[Effect of single nucleotide polymorphisms of RS1826690 located in UGT2B4 gene on the pathological complete response to neoadjuvant chemotherapy in breast cancer patients]

Objective: To evaluate the association between single nucleotide polymorphisms (SNPs) of RS1826690 located in UGT2B4 gene and pathological complete response (pCR) to neoadjuvant chemotherapy in breast cancer patients. Methods: A total of 146 breast cancer patients were enrolled to detect the SNPs of RS1826690 by sequenom. The relationship between SNPs of RS1826690 and pCR, predictors of pCR were analyzed by univariate or multivariate analysis. Results: The frequency of CC, CT and TT genetype of RS1826690 was 20.6%, 39.7% and 39.7%, respectively. Of the 171 patients, pCR was achieved in 39 cases (26.7%), with CC allele in 14 cases, CT allele in 7 cases and TT allele in 18 cases, and statistically significant difference was observed (χ(2)=16.684, P=0.003). Multivariate logistic regression analysis showed that SNPs of RS1826690 was an independent predictor of pCR (95% CI: 2.311-28.810, P=0.001) . SNPs of RS1826690 was statistically associated with estrogen receptor (ER) status (χ(2)=7.872, P=0.020). Conclusion: SNPs of RS1826690 was associated with pCR, and breast cancer patients with CC allele were more likely to achieve pCR.

Field-Driven Quantum Criticality in the Spinel Magnet ZnCr_{2}Se_{4}

We report detailed dc and ac magnetic susceptibilities, specific heat, and thermal conductivity measurements on the frustrated magnet ZnCr_{2}Se_{4}. At low temperatures, with an increasing magnetic field, this spinel material goes through a series of spin state transitions from the helix spin state to the spiral spin state and then to the fully polarized state. Our results indicate a direct quantum phase transition from the spiral spin state to the fully polarized state. As the system approaches the quantum criticality, we find strong quantum fluctuations of the spins with behaviors such as an unconventional T^{2}-dependent specific heat and temperature-independent mean free path for the thermal transport. We complete the full phase diagram of ZnCr_{2}Se_{4} under the external magnetic field and propose the possibility of frustrated quantum criticality with extended densities of critical modes to account for the unusual low-energy excitations in the vicinity of the criticality. Our results reveal that ZnCr_{2}Se_{4} is a rare example of a 3D magnet exhibiting a field-driven quantum criticality with unconventional properties.

Evaluating the Rotation Correction of the Main Thoracic Curve in Severe Adolescent Idiopathic Scoliosis: Bending and Traction vs. Fulcrum - A Preliminary Report

Background

Flexibility evaluation methods were only used to assess the changes of coronal Cobb angle in patients with adolescent idiopathic scoliosis (AIS). Little attention was attached to the vertebral rotation in these methods.

Material/Method

21 patients with severe adolescent idiopathic scoliosis were enrolled in this study. Coronal flexibility and rotation correction were compared on the supine bending, traction and fulcrum bending radiographs. The apical vertebral body rib ratio (AVB-R), and Perdriolle rotation angles were used to measure the rotation of the main thoracic curve. Statistical analysis was performed with one-way Analysis of Variance(ANOVA). Correlations between postoperative AVB-R and AVB-R in supine bending, traction and fulcrum bending radiographs were assessed utilizing the Linear Regression.

Results

There were trends towards increased coronal flexibility in fulcrum bending versus traction versus supine bending, but there were no significant differences due to the limited sample size. And all were significantly lower than postoperative correction. The correction of AVB-R at traction and supine bending radiographs were significantly better than fulcrum bending, however, all were significantly lower than postoperative correction. Correction of Perdriolle rotation angle at traction radiograph was best among these methods. A univariant linear regression analysis showed a strong linear correlation between the postoperative AVB-R and the AVB-R in the traction radiograph.

Conclusions

As to patients with severe AIS, the coronal plane flexibility evaluated at the fulcrum bending radiograph is superior to that at the traction radiograph. This may be explained by the measurement errors induced by the better derotation capacity at the traction radiograph. Rotation correction evaluated at the traction radiograph proves better than the fulcrum bending radiographs, showing a linear correlation with the postoperative correction.

Neuroprotective Effects of Valproic Acid in a Rat Model of Cauda Equina Injury

BACKGROUND

Histone deacetylase inhibitors, including valproic acid (VPA), are promising therapeutic interventions in neurological disorders and play an important role in synaptic activity and neuronal function.

