Vaccinols J-S, ten new salicyloid derivatives from the marine mangrove-derived endophytic fungus Pestalotiopsis vaccinii

Ten new salicyloid derivatives, namely vaccinols J-S (1-10), along with five known compounds (11-15) were isolated from Pestalotiopsis vaccinii (cgmcc3.9199) endogenous with the mangrove plant Kandelia candel (L.) Druce (Rhizophoraceae). Their structures including absolute configurations were established on the basis of spectroscopic analysis, optical rotation, CD spectra, quantum ECD calculations. To the best of our knowledge, vaccinol J (1) is the first example of salicyloid derivatives containing 2-methylfuran moiety. All of the new compounds were tested for their anti-enterovirus 7l (EV71) and cytotoxic activities. Among them, vaccinol J (1) exhibited in vitro anti-EV71 with IC₅₀ value of 30.7μM (IC₅₀ 177.0μM for the positive control ribavirin).

Three new polyketides from the marine sponge-derived fungus Trichoderma sp. SCSIO41004

Three new polyketides named trichbenzoisochromen A (1), 5,7-dihydroxy-3-methyl -2-(2-oxopropyl)naphthalene-1,4-dione (2) and 7-acetyl-1,3,6-trihydroxyanthracene-9,10- dione (3) together with six known compounds (4-9) were isolated from a sponge-derived fungus Trichoderma sp. SCSIO41004. The structures of three new polyketides (1-3) were determined by the extensive spectroscopic analysis, including 1D, 2D NMR and HRESIMS data. The absolute configuration of compound 1 was confirmed by the specific optical rotation value and CD spectra analyses. Compound 4 exhibited significant inhibitory activity against EV71 with the IC₅₀ value of 25.7 μM.

[Treatment of intractable aspiration after partial laryngectomy by cuffed tracheostomy tube with inner cannula]

Objective: To evaluate the efficacy of cuffed tracheostomy tube with inner cannula for the treatment of intractable aspiration after partial laryngectomy. Methods: From May 2010 to June 2015, 15 patients with intractable aspiration after partial laryngectomy of laryngeal and hypopharyngeal carcinoma were enrolled. Cuffed tracheostomy tube with inner cannula was used in the 15 patients for treatment of intractable aspiration. The patients and their family were trained to manage the cuffed tracheostomy tube with inner cannula and to eat since the 14th day after surgery. Cuff was initially inflated with 10 ml air and then deflated of 0.5 ml air every 2-3 days. Until the inflation of cuff was no longer required, the cuffed tracheostomy tube was replaced by metal tracheostomy tube. The patients' swallowing function and aspiration were evaluated 6 months after treatment. Results: The 15 cases with intractable aspiration were treated with cuffed tracheostomy tube with inner cannula and after 2-3 months, 14 of them replaced the cuffed tracheostomy tubes with inner cannula by metal tracheostomy tubes and recovered oral eating, and tracheostomy tubes were no longer required for 12 of 14 patients in following 3-6 months, showing a total decannulation rate of 80% in the patients with refractory aspiration. Conclusion: It was safe and effective to treat aspiration after laryngeal and hypopharyngeal surgery with cuffed tracheostomy tube with inner cannula.

Platycodin D, a triterpenoid saponin from Platycodon grandiflorum, suppresses the growth and invasion of human oral squamous cell carcinoma cells via the NF-κB pathway

This work was undertaken to explore the effects of platycodin D, a triterpenoid saponin from Platycodon grandiflorum, on the growth and invasiveness of human oral squamous cell carcinoma (OSCC). Platycodin D caused a significant, concentration-dependent inhibition of cell viability and induced significant apoptosis in OSCC cells. Moreover, platycodin D significantly inhibited OSCC cell invasion. At the molecular level, platycodin D increased the amounts of IκBα protein and reduced the expression of phosphorylated NF-κB p65, MMP-2, and MMP-9. Ectopic expression of constitutively active NF-κB p65 prevented platycodin D-mediated induction of apoptosis and suppression of invasion in OSCC cells. In vivo studies confirmed that platycodin D retarded the growth of subcutaneous SCC-4 xenograft tumors and reduced phosphorylation of NF-κB p65. Altogether, platycodin D shows inhibitory activity on OSCC growth and invasion through inactivation of the NF-κB pathway and might provide therapeutic benefits in the treatment of OSCC.

