A literature search of the PubMed, Embase, and Cochrane Library databases was undertaken through August 2017. The primary outcome was major adverse cardiac events (MACE), defined as the composite of cardiac death, myocardial infarction, and target lesion revascularization. Overall hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the random-effects model.

RESULTS

Ten studies comprising 7364 patients treated with a one-stent technique were included in the analysis. Overall, FKB did not demonstrate a significant reduction in MACE compared with non-FKB in both randomized trials (HR: 1.13; 95% CI: 0.65-1.98) and observational studies (HR: 0.86; 95% CI: 0.61-1.20). The risk of cardiac death (HR: 0.89; 95% CI: 0.53-1.49), myocardial infarction (HR: 0.76; 95% CI: 0.53-1.09), and target lesion revascularization (HR: 0.96; 95% CI: 0.74-1.23) was also similar in both groups.

CONCLUSION

FKB may not be mandatory and a selective FKB strategy might be more justified in one-stent techniques for bifurcation lesions.

Unusual interlayer quantum transport behavior caused by the zeroth Landau level in YbMnBi2

Relativistic fermions in topological quantum materials are characterized by linear energy-momentum dispersion near band crossing points. Under magnetic fields, relativistic fermions acquire Berry phase of π in cyclotron motion, leading to a zeroth Landau level (LL) at the crossing point, a signature unique to relativistic fermions. Here we report the unusual interlayer quantum transport behavior resulting from the zeroth LL mode observed in the time reversal symmetry breaking type II Weyl semimetal YbMnBi2. The interlayer magnetoresistivity and Hall conductivity of this material are found to exhibit surprising angular dependences under high fields, which can be well fitted by a model, which considers the interlayer quantum tunneling transport of the zeroth LL's Weyl fermions. Our results shed light on the unusual role of zeroth LLl mode in transport.The transport behavior of the carriers residing in the lowest Landau level is hard to observe in most topological materials. Here, Liu et al. report a surprising angular dependence of the interlayer magnetoresistivity and Hall conductivity arising from the lowest Landau level under high magnetic field in type II Weyl semimetal YbMnBi2.

Necroptosis in the periodontal homeostasis: Signals emanating from dying cells

Periodontal tissues are constantly exposed to microbial stimuli. The equilibrium between microbes and host defense system helps maintain the homeostasis in the periodontal microenvironment. Growth of pathogenic bacteria in dental biofilms may induce proinflammatory cytokine production to recruit sentinel cells, mainly neutrophils and monocytes into the gingival sulcus or the periodontal pocket. Moreover, dysbiosis with overgrowth of anaerobic pathogens, such as Porphyromonas gingivalis and Tannerella forsythia, may induce death of both immune cells and host resident cells. Necroptosis is one newly characterized programmed cell death mediated by receptor-interacting protein kinase (RIPK)-1, RIPK3, and mixed lineage kinase like (MLKL). With its release of death-associated molecular patterns (DAMPs) into extracellular environment, necroptosis may help transmit the danger signal and amplify the inflammatory responses. In this review, we present recent advances on how necroptosis influences bacterial infection progression and what a role necroptosis plays in maintaining the homeostasis in the periodontal niche. Until we fully decipher the signals emanated from dying cells, we cannot completely understand the mechanism of disease progression.

[Expression of Oct4 and Sox2 and their clinical significance in tongue squamous cell carcinoma]

Objective: To investigate Oct4 and Sox2 protein expression in tongue squamous cell carcinoma (TSCC) and the relationships between the expressions of Oct4 and Sox2 and clinical pathological characteristics and survival of patients. Methods: The paraffin imbedded tissue specimens of 51 patients with histologically confirmed TSCC were included. Immunohistochemistry was employed to detect the protein expression of Oct4 and Sox2 in 51 TSCC tissue samples. The protein expression levels of Oct4 and Sox2 and their relationships with both clinicopathological features and survival of patients with TSCC were evaluated. Results: In 51 TSCC cases,positive expressions of Oct4 and Sox2 were mainly located in the nucleus of tumor cells. The expression of Oct4 was strongly positive in 27 cases (53%), weakly positive in 16 (31%) and negative in 8 (16%), whereas that of Sox2 was strongly positive in 25 cases (49%), weakly positive in 22 (43%) and negative in 4 (8%). Oct4 and Sox2 expression levels were significantly correlated with the histological grade of TSCC (P=0.004, P=0.006, respectively), not correlated with age, gender, T stage, tobacco smoking and alcohol consumption status (P>0.05), but Oct4 expression level was significantly associated with lymph node metastasis (P=0.001). Sox2 expression level was not associated with lymph node metastasis (P>0.05). The expression of Sox2 was significantly correlated with Oct4 (P<0.001). Oct4 and Sox2 expression was associated with poor overall survival of patients with TSCC (P=0.001, P=0.002, respectively), cases with higher Oct4 and Sox2 expression had the poorest overall survival (P<0.001). Sox2 expression and lymph node metastasis were independent prognostic factors of overall survival in patients with TSCC (P=0.02, P=0.001, respectively). Conclusions: Sox2 had independent prognostic effects on overall survival, suggesting that Sox2 expression may be an usefull indicator for predicting the prognosis of patients with TSCC.

