Multiple-centre clinical evaluation of an ultrafast single-tube assay for SARS-CoV-2 RNA

OBJECTIVE

To evaluate the performance of an ultrafast single-tube nucleic acid isothermal amplification detection assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA using clinical samples from multiple centres.

METHODS

A reverse transcription recombinase-aided amplification (RT-RAA) assay for SARS-CoV-2 was conducted within 15 minutes at 39°C with portable instruments after addition of extracted RNA. The clinical performance of RT-RAA assay was evaluated using 947 clinical samples from five institutions in four regions of China; approved commercial fluorescence quantitative real-time PCR (qRT-PCR) kits were used for parallel detection. The sensitivity and specificity of RT-RAA were compared and analysed.

RESULTS

The RT-RAA test results of 926 samples were consistent with those of qRT-PCR (330 were positive, 596 negative); 21 results were inconsistent. The sensitivity and specificity of RT-RAA was 97.63% (330/338, 95% confidence interval (CI) 95.21 to 98.90) and 97.87% (596/609, 95% CI 96.28 to 98.81) respectively. The positive and negative predictive values were 96.21% (330/343, 95% CI 93.45 to 97.88) and 98.68% (596/604, 95% CI 97.30 to 99.38) respectively. The total coincidence rate was 97.78% (926/947, 95% CI 96.80 to 98.70), and the kappa was 0.952 (p < 0.05).

CONCLUSIONS

With comparable sensitivity and specificity to the commercial qRT-PCR kits, RT-RAA assay for SARS-CoV-2 exhibited the distinctive advantages of simplicity and rapidity in terms of operation and turnaround time.

Analysis on expression level and diagnostic value of miR-19 and miR-21 in peripheral blood of patients with undifferentiated lung cancer

OBJECTIVE

This paper aims to investigate the expression level and diagnostic value of miR-19 miR-21 in peripheral blood of patients with undifferentiated lung cancer.

PATIENTS AND METHODS

58 patients with undifferentiated lung cancer hospitalized in the oncology department of The First Affiliated Hospital of Nanchang University from September 2014 to May 2017 were selected as the experimental group, and 42 healthy volunteers in the same period as the control group at the same time. General clinical data in the two groups were collected. The expression levels of miR-19 and miR-21 in peripheral blood of the two groups were measured by Real-Time fluorescence quantitative Polymerase Chain Reaction. The expression levels of peripheral blood miR-19 and miR-21 in large and small cell lung cancer of undifferentiated lung cancer were analyzed and compared. ROC curve was used to analyze the diagnostic value of miR-19 and miR-21 in undifferentiated lung cancer.

RESULTS

The expression levels of miR-19 and miR-21 in peripheral blood of the experimental group were significantly higher than those of the control group (p<0.05). The AUC of miR-19 in the diagnosis of undifferentiated lung cancer was 0.854; the sensitivity was 98.30%; the specificity was 54.29% and the cut off was 3.54. The AUC of miR-21 in the diagnosis of undifferentiated lung cancer was 0.923; the sensitivity was 86.20%; the specificity was 76.19% and the cut off was 3.89. The AUC of combined detection in the diagnosis of undifferentiated lung cancer was 0.952; the sensitivity was 86.60%; the specificity was 97.62% and the cut off was 0.68. The specificity of combined detection was higher than that of miR-19 and miR-21 (p<0.05).

CONCLUSIONS

MiR-19 and miR-21 are highly expressed in peripheral blood of patients with undifferentiated lung cancer; miR-19 and miR-21 are expected to be used as diagnostic markers for undifferentiated lung cancer.

Synthetic and living micropropellers for convection-enhanced nanoparticle transport

Nanoparticles (NPs) have emerged as an advantageous drug delivery platform for the treatment of various ailments including cancer and cardiovascular and inflammatory diseases. However, their efficacy in shuttling materials to diseased tissue is hampered by a number of physiological barriers. One hurdle is transport out of the blood vessels, compounded by difficulties in subsequent penetration into the target tissue. Here, we report the use of two distinct micropropellers powered by rotating magnetic fields to increase diffusion-limited NP transport by enhancing local fluid convection. In the first approach, we used a single synthetic magnetic microrobot called an artificial bacterial flagellum (ABF), and in the second approach, we used swarms of magnetotactic bacteria (MTB) to create a directable "living ferrofluid" by exploiting ferrohydrodynamics. Both approaches enhance NP transport in a microfluidic model of blood extravasation and tissue penetration that consists of microchannels bordered by a collagen matrix.

