[A long-term follow-up report of pediatric relapsed Wilms tumor after retreatment]

Objective: To investigate the long-term efficacy and prognostic factors of pediatric relapsed Wilms tumor (WT) after retreatment. Method: Sixteen children in Shanghai Children's Medical Center with relapsed Wilms tumor were enrolled consecutively in this study between April 2006 and June 2016. All patients were diagnosed according to pathology, imaging and medical and surgical oncologist's assistance. Relapse treatment included surgical excision, chemotherapy and selective radiation therapy. The clinical features, long-term outcomes and prognostic factors of patients were analyzed retrospectively.Survival data were analyzed by Kaplan-Meier.Log-Rank analysis was used for univariate analysis. Result: One case was excluded because of giving up the therapy even though no disease progress was identified. A total of 15 cases (5 males and 10 females) were included in this study. The median age at diagnosis was 3.8 years (range 0.5-9.1 years). The tumor staging at diagnosis included one case of stageⅠ, 7 cases of stageⅡand 7 cases of stage Ⅲ. Among cases of stage Ⅲ, 6 cases had radiation therapy history. The pathology of all patients' recurrent tumor was favorable histology (FH). The median follow-up time was 34.6 months (range 12.5-132.7 months) until March 21, 2017. The time from initial diagnosis to relapse was 7.9 months (range 3.1-17.9 months). Four cases experienced local recurrence, 9 cases relapsed with metastases (6 cases in lungs, 2 in livers, 1 in mediastinum) and 2 cases relapsed in both local site and with metastases. Except to 2 cases received irregular retreatment, 13 cases received regimen I (doxorubicin, vincristine, epoposide and cyclophosphamide for 25 weeks) as relapsed chemotherapy. Five cases received autologous bone marrow transplantation (ABMT). Until the last follow-up, 8 cases achieved continuous complete remission (range 6.7-104.3 months), 3 cases had relapse again or progressing and 4 cases died. The estimated 5-year overall survival (OS) rate and event free survival (EFS) rate were (70±15)% and (52±15)%. According to whether received ABMT or not, the 5-year EFS rate were 51% and 53%. According to whether relapsed within 6 months after diagnosis or not, the 5-year EFS rate were 38% and 56% respectively. Conclusion: The 5-year EFS rate of pediatric relapsed FH WT have reached above 50% by multi-disciplinary treatment in our experience and we encourage patients and doctors to receive retreatment.

Quantum Wires and Waveguides Formed in Graphene by Strain

Confinement of electrons in graphene to make devices has proven to be a challenging task. Electrostatic methods fail because of Klein tunneling, while etching into nanoribbons requires extreme control of edge terminations, and bottom-up approaches are limited in size to a few nanometers. Fortunately, its mechanical flexibility raises the possibility of using strain to alter graphene's properties and create novel straintronic devices. Here, we report transport studies of nanowires created by linearly-shaped strained regions resulting from individual folds formed by layer transfer onto hexagonal boron nitride. Conductance measurements across the folds reveal Coulomb blockade signatures, indicating confined charges within these structures, which act as quantum dots. Along folds, we observe sharp features in traverse resistivity measurements, attributed to an amplification of the dot conductance modulations by a resistance bridge incorporating the device. Our data indicates ballistic transport up to ∼1 μm along the folds. Calculations using the Dirac model including strain are consistent with measured bound state energies and predict the existence of valley-polarized currents. Our results show that graphene folds can act as straintronic quantum wires.

Scalable and cost-effective Ag nanowires flexible transparent electrodes

Flexible transparent electrodes (TEs) are important for new electronic devices. This paper reports a scalable, cost effective Ag nanowires (AgNWs) TE, which is made of a SnO₂·xH₂O and AgNWs composite layer and a flexible polyethylene terephthalate (PET) bottom layer by a solution method at room temperature. The AgNWs/SnO₂·xH₂O composite TEs reveal a significant reduction of four orders in magnitude of sheet resistance, from 90 kΩ sq⁻¹ to 12 Ω sq⁻¹, while retaining transmittance of about 92% at 550 nm. This could be owing to the significant reduction of contact resistance for the weld-like junction of bound AgNWs. Compared with others, this method is characterized by filling gaps of the silver nanowire network with SnO₂·xH₂O. In addition, the adhesive forces between the AgNWs and the substrate are improved. This could be attributed to strong adhesion of SnO₂·xH₂O with the substrate. Moreover, this foldable transparent electrode is applicable for any non-planar surfaces and ultimately for future wearable optoelectronic devices.

