Erratum: PPAR δ inhibition protects against palmitic acid-LPS induced lipidosis and injury in cultured hepatocyte L02 cell: Erratum

[This corrects the article DOI: 10.7150/ijms.37677.].

LncRNA IDH1-AS1 sponges miR-518c-5p to suppress proliferation of epithelial ovarian cancer cell by targeting RMB47

Long noncoding RNA (lncRNA) IDH1 antisense RNA 1 ( IDH1-AS1) is involved in the progression of multiple cancers, but its role in epithelial ovarian cancer (EOC) is unknown. Therefore, we investigated the expression levels of IDH1-AS1 in EOC cells and normal ovarian epithelial cells by quantitative real-time PCR (qPCR). We first evaluated the effects of IDH1-AS1 on the proliferation, migration, and invasion of EOC cells through cell counting kit-8, colony formation, EdU, transwell, wound-healing, and xenograft assays. We then explored the downstream targets of IDH1-AS1 and verified the results by a dual-luciferase reporter, qPCR, rescue experiments, and Western blotting. We found that the expression levels of IDH1-AS1 were lower in EOC cells than in normal ovarian epithelial cells. High IDH1-AS1 expression of EOC patients from the Gene Expression Profiling Interactive Analysis database indicated a favorable prognosis, because IDH1-AS1 inhibited cell proliferation and xenograft tumor growth of EOC. IDH1-AS1 sponged miR-518c-5p whose overexpression promoted EOC cell proliferation. The miR-518c-5p mimic also reversed the proliferation-inhibiting effect induced by IDH1-AS1 overexpression. Furthermore, we found that RNA binding motif protein 47 (RBM47) was the downstream target of miR-518c-5p, that upregulation of RBM47 inhibited EOC cell proliferation, and that RBM47 overexpressing plasmid counteracted the proliferation-promoting effect caused by the IDH1-AS1 knockdown. Taken together, IDH1-AS1 may suppress EOC cell proliferation and tumor growth via the miR-518c-5p/RBM47 axis.

Charge Oscillations in Bilayer Graphene Quantum Confinement Devices

Quantum confinement structures are building blocks of quantum devices in fundamental physics exploration and technological applications. In this work, we fabricate dual-gated bilayer graphene Fabry-Pérot quantum Hall interferometers employing two different gating strategies and conduct finite element simulations to understand the electrostatics of the confinement structures and to guide device design and fabrication. We observe two types of resistance oscillations arising from the charging of quantum dots formed inside the interferometers. We obtain the size, location, and charging energy of the dots by measuring the dependence of the oscillations on the magnetic field, gate voltages, and dc bias. We analyze and discuss the origin of the quantum dots and their impact on quantum Hall edge state backscattering and interference. Insights gained in these studies shed light on the construction of van der Waals quantum confinement devices.

Dynamics of microbial communities associated with flavor formation during sour juice fermentation and the milk fan drying process

Milk fan is an acid-curd cheese with strong national characteristics (a traditional dairy product of the Bai nationality with a shape like a piece of paper) and a long history in Yunnan province, China. In our previous study, we characterized the microbial community diversity of milk fan, but the succession of microorganisms associated with flavor formation in milk fan is still unknown. Therefore, we examined the predominant microorganisms and their correlations with the formation of flavor in the fermentation of sour juice and drying of milk fan by gas chromatography mass spectrometry, high-throughput 16S rDNA sequencing, intergenic spacer sequencing and metatranscriptome analysis. We found that the relative abundances of Lactobacillus and Issatchenkia initially decreased and then increased with time during the fermentation of sour juice. However, the relative abundances of Acetobacter, Leuconostoc, Lactococcus, Geotrichum, and Dipodascus initially increased and then decreased. During the drying step, the relative abundances of Lactobacillus and Issatchenkia continuously increased and became the dominant microorganisms in the milk fan. The metatranscriptomes generated from the milk fan showed that "carbohydrate metabolism," "translation," and "signal transduction" were the main metabolic functions of the microbial communities. Rhodotorula and Yarrowia contained more differentially expressed genes than other genera, which indicated they may be associated with the production of the characteristic flavor. Furthermore, a Pearson correlation analysis showed that Lactococcus, Rhodotorula, Candida, Cutaneotrichosporon, and Yarrowia were significantly positively correlated with more aroma-active compounds, mainly ethyl acetate, 2-heptanone, isovaleraldehyde, butyric acid, nonanal, and hexanal. In conclusion, these findings contribute to a better understanding of the flavor production mechanism during the production of milk fan.