Risk Factors for the Development of Cytomegalovirus Resistance in Solid Organ Transplantation: A Retrospective Case-Control Study

BACKGROUND

Cytomegalovirus (CMV) resistance is an emerging problem in solid organ transplant recipients. Risk factors are not well defined.

METHODS

Recipients with CMV viremia of solid organ transplants who underwent CMV resistance testing between January 2010 and March 2016 were divided in 2 groups: proven CMV resistance and refractory CMV infection. A third group was added to compare patients with viremia during the study period with patients with no resistance proven or suspected. We aimed to identify risk factors associated with the occurrence of CMV genotypic resistance.

RESULTS

Forty-nine patients underwent resistance testing. Eleven (22.45%) developed genotypic mutations. Group 1 vs groups 2 and 3 had higher prednisone (P = .01) and tacrolimus levels (P = .03); did not respond to antivirals (P < .0001); and had a higher rate of fungal infections (P = .03). CMV resistance was less common in liver and kidney vs heart, small bowel, and mutivisceral recipients (P = .0007). There was no difference in duration of antiviral prophylaxis, viremia while on antiviral prophylaxis, rate of end-organ disease, graft loss, and overall survival. Persistent clinical disease and viremia despite antiviral therapy was the most important risk factor for development of CMV resistance.

CONCLUSION

Persistent clinical disease despite antiviral therapy is an important risk factor and may in part be due to a high degree of immunosuppression. Graft loss and survival were not impacted by CMV resistance.

Adenovirus-A Deadly Disease in the Solid Organ Transplant Population: Risk Factors and Outcomes

BACKGROUND

The importance of adenoviruses (AdV) in the immunocompromised population has been more recognized in recent decades. We aimed to assess the risk factors and outcomes associated with AdV in solid organ transplant recipients.

METHODS

This was a retrospective cohort study of solid organ transplant recipients who tested positive for AdV between January 1, 2004, and March 12, 2014. The subjects were divided in 2 groups: AdV asymptomatic infection and AdV disease. The characteristics and outcomes of the groups were compared using Wilcoxon rank-sum and Fisher exact tests; logistic regression was performed to evaluate risk factors.

RESULTS

A total of 125 patients were included with a mean (SD) age of 9.79 years (16.54); 49.6% were male, and 20.8% had AdV disease. No significant risk factors were found for AdV disease by univariate analyses. Comparing patients with disease and with asymptomatic infection, rejections during the first year after testing positive for AdV were 7 (26.92%) vs 17 (17.17%); mortality at 1 year post-transplantation was 26.92% vs 6.06% (P = .006), respectively, and at 1 year after testing positive for AdV was 38.46% vs 11.11% (P = .002), respectively.

CONCLUSION

No independent risk factor for AdV disease was identified, but patients with AdV disease had a significantly higher mortality compared with those with asymptomatic infection.

Perioperative Prophylaxis for Total Artificial Heart Transplantation

BACKGROUND

Practice variation regarding perioperative antimicrobial prophylaxis in total artificial heart transplantations (TAH-t) across institutions is unknown. The aim of our survey was to assess the current practices for prevention of infection in TAH-t recipients among different programs.

METHODS

An electronic survey was sent to programs that implant Syncardia TAH (Syncardia Systems, Tuscon, Ariz, USA). Proportions were analyzed for categorical variables; means and SDs were analyzed for continuous variables.

RESULTS

The majority of centers (80.8%) had a formal surgical infection prophylaxis protocol. For non-penicillin-allergic patients, five (20.1%) institutions reported using a 4-drug regimen, seven (29.2%) used a 3-drug regimen, five (20.1%) used a 2-drug regimen, and seven (29.2%) used a cephalosporin alone. Similar data was seen in the penicillin-allergic patients. Infections were reported to occur postoperatively in 52.2% centers. During the first month after TAH-t, bacteremia represented 27.3%, driveline infections 27.2%, pulmonary infections 9%, and mediastinal infections 18.2%. The most common organisms seen within the first month were Candida spp., Escherichia coli, and Pseudomonas aeruginosa (21.4%). In 65% of centers, the mean rate of death post-TAH-t due to infection was 14.5% (SD, 22.3%). The mean rate of patients surviving until orthotopic heart transplantation was 58.6% (SD, 27.7%).