Differential methylation is associated with non-syndromic cleft lip and palate and contributes to penetrance effects

Non-syndromic cleft lip and/or palate (NSCLP) is a common congenital malformation with a multifactorial model of inheritance. Although several at-risk alleles have been identified, they do not completely explain the high heritability. We postulate that epigenetic factors as DNA methylation might contribute to this missing heritability. Using a Methylome-wide association study in a Brazilian cohort (67 NSCLP, 59 controls), we found 578 methylation variable positions (MVPs) that were significantly associated with NSCLP. MVPs were enriched in regulatory and active regions of the genome and in pathways already implicated in craniofacial development. In an independent UK cohort (171 NSCLP, 177 controls), we replicated 4 out of 11 tested MVPs. We demonstrated a significant positive correlation between blood and lip tissue DNA methylation, indicating blood as a suitable tissue for NSCLP methylation studies. Next, we quantified CDH1 promoter methylation levels in CDH1 mutation-positive families, including penetrants, non-penetrants or non-carriers for NSCLP. We found methylation levels to be significantly higher in the penetrant individuals. Taken together, our results demonstrated the association of methylation at specific genomic locations as contributing factors to both non-familial and familial NSCLP and altered DNA methylation may be a second hit contributing to penetrance.

A functional variant of miRNA-149 confers risk for allergic rhinitis and comorbid asthma in Chinese children

The prevalence of allergic rhinitis (AR) and asthma has been increasing, and the comorbidity rates of these diseases are very high. Here, 176 AR patients, 124 patients with comorbid AR and asthma (AR-A) and 206 healthy Chinese children as controls were included in a case-control study. Six single-nucleotide polymorphisms (SNPs), miR-146a (rs2910164, rs57095329 and rs6864584), miR-196a2 (rs11614913), miR-499 (rs3746444) and miR-149 (rs2292832), were genotyped. The prevalence of homozygous miR-149 (rs2292832) CC genotype and C allele were considerably increased in AR and AR-A patients, compared with the controls. AR-A group showed higher frequencies of CC genotype and C allele of rs2292832 than AR group. No significant difference in the genotypic and allelic frequencies of other miRNA SNPs was found between the groups. MiR-149 levels in peripheral blood mononuclear cells (PBMCs) were significantly lower in CC (variant type) cases compared with TT (wild-type) cases. In further experiments, PBMCs obtained from the healthy controls with CC, CT and TT genotypes were stimulated by house dust mite extracts, which led to a significant decrease in the levels of miR-149 in PBMCs obtained from CC and TT individuals. This decrease was more pronounced in CC compared with TT cases. Our results demonstrate that miR-149 rs2292832 variant is not only strongly associated with AR and AR-A, but it may lead to an increase in the susceptibility to allergies following the stimulation with an allergen, through the changes in miR149 expression. Additionally, AR patients with CC genotypes were shown to be more susceptible to asthma.

[The guiding role of preoperative visual analog scale symptom scores in patients with chronic rhinosinusitis during perioperative period]

Objective:To assess the guiding role of preoperative visual analog scale(VAS) symptom scores in patients with chronic rhinosinusitis(CRS) during perioperative period.Method:The patients with CRS undergoing endoscopic sinus surgery were divided into experimental group and control group according to doctor group.Preoperative VAS symptom scores which including the overall symptom score and every single symptom scores were assessed. Patients with symptom(nasal congestion, nasal discharge, dizziness or headache, hypoamia or anosmia, rhinocnesmus, sneeze) scores more than 5 points were taken corresponding appropriate strategies in experimental group, but conventional empirical measures in control group during perioperative period.Nasal endoscopic surgeries were performed under local or general anesthesia after preoperative preparation. Postoperative followup were performed in six months and one year for the overall symptom and each symptom scores in both groups. SPSS17.0 was used for statistical analysis.Result:There was no statistical difference in general condition, overall symptom score and every symptom scores before operation between experimental group(120 cases) and control group(82 cases) (P >0.05). At the three time points (preoperative, six months, one year after operation), significant differences were found in the two groups about VAS overall symptom score (P <0.05). Except hypoamia, VAS for the other symptoms in different postoperative time showed statistical significance (P <0.05).Conclusion:Preoperative VAS symptom score can be used not only in the evaluation of severity and treatment effect,but also in the guiding of perioperative treatment for CRS, which is worthy of using widely in clinic.