Techniques for navigating postsurgical adhesions: Insights into mechanisms and future directions

Postsurgical adhesions are a common complication of surgical procedures that can lead to postoperative pain, bowel obstruction, infertility, as well as complications with future procedures. Several agents have been developed to prevent adhesion formation, such as barriers, anti-inflammatory and fibrinolytic agents. The Food and Drug Administration (FDA) has approved the use of physical barrier agents, but they have been associated with conflicting clinical studies and controversy in the clinical utilization of anti-adhesion barriers. In this review, we summarize the human anatomy of the peritoneum, the pathophysiology of adhesion formation, the current prevention agents, as well as the current research progress on adhesion prevention. The early cellular events starting with injured mesothelial cells and incorporating macrophage response have recently been found to be associated with adhesion formation. This may provide the key component for developing future adhesion prevention methods. The current use of physical barriers to separate tissues, such as Seprafilm®, composed of hyaluronic acid and carboxymethylcellulose, can only reduce the risk of adhesion formation at the end stage. Other anti-inflammatory or fibrinolytic agents for preventing adhesions have only been studied within the context of current research models, which is limited by the lack of in-vitro model systems as well as in-depth study of in-vivo models to evaluate the efficiency of anti-adhesion agents. In addition, we explore emerging therapies, such as gene therapy and stem cell-based approaches, that may offer new strategies for preventing adhesion formation. In conclusion, anti-adhesion agents represent a promising approach for reducing the burden of adhesion-related complications in surgical patients. Further research is needed to optimize their use and develop new therapies for this challenging clinical problem.

Two-tiered mutualism improves survival and competitiveness of cross-feeding soil bacteria

Metabolic cross-feeding is a pervasive microbial interaction type that affects community stability and functioning and directs carbon and energy flows. The mechanisms that underlie these interactions and their association with metal/metalloid biogeochemistry, however, remain poorly understood. Here, we identified two soil bacteria, Bacillus sp. BP-3 and Delftia sp. DT-2, that engage in a two-tiered mutualism. Strain BP-3 has low utilization ability of pyruvic acid while strain DT-2 lacks hexokinase, lacks a phosphotransferase system, and is defective in glucose utilization. When strain BP-3 is grown in isolation with glucose, it releases pyruvic acid to the environment resulting in acidification and eventual self-killing. However, when strain BP-3 is grown together with strain DT-2, strain DT-2 utilizes the released pyruvic acid to meet its energy requirements, consequently rescuing strain BP-3 from pyruvic acid-induced growth inhibition. The two bacteria further enhance their collective competitiveness against other microbes by using arsenic as a weapon. Strain DT-2 reduces relatively non-toxic methylarsenate [MAs(V)] to highly toxic methylarsenite [MAs(III)], which kills or suppresses competitors, while strain BP-3 detoxifies MAs(III) by methylation to non-toxic dimethylarsenate [DMAs(V)]. These two arsenic transformations are enhanced when strains DT-2 and BP-3 are grown together. The two strains, along with their close relatives, widely co-occur in soils and their abundances increase with the soil arsenic concentration. Our results reveal that these bacterial types employ a two-tiered mutualism to ensure their collective metabolic activity and maintain their ecological competitive against other soil microbes. These findings shed light on the intricateness of bacterial interactions and their roles in ecosystem functioning.

Experimental infection and co-infection with Chinese strains of Ehrlichia canis and Babesia vogeli in intact and splenectomized dogs: Insights on clinical, hematologic and treatment responses

Animal infection models are crucial for studying various aspects of Ehrlichia canis infections. To understand the pathogenesis of the first Chinese isolate of E. canis and simulate the natural progression of canine ehrlichiosis, we developed a model with 18 Beagle dogs that consisted of E. canis initial infection (days 0-17), treatment with doxycycline or rifampicin (days 18-32), recovery (days 33-66), E. canis reinfection (days 67-91), and Babesia vogeli superinfection (days 92-116). We measured body weight and rectal temperature every other day, drew blood every 4 days for routine hematology and biochemistry tests, and for quantification of E. canis and B. vogeli by quantitative PCRs. In this study, the first isolate of E. canis from China was used to experimentally infect dogs, and the infected dogs exhibited clinical signs of acute severe ehrlichiosis, including high fever, loss of appetite, dehydration, and body weight loss, confirming the similar pathogenicity of E. canis in China as compared to isolates from other regions. Infection with E. canis and B. vogeli led to reduced body weight and fever in dogs. Doxycycline treatment led to absence of E. canis DNA in infected dogs, while rifampicin treatment lowered the blood E. canis copy number up to 1.5 folds. E. canis-free infected dogs after doxycycline treatment were successfully re-infected with E. canis, indicating dogs with antibodies are still at risk of re-infection. Super-infection with B. vogeli resulted in higher fever, more severe anemia, and a reduced number of platelets. Splenectomized dogs showed significantly higher E. canis numbers during recovery and re-infection than intact dogs. The histological changes were observed in brain, lung, kidney, liver and spleen of the infected dogs. The findings in this study provide insights into clinical and hematologic responses, as well as effective treatment options, for dogs infected with the first Chinese isolate of E. canis, and may contribute to our understanding of the diagnosis and prevention of tick-borne diseases in dogs, including canine monocytic ehrlichiosis.