CONCLUSIONS

Preventing infections post-TAH-t is key to decreasing morbidity and mortality. All institutions administered perioperative prophylaxis for TAH-t with significant variation among the centers. The majority of the centers have a formal perioperative prophylactic protocol.

Risk factors for Clostridium difficile infection in intestinal transplant recipients during the first year post-transplant

BACKGROUND

Clostridium difficile is the most common cause of healthcare-associated infectious diarrhea. Risk factors for C. difficile infections (CDI) in intestinal transplant recipients (ITR) are not well-defined. The aim of our study was to assess specific risk factors for CDI in ITR.

METHODS

This is a 1:3 case-control study that included 29 ITR who developed CDI (cases) and 87 ITR without CDI (controls) observed during the first year post-transplantation. Wilcoxon rank sum and Fisher's exact tests were used to compare variables. Univariate and multivariable conditional logistic regressions analysis were performed to identify risk factors for CDI.

RESULTS

The multivariable conditional logistic regression analysis showed that proton pump inhibitors (PPI) administration (odds ratio [OR] = 0.06; 95% confidence interval [CI]: 0.007-0.52; P = .01) was the only factor associated with lower rates of CDI. Outcomes for cases vs controls: rejection episodes 24.14% vs 20.69% (P = .7), graft loss 0% vs 2.3% (P = .99), and survival rate 1 year post-transplantation 79.3% (59.6-90.1%) vs 87.2% (78.1-92.7%) (P = .38).

CONCLUSIONS

Proton pump inhibitor administration might be protective for CDI in ITR. Risks factors for CDI might be different in ITR compared to other populations; anatomical differences and medications administered in the post-transplantation period may affect intestinal microbiota.

A Changing of the Abbreviated Injury Scale that Improves Accuracy and Simplifies Scoring

Objective

We present here a changing of the abbreviated injury scale (AIS). It is called the changed injury severity score (CISS), and significantly outperforms the venerable but dated the injury severity score (ISS) and the new injury severity score (NISS) as a predictor of mortality.

Methods

The CISS is defined as a change of AIS values by raising each AIS severity score (1-6) by a power of 4.12 divided by 30.33 and then summing the three most severe (i.e. highest AIS) regardless of body regions. CISS values were calculated for every patient in two large independent data sets: 3455, 3900 patients treated during a five-year period at the class A grade III comprehensive hospitals in Affiliated Hospital of Hangzhou Normal University (Hangzhou) and Zhejiang Provincial People's Hospital (Zhejiang). The power of CISS to predict morality was then compared with previously calculated NISS values of the same group patients in the two hospitals.

Results

We found CISS was more accurate than NISS to predict the survival. The receiver operating characteristic (ROC) of NISS and CISS in Hangzhou were 0.919 and 0.937 respectively (p=0.026), whereas for Zhejiang were 0.917 and 0.940 respectively (p=0.022). Moreover, CISS provided a better fit throughout its entire range of prediction. Hosmer-Lemeshow (H-L) statistic for NISS and CISS in Hangzhou were 24.00 (p=0.002) and 19.38 (p=0.007), whereas in Zhejiang were 22.70 (p=0.001) and 18.43 (p=0.005) respectively.

Conclusions

CISS is a modified version of NISS/ISS with better statistical property and can be considered in trauma research.