This paper reports one of a scalable, cost effective Ag nanowires (AgNWs) TE, which reveals a significant reduction of four orders in magnitude of sheet resistance, from 90 kΩ sq⁻1 to 12 Ω sq⁻1, while keep transmittance of about 92% at 550 nm.

Identification and genomic characterization of the emerging Senecavirus A in southeast China, 2017

Senecavirus A (SVA) is an emerging non-enveloped virus with a single-stranded, positive-sense RNA genome that belongs to the Senecavirus genus in the Picornaviridae family. Senecavirus A-associated swine idiopathic vesicular disease and epidemic transient neonatal losses have caused substantial economic losses for the swine industry. Here, we describe a case of re-emerging vesicular disease among sows and finishing pigs on a swine farm in Fujian Province of southeast China. Other causative pathogens, including FMDV, SVDV and VSV, were excluded, and a novel SVA strain, CH-FJZZ-2017, was isolated. Sequencing and phylogenetic analysis of the complete genome and individual viral proteins revealed that CH-FJZZ-2017 is closely related to the US strains in 2015. The results further showed that Chinese SVAs have formed two distinct subclades with 2016 as the turning point. Viruses causing outbreaks after late 2016 shared higher nucleotide identities with the US strains in 2015. There is still some evolutionary distance between CH-FJZZ-2017 and other strains isolated in late 2016, suggesting that Chinese SVA isolates have been evolving in different directions. This study provides a basis for the development of effective prevention and control strategies.

[Efficacy and safety of pegylated interferon α-2b injection (Y shape, 40 kD) in treatment of patients with genotype 1/6 chronic hepatitis C]

Objective: To investigate the efficacy and safety of the new investigational drug pegylated interferon α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 µg/week) combined with ribavirin in the treatment of patients with genotype 1/6 chronic hepatitis C (CHC), with standard-dose Peg-IFN-α-2a combined with ribavirin as a positive control. Methods: A multicenter, randomized, open-label, and positive-controlled phase III clinical trial was performed. Eligible patients with genotype 1/6 CHC were screened out and randomly divided into Peg-IFN-α-2b(Y shape, 40kD) group and Peg-IFN-α-2a group at a ratio of 2:1. The patients in both groups were given oral ribavirin for 48 weeks in addition and then followed up for 24 weeks after drug withdrawal. Abbott Real Time HCV Genotype II was used to determine HCV genotype, and Cobas TaqMan quantitative real-time PCR was used to measure HCV RNA level at 0, 4, 12, 24, 48, and 72 weeks. Adverse events were recorded in detail. The primary efficacy endpoint was sustained virological response (SVR), and a non-inferiority test was also performed. Results: A total of 561 patients with genotype 1/6 CHC were enrolled, among whom 529 received treatment; 90.9% of these patients had genotype 1 CHC. The data of the full analysis set showed that SVR rate was 69.80% (95% CI 65.00%-74.60%) in the trial group and 74.16% (95% CI 67.73%-80.59%) in the control group (P = 0.297 0). The data of the per protocol set (PPS) showed that SVR rate was 80.63% (95% CI 76.04%-85.23%) in the trial group and 81.33% (95% CI 75.10%-87.57%) in the control group (P = 0.849 8), and the 95% CI of rate difference conformed to the non-inferiority standard. The analysis of the PPS population showed that of all subjects, 47.9% achieved rapid virologic response, with a positive predictive value of 93.8%. The incidence rate of adverse events was 96.30% in the trial group and 94.94% in the control group, and the incidence rate of serious adverse events was 5.13% in the trail group and 5.06% in the control group. Conclusion: In the regimen of Peg-IFN-α combined with ribavirin for the treatment of genotype 1/6 CHC, the new investigational drug Peg-IFN-α-2b(Y shape, 40 kD) has comparable clinical effect and safety to the control drug Peg-IFN-α-2a.