Colossal Magnetoresistance in a Mott Insulator via Magnetic Field-Driven Insulator-Metal Transition

We present a new type of colossal magnetoresistance (CMR) arising from an anomalous collapse of the Mott insulating state via a modest magnetic field in a bilayer ruthenate, Ti-doped Ca_{3}Ru_{2}O_{7}. Such an insulator-metal transition is accompanied by changes in both lattice and magnetic structures. Our findings have important implications because a magnetic field usually stabilizes the insulating ground state in a Mott-Hubbard system, thus calling for a deeper theoretical study to reexamine the magnetic field tuning of Mott systems with magnetic and electronic instabilities and spin-lattice-charge coupling. This study further provides a model approach to search for CMR systems other than manganites, such as Mott insulators in the vicinity of the boundary between competing phases.

[Association between IL-27 gene polymorphisms and susceptibility to allergic rhinitis]

Objective: To evaluate the potential association of IL-27 polymorphisms with allergic rhinitis(AR) in a Chinese Han population. Method:A case-control study was performed in 445 Chinese AR patients and 691 healthy controls. Three SNPs in the IL-27p28 gene, including rs153109, rs17855750 and rs181206, were detected using a polymerase chain reaction-restriction fragment length polymorphism assay(PCR-RFLP). Result:A significantly increased prevalence of the rs153109 TT genotype and the T allele was found in AR patients, while a decreased prevalence of the CT and CC genotypes and the C allele was found. For rs153109, the TT genotype and the T allele were significantly associated with the risk of AR, but the CT and CC genotypes and the C allele decreased the risk of AR; for rs17855750, the TT genotype and T allele were risk factors for AR, and the GT genotype and G allele provided protection. TTT and TTC haplotypes in the IL-27 p28 gene were positively correlated with AR, while CGT, CTC and CTT haplotypes were associated with a significantly decreased risk of AR. Conclusion:This study indicates that IL-27 p28 polymorphisms rs153109 and rs17855750 are likely involved in AR susceptibility, making them potentially useful genetic biomarkers for AR susceptibility in the Chinese Han population.

Long non-coding antisense RNA KRT7-AS is activated in gastric cancers and supports cancer cell progression by increasing KRT7 expression

Alterations in long non-coding RNAs (lncRNAs) are associated with human carcinogenesis. One group of lncRNAs, which are antisense in orientation to coding mRNAs (ASs), have been recently described in cancers but are poorly understood. We sought to identify ASs involved in human gastric cancer (GC) and to elucidate their mechanisms of action in carcinogenesis. We performed massively parallel RNA sequencing in GCs and matched normal tissues, as well as in GC-derived and normal gastric epithelial cell lines. One AS, designated Homo sapiens keratin 7 (KRT7-AS), was selected due to its marked upregulation and concordant expression with its cognate sense counterpart, KRT7, in GC tissues and cell lines. KRT7-AS formed an RNA-RNA hybrid with KRT7 and controlled KRT7 expression at both the mRNA and the post-transcriptional levels. Moreover, forced overexpression of the KRT7-overlapping region (OL) of KRT7-AS (but not its non-KRT7-OL portions) increased keratin 7 protein levels in cells. Finally, forced overexpression of full-length KRT7-AS or OL KRT7-AS (but not its non-KRT7-OL regions) promoted GC cell proliferation and migration. We conclude that lncRNA KRT7-AS promotes GC, at least in part, by increasing KRT7 expression.

[Levels of phthalate internal exposure levels in pregnant women and influencing factors]

OBJECTIVE

To investigate the levels and influencing factors of phthalate internal exposure in pregnant women (gestation age ≤ 16 weeks).