Melatonin mediates vasodilation through both direct and indirect activation of BKCa channels

Melatonin, synthesized primarily by the pineal gland, is a neuroendocrine hormone with high membrane permeability. The vascular effects of melatonin, including vasoconstriction and vasodilation, have been demonstrated in numerous studies. However, the mechanisms underlying these effects are not fully understood. Large-conductance Ca²⁺-activated K⁺ (BK_Ca) channels are expressed broadly on smooth muscle cells and play an important role in vascular tone regulation. This study explored the mechanisms of myocyte BK_Ca channels and endothelial factors underlying the action of melatonin on the mesenteric arteries (MAs). Vascular contractility and patch-clamp studies were performed on myocytes of MAs from Wistar rats. Melatonin induced significant vasodilation on MAs. In the presence of N^ω-nitro-l-arginine methyl ester (l-NAME), a potent endothelial oxide synthase (eNOS) inhibitor, melatonin elicited concentration-dependent relaxation, with lowered pIC₅₀ The effect of melatonin was significantly attenuated in the presence of BK_Ca channel blocker iberiotoxin or MT1/MT2 receptor antagonist luzindole in both (+) l-NAME and (-) l-NAME groups. In the (+) l-NAME group, iberiotoxin caused a parallel rightward shift of the melatonin concentration-relaxation curve, with pIC₅₀ lower than that of luzindole. Both inside-out and cell-attached patch-clamp recordings showed that melatonin significantly increased the open probability, mean open time and voltage sensitivity of BK_Ca channels. In a cell-attached patch-clamp configuration, the melatonin-induced enhancement of BK_Ca channel activity was significantly suppressed by luzindole. These findings indicate that in addition to the activation of eNOS, melatonin-induced vasorelaxation of MAs is partially attributable to its direct (passing through the cell membrane) and indirect (via MT1/MT2 receptors) activation of the BK_Ca channels on mesenteric arterial myocytes.

Hepatectomy for spontaneous rupture of hepatocellular carcinoma without portal triad clamping

Hepatectomy without portal triad clamping may decrease the incidence of liver injury; however, the effects of hepatectomy without portal triad clamping in the treatment of spontaneous rupture of hepatocellular carcinoma (SRHCC) remain unclear. The aims of the present study were to evaluate the therapeutic value of hepatectomy without portal triad clamping in the treatment of patients with SRHCC. The present study retrospectively reviewed patients with SRHCC who received hepatectomy without portal triad clamping (non-clamping group) and the therapeutic efficacy was compared with that of 20 patients with SRHCC undergoing the same surgery in the presence of portal triad clamping (clamping group). Following hepatectomy, the non-clamping group exhibited a significantly lower incidence of acute liver failure compared with the clamping group (P<0.05). No significant differences in operative time, intra-operative blood loss, disease-free or overall survival times between the two groups were identified (all P>0.05). At 1 week and 2 weeks after surgery, the non-clamping group exhibited significantly lower alanine aminotransferase, aspartate aminotransferase and total bilirubin serum levels compared with the clamping group (all P<0.05). Hepatectomy without portal triad clamping may decrease the incidence of liver injury and liver failure in patients with SRHCC, suggesting that it may be a safe and effective therapeutic strategy.

[Identification of mutations associated with coronary artery lesion susceptibility in Kawasaki disease by targeted enrichment of genomic region sequencing technique]

Objective: To screen and identify the mutations in Kawasaki disease by targeted enrichment of genomic region sequencing technique and investigate susceptibility genes associated with coronary artery lesion. Method: This was a case-control study.A total of 114 patients diagnosed as Kawasaki disease treated in Shanghai Children's Hospital between December 2015 and November 2016 were studied and another 45 healthy children who were physically examined in outpatient department were enrolled as control group. Patients were divided into two groups based on the results of echocardiogram. Peripheral venous blood was obtained from patients and controls. Genomic DNA was extracted. SeqCap EZ Choice libraries were prepared by targeted enrichment of genomic region technology. Then the libraries were sequenced to identify susceptibility genes associated with coronary artery lesion in patients diagnosed as Kawasaki disease.Susceptible genes were identified by Burden test, Pearson chi-square test or Fisher's exact probability test. Result: There was statistically significant difference in TNFRSF11B(rs2073618)G>C(p.N3K)mutation and GG/GC/CC genotype between Kawasaki disease group and control group(χ(2)=15.52, P=0.00). There was statistically significant difference in TNFRSF13B(rs34562254)C>T(p.P251L)mutation(χ(2)=10.40, P=0.01)and LEFTY1(rs360057)T>G(p.D322A)mutation(χ(2)=8.505, P=0.01)between patients with coronary artery lesions and those without. Conclusion: Targeted enrichment of genomic region sequencing technology can be used to do primary screening for the susceptible genes associated with coronary artery lesions in Chinese Kawasaki patients and may provide theoretical basis for larger sample investigation of risk prediction score standard in Kawasaki disease.