[Analysis of clinicopathological features and prognosis of 98 cases of small hepatocellular carcinoma]

Objective: To analyze the clinicopathological features and prognosis of patients with small hepatocellular carcinoma. Methods: The clinicopathological and follow-up data of 98 patients with small hepatocellular carcinoma who underwent R0 resection from January 2009 to December 2013 were analyzed retrospectively. Results: All of the patients were followed up. Their postoperative 1-year, 3-year and 5-year overall survival rates were 99.0%, 91.7%, and 76.3%, respectively. Their postoperative median overall survival (OS) period was 52 months. The postoperative progression-free survival rates were 86.7%, 66.2% and 55.0%, respectively, and the median progression-free survival (PFS) period was 43.5 months. The univariate analysis showed that satellite nodules, liver capsule invasion and postoperative recurrence time were associated with OS (P<0.05), and long-term heavy drinking, satellite nodules and liver capsule invasion with PFS (P<0.05). The multivariate analysis indicated that long-term heavy drinking was an independent factor influencing the progression-free survival period of patients with small hepatocellular carcinoma (P=0.003) and postoperative recurrence time and liver capsule invasion were independent factors affecting their overall survival period (P<0.05). Conclusions: The treatment of small hepatocellular carcinoma still concentrates on the active treatment of surgery. It is beneficial to patients to minimize the resection scope of normal liver under the premise of R0 removal of tumor. Postoperative recurrence time of ≤2 years suggests poor prognosis of small hepatocellular carcinoma. Long-term heavy drinking can accelerate the recurrence of small hepatocellular carcinoma.

[The adhesion separation operation with CO₂ laser combined withtriamcinolone acetonide vocal cord submucosal injection for the treatment to vocal cord adhesion]

Objective:To investigate the effect of adhesion separation operation with CO₂ laser via prop-up laryngoscope combine with triamcinolone acetonide submucosal injection via electrolaryngoscope to vocal cords adhesion.Method:Sixteen cases of vocal cord adhesion patients(2 cases of children,14 cases of adult) were enrolled in the study. Fourteen patients had the history of surgery(Reinke edema,vocal polyp,pediatric laryngeal papilloma,laryngeal cancer),2 cases were diagnosed as laryngeal tuberculosis. Adhesion separation operation and triamcinolone acetonide submucosal injection(once a week,three weeks) were conducted. All patients were examined with electronic laryngoscope every month for six monthes.Result:Fourteen patients had good triangle shape of glottis vocalis and good sound voice. One cases of laryngeal cancer and 1 cases of laryngeal tuberculosis patients still had adhesion in the anterior commissure of the vocal cords,but with the improvement in breathing and pronunciation.Conclusion:Adhesion separation operation with CO₂ laser via prop-up laryngoscope combine with triamcinolone acetonide submucosal injection via electrolaryngoscope were effective for treatment to vocal cord adhesion,whichimprove the patient's breathing and voice with little trauma and few complications.

Biotransformation of RDX and HMX by Anaerobic Granular Sludge with Enriched Sulfate and Nitrate

  RDX and HMX are widely used energetic materials and they are recognized as environmental contaminants at numerous locations. The present study investigated the biotransformation of RDX and HMX by anaerobic granular sludge under sulfate- and nitrate-enriched conditions. The results showed that RDX and HMX could be transformed by anaerobic granular sludge when nitrate was present. However, the biotransformation of RDX and HMX was negatively influenced, especially with high nitrate concentrations. Sulfate-enriched conditions were more favorable for the removal of ammunition compounds by anaerobic granular sludge than nitrate-enriched conditions. The removal of RDX and HMX under both nitrate- and sulfate-enriched conditions was facilitated by the use of glucose as additional substrate. This knowledge may help identify factors required for rapid removal of RDX and HMX in high-rate bioreactors. These results can also be applied to devise an appropriate and practical biological treatment strategy for explosive contaminated wastewater.