METHODS

A total of 30 rats were randomly allocated to 3 groups: sham, control, and VPA. The rats in the VPA and control groups received laminectomy at the L4 level of the vertebrae and silicone gel implantation into the epidural spaces L5 and L6. Rats in the sham group only received laminectomy at the L4 level of vertebrae without any implantation. VPA (300 mg/kg in saline) was administered 2 hours before the surgery. After the surgery, the VPA group received further VPA injections at 300 mg/kg twice a day for 1 week. The same volume of saline was injected in the control group. Neurobehavioral tests using the Basso, Beattie, Bresnahan scale and the oblique board test were performed for 1 week starting at 2 hours before surgery up to day 7 after surgery. At day 7 after surgery, tissues from the compressed cauda equina (L5-L6) were subjected to hematoxylin and eosin, luxol fast blue, or immunofluorescence staining, whereas the terminal deoxynucleotidyl transferase-mediated biotinylated UTP nick-end label assay staining was performed on the tissue from the dorsal root ganglions and the lumbar segment of the spinal cord proximal to the compressed cauda equina (L5-L6).

RESULTS

The behavioral results suggested a significant improvement in the lower limb motor function in the VPA group compared with controls (P < 0.05). Furthermore, histologic assessment revealed a significant reduction in nerve fibers showing Wallerian degeneration and demyelinating lesions in the VPA group, in addition to an increased myelination compared with the control group (P < 0.05). The terminal deoxynucleotidyl transferase-mediated biotinylated UTP nick-end label assay staining revealed a significant decrease in the number of apoptotic neurons in the spinal cord anterior horn and dorsal root ganglions in the VPA group compared with controls (P < 0.05).

CONCLUSIONS

Our data demonstrated that VPA could alleviate cauda equina injury, reduce apoptotic cells, and improve motor recovery, suggesting a neuroprotective effect in acute cauda equina syndrome.

[Analysis of the lymphoepithelial carcinoma of the salivary gland: 12 cases report]

Objective:To improve recognization of clinical, imaging and pathological characteristics of lymphoepithelial carcinoma (LEC) of the salivary glands.Method:The clinical manifestations, imaging features, histological and immunohistochemical characteristics of LEC of the salivary glands (n = 12) between 2003 and 2013 were retrospectively reviewed.Result: Four cases of male and 8 cases of female were enrolled, and the average age of 53.25 years. Ten lesions were located in the parotid gland, and 2 cases were in the submandibular gland. Two cases were unilateral multiple tumors, 10 cases were unilateral solitary tumor, 4 cases were with cervical lymph node metastasis and 1 case was with peripheral facial paralysis. Ten patients had positive EB VCA IgA test. Homogeneous density and obvious enhancement were achieved in all lesions on CT scan. 8 cases were with irregular shapes, partially or ill-defined margin, and heterogeneous enhancement. Incomplete capsule was found in 4 cases, while no obvious capsule was found in 6 cases. HE staining showed that the infiltrative tumors were formed by the presence of sheets or nests of epithelial cells and interstitial lymphoid tissue. Immunohistochemistry staining revealed that the epithelial cells were reactive for pan CK, the lymphoid cells showed reactivity for both CD20 and CD3 markers. All cases underwent primary tumor and involved gland resection with ipsilateral neck dissection, and postoperative radiotherapy, and 2 cases combined with postoperative chemotherapy. The 3 year survival rate of patients was 75.0%(9/12), and 3 cases died of local recurrence or (and) distant metastasis within 1-2 years of definite diagnosis.Conclusion: LEC of salivary gland is associated with EB virus infection. Most cases present with unilateral solitary mass, and incidence of regional lymph node involvement is high. The imaging characteristics of tumor seem to be malignant on CT scan in most cases. Treatment includes multimodality therapy including surgical resection, neck dissection, and radiotherapy. Local recurrence and distant metastasis are the main causes of death.

[The indications for glucocorticoids in treating community-acquired pneumonia in adults: a meta-analysis]

OBJECTIVE

Community acquired pneumonia (CAP) is a common pulmonary infectious disease. Glucocorticoids (GCS) as one of the most powerful anti-inflammation drugs, are still the most controversial adjuvant therapy in treating CAP. Which sub-groups of CAP patients would benefit from GCS is a debating topic. Our aim of this study is to find the indications for GCS in treating adult CAP patients by using meta-analysis.