[Analysis of the clinical features of vestibular migraine with MRI changes]

Objective: To investigate the clinical features of vestibular migraine with MRI changes. Methods: The clinical data of 150 patients with vestibular migraine completing MRI examination in navy general hospital from August 2008 to August 2016 were retrospectively analyzed.Clinical features of 94 (62.7%) vestibular migraine patients with MRI changes were collected and analyzed according to the medical history, clinical symptoms and signs, as well as the result of auxiliary examinations. Results: The manifestations of MRI in vestibular migraine patients were mainly multiple punctate equal T(1) and long T(2) signals or high signals on FLAIR (fluid attenuated inversion recovery) in subcortical white matter. The average age of the patients at the visit was (52±15) years old, with the male to female ratio of 1∶3.1. The occurrence of vertigo and migraine were in no particular order, with 54.3% patients presenting migraine several years before vertigo. The duration of vertigo was mostly 24 hours to 72 hours (31.9%). The visual aura (55.3%), photophobia and phonophobia (67.0%) were the most frequently associated symptoms. Conclusions: The vestibular migraine patients with MRI changes have its own specific clinical characteristics and are mainly seen in female with visual aura. The associated symptoms of vestibular migraine appear mostly during the process of vertigo. The pathogenesis of cerebral white matter hyperintensities (WMHs) is not clear.

Abstract P4-02-10: Adjunct diagnosing with breast specific gamma imaging or ultrasound in symptomatic women with mammographic dense breasts: A single center retrospective and comparative analysis

This abstract was not presented at the symposium.

[Prognostic factors for inability to walk independently in patients with multiple system atrophy]

Objective: To explore the prognostic factors for inability to walk independently in patients with multiple system atrophy (MSA). Methods: A total of 123 patients with clinically confirmed MSA admitted to Navy General Hospital and Dongfang Hospital affiliated to the Second Clinical Medical College of Beijing University of Chinese Medicine, from February 2013 to February 2016, were retrospectively reviewed. Clinical data and all records were collected and all subjects were followed up by a telephone call in February 2016. The second milestone of activities of daily living scale (ADL), defined as inability to walk independently, was taken as the primary outcome. Eight possible prognostic factors were investigated and the survival analysis was performed with Cox proportional hazards model regression. Results: Of all the MSA patients, 74 subjects were men and 49 were women with a sex radio of 1.51∶1(M∶F). Seventy cases were diagnosed with MSA-cerebellar type (MSA-C) and 53 with MSA-Parkinson type (MSA-P) (C∶P=1.32∶1). Mean age at the onset of first symptom was (53±8) years old. All patients had severe autonomic nervous dysfunction. At the last follow-up, 56 cases (45.5%) were unable to walk independently. The median survival time from the onset of MSA to inability to walk independently was 73 months. The age of onset ≥ 55 years (HR=1.969, 95%CI 1.095-3.542, P=0.024) and the interval time from disease onset to combined motor and autonomic involvement≤3 years (HR=2.308, 95%CI 1.158-4.600, P=0.017) were independent prognostic factors for inability to walk independently, while gender, MSA clinical subtypes, initial symptoms, alcohol intake, smoking and toxic exposure were not indicators for independent walking (P>0.05). Conclusions: The prognostic factors for inability to walk independently in patients with MSA are the age of onset ≥55 years and the interval time from disease onset to combined motor and autonomic involvement≤3 years. Although factors including gender, MSA clinical subtypes, initial symptoms, alcohol intake, smoking and toxic exposure are not the predictive factors for inability to walk independently in our MSA patients, their roles in the prognosis of MSA still need further investigation.

Impact of Immunoglobulin Therapy in Intestinal Transplant Recipients With Posttransplantation Hypogammaglobulinemia

BACKGROUND

Severe hypogammaglobulinemia (HGG) (IgG <400 mg/dL) following intestinal transplantation is common. Although IgG replacement therapy is commonly used, clinical outcomes associated with increasing IgG levels to >400 mg/dL are not well described.