[Comparioson after laser surgery versus radiotherapy of T1a glottic carcinoma: A Meta-analysis]

Objective:To compare larynx preservation rate, local control rate, overall survival rate and disease-specific survival rate after laser surgery and radiotherapy of T1a glottic carcinoma. Method:PubMed, Web of Science, Embase, Cochrane Library，Chinese biomedical literature datebase,CNKI and Wanfang digital journals were searched from the built of the datebases to October 2016 by computer. Literature screening,date extraction and quality assessment were conducted independently by two co-authors,and the meta-analysis was made with Review Manager 5.3. Result:Twelve literatures were included finally, and statistical analysis results showed that radiotherapy was superior to laser surgery in the laynx preservation rate of T1a glottic carcinoma(OR=3.23，95%CI=1.21～8.60，P=0.02) , overall survival rate and specific disease survival rate were not significant different between laser surgery and radiotherapy. Conclusion:Radiotherapy is superior to laser surgery in the laynx preservation rate of T1a glottic carcinoma.

[Allergen detection and etiological study of adenoidal hypertrophy in children]

Objective:To investigate the etiology of adenoidal hypertrophy by detection of allergen and total serum IgE in children.Method:Using the German Allergy Screen Test Kit testing system, total serum IgE was detected and quentitative detection of allergen specific IgE in 19 groups in 782 children with adenoidal hypertrophy, the proportion of total IgE in serum and the positive rate of allergens were counted, the proportion of atopy and the characteristics of the allergens were analyzed. Result:The proportion of total IgE in serum of 782 children with adenoidal hypertrophy was 66.8%. The top ten allergens (by positive rate) were: milk（32.0%），house dust mite（27.7%），moulds（25.3%），dog hair（22.4%），egg whites（16.5%），cashew nuts（10.5%），house dust（10.4%），cat hair（9.5%），crab（5.1%），beef（3.7%）. Conclusion:In present study, 66.8% adenoidal hypertrophy children with atopy. The following inhalation allergens positive rate of top three in children with adenoidal hypertrophy are: house dust mite, moulds, dog hair. The positive rate of food intake of the first three are: milk,egg whites, cashew nuts.

New Metabolites and Bioactive Chlorinated Benzophenone Derivatives Produced by a Marine-Derived Fungus Pestalotiopsis heterocornis

Four new compounds, including two isocoumarins, pestaloisocoumarins A and B (1, 2), one sesquiterpenoid degradation, isopolisin B (4), and one furan derivative, pestalotiol A (5), together with one known isocoumarin, gamahorin (3), and three chlorinated benzophenone derivatives, pestalachloride B (6), pestalachloride E (7) and a mixture of pestalalactone atropisomers (8a/8b), were isolated from a culture of the fungus Pestalotiopsis heterocornis associated with sponge Phakellia fusca. These new chemical structures were established using NMR and MS spectroscopic data, as well as single-crystal X-ray crystallographic analysis and CD Cotton effects. All of the isolated compounds were evaluated for their antimicrobial and cytotoxic activities. Isocoumarins 1-3, showed antibacterial activities against Gram-positive bacteria Staphylococcus aureus and Bacillus subtilis with MIC values ranging from 25 to 100 μg/mL and weak antifungal activities. Chlorinated benzophenone derivatives 6-8 exhibited antibacterial activities against S. aureus and B. subtilis with MIC values ranging from 3.0 to 50 μg/mL and cytotoxicities against four human cancer cell lines with IC50 values of 6.8-87.8 μM.

[The impact of laser treatment for postoperative different vocal functions in early laryngeal cancer: network Meta-analysis]

Objective:To evaluate the impact of postoperative vocal different functional characteristics with laser treatment for early laryngeal cancer.Method:Computer searching the major medical-related databases: PubMed, Web of Science and Embase, searching and screening by two staff members at the same time to read the relevant literatures, extraction of data and research related to the purpose from the selected literature. Using Stata 14.0 software analysis the extracted data with Bayesian network Metaanalysis, get the laser surgery of early laryngeal cancer effects of different voice characteristics of vocal cord.Result:A total of nine articles was included finally according through the necessary conditions, statistical analysis results showed that early laryngeal laser surgery can significantly reduce GRABS and VHI assessment score.Conclusion:Laser treatment of early laryngeal cancer could reduce VHI and the GRABS assessment score postoperatively, improve overall postoperative vocal cord function and the quality of life of patients after surgery, but not in the early post-operative function and physiology in vocal function.