Risk factors of chronic periodontitis on healing response: a multilevel modelling analysis

Background

Chronic periodontitis is a multifactorial polygenetic disease with an increasing number of associated factors that have been identified over recent decades. Longitudinal epidemiologic studies have demonstrated that the risk factors were related to the progression of the disease. A traditional multivariate regression model was used to find risk factors associated with chronic periodontitis. However, the approach requirement of standard statistical procedures demands individual independence. Multilevel modelling (MLM) data analysis has widely been used in recent years, regarding thorough hierarchical structuring of the data, decomposing the error terms into different levels, and providing a new analytic method and framework for solving this problem. The purpose of our study is to investigate the relationship of clinical periodontal index and the risk factors in chronic periodontitis through MLM analysis and to identify high-risk individuals in the clinical setting.

Methods

Fifty-four patients with moderate to severe periodontitis were included. They were treated by means of non-surgical periodontal therapy, and then made follow-up visits regularly at 3, 6, and 12 months after therapy. Each patient answered a questionnaire survey and underwent measurement of clinical periodontal parameters.

Results

Compared with baseline, probing depth (PD) and clinical attachment loss (CAL) improved significantly after non-surgical periodontal therapy with regular follow-up visits at 3, 6, and 12 months after therapy. The null model and variance component models with no independent variables included were initially obtained to investigate the variance of the PD and CAL reductions across all three levels, and they showed a statistically significant difference (P < 0.001), thus establishing that MLM data analysis was necessary. Site-level had effects on PD and CAL reduction; those variables could explain 77–78% of PD reduction and 70–80% of CAL reduction at 3, 6, and 12 months. Other levels only explain 20–30% of PD and CAL reductions. Site-level had the greatest effect on PD and CAL reduction.

Conclusions

Non-surgical periodontal therapy with regular follow-up visits had a remarkable curative effect. All three levels had a substantial influence on the reduction of PD and CAL. Site-level had the largest effect on PD and CAL reductions.

Electronic supplementary material

The online version of this article (10.1186/s12911-017-0533-2) contains supplementary material, which is available to authorized users.

Layer Polarizability and Easy-Axis Quantum Hall Ferromagnetism in Bilayer Graphene

We report magnetotransport measurements of graphene bilayers at large perpendicular electric displacement fields, up to ∼1.5 V/nm, where we observe crossings between Landau levels with different orbital quantum numbers. The displacement fields at the studied crossings are primarily determined by energy shifts originating from the Landau level layer polarizability or polarization. Despite decreasing Landau level spacing with energy, successive crossings occur at larger displacement fields, resulting from decreasing polarizability with orbital quantum number. For particular crossings we observe resistivity hysteresis in displacement field, indicating the presence of a first-order transition between states exhibiting easy-axis quantum Hall ferromagnetism.

[A meta-analysis of low tidal volume on the outcome of adult patients without acute respiratory distress syndrome]

Objective: To evaluate the effects of tidal volume on the survival in adult patients without acute respiratory distress syndrome (non-ARDS). Methods: We searched relevant clinical randomized controlled trials (RCT) from January 2000 to December 2015. Meta analyses related to the effects of tidal volume on mortality in non-ARDS adults were conducted using the methods recommended by the Cochrane Collaboration. Results: A total of nineteen RCTs (n=1 679) were finally included. There were 838 patients ventilated with low tidal volume, and the other 841 patients ventilated with normal tidal volume. The mortality rates were not significantly different between low tidal volume group and control group (5.87% vs 6.52%; RR=0.9, P=0.58). But respiratory complications were significantly lower in low tidal volume group, such as development of acute respiratory distress syndrome(RR=0.32, 95% CI 0.16-0.63, P=0.001), pneumonia (RR=0.48, 95%CI 0.29-0.78, P=0.003), while the incidence of atelectasis was quite comparable between two groups (RR=0.78, 95%CI 0.391-1.356, P=0.48). Conclusion: Non-ARDS patients ventilated with low tidal volume is associated with a lower risk of pulmonary complications, yet clinical outcome, mainly mortality is similar to that of patients with regular tidal volume.