METHOD

"Steroids, glucocorticoids, corticosteroids, hydrocortisone, prednisone, cortisol, methylprednisolone, dexamethasone"and"community-acquired pneumonia"were used as key words both in Chinese and English to search all published literature in Pubmed, EMBASE MEDLINE, Cochrane, CNKI and Wanfang Database until March 2015.

RESULTS

All 840 articles were reviewed, and 11 high quality randomized clinical trials involving 1942 adult CAP patients were included in this meta-analysis. Using GCS did not significantly reduce mortality in all CAP patients (OR=0.68, 95%CI 0.46-0.99, P=0.04). But in the subgroup analysis, patients with severe CAP benefited from GCS treatment (OR=0.35, 95%CI 0.17-0.75, P=0.007). GCS also increased the risk of hyperglycemia (OR=1.99, 95%CI 1.50-2.65, P<0.000 01).

CONCLUSION

RESULTS from this meta-analysis suggested that GCS should only be rigorously used in severe CAP patients.

The role of glutamine supplemented total parenteral nutrition (TPN) in severe acute pancreatitis

OBJECTIVE

To evaluate the role of glutamine-supplemented total parenteral nutrition (TPN) in severe acute pancreatitis.

PATIENTS AND METHODS

Forty-seven patients with severe acute pancreatitis were admitted to Huaihe Hospital, China, over a period of one year (July 2013 to June 2014) were randomly divided into two therapeutic groups. Patients in group 1 (24 patients in total) and group 2 (23 patient in total) were treated with glutamine-supplemented TPN and standard TPN respectively. Patients were assessed for nutritional parameters, the prevalence of complications, mortality, length of hospital stay (LOS) and length of TPN.

RESULTS

The majority of patients were male in both groups (62.5% in group 1 and 60.9% in group 2) and the average age was similar (39.13±4.46 years in group 1 and 40±3.96 years in group 2). The major causative factor was also similar in both groups, i.e. gall stones. The prevalence of complications in the group 2 was much higher (47.85%) than those in the group 1 (25%). The mortality rate for group 1 and 2 were 4.2% (1/24) and 17.4% (4/23), respectively. The length of hospital stay in the group 2 (23.08 ± 2.02 days) was longer than those of the group 1 (20.33 ± 2.40 days). The length of TPN was also longer in the group 2 (16.47 ± 2.72 days) than those of the group 1 (10.56 ± 2.21 days). Glutamine was also associated with significant increase in serum albumin level.

CONCLUSIONS

Glutamine-supplemented TPN can reduce the mortality and the occurrence of complications, shorten the length of stay and improve the nutritional status of the patients with severe acute pancreatitis.

Rapamycin ameliorates CCl4-induced liver fibrosis in mice through reciprocal regulation of the Th17/Treg cell balance

Previous investigations have suggested that the activation of Th17 cells and/or deficiency of regulatory T cells (Tregs) are involved in the pathogenesis of liver fibrosis. The aim of the present study was to investigate the effect of rapamycin on immune responses in a carbon tetrachloride (CCl₄)-induced murine liver fibrosis model. Liver fibrosis was induced by intraperitoneal administration with CCl₄. Following injection of CCl₄, the mice were treated intraperitoneally with rapamycin (1.25 mg/kg/day) for 8 weeks. Hematoxylin and eosin staining and Masson's trichrome staining were used for histological examination. The protein levels of forkhead/winged helix transcription factor P3, retinoic-acid-related orphan receptor (ROR)-γt in liver tissue were determined by western blotting, the frequency of Th17 and Treg cells in the liver was evaluated by flow cytometry, and a suppression assay was measured by incorporating [3H]-thymidine. In addition, to explore the effect of Tregs expanded with rapamycin on hepatic stellate cells (HSC), HSCs were co-cultured with Tregs from rapamycin or phosphate-buffered saline-treated mice. It was found that rapamycin treatment led to a significant reduction in the number of Th17 cells and in the expression levels of ROR-γt in the liver tissues. Simultaneously, the results of the present study showed a significant increase in the frequency of Tregs and a marked enhancement in the expression of forkhead/winged helix transcription factor P3 in the rapamycin-treated mice. Furthermore, the Tregs in rapamycin-treated mice had significantly higher suppressive effects, compared with the cells from mice treated with phospphate-buffered saline. Consequently, rapamycin treatment prevented the development of CCl₄-induced hepatic fibrosis, which was shown by its histological appearances. These results suggested that the immunosuppressive effect of rapamycin on liver fibrosis was associated with the suppression of hepatic fibrogenesis and regulation of the Th17/Treg cell balance.