Spatiotemporal evolution trend and decoupling type identification of transport carbon emissions from economic development in China

Carbon emissions are a major concern in China, and transportation is an important part of it. In this paper, data on China's 30 provinces' transport carbon emissions from 2005 to 2019 were selected to construct a spatial autocorrelation model and identified the decoupling types, which revealed the relationship between transport carbon emissions and economic development. This study suggests a regulation strategy for provincial transport carbon emissions in China based on the contribution rates of transport carbon emission variables. According to the findings, transport carbon emissions of China indicated a slow rise from 2005 to 2019, the annual growth rate has fluctuated downward, and petroleum products have been the most major source. The geographical correlation of transport carbon emissions has gradually improved, and the transport carbon emission intensity has become more significant. Differences in the transport carbon emission intensity slightly increased, which were significantly regionally correlated. There were seven forms of decoupling between yearly provincial transport carbon emissions and economic development, with weak decoupling accounting for the largest proportion, 45.24%. Decoupling was achieved in 83.33% of the provinces in the period of 2005-2019. As a consequence of factor decomposition, the energy intensity, transport intensity, and economic structure played an overall inhibitory role, while the carbon emission intensity, economic scale, and population played promoting roles. The economic scale was the most important influencing factor.

Coexistence of ETV6-RUNX1 and MLL aberration among pediatric acute lymphoblastic leukemia: case reports and a literature review

Background

It is known that ETV6-RUNX1 is usually related to favorable prognosis, but MLL aberration has been associated with poor prognosis among pediatric acute lymphoblastic leukemia (ALL). However, the outcome of coexistence of ETV6-RUNX1 and MLL aberration in pediatric ALL patients is unknown. Herein, we report 4 cases of the coexistence of ETV6-RUNX1 and MLL-partial tandem duplications (MLL-PTD) in pediatric ALL patients and show the favorable outcome, which was never reported before.

Case Description

The frequency of coexistence of ETV6-RUNX1 and MLL aberration at our children's medical center was calculated as 0.98% (4/410). All of them were ETV6/RUNX1-positive cases that exhibited MLL-PTD, and the 10-year event-free survival (EFS) and overall survival (OS) were both 75%. With the following keywords of "ETV6-RUNX1", "MLL", "children" and "acute lymphoblastic leukemia", a literature search of coexistence of ETV6-RUNX1 and MLL aberration was conducted in the database of PubMed, and 4 articles were retrieved finally, involving 16 cases of children. Among the 16 cases of pediatric ALL, the age ranged from 2 to 7 years old, including 9 males and 7 females and the white blood cell (WBC) count was (2.66-68.6)×109/L. In terms of fusion genes, they all had positive ETV6/RUNX1. Among them, MLL deletion was exhibited among 8 ETV6/RUNX1-positive patients, and 2 cases of der(21) duplication. MLL allelic deletions were shown among the remaining ETV6/RUNX1-positive patients. All patients showed a favorable outcome.

Conclusions

The results of our analysis primarily provide compelling evidence that cases with an MLL-PTD or other types of MLL aberration are in fact a distinct subentry among ETV6-RUNX1 B-cell ALL (B-ALL).

Primulaxilingensis (Primulaceae), a new species from Sichuan, China

A new species, Primulaxilingensis K.Huang & Z.X.Fu, sp. nov. (Primulaceae), is described and illustrated. In gross morphology, it is clearly allied to section Minutissimae on account of having stolons, being glabrous, leaf rosette less than or equal to corolla, flower solitary and bract not swollen at base. The new species is easily distinguished by the combination of scape densely yellow farinose, leaf apex acute, rarely broadly obtuse, corolla pale purplish blue and style 3.0-6.0 mm above base of corolla tube, stamens reaching the corolla tube mouth in thrum flower. In addition, the distribution map, morphological comparison of related species and conservation status of the new species are also provided.