[A follow-up report of childhood hepatoblastoma from 74 cases in a single center]

Objective: To investigate the efficacy and the prognostic factors in pediatric hepatoblastoma according to the standard diagnostic and therapeutic regimen. Method: Eighty-four consecutive patients were enrolled in this study between June 2000 and June 2015. Diagnosis and staging was decided by the multi-disciplinary team including oncologists, surgeons, pathologists and sub-specialized radiologists refering to protocol of Children's Oncology Group(COG) and International Society of Pediatric Oncology Liver Tumor Study Group (SIOPEL) in a case observational study. Univariate analysis was tested by the log-rank and multivariate analysis by COX regression. All consecutive cases were divided into low risk group and high risk group according to grouping criteria. Complete remission was defined as both imaging negative and α fetoprotein (AFP) normalization. Retrospective analysis was performed in clinical features, long-term outcomes and prognostic factors. Result: Ten patients were excluded because of giving up after less than or equal to three cycles of treatment. A total of 74 cases were included in this study; 45 males and 29 females. The median age at diagnosis was 1.7 years(range 0.2-14.8 years). Untill August 30, 2016, the median follow-up time was 24.2 months (range 4.1-135.3 months); 59 cases achieved complete remission.The estimated five years overall survival (OS) and event free survival(EFS) were 90%(68/74)and 72%(58/74). AFP could be normalized after 5 circles of treatment or 2 circles of postoperation.In univariate analysis , the five years OS and EFS in low risk group were both 100%(18/18), and those in high risk group were 88%(50/56)and 68%(40/56), respectively. The five years OS rates were 75%(15/19) and 95%(53/55) in patients with or without distant metastasis (P=0.016). After 3 cycles of chemotherapy post tumor resection, we divided these patients into 2 groups according to AFP recover or not, the five years OS were 100%(43/43)and 81%(22/26), respectively (P=0.011). Conclusion: The result of this protocol is reasonable when comparing with other worldwide research. Except for staging, metastasis, pathological subtypes, postoperative AFP recover or not is a prognostic factor after 3 cycles of chemotherapy.

[Liver transplantation for benign liver tumor: six cases report and literature review]

OBJECTIVE

To analyse and explore the indications and efficacy of liver transplantation for benign liver tumor.

METHODS

From Jan.2001 to Dec.2014, 6 patients, incluing 3 males and 3 females, with benign liver tumor underwent liver transplantation in our department.There were 2 cases of hepatic epithelioid hemangioendothelioma, 1 case of hepatic cavernous hemangioma, 1 case of liver mesenchymal hamartoma, 1 case of hilar bile duct mucinous cystadenoma, and 1 case of hepatic adenoma. The data of surgical procedure, perioperative complications, postoperative management, and the outcome of follow-up were analyzed.

RESULTS

Six orthotopic liver transplantation from one living donor and five cadaveric donors were performed. One patient died in the perioperative period, and other patients were discharged with normal liver and kidney function. Within the follow-up time of 22 to 88 months, these patients could live the normal lives with stable graft function and nutritional status.

CONCLUSIONS

Liver transplantation is the most efficient treatment for unresectable and symptomatic benign lesions, with the favourable outcome.

Abstract P4-22-12: Ribociclib + fulvestrant in postmenopausal women with HR+, HER2– advanced breast cancer (ABC)

Background: Endocrine therapy (ET) is the treatment backbone for hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2–) ABC, but efficacy is limited by ET resistance. The cyclin-dependent kinase (CDK) 4/6–cyclin D (CCND1)–retinoblastoma (Rb) and phosphatidylinositol 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) pathways have been implicated in ET resistance. CDK4/6 and PI3K/mTOR inhibitors act synergistically with ET in preclinical and clinical studies of HR+ breast cancer. Ribociclib (LEE011; CDK4/6 inhibitor) + fulvestrant ± alpelisib (BYL719) or buparlisib (BKM120) in HR+, HER2– ABC is being investigated in a Phase Ib/II study (NCT02088684). Here, we present results from the ribociclib + fulvestrant combination, with intermittent and continuous ribociclib dosing.