Comparison of 6-mercaptopurine with 6-thioguanine for the analysis of thiopurine S-methyltransferase activity in human erythrocyte by LC-MS/MS

Thiopurines (TPDs) are first-line drugs in treating neuromyelitis optica spectrum disorders (NMOSD). Evaluation of thiopurine S-methyltransferase activity (TPMT), a major determinant of TPD toxicity, before TPD treatment using 6-mercaptopurine (6-MP) and 6-thioguanine (6-TG) as substrate was suggested. However, the equivalent of the two substrates in TPMT activity evaluation was unknown, and an alternative substrate was required in TPMT activity evaluation in patients who were already taking 6-MP or 6-TG. Before evaluating the agreement of 6-MP and 6-TG in TPMT activity measurement in patients with NMOSD, the affinity of the two substrates for the active center of TPMT should be established. A computer-based simulation indicated that 6-MP and 6-TG had similar affinities for the two active sites of TPMT. According to the guidelines, an LC-MS/MS method was developed and validated to evaluate the TPMT activity in human erythrocyte hemolysate using 6-MP or 6-TG as substrates via 1 h incubation at 37°C. The method was applied in 81 patients with NMOSD. Evaluated by Bland-Altman plot, 6-methylmercaptopurine and 6-methylthioguanine represented TPMT activities were in agreement with each other. Further studies are warranted to confirm the results.

Antimicrobial Compounds from Marine Invertebrates-Derived Microorganisms

It is known that marine invertebrates, including sponges, tunicates, cnidaria or mollusks, host affluent and various communities of symbiotic microorganisms. The microorganisms associated with the invertebrates metabolized various biologically active compounds, which could be an important resource for the discovery and development of potentially novel drugs. In this review, the new compounds with antimicrobial activity isolated from marine invertebrate-derived microorganisms in the last decade (2004-2014) will be presented, with focus on the relevant antimicrobial activities, origin of isolation, and information of strain species. New compounds without antimicrobial activity were not revealed.

[The role of Hong's single-stitch duct to mucosa pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy]

Objective: To investigate the role of "Hong's single-stitch duct to mucosa pancreaticojejunostomy(HSDMP)" in laparoscopic pancreaticoduodenectomy (LPD). Methods: The clinical data including perioperative and short-term outcomes of 51 cases of LPD with HSDMP which performed in Zhejiang Provincial People's Hospital(33 cases) and Frist Clinical Hospital of Jilin University(18 cases) between April and October 2016 were reviewed retrospectively. There were 31 male patients and 20 female patients. The mean age was(59±11)years. Body mass index (BMI) was 18 to 28 kg/m(2) and the average BMI was (23.2±4.4)kg/m(2). Preoperative diagnosis: 18 cases with pancreatic mass, 26 cases with peri-ampullary tumor, 3 cases with intra-ductal papillary mucinous neoplasms, 2 cases with duodenal carcinoma, 2 cases with serous cystadenoma. Results: Fifty-one patients accepted LPD using HSDMP. One patient underwent LPD combined with resection of superior mesentery vein. The mean operation time was (307±69)minutes, the mean diameter of pancreatic duct for reconstruction was (3.1±1.1)mm.The mean operation time for HSDMP was (34±5) minutes, the estimated blood loss was (170±127)ml. Twelve cases(23.5%) had pancreatic fistula according to International Study Group definition, including 9 cases(17.6%) of grade A and 3 cases (5.9%) of grade B. Five cases(9.8%) had delayed gastric empty, 5 cases(9.8%) had bile leakage and 2 cases(3.9%) had pulmonary infection postoperative.All these complications were treated by non-surgical strategies. One patient(2.0%) suffered from postoperative intra-abdominal bleeding and recovered after reoperation. Pathologic results showed pancreatic ductal adenocarcinomas in 20 cases(39.2%), non-pancreatic original peri-ampullary tumors in 23 cases(45.1%), intra-ductal papillary mucinous neoplasms in 3 cases(5.9%), duodenal carcinoma in 2 cases(3.9%), serous cystadenoma in 2 cases(3.9%) and neuroendocrine tumors in one case(2.0%). Conclusions: HSDMP could not only reduce the incidence of clinical pancreatic fistula, but also save operation time. It is a feasible and safe method for pancreaticojejunostomy.