Cancer-associated fibroblasts undergoing neoadjuvant chemotherapy suppress rectal cancer revealed by single-cell and spatial transcriptomics

Neoadjuvant chemotherapy (NAC) for rectal cancer (RC) shows promising clinical response. The modulation of the tumor microenvironment (TME) by NAC and its association with therapeutic response remain unclear. Here, we use single-cell RNA sequencing and spatial transcriptome sequencing to examine the cell dynamics in 29 patients with RC, who are sampled pairwise before and after treatment. We construct a high-resolution cellular dynamic landscape remodeled by NAC and their associations with therapeutic response. NAC markedly reshapes the populations of cancer-associated fibroblasts (CAFs), which is strongly associated with therapeutic response. The remodeled CAF subsets regulate the TME through spatial recruitment and crosstalk to activate immunity and suppress tumor progression through multiple cytokines, including CXCL12, SLIT2, and DCN. In contrast, the epithelial-mesenchymal transition of malignant cells is upregulated by CAF_FAP through MIR4435-2HG induction, resulting in worse outcomes. Our study demonstrates that NAC inhibits tumor progression and modulates the TME by remodeling CAFs.

Carbon dots/TiO2 enhanced visible light-assisted photocatalytic of leachate: Simultaneous effects and Mechanism insights

The persistence and potential fouling risks associated with humic substances and bacteria present in leachate have gained increasing attention. Therefore, developing efficient and environmentally compatible technologies for their removal is essential. This study presented the hydrothermal synthesis of a photocatalyst by coupling carbon dots (CDs) and bulk TiO2 (P25). The incorporation of CDs increased the photocatalytic performance by enhancing visible light absorption and facilitating the separation of electrons/holes. Compared to P25, the CDs/P25 exhibited optimal photocatalytic activity for humic acid (HA), fulvic acid (FA), and leachate, with 1.64, 1.02, and 1.12 times higher activity, respectively. Remarkedly, the CDs/P25 accelerated the conversion of large HA molecules into small molecules at a faster rate and higher amount than the bulk P25, due to the increase of hydroxyl radicals, monoclinic oxygen radicals, and superoxide radicals. Additionally, the CDs/P25 demonstrated better bacterial-deactivation ability than the P25, with dead bacteria percentages of 83.3% and 34.6%, respectively. This study provides a promising strategy for efficiently applying CDs/P25 photocatalysis to leachate treatment.

Eosinophils promote pulmonary matrix destruction and emphysema via Cathepsin L

Patients with chronic obstructive pulmonary disease (COPD) who exhibit elevated blood eosinophil levels often experience worsened lung function and more severe emphysema. This implies the potential involvement of eosinophils in the development of emphysema. However, the precise mechanisms underlying the development of eosinophil-mediated emphysema remain unclear. In this study, we employed single-cell RNA sequencing to identify eosinophil subgroups in mouse models of asthma and emphysema, followed by functional analyses of these subgroups. Assessment of accumulated eosinophils unveiled distinct transcriptomes in the lungs of mice with elastase-induced emphysema and ovalbumin-induced asthma. Depletion of eosinophils through the use of anti-interleukin-5 antibodies ameliorated elastase-induced emphysema. A particularly noteworthy discovery is that eosinophil-derived cathepsin L contributed to the degradation of the extracellular matrix, thereby leading to emphysema in pulmonary tissue. Inhibition of cathepsin L resulted in a reduction of elastase-induced emphysema in a mouse model. Importantly, eosinophil levels correlated positively with serum cathepsin L levels, which were higher in emphysema patients than those without emphysema. Expression of cathepsin L in eosinophils demonstrated a direct association with lung emphysema in COPD patients. Collectively, these findings underscore the significant role of eosinophil-derived cathepsin L in extracellular matrix degradation and remodeling, and its relevance to emphysema in COPD patients. Consequently, targeting eosinophil-derived cathepsin L could potentially offer a therapeutic avenue for emphysema patients. Further investigations are warranted to explore therapeutic strategies targeting cathepsin L in emphysema patients.

Anticancer effects of gossypetin from Hibiscus sabdariffa in oral squamous cell carcinoma

OBJECTIVE

Gossypetin, isolated from Hibiscus sabdariffa L, has been shown to have various pharmacological effects including anti-inflammatory and antibacterial activity against various diseases. However, since the effect of gossypetin in oral cancer remains to be reported, we aimed to investigate the anticancer activity and mechanisms of gossypetin in oral squamous cell carcinoma (OSCC).