Methods: Postmenopausal patients (pts) with HR+, HER2– ABC refractory to aromatase inhibitors received ribociclib intermittently (600 mg/day, 3-weeks-on/1-week-off; Arm A) or continuously (400 mg/day; Arm B; following Arm A safety evaluation) + fulvestrant (500 mg; Cycle 1 Day 1 and 15; subsequent cycles Day 1). Primary objective: dose-limiting toxicities (DLTs) to confirm the recommended Phase II dose of ribociclib + fulvestrant. Secondary objectives: safety, pharmacokinetics, and preliminary antitumor activity (RECIST v1.1); biomarkers that may correlate with response were also assessed.

Results: As of March 10, 2016, 24 pts received ribociclib + fulvestrant (Arm A, n=13; Arm B, n=11); 4 pts in Arm B were ongoing; median duration of exposure was 7.4 (Arm A) and 4.5 (Arm B) months. Median number of prior regimens: 4 (Arm A) and 3 (Arm B). Treatment discontinuation (n; Arm A, Arm B) was due to disease progression (11, 4), physician decision (1, 2), and adverse events (AEs; 1, 1). DLTs in Cycle 1 (n; Arm A, Arm B) were Grade [G] 3 pulmonary embolism (1, 0) and G3 aspartate aminotransferase elevation (0, 1). The most common G3/4 drug-related AE (Arm A, Arm B) was neutropenia (62%, 36%); 5 pts had QTcF prolongation &gt;60 ms (n; 4, 1).

Common all-Grade drug-related AEs (&gt;35% pts) n (%)Arm A (n=13)Arm B (n=11)Neutropenia10 (77)7 (64)Fatigue9 (69)3 (27)Nausea6 (46)5 (46)Anemia6 (46)0 (0)Reduced appetite5 (39)1 (9)

Best overall responses (BORs; n; Arm A, Arm B): partial response (PR; 3, 1), stable disease (SD; 9, 6), and neither complete response nor progressive disease (NCRNPD; non-measurable disease; 1, 4). Overall response rate: 23% (Arm A) and 9% (Arm B); disease control rate (BOR of complete response, PR, SD, or NCRNPD): 100% in both arms. Next-generation sequencing data (n; Arm A, Arm B) were available for 16 pts (7, 9): 5 pts had CCND1 alterations (PR [1, 0], SD [2, 1], and NCRNPD [0, 1]); 11 pts had PIK3CA alterations (PR [1, 0], SD [3, 4], and NCRNPD [1, 2]); 2 of these pts had both CCND1 and PIK3CA alterations (SD [1, 0] and NCRNPD [0, 1]).

Conclusions: Ribociclib + fulvestrant has a manageable safety profile and shows preliminary clinical activity in pretreated pts with HR+, HER2– ABC. Both ribociclib intermittent and continuous dosing schedules were well tolerated. Clinical responses were observed in tumors with and without CDK4/6–cyclin D–Rb and PI3K/mTOR pathway alterations.

Citation Format: Tolaney SM, Forero-Torres A, Boni V, Bachelot T, Lu Y-S, Maur M, Fasolo A, Motta M, Pan C, Dobson J, Hewes B, Chin Lee S. Ribociclib + fulvestrant in postmenopausal women with HR+, HER2– advanced breast cancer (ABC) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-22-12.