METHODS

Kaplan-Meier analysis was performed to estimate survival, the log-rank test to compare survival distributions between groups, and the Fisher exact test to determine the association between HGG and rejection.

RESULTS

A total of 23 intestinal transplant (IT) recipients with a median age of 2.3 years (range, 0.7-41 years) at the time of HGG diagnosis were included. The types of transplants were liver-small bowel (73.9%), liver-small bowel-kidney (8.7%), and small bowel only (17.4%). The 3-year survival after the diagnosis of HGG was 50.2% (95% confidence interval [CI] = 28.2%-68.7%). There was no difference in survival (P = .67) when patients were dichotomized based upon IgG level at last follow-up (IgG ≥400 mg/dL, n = 14; and IgG <400 mg/dL, n = 9). There was no also evidence of an association between survival and: total dose (P = .58), frequency (P = .11), and number of IgG doses administered (P = .8). There was no difference in survival between patients receiving (n = 12) or not receiving (n = 11) cytomegalovirus hyperimmunoglobulin (P = .10).

CONCLUSIONS

Improved survival rates were not found in our IT recipients with severe HGG with immunoglobulin therapy to IgG levels of ≥400 mg/dL, even when cytomegalovirus hyperimmunoglobulin was administered.

Colistin, an Old Drug in a New Territory, Solid Organ Transplantation

BACKGROUND

The clinical experience with colistin therapy for multidrug-resistant Gram-negative pathogens in solid organ transplantation is limited.

METHODS

Patients transplanted from January 2003 to July 2011 and treated with intravenous or nebulized colistin were included. Descriptive statistics were used to summarize patients' characteristics and Kaplan-Meier curves for survival analysis.

RESULTS

Fifteen patients were included: 10 adults (median age, 54.6 y; range, 32.2-79.6 y) and 5 children (median age, 3.3 y; range, 1.1-10.4 y). Eight patients had intra-abdominal infections, 3 had pneumonia, and 4 had bacteremia. The infections were diagnosed at a median of 5.9 months (range, 0.8-49.8 mo) after transplantation. Eight patients had coinfections, mainly with enteric pathogens. Pseudomonas aeruginosa was isolated in 13 cases and ESBL Klebsiella oxytoca and ESBL Escherichia coli were isolated in 1 case each. Thirteen patients received concomitant antibiotics with colistin. The median dose of intravenous colistin (13 patients) was 2.7 mg/kg/d (range, 1-4.9 mg/kg/d) and nebulized colistin (2 patients) was 241.7 mg/d (range, 150-333.3 mg/d). Clinical cure was achieved in 9 patients (60%). Four-week survival rate after infection was 86.7% (95% confidence interval, 56.4%-96.5%). There was no difference in the median creatinine clearance in adults (P = .38) or children (P = .88) before and after colistin. One patient had both neurotoxicity and nephrotoxicity, and 1 patient had neurotoxicity only.

CONCLUSIONS

Colistin might be used as an alternate therapy for transplant patients with multidrug-resistant Gram-negative pathogens.

Exploring the regulatory role of isocitrate dehydrogenase mutant protein on glioma stem cell proliferation

OBJECTIVE

Glioma is the most lethal form of cancer that originates mostly from the brain and less frequently from the spine. Glioma is characterized by abnormal regulation of glial cell differentiation. The severity of the glioma was found to be relaxed in isocitrate dehydrogenase 1 (IDH1) mutant. The present study focused on histological discrimination and regulation of cancer stem cell between IDH1 mutant and in non-IDH1 mutant glioma tissue.

PATIENTS AND METHODS

Histology, immunohistochemistry and Western blotting techniques are used to analyze the glioma nature and variation in glioma stem cells that differ between IDH1 mutant and in non-IDH1 mutant glioma tissue.

RESULTS

The aggressive form of non-IDH1 mutant glioma shows abnormal cellular histological variation with prominent larger nucleus along with abnormal clustering of cells. The longer survival form of IDH1 mutant glioma has a control over glioma stem cell proliferation. Immunohistochemistry with stem cell markers, CD133 and EGFRvIII are used to demonstrate that the IDH1 mutant glioma shows limited dependence on cancer stem cells and it shows marked apoptotic signals in TUNEL assay to regulate abnormal cells. The non-IDH1 mutant glioma failed to regulate misbehaving cells and it promotes cancer stem cell proliferation.