[Comparison of naming impairment among patients with Parkinson's disease without dementia, Parkinson's disease dementia and Alzheimer's disease]

OBJECTIVE

To compare the characteristics of naming impairment in Parkinson's disease (PD) without dementia, Parkinson's disease dementia (PDD) and Alzheimer's disease (AD).

METHODS

All participants came from outpatient clinic or inpatients of our hospital during 2011-2013. Object and action naming tests were evaluated among patients with PD without dementia (n=60), PDD (n=60), AD (n=60) and healthy control group (n=60).

RESULTS

The object naming score of PD without dementia group was 40.2±2.8, PDD group was 36.0±3.1, AD group was 31.6±4.0 and healthy control group was 44.1±2.2, while the action naming score of PD without dementia group was 27.3±2.6, PDD group was 20.5±4.0, AD group was 22.5±2.7 and healthy control group was 31.6±1.4. The object and action naming were both impaired in PD without dementia, PDD and AD patients compared with healthy control group (P<0.01).

CONCLUSIONS

PD patients without dementia have slight object and action naming impairments with more impairments in action naming. Action naming is more impaired in PDD patients, while object naming is more impaired in AD patients.

Thermal conductivity of the diamond-chain compound Cu₃(CO₃)₂(OH)₂

Thermal conductivity (κ) of a distorted spin diamond-chain system, Cu3(CO3)2(OH)2, is studied at low temperatures down to 0.3 K and in magnetic fields up to 14 T. In zero field, the κ(T) curve with heat current along the chain direction has very small magnitudes and shows a pronounced three-peak structure. The magnetic fields along and perpendicular to the chains change the κ strongly in a way having good correspondence to the changes of magnetic specific heat in fields. The data analysis based on the Debye model for phononic thermal conductivity indicates that the heat transport is due to phonons and the three-peak structure is caused by two resonant scattering processes by the magnetic excitations. In particular, the spin excitations of the chain subsystem are strongly scattering phonons rather than transporting heat.

DFT/TD-DFT calculations on the sensing mechanism of a dual response near-infrared fluorescent chemosensor for superoxide anion and hydrogen polysulfides: photoinduced electron transfer

Fluorescence quenching by the PET process in HCy-FN.

Brain metastasis in children with stage 4 neuroblastoma after multidisciplinary treatment

Introduction

Brain metastasis is common in relapsed neuroblastoma patients, but the characteristics of brain metastasis remain largely unknown. This study aimed to investigate the status of brain metastasis with neuroblastoma in South China.

Methods

In this retrospective case-based study, 106 patients with stage 4 neuroblastoma from the Department of Pediatric Oncology in Sun Yat-sen University Cancer Center between January 2004 and May 2013 were included. The incidence, risk factors, and survival status of these patients were reviewed and analyzed.

Results

Of the 106 patients, 11 (10.4%) developed brain metastasis, accounting for 20.0% of 55 patients with relapse or progression. The age at initial diagnosis of the 11 patients ranged from 2 to 10 years (median 4 years), which was younger than that of the patients without brain metastasis (median 5 years, range 1–10 years, P = 0.073). The male to female ratio of the 11 patients was 8:3, which was not significantly different from that of the patients without brain metastasis (P = 0.86). Patients with brain metastasis had higher lactate dehydrogenase levels than those without brain metastasis, but the differences were not significant (P = 0.076). Eight patients died, and 3 patients survived. The median interval from the initial diagnosis to the development of brain metastasis was 18 months (range 6–32 months). The median survival was 4 months (range 1 day to 29 months) after the diagnosis of brain metastasis. The median interval from the manifestation of brain metastasis to death was 3 months (range 1 day to 11 months).

Conclusions

High-risk factors for brain metastasis in cases of neuroblastoma include bone marrow involvement and a younger age at initial diagnosis. Nevertheless, multiple treatment modalities can improve disease-free survival.