METHODS

During April to June in 2013, 1 020 pregnant women (gestation age ≤ 16 weeks) who had established the maternal care manual were recruited in maternal and child health hospital of Siming District, Xiamen city. Participators were asked to complete a questionnaire to obtain information on socio-demographic characteristics, lifestyle behaviors, and antenatal examination and to provide a urine sample. Finally, 998 pregnant women who provided a urine sample and completed the questionnaire were enrolled. Adopting systematic sampling method, 100 ones were selected randomly among 998 pregnant women. High performance liquid chromatography-electrospray ionization-tandern mass was used to determine the concentration of five phthalate monoesters in each urine, including mono-n-methyl phthalate (MMP), mono-ethyl phthalate (MEP), mono-butyl phthalate (MBP), mono-benzyl phthalate (MBzP), mono-ethylhexyl phthalate (MEHP). Based on the measurements and questionnaire data, multivariate logistic regression was used to analyze the association between the phthalate monoester levels and potential influential factors.

RESULTS

The detection rates of MMP, MEP, MBP, MBzP and MEHP in 100 pregnant urine samples were 94%, 93%, 87%, 83%, 99%, respectively. And the urinary median uncorrected concentrations of MMP, MEP, MBP, MBzP and MEHP in 100 urine samples were 20.56, 17.62, 10.15, 2.03, and 5.12 ng/ml, respectively. Specific gravity-corrected concentration were 20.81, 20.36, 12.88, 2.58, 5.00 ng/ml, respectively. The results of multivariate logistic regression analysis indicated that: education degree was negatively associated with urinary concentration of MMP, MEP, MBP, MBzP and MEHP, OR (95% CI) were 0.495 (0.253-0.966), 0.380 (0.191-0.755), 0.379 (0.186-0.774), 0.401 (0.196-0.819), 0.373(0.183-0.762), respectively. Participants who had hair permed and dyed during pregnancy had higher urinary level of MBP and MBzP, OR (95% CI) were 12.867 (1.240-133.525), 15.982 (1.367-186.911), respectively; Participants who use cosmetics during pregnancy had higher urinary level of MEP and MBP, OR (95% CI) were 2.977 (1.012-8.757), 4.440 (1.485-13.272), respectively; plastic bottled water consumption was positively associated with urinary concentrations of MEP and MEHP, OR (95% CI) were 3.780 (1.417-10.083), 2.699 (1.039-7.010), respectively; annual household income was negatively associated with urinary concentration of MMP, OR (95% CI) was 0.597 (0.372-0.959); individuals who took medications during pregnancy had higher urinary level of MEHP than non-takers, OR (95% CI) was 4.853 (1.084-21.732).

CONCLUSION

Pregnant women whose gestation age was less than 16 weeks are generally exposed to phthalate. Phthalate internal exposure levels are significantly associated with most measured factors and the influencing factors with different phthalates internal exposure levels are different.

Results from a multicenter, open-label, pivotal phase II study of chidamide in relapsed or refractory peripheral T-cell lymphoma

BACKGROUND

Chidamide is a novel benzamide type of subtype-selective histone deacetylase (HDAC) inhibitor with unique mechanisms of action compared with marketed HDAC inhibitors. This phase II study was to evaluate the efficacy and safety of chidamide in relapsed or refractory peripheral T-cell lymphoma (PTCL) in Chinese population.

PATIENTS AND METHODS

Patients with relapsed or refractory PTCL of different subtypes received chidamide of 30 mg orally twice per week. The primary end point was overall response rate (ORR). Responding patients should be confirmed at least 4 weeks after the criteria of the response were first met, and were reviewed by an independent review committee.

RESULTS

Eighty-three patients were enrolled and 79 patients with eligible PTCL histology were for efficacy assessments. Patients enrolled over 10% were with subtypes of PTCL not otherwise specified (34%), anaplastic large-cell lymphoma (22%), extranodal natural killer (NK)/T-cell lymphoma, nasal type (20%), or angioimmunoblastic T-cell lymphoma (AITL, 13%). The ORR was 28% (22 of 79) including 14% (11 of 79) with complete response/unconfirmed complete response (CR/CRu). Median progression-free survival and overall survival were 2.1 and 21.4 months, respectively. AITL patients tended to have higher ORR (50%) and CR/CRu rate (40%), as well as more durable responses, to chidamide treatment. Most adverse events (AEs) were grade 1 or 2, and AEs ≥grade 3 that occurred in ≥10% patients were thrombocytopenia (22%), leucopenia (13%) and neutropenia (11%), respectively.

CONCLUSION

Chidamide represents a novel oral benzamide class of HDAC inhibitor with significant single-agent activity and manageable toxicity in relapsed or refractory PTCL, and provides a much needed treatment option in this indication in China. Results led to China Food and Drug Administration approval of chidamide in this indication.