CONCLUSIONS

Our finding supports that the IDH1 mutant glioma has a regulatory role in glioma stem cells and their survival.

Direct growth of Ge quantum dots on a graphene/SiO2/Si structure using ion beam sputtering deposition

The growth of Ge quantum dots (QDs) using the ion beam sputtering deposition technique has been successfully conducted directly on single-layer graphene supported by SiO2/Si substrate. The results show that the morphology and size of Ge QDs on graphene can be modulated by tuning the Ge coverage. Charge transfer behavior, i.e. doping effect in graphene has been demonstrated at the interface of Ge/graphene. Compared with that of traditional Ge dots grown on Si substrate, the positions of both corresponding photoluminescence (PL) peaks of Ge QDs/graphene hybrid structure undergo a large red-shift, which can probably be attributed to the lack of atomic intermixing and the existence of surface states in this hybrid material. According to first-principles calculations, the Ge growth on the graphene should follow the so-called Volmer-Weber mode instead of the Stranski-Krastanow one which is observed generally in the traditional Ge QDs/Si system. The calculations also suggest that the interaction between Ge and graphene layer can be enhanced with the decrease of the Ge coverage. Our results may supply a prototype for fabricating novel optoelectronic devices based on a QDs/graphene hybrid nanostructure.

TM4SF1 Promotes Proliferation, Invasion, and Metastasis in Human Liver Cancer Cells

Transmembrane 4 superfamily member 1 (TM4SF1) is a member of tetraspanin family, which mediates signal transduction events regulating cell development, activation, growth and motility. Our previous studies showed that TM4SF1 is highly expressed in liver cancer. HepG2 cells were transfected with TM4SFl siRNA and TM4SF1-expressing plasmids and their biological functions were analyzed in vitro and in vivo. HepG2 cells overexpressing TM4SF1 showed reduced apoptosis and increased cell migration in vitro and enhanced tumor growth and metastasis in vivo, whereas siRNA-mediated silencing of TM4SF1 had the opposite effect. TM4SF1 exerts its effect by regulating a few apoptosis- and migration-related genes including caspase-3, caspase-9, MMP-2, MMP-9 and VEGF. These results indicate that TM4SF1 is associated with liver tumor growth and progression, suggesting that TM4SF1 may be a potential target for treatment of liver cancer in future.

Prognostic and predictive value of tumor-infiltrating lymphocytes in breast cancer: a systematic review and meta-analysis

BACKGROUND

Breast cancer is the most common invasive cancer to affect women in the world. Studies showed tumor-infiltrating lymphocytes can exhibit both beneficial and harmful effects on the biology and clinical outcome of breast cancer, the conclusion still remains incomplete. Here, we conducted a meta-analysis to evaluate the relationship between tumor-infiltrating lymphocytes and breast cancer.

METHODS

A comprehensive search strategy was used to search relevant literatures in PubMed and the ISI Web of Science. The correlation among TILs and breast cancer clinicopathological features and prognosis was analyzed by using Review Manager 5.3 and Stata 12.0.

RESULT

Seventeen eligible studies consisting of 12,968 participants were included. We found that higher value of tumor-infiltrating lymphocytes had no relationship with breast cancer clinicopathological variables. Interestingly, it was correlated with response to neoadjuvant chemotherapy in majority (pooled RR 2.43, 95% CI 1.99-2.97). Moreover, higher value of total tumor-infiltrating lymphocytes (both intraepithelial and stromal) was associated with better prognosis (pooled HR 0.88, 95% CI 0.83-0.94), whereas some subtypes predicted a worse prognosis.

CONCLUSION

This meta-analysis indicated that high value of total TILs is not associated with breast cancer clinicopathological features, but can predict a favorable outcome for neoadjuvant chemotherapy in majority except for hormone receptor (-) subtype. And higher total TILs (both intraepithelial TILs and stromal TILs) may be the potential better prognostic indicators, while some subtypes like PD-1(+) TILs and Foxp3(+) TILs show a worse prognosis.