Brain endogenous angiotensin II receptor type 2 (AT2-R) protects against DOCA/salt-induced hypertension in female rats

Background

Recent studies demonstrate that there are sex differences in the expression of angiotensin receptor type 2 (AT2-R) in the kidney and that AT2-R plays an enhanced role in regulating blood pressure (BP) in females. Also, brain AT2-R activation has been reported to negatively modulate BP and sympathetic outflow. The present study investigated whether the central blockade of endogenous AT2-R augments deoxycorticosterone acetate (DOCA)/salt-induced hypertension in both male and female rats.

Methods

All rats were subcutaneously infused with DOCA combined with 1% NaCl solution as the sole drinking fluid. BP and heart rate (HR) were recorded by telemetric transmitters. To determine the effect of central AT2-R on DOCA/salt-induced hypertension, male and female rats were intracerebroventricularly (icv) infused with AT2-R antagonist, PD123,319, during DOCA/salt treatment. Subsequently, the paraventricular nucleus (PVN) of the hypothalamus, a key cardiovascular regulatory region of the brain, was analyzed by quantitative real-time PCR and Western blot.

Results

DOCA/salt treatment elicited a greater increase in BP in male rats than that in females. Icv infusions of the AT2-R antagonist significantly augmented DOCA/salt pressor effects in females. However, this same treatment had no enhanced effect on DOCA/salt-induced increase in the BP in males. Real-time PCR and Western blot analysis of the female brain revealed that DOCA/salt treatment enhanced the mRNA and protein expression for both antihypertensive components including AT2-R, angiotensin-converting enzyme (ACE)-2, and interleukin (IL)-10 and hypertensive components including angiotensin receptor type 1 (AT1-R), ACE-1, tumor necrosis factor (TNF)-α, and IL-1β, but decreased mRNA expression of renin in the PVN. The central blockade of AT2-R reversed the changes in mRNA and protein expressions of ACE-2, IL-10, and renin, further increased the expressions of TNF-α and IL-1β, and kept higher the expressions of AT1-R, ACE-1, and AT2-R.

Conclusions

These results indicate that endogenous AT2-R activation in the brain plays an important protective role in the development of DOCA/salt-induced hypertension in females, but not in males. The protective effect of AT2-R in females involves regulating the expression of brain renin-angiotensin system components and proinflammatory cytokines.

Clinicopathological features of thirty patients with primary breast lymphoma and review of the literature

Primary breast lymphoma (PBL) is a rare disease accounting for 0.4-0.5 % of all breast malignancies. Accumulating evidence indicates that the diagnosis, prognostic factors, and optimal management of PBL are difficult. The present study aims to investigate the clinicopathological features and optimal treatment of PBL and to evaluate the institutional experience in this patient population. A total of 30 patients with PBL from January 2002 to December 2012 treated in He'nan Province Tumor Hospital were selected. The patients' clinical and pathological characteristics, treatment and response data, patterns of recurrence, and outcomes were retrospectively analyzed, and the relevant literatures were reviewed. All the cases were female, and the median age was 45. Diffuse large B cell lymphoma was the most common histological subtype seen in 23 of 30 patients. With a median follow-up time 32 months, median OS was 42 months (95 % CI 25-58 months), with 5-year OS rates 48 % (95 % CI 36-59 %). The median PFS was 14 months (95 % CI 6-30 months), with 5-year PFS rates 32 % (95 % CI 20-45 %). The prognostic factors that retained statistical significance for OS were IPI (P < 0.001), age (P = 0.04), and stage (P < 0.001). For PFS, significant prognostic factors were IPI (P = 0.01), radiotherapy given (P = 0.02) and stage (P = 0.02). PBL appears to have a worse prognosis. The present treatment method for PBL is a comprehensive way of diagnostic surgery together with radiotherapy and chemotherapy.