[Hot topics of circulating tumor DNA testing in breast cancer]

The progress of gene detection technologies represented by next generation sequencing (NGS) and digital PCR laid a foundation for studies of circulating tumor DNA (ctDNA) in breast cancer. In 2014, the NGS workgroup organized by the College of American Pathologists (CAP) published the College of American Pathologists' Laboratory Standards for Next-Generation Sequencing Clinical Tests, which provides a blueprint for the standardization of gene testing. In 2015, the Guidelines for Diagnostic Next-generation Sequencing published by the European Society of Human Genetics claimed that NGS is unacceptable in clinical practice before studies guided by guidelines are approved. Although existing studies show the benefits of ctDNA testing in disease monitoring and prognosis analyzing, we have a ways to go to normalize the procedure and build strict detection criteria.

[Research progress of transoral robotic surgery in oropharyngeal cancer]

When it comes to the treatment of oropharyngeal cancer, the recurrence rate is high after radiotherapy, chemotherapy or open surgery. Transoral robotic surgery is a relatively new surgical therapy in oropharyngeal cancer, which can promote the development of minimally invasive surgery of oropharyngeal cancer. In this study, we reviewed flap reconstruction techniques of transoral robotic surgery, outcomes, contraindications,advantages and disadvantages.

[Therapeutic response of radiosynovectomy with p-32 colloid in 326 patients with hemophilic arthropathy]

Objective: To observe the therapeutic response of radiosynovectomy with p-32 colloid on hemophilic arthropathy, and to assess the effects of radiosynovectomy with Denver Score on hemophilic arthritis staging. Methods: Radiosynovectomy with p-32 colloid was performed on 326 hemophilic arthritis patients (405 joints) , and recorded bleeding before and after treatment. The MRI performance of 102 joints was evaluated by using Denver scoring system, then was divided into 0-6 and 7-10 groups. Finally, the differences between 2 groups were analyzed. Results: Average pain score of all hemophilic arthritis patients at 6 months, 1, 2 and 3 years post treatment decreased from 3.2±2.4 (n=326) to 1.2±0.6 (n=285, P=0.021) , 1.7±0.5 (n=242, P=0.032) , 2.1±1.1 (n=212, P=0.030) and 2.2±1.6 (n=176, P=0.037) , respectively. The frequency of bleeding in 405 joints at 1, 2 and 3 years post treatment decreased from 15.1±3.6 to 2.1±0.7, 4.3±0.6, and 4.8±0.8 times per year (P<0.01) , respectively; Meanwhile, the proportions of significantly ameliorated joints' activities were observed as of 68.50% (248/362) , 58.39% (181/310) , 55.67% (162/239) and 42.61% (75/176) , respectively. The frequencies of haemarthrosis at 1 and 2 years post treatment in patients with 0-6 Denver Score (45 target joints) reduced from 13.0±1.9 to 1.3±0.6 (P=0.002) and 3.1±0.9 (P=0.009) times per year, respectively, which also decreased in 7-10 group (57 target joints) from 16.6±2.1 to 3.1±0.9 (P=0.008) and 5.7±1.1 (P=0.004) times per year, respectively. There was no statistical difference between 0-6 and 7-10 groups before treatment in the terms of haemarthrosis frequency (P=0.773) . However, 7-10 group had higher haemarthrosis frequency at 1 and 2 years post treatment compare with 0-6 group (P=0.028 and 0.042, respectively) . Synovial volumes in 29 joints reduced after 6 month when compared with baseline [ (2 362.15±32.41) mm(3) vs (3 012.40±39.78) mm(3), t=7.621, P<0.001]. Conclusion: Radiosynovectomy with p-32 colloid on haemophilic synovitis was a safe and effective procedure. The patients with Denver Score of 0-7 had lower frequency of haemarthrosis.