METHODOLOGY

The proliferation of OSCC cells was evaluated by cell viability and soft agar colony assays. The effects of gossypetin on the migration and invasion of OSCC cells was investigated by wound healing and transwell invasion assays, respectively. Apoptosis and cell cycle arrest were measured by flow cytometry. Moreover, the anticancer mechanism of gossypetin in OSCC cells was analyzed by western blotting.

RESULTS

Gossypetin inhibited the proliferation, migration, and invasion of OSCC cells and induced apoptosis by upregulating the Bax/Bcl-2 ratio and cell cycle arrest at the G2/M phase. Furthermore, gossypetin regulated the activation of extracellular signal-regulated kinase and nuclear factor-kappa B.

CONCLUSION

Results showed that gossypetin inhibits the proliferation, migration, and invasion of OSCC cells and triggers apoptosis and cell cycle arrest in OSCC. Therefore, gossypetin has the potential for use as a chemopreventive agent in oral cancer.

[Clinical observation on the efficacy and safety of dupilumab in the treatment of moderate to severe atopic dermatitis]

To investigate the clinical efficacy and safety of dupilumab in the treatment of moderate to severe atopic dermatitis (AD) in China. A small sample self-controlled study before and after treatment was conducted to retrospective analysis patients with moderate to severe AD treated with dupilumab in the department of dermatology of the First Affiliated Hospital of Chongqing Medical University from July 2020 to March 2022. Dupilumab 600 mg was injected subcutaneously at week 0, and then 300 mg was injected subcutaneously every 2 weeks. The condition was evaluated by SCORAD(severity scoring of atopic dermatitis), NRS(numerical rating scale), DLQI(dermatology life quality index) and POEM(patient-oriented eczema measure). The improvement of SCORAD, NRS, DLQI and POEM was analyzed by paired t test and non-parametric paired Wilcoxon. The results showed that a total of 67 patients with moderate to severe AD received dupilumab treatment, of which 41 patients (the course of treatment was more than 6 weeks) had reduced the severity of skin lesions, improved quality of life and reduced pruritus. A total of 23 patients completed 16 weeks of treatment. At 4, 8, 12 and 16 weeks, SCORAD, NRS, DLQI and POEM decreased compared with the baseline, and the differences were statistically significant. SCORAD (50.13±15.19) at baseline, SCORAD (36.08±11.96)(t=6.049,P<0.001) at week 4,SCORAD (28.04±11.10)(t=10.471,P<0.001) at week 8, SCORAD (22.93±9.72)(t=12.428,P<0.001) at week 12, SCORAD (16.84±7.82)(t=14.609,P<0.001) at week 16, NRS 7(6,8) at baseline, NRS 4(3,5)(Z=-3.861,P<0.001) at week 4, NRS 2(1,4)(Z=-4.088,P<0.001) at week 8, NRS 1(0,2)(Z=-4.206,P<0.001) at week 12, NRS 2(0,2)(Z=-4.222,P<0.001) at week 16, DLQI (13.83±5.71) at baseline, DLQI (8.00±4.02)(t=6.325,P<0.001) at week 4, DLQI (5.61±3.50)(t=8.060,P<0.001) at week 8, DLQI (3.96±1.99)(t=8.717,P<0.001) at week 12, DLQI (2.70±1.89)(t=10.355,P<0.001) at week 16, POEM (18.04±6.41) at baseline, POEM (9.70±4.70)(t=7.031,P<0.001) at week 4, POEM (7.74±3.48)(t=8.806,P<0.001) at week 8, POEM (6.35±3.33)(t=10.474,P<0.001) at week 12, POEM (4.26±2.51)(t=11.996,P<0.001) at week 16. In the 16th week, 100%(23 patients), 91.3%(21 patients), 34.8%(8 patients) and 8.7%(2 patients) of 23 patients reached SCORAD30, SCORAD50, SCORAD70, and SCORAD90 statuses, respectively. There were 82.6%(19 patients), 95.7%(22 patients) and 95.7%(22 patients) of 23 patients with NRS, DLQI and POEM improved by≥4 points compared with baseline. Twelve patients with AD who continued to receive dupilumab after 16 weeks showed further improvement in skin lesions. The adverse events were conjunctivitis and injection site reaction. In conclusion, dupilumab is an effective and safe treatment for moderate and severe AD. However, the longer-term efficacy and safety require further studies involving larger sample sizes and a longer follow-up time.

Urinary essential and toxic metal mixtures, and type 2 diabetes mellitus: Telomere shortening as an intermediary factor?