[Prognostic value of a logistic regression model based on keratin 18 in patients with HBV-related liver failure]

Objective: To investigate the association between serum keratin 18 (K18) level and prognosis in patients with HBV-related acute-on-chronic liver failure (ACLF). Methods: A total of 120 patients who visited Department of Hepatology in Fuzhou Infectious Disease Hospital and were diagnosed with HBV-related ACLF from December 2012 to March 2014 were enrolled and followed up for 3 months. The patients were divided into death group and survival group. The serum levels of K18 fragments (M30 and M65) were measured and related laboratory data were collected to analyze the differences in M30, M65, M30/M65, and other laboratory markers. Binary logistic regression analysis was performed to screen out independent risk factors for death in patients with HBV-related ACLF, and the corresponding logistic regression model (LRM) was established. Another 51 patients with HBV-related ACLF from April to October, 2014 were enrolled; M30 and M65 were measured and related clinical data were collected to calculate LRM value and validate the diagnostic value of LRM. Results: The 120 patients with HBV-related ACLF were followed up for 3 months, and 40 of them died, resulting in a mortality rate of 33.3%. Compared with the survival group, the death group had significantly higher age, percentage of neutrophils, blood ammonia, international normalized ratio, Model for End-Stage Liver Disease (MELD) score, and M65, as well as significantly lower prothrombin time activity and alpha-fetoprotein level. The death group also had significantly higher incidence rates of underlying diseases and complications such as diabetes, liver cirrhosis, hepatic encephalopathy (HE), pulmonary infection, upper gastrointestinal bleeding, and hepatorenal syndrome than the survival group. Age, HE, upper gastrointestinal bleeding, direct bilirubin (DBil), and M30/M65 were independent risk factors for the prognosis of patients with HBV-related ACLF. The model established was LRM = 0.061 × age + 0.69 × HE + 4.11 × upper gastrointestinal bleeding + 3.201 × ln(DBil) - 3.875 × ln(M30/M65) - 24.248. The 51 patients with HBV-related ACLF were followed up for 3 months, and the LRM value and MELD score were calculated. The areas under the ROC curve for the LRM model and MELD score were 0.889 and 0.858, respectively, and there was no significant difference between them (Z = 0.417, P > 0.05). Conclusion: M30/M65 ratio has a high value in the diagnosis of HBV-related ACLF, and the LRM model containing M30/M65 ratio can well predict the short-term outcome of patients with HBV-related ACLF.

Knockdown of HMGB1 inhibits cell proliferation and induces apoptosis in hemangioma via downregulation of AKT pathway

The high mobility group box 1 (HMGB1) as a conserved non-histone nuclear protein has been involved in a variety of biological processes of cancer, such as cell proliferation, apoptosis, angiogenesis and metastasis. Despite the increased expression of HMGB1 in many malignant tumors, the functions and molecular mechanisms by which HMGB1 contributes to the formation of hemangioma (HA) remain unclear. In the present study, immunohistochemistry was used to detect the expression levels of HMGB1 in different phases of human HAs. Cell function experiments, including MTT, cell colony formation and flow cytometry analysis were performed to evaluate the effects of HMGB1 knockdown on cell proliferation and apoptosis in HA CRL-2586 EOMA cells. As a consequence, we found that HMGB1 expression was significantly increased in proliferating phase HAs compared with the involuting phase HAs and normal skin tissues (P less than 0.01). Moreover, knockdown of HMGB1 gene in vitro suppressed EOMA cell proliferation and colony formation and induced cell apoptosis and cycle arrest at G0/G1 phase by downregulation of PCNA, CyclinD1, p-AKT and upregulation of p53 and cleaved PARP. Taken together, our findings demonstrate that HMGB1 may be implicated in the formation of HA through upregulation of AKT pathway, and represent a potential therapeutic target for treating HA.

[Clinical analysis of 51 cases with rare childhood soft tissue sarcomas]