[The prevalence and etiology of anemia in urban community dwelling elderly population in Beijing]

OBJECTIVE

To estimate the prevalence of anemia in urban community dwelling elderly population.

METHODS

This study was a cross-sectional survey of prevalence of anemia in randomly selected community dwelling residents aged over 65 years in Beijing. Anemia was defined as hemoglobin concentration less than 130 g/L in men and 120 g/L in women.

RESULTS

The hemoglobin concentration was (135.65±14.48) g/L in total of 1 947 eligible participants and was much higher in men than in women [(142.56±15.56) g/L vs (130.95±11.53) g/L, P<0.001]. There were 288 (14.8%) patients with anemia, including 16.3%(129/789) in men and 13.7%(159/1 158) in women. The prevalence of anemia increased significantly with age, which was 7.6% in 65-69 years, 10.8% in 70-74 years, 18.8% in 75-79 years and 24.1% over 80 years (P<0.001). Two hundred and seventy-nine (96.9%) subjects were mild anemia, 8 (2.8%) moderate, only 1 subject (0.3%) severe. Unexplained anemia was predominant, which accounted for 63.2%. Only 16.7% people were diagnosed as nutritional anemia, renal anemia 5.2%, anemia of chronic disease (ACD) 12.2%. There were 2.4% people with overlapped renal anemia and ACD. Compared with non-anemic subjects, more subjects with unexplained anemia represented macrocytosis (7.1% vs 3.2%, P=0.007).

CONCLUSIONS

Anemia is a common health problem in urban community dwelling elderly population. Most subjects have anemia with unknown origin. Further investigation is needed to explore the mechanism and related factors of elderly anemia.

Antituberculosis compounds from a deep-sea-derived fungus Aspergillus sp. SCSIO Ind09F01

Eleven diketopiperazine and fumiquinazoline alkaloids (1-11) together with a tetracyclic triterpenoid helvolic acid (12) were obtained from the cultures of a deep-sea derived fungus Aspergillus sp. SCSIO Ind09F01. The structures of these compounds (1-12) were determined mainly by the extensive NMR, ESIMS spectra data and by comparison with previously described compounds. Besides, anti-tuberculosis, cytotoxic, antibacterial, COX-2 inhibitory and antiviral activities of these compounds were evaluated. Gliotoxin (3), 12,13-dihydroxy-fumitremorgin C (11) and helvolic acid (12) exhibited very strong anti-tuberculosis activity towards Mycobacterium tuberculosis with the prominent MIC₅₀ values of <0.03, 2.41 and 0.894 μM, respectively, which was here reported for the first time. Meanwhile gliotoxin also displayed significant selective cytotoxicities against K562, A549 and Huh-7 cell lines with the IC₅₀ values of 0.191, 0.015 and 95.4 μM, respectively.

[Lymphadenectomy using dissection and protection of carotid sheath and main nerves in surgery for benign diseases in the neck]

Objective: To investigate the significance of lymphadenectomy using dissection and protection of carotid sheath and main nerves in treating complex benign disease of neck. Methods: A total of 54 cases with benign diseases in neck who received the protective surgical treatments were reviewed. There were 25 cases of recurrent branchial fistula, 15 cases of lymphoid tuberculosis, 5 cases of cystic hygroma, 5 cases of racemose angioma, and 4 cases of Madelung's disease. According to the location and extent of disease, all cases received operation with dissection and protection of carotid sheath and main nerves to removal lesions with lymphoid tissue and fat-connective tissue. Results: All cases recovered well, and no recurrence occurred with follow-up of 3 to 65 months. There was no other complication except for occurring of Horner syndrome in 1 patient. Conclusion: The protective surgical method has certain application value in the treatment of benign neck diseases that have no indefinite boundary and widely distribute.