The joint effect of metal mixtures on telomere function and type 2 diabetes mellitus (T2DM) is unclear. This large-scale cross-sectional study sought to assess the role of telomere length (TL) in the relationship between urinary essential and toxic metal mixtures, and T2DM in 7410 Chinese adults ≥ 60 years of age. Essential (Cr, Cu, Zn, Se) and non-essential metals (V, Al, Sb, Sn, Cd, Pb) in urine samples were quantified, while leukocyte TL was measured from blood samples. Restricted cubic splines regression showed nonlinear relationships between single metal and T2DM, and between TL and T2DM. Bayesian kernel machine regression and quantile-based g-computation showed that the overall status of urinary metals was positively associated with risk of developing T2DM, which was mainly explained by exposure to Pb, Cd, and Sb, excessive Se intake, and high excretion of Zn. Mediation analyses showed that shortened TL mediated 27.9% of the overall positive effect of metal exposure on T2DM, and this mediation was mainly explained by toxic metal exposure and excessive Se intake. Tobacco smoke exposure, extensive cooking at home, and black tea consumption were found to be important contributors of toxic metal exposures. Further studies are needed to explore the recommended Zn dosage for T2DM patients at different stages, which may ameliorate pancreatic senescence and glycemic progression.

Dosimetric Advantages of VMAT TBI Plans: A Direct Comparison to Conventional TBI Plans

PURPOSE/OBJECTIVE(S)

Total body irradiation (TBI) continues to play an integral role in the conditioning of patients undergoing bone marrow transplantation. Historically, conventional TBI (C-TBI) has been delivered based on a clinical plan without CT simulation. However, volumetric modulated arc therapy TBI (V-TBI) is emerging as an alternative method to deliver TBI in a contemporary fashion. We aimed to compare these two methods of TBI delivery.

MATERIALS/METHODS

Patients undergoing treatment with V-TBI were identified. C-TBI plans were created using their existing simulation CT images. Patient thickness was measured on the scan and compensators such as lead sheets to attenuate dose in areas with less separation and lung blocks drawn on digitally reconstructed radiographs (DRR) were added when necessary. A 3D dose distribution was then calculated allowing for the direct comparison between C-TBI and V-TBI on the same patient using the same CT image set. Dosimetric data from each plan including target volume coverage, dose homogeneity, absolute max dose, and dose to lungs were recorded.

RESULTS

V-TBI and C-TBI plans for a total of four patients were preliminarily analyzed. Two patients were prescribed 200 cGy in a single fraction, while the other two were prescribed 1200 cGy in eight fractions. V-TBI resulted in a more favorable dosimetry for all four patients in most evaluated metrics including dose coverage, dose homogeneity, and lung dose (Table 1). V-TBI did result in an increased absolute maximum dose to all four patients compared to c-TBI, but still met the desired constraint of D0.03cc<125%.

CONCLUSION

V-TBI resulted in more favorable dosimetry for all four patients compared to C-TBI. To our knowledge, this is the first direct dosimetric comparison between the two methods. Analysis of 8 more V-TBI cases is currently underway. In the future, we plan to design a prospective study to evaluate the clinical outcomes of patients undergoing V-TBI vs C-TBI.

Dose Coverage Variation Caused by Setup Uncertainties in VMAT-TBI Treatment

PURPOSE/OBJECTIVE(S)

Volumetric Modulated Arc Therapy Total Body Irradiation (VMAT TBI) offers several advantages over conventional TBI techniques, including reduced cost of the treatment room (a normal-sized vault versus a large shielded vault), increased patient comfort during treatment, lung sparing without the need for physical blocks, and a more homogeneous dose distribution. In VMAT-TBI treatment, plans at multiple isocenters are utilized to cover the entire body, and patients are positioned with the aid of image guidance. However, aligning the patient's entire body during setup can be challenging due to its pliability, and the setup time is heavily dependent on the tolerance allowed by the image guidance. Therefore, studying the variation in dose coverage caused by setup uncertainties in VMAT-TBI treatments can help optimize the clinical workflow and determine the optimal tolerance for patient positioning.

MATERIALS/METHODS

New plans were generated to simulate the uncertainties that occur during treatment setup for each patient. These plans were created by shifting the original VMAT TBI plans at the head, chest, abdomen (or pelvis) isocenters by 5mm and 1cm in the left-right (LR), inferior-superior (IS), and anterior-posterior (AP) directions, respectively. Dose DicomRT files were exported, and the dose change due to the shifts was analyzed. The statistical quantification of the percentage of the body that experienced a dose change of over 2%, 5%, and 10% of the prescription due to the shifts from the original plans was calculated for all patients. Histograms were generated, showing the percentage of body getting dose change of 1-2%, 2-3%, 3-5%, 5-7%, 7-10%, 10-15%.