Objective: To analyze the clinical characteristics and prognosis of rare soft tissue sarcomas. Method: Clinical data of 51 patients with rare soft tissue sarcomas including fibrosarcoma, synovial sarcoma, extrarenal rhabdoid tumor, alveolar soft part sarcoma, desmoplastic small round cell tumor and undifferentiated sarcoma in children and adolescents, diagnosed at Shanghai Children's Medical Center from June 1998 to December 2013, were retrospectively analyzed. All types were treated with the same strategy and chemotherapy regimens. Their clinical features, treatment and prognosis were discussed. Result: Seventeen patients with fibrosarcoma, 10 with synovial sarcoma, 9 with extrarenal rhabdoid tumor, 6 with alveolar soft part sarcoma, 3 with desmoplastic small round cell tumor and 6 with undifferentiated sarcoma were included. The mean age at initial diagnosis was 5 years(range from 1 month to 13.5 years). The most common primary site of tumors was limbs, followed by the thoracic and abdominal cavity, accounting for 41% and 24% respectively. Twelve cases presented distant tissue or organ involvement in which bone metastases occupied the first place. Seven cases(accounting for 14%)were at stage Ⅰ, 13 cases were at stage Ⅱ(accounting for 25%), 19 cases were at stage Ⅲ(accounting for 37%) and 12 cases were at stage Ⅳ(accounting for 24%). The median follow-up period was 36 months(range from 1 month to 123 months). Forty-four patients achieved complete remission and 3 patients achieved partial remission after initial treatment, the overall response rate was 92%. Subsequent follow-up showed 29 patients remained relapse-free while 13 patients had relapsed disease. Overall survival and event-free survival at 2 years were 88% and 57%.Postoperative surgical staging was the main prognostic factors. Patients with stage Ⅲ+ Ⅳ had poorer results than those with Ⅰ+ Ⅱ (χ²=4.909, P=0.027). Conclusion: These 6 types of soft tissue sarcomas are rare in children and adolescents. The tumor can occur anywhere in the body but commonly presents in the extremities. Complete resection of tumor remains the most important modality of treatment and is directly related to prognosis. Neoadjuvant chemotherapy helps improve the resection rate of some unresectable tumors at diagnosis. Radiation therapy is primarily adopted for focal tumor control.

Tunable Plasmonic Reflection by Bound 1D Electron States in a 2D Dirac Metal

We show that the surface plasmons of a two-dimensional Dirac metal such as graphene can be reflected by linelike perturbations hosting one-dimensional electron states. The reflection originates from a strong enhancement of the local optical conductivity caused by optical transitions involving these bound states. We propose that the bound states can be systematically created, controlled, and liquidated by an ultranarrow electrostatic gate. Using infrared nanoimaging, we obtain experimental evidence for the locally enhanced conductivity of graphene induced by a carbon nanotube gate, which supports this theoretical concept.

Triptolide Improves Diabetic Nephropathy by Regulating Th Cell Balance and Macrophage Infiltration in Rat Models of Diabetic Nephropathy

OBJECTIVE

To investigate the therapeutic effect of triptolide (TP) on diabetic nephropathy (DN) in addition to its influence on helper T lymphocytes (Th) cells and monocytes/macrophages in rat models of DN.

METHODS

Diabetes was induced in rats by feeding them high-fat diets and administering low-dose streptozotocin (STZ); subsequently, they were treated with TP (6, 12, or 24 mg/kg/day respectively) for 4 weeks. The general characteristics of the rats and their kidney weight to body weight ratio were observed. Liver and kidney function tests, routine blood tests, and 24 h urine protein tests were performed. Histological and ultrastructural pathologic changes in the kidneys were examined. Changes in the proportion of Th1/Th2 cells in peripheral blood and CD4(+) T cells were measured. The serum levels of interferon (IFN)-γ, tumor necrosis factor (TNF)-α, interleukin (IL)-4, and IL-10 were determined and the expression of these 4 cytokines in the kidneys was measured. Expression of the CD68 macrophage surface marker as well as that of phospho-nuclear factor kappa B (p-NF-κB), NF-κB, monocyte chemoattractant protein (MCP)-1, transforming growth factor (TGF)-β1, fibronectin (FN), IL-12, and signal transducer and activator of transcription-4 (STAT4) was evaluated in the kidneys.

RESULTS

Elevated urine micro-albumin (UMA) and renal histological and ultrastructural changes were observed after the induction of diabetes. DN was associated with delayed immune-inflammatory responses induced by up-regulation of the proportion of Th1 cells and increase of the pro-inflammatory cytokines IFN-γ and TNF-α secreted by Th1 cells. In addition, down-regulation of the proportion of Th2 cells and decrease of the anti-inflammatory cytokines IL-4 and IL-10 secreted by Th2 cells were observed. TP could improve DN by regulating the Th1/Th2 cell balance. Macrophage infiltration as well as expression of inflammatory and pro-fibrogenic factors significantly increased in the kidneys of diabetic rats, which were suppressed by TP with the improvement in the medium-dose TP group (12 mg/kg/d) being the most significant.