MicroRNA-141 regulates the tumour suppressor DLC1 in colorectal cancer

Our previous study has showed that DLC1 acts as a functional tumor suppressor in colorectal cancer (CRC) cell lines. The aims of this study were to determine whether DLC1 is a target of MicroRNA (miRNA) regulation and to evaluate the role of this mechanism in CRC. By bioinformatics approach and literature, miR-141 was chosen for further study. The miR-141 mimic, miR-141 inhibitor were synthesized and transfected to Lovo cells. Cell growth was determined by MTT and in vivo models. The flow cytometric analysis for cell cycle determination and transwell assays for evaluating the cell invasion were used. Luciferase reporter assays and Western blots showed that DLC1 was a direct target of miR-141 in CRC. The expression levels of miR-141 were obviously up-regulated in CRC tissues compared to non-cancerous tissues, while DLC1 expression levels were down-regulated in a high proportion of clinical samples (14/18). In addition, correlation analyses revealed negative correlation between miR-141 levels and DLC1 expression levels in CRC tissues. MiR-141 overexpression promoted cell growth in vitro and in vivo, promoted cell cycle progression and invasion in Lovo cells. Furthermore, re-introduction of DLC-1 in miR-141-overexpressing Lovo cells decreased growth rate of cells, increase of the percentage in G0/G1 phase and decreased the number of migrating cells. In conclusion, we demonstrated that miR-141 is up-regulated in CRC and acts as a functional oncogene by targeting DLC1.

Acid sphingomyelinase, a novel negative biomarker of ovarian cancer

OBJECTIVE

Ovarian cancer is the sixth most common cancer and the main cause of death in women. However, the molecular mechanism for the cause of the ovarian cancer has not been fully elucidated. Acid sphingomyelinase (ASM), a lipid hydrolase, has been suggested for treating cancer and may affect the development of ovarian cancer. We want to find the function of ASM in the development of ovarian cancer.

PATIENTS AND METHODS

Human ovarian cancer cells HO 8910 (HOCC) and human primary ovarian cells (HPOC) were transfected with ASM gene and ASM RNAi. Real-time qPCR and western blot analysis was carried out to examine the level of ASM. The growth rate of transfected and non-transfected cells was measured. Ovarian biopsies were collected from 80 ovarian cancer patients and 20 healthy subjects.

RESULTS

The growth rate of HOCC and HPOC was decreased by 22% and 19% in the ASM-transfected group compared with non-transfected group. Inversely, the growth rate of HOCC and HPOC was increased by 16% and 35% in the ASM-RNAi-transfected group compared with non-transfected group. In the transfected and non-transfected cells, the change level of SAM was approved by Real-time qPCR and western blot analysis. The levels of SAM were reducing with the development of ovarian cancer.

CONCLUSIONS

SAM is higher expressed in normal cell than that in ovarian cancer, and can be a negative biomarker for the diagnosis of ovarian cancer. SAM can be developed a new drug for the ovarian cancer therapy.

Expression of the apoptosis inhibitor livin in colorectal adenoma-carcinoma sequence: correlations with pathology and outcome

The inhibitor of apoptosis family member livin is expressed in several types of cancer but not in most benign tissues, and it has been considered to be a poor prognostic mark in various malignancies. However, livin expression and its prognostic relevance have not been evaluated in colorectal adenoma-carcinoma sequence. In this study, we analyzed the difference of livin expression among normal mucosa, adenoma, and adenocarcinoma and investigated the relationship of livin expression in carcinomas with clinicopathological variables using immunohistochemistry and real-time reverse transcription-PCR. We observed that the expression of livin protein was mainly present on base of colorectal crypts in adenoma and throughout the epithelium in carcinoma, whereas did not present in accompanying normal mucosa, and the expression of livin messenger RNA (mRNA) in adenocarcinomas was significantly higher than in adenomas and in normal mucosa (P = 0.001, respectively), whereas, compared with normal mucosa, the expression level of livin mRNA was up-regulated in adenomas but no significant difference (P = 0.196). We also found that the expression levels of livin mRNA in rectal cancer was significantly higher than those in colonic cancer, and livin mRNA expression was strongly related to colorectal cancer invasive depth but not to clinical tumor stage, differentiation, lymph node metastasis, tumor morphological category and pathological type, and patient's age and gender. These findings support the possibility that the livin gene may play a role in colorectal tumorigenesis, and increased expression of livin mRNA may serve as a new target for colorectal cancer treatment.