RESULTS

The table below displays the percent volume receiving a dose change of 2%, 5%, and 10% of the prescription for a 5mm shift. Among the shift directions, the dose change is most sensitive in the IS direction, with similar impact observed the in LR and AP directions. Among different sites, the chest experiences the largest dose change, followed by the pelvis. For a 5mm shift in the IS direction, the average percent volume receiving a dose change of 2%, 5%, and 10% in the chest is 9.25%, 2.64%, and 0.27%, respectively. For a 1cm shift, the numbers are 12.23%, 6.75%, and 1.29%. In the pelvis (abdomen), these values are 9.03%, 1.67%, and 0.17% for a 5mm shift and 13.28%, 6.1%, and 0.85% for a 1cm shift. For head plans, the values are 2.72%, 0.9%, and 0.14% for a 5mm shift and 3.77%, 1.66%, and 0.53% for a 1cm shift.

CONCLUSION

Accurate alignment in the chest region is crucial in VMAT TBI treatment. Efforts should be made to minimize shifts over 1cm in the IS direction.

A Randomized Single-Blinded Study Comparing Preoperative with Post-Mastectomy PECS Block for Post-operative Pain Management in Bilateral Mastectomy with Immediate Reconstruction

BACKGROUND

Ultrasound-guided pectoralis muscle blocks (PECS I/II) are well established for postoperative pain control after mastectomy with reconstruction. However, optimal timing is unclear. We conducted a randomized controlled single-blinded single-institution trial comparing outcomes of block performed pre-incision versus post-mastectomy.

METHOD

Patients with breast cancer undergoing bilateral mastectomy with immediate expander/implant reconstruction were randomized to receive ultrasound-guided PECS I/II either pre-incision (PreM, n = 17) or post-mastectomy and before reconstruction (PostM, n = 17). The primary outcome was the average pain score using the Numerical Rating Score during post-anesthesia care unit (PACU) and inpatient stay, with the study powered to detect a difference in mean pain score of 2. Secondary outcomes included mean pain scores on postoperative day (POD) 2, 3, 7, 14, 90, and 180; pain catastrophizing scores; narcotic requirements; PACU/inpatient length of stay; block procedure time; and complications.

RESULT

No significant differences between the two groups were noted in average pain score during PACU (p = 0.57) and 24-h inpatient stay (p = 0.33), in the 2 weeks after surgery at rest (p = 0.90) or during movement (p = 0.30), or at POD 90 and 180 at rest (p = 0.42) or during movement (p = 0.31). Median duration of block procedure (PreM 7 min versus PostM 6 min, p = 0.21) did not differ. Median PACU and inpatient length of stay were the same in each group. Inpatient narcotic requirements were similar, as were length of stay and post-surgical complication rates.

CONCLUSION

Intraoperative ultrasound-guided PECS I/II block administered by surgeons following mastectomy had similar outcomes to preoperative blocks.

TRIAL REGISTRATION

This trial is registered with Clinical Research Information Service (NCT03653988).

Simplified Rapid Enrichment of CTCs and Selective Recognition Prereduction Enable a Homogeneous ICP-MS Liquid Biopsy Strategy of Lung Cancer

The effective enrichment and hypersensitivity analysis of circulating tumor cells (CTCs) in clinical whole blood samples are highly significant for clinical tumor liquid biopsy. In this study, we established an easy operation and affordable CTCs extraction technique while simultaneously performing the homogeneous inductively coupled plasma mass spectrometry (ICP-MS) determination of CTCs in lung cancer clinical samples based on selective recognition reactions and prereduction phenomena. Our strategy allowed for the pretreatment of whole blood samples in less than 45 min after step-by-step centrifugation, which only required lymphocyte separation solution and erythrocyte lysate. Furthermore, a three-stage signal amplification system consisting of catalytic hairpin assembly (CHA), selective recognition for C-Ag+-C structures and Ag+ of copper sulfide nanoparticles (CuS NPs), and prereduction of Hg2+ through ascorbic acid (AA) was constructed by using mucin 1 as the CTCs marker and the aptamer for identification probes. In optimal conditions, the detection limits of ICP-MS were as low as 0.3 ag/mL for mucin 1 and 0.25 cells/mL for A549 cells. This method analyzed CTCs in 58 clinical samples quantitatively, and the results were consistent with clinical CT images and pathological findings. The area under the curve (AUC) value of the receiver operating characteristic (ROC) curve was 0.957, which provided a specificity of 100% and a sensitivity of 91.5% for the assay. Therefore, the simplicity of the extraction method, the accessibility, and the high sensitivity of the assay method make the strategies attractive for clinical CTCs testing applications.