CONCLUSION

TP can improve DN by regulating the Th1/Th2 cell balance and by reducing macrophage infiltration as well as the expression of relevant inflammatory factors in the kidney.

[Outcome of childhood T-cell acute lymphoblastic leukemia: a report of 99 cases]

OBJECTIVE

To explore the incidence, clinical characteristics and prognosis of childhood T-cell acute lymphoblastic leukemia (T-ALL) enrolled in protocol ALL-2005.

METHOD

Retrospective reviews of patients diagnosed as having T-ALL were studied in the period between May 2005 and August 2013 in Shanghai Children's Medical Center. Predictive values of early treatment responses, including prednisone response, bone marrow morphology on day 35 during induction chemotherapy, and minimal residual disease (MRD) monitored by flow cytometry on day 35 and 55, were analyzed. The Kaplan-Meier method was used to assess the survival rates.

RESULT

Ninety-nine evaluable patients aged 1-18 years with newly diagnosed T-ALL were enrolled in protocol ALL-2005. The median follow-up period for patients remaining alive in continuous remission was 60 months (24-109 months). The 5-year event free survival (EFS) and overall survival (OS) rates for these patients were 65% and 69%, respectively. Forty-three (43%) patients were older than 10 years at diagnosis. A total of 61 patients presented with initial white blood cell count (WBC)≥50×10(9)/L. Thirty-seven patients with mediastinal mass were found in this study. Seventy-one patients were defined as prednisone good responders (PGR) on day 8 of prednisone therapy. Ninty-four patients achieved complete remission (CR) on day 35 of induction therapy. MRD negative status (<0.01%) on day 35 were seen in 55% of the 42 assessed patients. MRD negative status on day 55 was seen in 78% of the 52 assessed patients. Patients with high MRD (>1%) on day 55 5-year EFS was 40% were associated with poor prognosis (P=0.03). Early T-cell precursor (ETP) subtype was not associated with treatment outcome in this study. Six patients abandoned therapy, 10 lost to follow-up, 22 had relapsed disease, 1 was diagnosed as having a second tumor and 20 patients died.

CONCLUSION

Overall outcome for T-ALL on protocol ALL-2005 is favorable. MRD results on day 55 of induction therapy have important prognostic and therapeutic implications.

[Clinical analysis of liver transplantation in treatment of liver metastatic cancer]

OBJECTIVE

To evaluate the feasibility and outcome of liver transplantation in the treatment of liver metastatic cancer.

METHODS

Four patients with pathologically confirmed liver metastatic cancer underwent liver transplantation, including one of liver metastases from pancreatic endocrine tumor, one from rectal endocrine tumor, one from stomach stromal tumor and one from colorectal carcinoma. Classic surgical method was adopted, i. e. orthotopic liver transplantation for the recipients and transplants came from cadaveric donors.

RESULTS

All the four patients had a smooth operation, an uneventful early postoperative recovery and good living quality. The patient with liver metastases from pancreatic endocrine tumor had liver tumor recurrence at four and a half years after the transplantation, and then underwent left lateral hepatic lobectomy, without any recurrence until now. The patient with liver metastases from rectal endocrine tumor had right renal and pelvic tumor metastasis at 16 months after the operation, and died of tumor recurrence 5 years after the liver transplantation. The patient with liver metastases from gastric stromal tumor had extensive pelvic metastases at five and a half months after the transplantation, and survived with tumor for 4 years and 6 months after the operation. The patient with liver metastases from colorectal carcinoma had extensive bilateral lung metastases at 3 months after the transplantation and died one and a half years after the operation.

CONCLUSION

For well-differentiated unresectable metastatic liver cancers, liver transplantation may serve as a treatment option and better treatment results can be achieved for some highly selected patients.