Survival analysis of children with stage II testicular malignant germ cell tumors treated with surgery or surgery combined with adjuvant chemotherapy

For children with stage II testicular malignant germ cell tumors (MGCT), the survival is good with surgery and adjuvant chemotherapy. However, there is limited data on surgical results for cases in which there was no imaging or pathologic evidence of residual tumor, but in which serum tumor markers either increased or failed to normalize after an appropriate period of half-life time post-surgery. To determine the use of chemotherapy for children with stage II germ cell tumors, we analyzed the outcomes (relapse rate and overall survival) of patients who were treated at the Sun Yat-sen University Cancer Center between January 1990 and May 2013. Twenty-four pediatric patients with a median age of 20 months (range, 4 months to 17 years) were enrolled in this study. In 20 cases (83.3%), the tumors had yolk sac histology. For definitive treatment, 21 patients underwent surgery alone, and 3 patients received surgery and adjuvant chemotherapy. No relapse was observed in the 3 patients who received adjuvant chemotherapy, whereas relapse occurred in 16 of the 21 patients (76.2%) treated with surgery alone. There were a total of 2 deaths. Treatment was stopped for 1 patient, who died 3 months later due to the tumor. The other patient achieved complete response after salvage treatment, but developed lung and pelvic metastases 7 months later and died of the tumor after stopping treatment. For children treated with surgery alone and surgery combined with adjuvant chemotherapy, the 3-year event-free survival rates were 23.8% and 100%, respectively (P = 0.042), and the 3-year overall survival rates were 90.5% and 100%, respectively (P = 0.588). These results suggest that adjuvant chemotherapy can help to reduce the recurrence rate and increase the survival rate for patients with stage II germ cell tumors.

The clinical characteristics and treatment outcome of 57 children and adolescents with primary central nervous system germ cell tumors

Primary central nervous system germ cell tumors (CNS-GCTs) in children and adolescents have unique clinical features and methods of treatment compared with those in adults. There is little information about Chinese children and adolescents with CNS-GCTs. Therefore, in this study we retrospectively analyzed the clinical features and treatment outcome of Chinese children and adolescents with primary CNS-GCTs. Between January 2002 and December 2012, 57 untreated patients from a single institution were enrolled. They were diagnosed with CNS-GCTs after pathologic or clinical assessment. Of the 57 patients, 41 were males and 16 were females, with a median age of 12.8 years (range, 2.7 to 18.0 years) at diagnosis; 43 (75.4%) had non-germinomatous germ cell tumors (NGGCTs) and 14 (24.6%) had germinomas; 44 (77.2%) had localized disease and 13 (22.8%) had extensive lesions. Fifty-three patients completed the prescribed treatment, of which 18 underwent monotherapy of surgery, radiotherapy, or chemotherapy, and 35 underwent multimodality therapies that included radiotherapy combined with chemotherapy or surgery combined with chemotherapy and/or radiotherapy. PEB (cisplatin, etoposide, and bleomycin) protocol was the major chemotherapy regimen. The median follow-up time was 32.3 months (range, 1.2 to 139 months). Fourteen patients died of relapse or disease progression. The 3-year event-free survival (EFS) and overall survival rates for all patients were 72.2% and 73.8%, respectively. The 3-year EFS was 92.9% for germinomas and 64.8% for NGGCTs (P = 0.064). The 3-year EFS rates for patients with NGGCTs who underwent monotherapy and multimodality therapies were 50.6% and 73.5%, respectively (P = 0.042). Our results indicate that multimodality therapies including chemotherapy plus radiotherapy were better treatment option for children and adolescents with CNS-GCTs.

Impaired balance of T helper 17/T regulatory cells in carbon tetrachloride-induced liver fibrosis in mice

AIM: To investigate the effect of T helper (Th) 17/T regulatory (Treg) cells on hepatic fibrosis in mice and its possible mechanism.

METHODS: Hepatic fibrosis was induced by intraperitoneal injection of carbon tetrachloride. Hepatic pathological changes were observed by hematoxylin and eosin staining; the protein levels of interleukin (IL)-6, transforming growth factor (TGF)-β and α-smooth muscle actin (SMA) in liver tissue were determined by Western blotting; and the frequency of Th17 and Treg cells in the liver was estimated by flow cytometry. In addition, hepatic stellate cells were isolated from healthy mouse liver and co-cultured with Th17 or Treg cells. Immunofluorescence staining and Western blotting were performed to determine the change in HSC activation.