Ultrafast Subcellular Biolabeling and Bioresponsive Real-Time Monitoring for Targeting Cancer Theranostics

Cell heterogeneity poses a formidable challenge for tumor theranostics, requiring high-resolution strategies for intercellular bioanalysis between single cells. Nanoelectrode-based electrochemical analysis has attracted much attention due to its advantages of label-free characteristics, relatively low cost, and ultra-high resolution for single-cell analysis. Here, we have designed and developed a subcellular biolabeling and bioresponsive real-time monitoring strategy for precise bioimaging-guided cancer diagnosis and theranostics. Our observations revealed the apparent intracellular migration of biosynthetic Au nanoclusters (Au NCs) at different subcellular locations, i.e., from the mitochondria to the mitochondrion-free region in the cytoplasm, which may be helpful for controlling over the biosynthesis of Au NCs. Considering the precise biolabeling advantage of the intracellular biosynthetic Au NCs for biomedical imaging of cancers, it is important to realize the biosynthetic Au NC-enabled precise control in real-time theranostics of cancer cells. Therefore, this work raises the possibility to achieve subcellular monitoring of H2O2 for targeting cancer theranostics, thereby providing a new way to explore the underlying mechanism and imaging-guided tumor theranostics.

Prognostic Value of Necroptosis-Related Genes Signature in Oral Squamous Cell Carcinoma

The dual role of necroptosis in inhibiting and promoting tumor development has gradually received much attention because of its essential significance for targeted treatment. Accordingly, this study aims to explore the relationship between necroptosis and oral squamous cell carcinoma (OSCC), and search for novel prognostic factors for OSCC. RNA-seq data and clinical information were downloaded from TCGA and GTEx databases. The prognostic signature of necroptosis-related genes (NRGs) was constructed by univariate Cox regression analysis and the LASSO Cox regression model. Moreover, survival analyses, ROC curves, and nomograms were adopted to further analyze. GO and KEGG analyses and immune infiltration analyses were used for function enrichment and immune feature research in turn. The NRG prognostic signature expression was higher in OSCC tissues than in normal tissues, and the overall survival (OS) rate of the high-expression group was much lower. HPRT1 was proved to be an independent prognostic factor in OSCC. Furthermore, the function enrichment analyses revealed that NRGs were involved in necroptosis, apoptosis, inflammation, and immune reaction. The expression of NRGs was related to immunosuppression in OSCC. Furthermore, the knockdown of HPRT1 could suppress the proliferation and migration of OSCC. In conclusion, the high expression of NRG prognostic signature is associated with poor prognosis in OSCC, and HPRT1 can serve as a novel independent prognostic factor for OSCC.

Real-World Presentation and Prognostic Effect of Allogeneic Blood Transfusion during the Intensive Induction Phase in Pediatric Acute Lymphoblastic Leukemia

Purpose: To determine associations between allogeneic blood transfusion (ABT) during the intensive induction phase of therapy and prognostic effect in a real-world cohort of pediatric patients with acute lymphoblastic leukemia (ALL). Methods: A total of 749 pediatric patients who were diagnosed with ALL were enrolled in this study by using a single-center retrospective cohort study method from February 2008 to May 2022. Results: Among the ABT patients, 711 (94.9%) children were transfused with packed red blood cells (PRBCs), 434 (57.9%) with single-donor platelets (SDPs), and 196 (26.2%) with fresh frozen plasma (FFP). Our multivariate analysis demonstrated that FFP transfusion was the unique independent factor that affected both relapse-free survival (RFS) and overall survival (OS). The transfusion of FFP was significantly associated with higher age (p < 0.001), being more likely to receive SCCLG-ALL-2016 protocol (p < 0.001), higher proportion of more than 25 blood product transfusions, more PRBC transfusion (p < 0.001), and higher D33-MRD-positive rates (p = 0.013). Generalized additive models and threshold effect analysis using piece-wise linear regression were applied to identify the cut-off value of 25 mL/kg for average FFP transfusion. K-M survival analysis further confirmed that average FFP transfusion > 25 mL/kg was an independent adverse indicator of inferior outcome in terms of RFS (p = 0.027) and OS (p = 0.033). Conclusions: In blood products, only FFP supplement is closely related to the prognosis of childhood ALL. During the intensive induction phase, the indications of FFP transfusion should be strictly grasped, and the total amount of FFP should be controlled and kept below 25 mL/kg.