RESULTS: In the model group, there were different degrees of fibroplasia, degeneration and necrosis. The protein levels of IL-6, TGF-β and α-SMA in liver tissue were significantly higher than those in the control group at 12 wk (P < 0.05). Compared with the control group, the frequency of Th17 cells in the model group was increased but the frequency of Treg cells decreased gradually. Furthermore, at 4, 8 and 12 wk, there were significant differences in the number of Th17 cells (0.52% ± 0.16%, 1.46% ± 0.24%, and 2.60% ± 0.41%, respectively, P < 0.05) and Treg cells (2.99% ± 0.40%, 2.16% ± 0.50%, and 1.49% ± 0.34%, respectively, P < 0.05). In vitro, Th17 cells promoted, whereas Treg cells inhibited the expression of α-SMA, both in a dose-dependent manner, compared with the control group.

CONCLUSION: Th17/Treg imbalance exists in mice with liver fibrosis, which potentially promotes liver fibrosis via HSC activation.

Agrobacterium tumefaciens-mediated genetic transformation of the Taxol-producing endophytic fungus Ozonium sp EFY21

An efficient Agrobacterium tumefaciens-mediated genetic transformation method was successfully established for a newly isolated Taxol-producing fungus, Ozonium sp EFY21. A specific hygromycin B resistance expression vector, pCAMBIA1304'AN7-1, was constructed for fungal transformation. Key factors affecting transformation efficiency were thoroughly investigated and optimized. PCR amplification and Southern hybridization were used to verify the transformation events. This study should pave the way for future genetic modification studies of Ozonium sp EFY21.

[Value assessment of high-risk HPV test and TCT in the screening of cervical carcinoma]

OBJECTIVE

To estimate the status of coincidence of high-risk HPV (HR-HPV) test and thinprep cytology test(TCT) with biopsy histopathological diagnosis. And explore the diagnostic value in the cervical cancer and precancerous lesions by combination of these two methods.

METHODS

Retrospective analysis cases with the positive cytological diagnosis. Acrodding to the principle of voluntariness and informed consent, 3197 cases were selected and further investigated by high-risk human papillomavirus testing and biopsy histopathological diagnosis. We had a comparative analysis to the coincidence of TCT, high-risk HPV-DNA test and biopsy histopathological diagnosis.

RESULTS

Among 3197 cases, 58.6% cases with chronic inflammation, 26.1% cases with condyloma or CIN I, 14.1% cases with CIN II-III, and 1.2% cases with invasive cervical carcinoma. Compared with pathological biopsy, the coincident rate of the diagnosis of TCT cytology and histopathology were 21.2% (ASC-US), 28.6% (ASC-H), 39.6% (LSIL), 56.2% (HSIL) and 72.4% (cervical carcinoma), respectively. Among cases of positive TCT diagnosis, Compared HR-HPV test and histopathological diagnosis, infection rate of HR-HPV increases significantly with increasing pathological grade (chi2 = 292.354, P = 0.000 < 0.05). As the TCT diagnostic level increases, the positive rate of HR-HPV marked grows (chi2 = 144.113, P = 0.000 < 0.05).

CONCLUSION

TCT can reduce the incidence of cancer effectively. But lower sensitivity in the low-grade cervical lesions may cause missed diagnosis. Combined TCT and HR-HPV test will improve the detection rate of cervical lesions; it is an ideal method to screening cervical cancer.

Lymphoma and cerebral vasculitis in association with X-linked lymphoproliferative disease

Lymphoma is seen in up to 30% of patients with X-linked lymphoproliferative disease (XLP), but cerebral vasculitis related with XLP after cure of Burkitt lymphoma is rarely reported. We describe a case of a 5-year-old boy with XLP who developed cerebral vasculitis two years after cure of Burkitt lymphoma. He had Burkitt lymphoma at the age of 3 years and received chemotherapy (non-Hodgkin's lymphoma-Berlin-Frankfurt-Milan-90 protocol plus rituximab), which induced complete remission over the following two years. At the age of 5 years, the patient first developed headache, vomiting, and then intellectual and motorial retrogression. His condition was not improved after anti-infection, dehydration, or dexamethasone therapy. No tumor cells were found in his cerebrospinal fluid. Magnetic resonance imaging showed multiple non-homogeneous, hypodense masses along the bilateral cortex. Pathology after biopsy revealed hyperplasia of neurogliocytes and vessels, accompanied by lymphocyte infiltration but no tumor cell infiltration. Despite aggressive treatment, his cognition and motor functions deteriorated in response to progressive cerebral changes. The patient is presently in a vegetative state. We present this case to inform clinicians of association between lymphoma and immunodeficiency and explore an optimal treatment for lymphoma patients with compromised immune system.