MicroRNA-188-5p inhibits hepatocellular carcinoma proliferation and migration by targeting forkhead box N2

BACKGROUND

This study aimed to identify the biological functions, expression modes, and possible mechanisms underlying the relationship between metastatic human hepatocellular carcinoma (HCC) and MicroRNA-188-5p (miR-188) dysregulation using cell lines.

METHODS

A decrease in miR-188 was detected in low and high metastatic HCC cells compared to that in normal hepatic cells and non-invasive cell lines. Gain- and loss-of-function experiments were performed in vitro to investigate the role of miR-188 in cancer cell (Hep3B, HepG2, HLF, and LM3) proliferation and migration.

RESULTS

miR-188 mimic transfection inhibited the proliferation of metastatic HLF and LM3 cells but not non-invasive HepG2 and Hep3B cells; nonetheless, miR-188 suppression promoted the growth of HLF and LM3 cells. miR-188 upregulation inhibited the migratory rate and invasive capacity of HLF and LM3, rather than HepG2 and Hep3B cells, whereas transfection of a miR-188 inhibitor in HLF and LM3 cells had the opposite effects. Dual-luciferase reporter assays and bioinformatics prediction confirmed that miR-188 could directly target forkhead box N2 (FOXN2) in HLF and LM3 cells. Transfection of miR-188 mimics reduced FOXN2 levels, whereas miR-188 inhibition resulted in the opposite result, in HLF and LM3 cells. Overexpression of FOXN2 in HLF and LM3 cells abrogated miR-188 mimic-induced downregulation of proliferation, migration, and invasion. In addition, we found that miR-188 upregulation impaired tumor growth in vivo.

CONCLUSIONS

In summary, this study showed thatmiR-188 inhibits the proliferation and migration of metastatic HCC cells by targeting FOXN2.

Alkaline phosphatase combined with γ-glutamyl transferase is an independent predictor of prognosis of hepatocellular carcinoma patients receiving programmed death-1 inhibitors

Background

Immunotherapy plays an increasingly critical role in the systemic treatment of HCC. This current study aimed to establish a novel prognostic predictor of Programmed death 1 (PD-1) inhibitor therapy in hepatocellular carcinoma (HCC) independent of Child-Pugh grade.

Methods

Our study screened patients with HCC who received PD-1 inhibitors at Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2018 to December 2020. ALG grade was determined by the patient's serum ALP and GGT levels before the initiation of PD-1 inhibitors. The endpoints of our study were overall survival (OS) and progression free survival (PFS). Follow-up ended at May 31, 2022.

Results

Eighty- five patients (77 with Child-Pugh grade A, 8 with Child-Pugh grade B at baseline) were enrolled according to the inclusion criteria. Patients with Child-Pugh grade A achieved longer PFS and OS than those with Child-Pugh grade B. Patients with ALG grade 3 at baseline showed worse tumor response and poorer survival, and ALG grade could stratify patients with Child-Pugh grade A into subgroups with significantly different prognosis.

Conclusions

ALG grade, combining ALP and GGT, is a novel and readily available prognostic marker and the predictive effect of ALG grade on patient prognosis is independent of Child-Pugh grade.

Postoperative outcomes and recurrence patterns of intermediate-stage hepatocellular carcinoma dictated by the sum of tumor size and number

BACKGROUND

The selection criteria for Barcelona Clinic Liver Cancer (BCLC) intermediate-stage hepatocellular carcinoma (HCC) patients who would truly benefit from liver resection (LR) remain undefined.

AIM

To identify BCLC-B HCC patients more suitable for LR.

METHODS

We included patients undergoing curative LR for BCLC stage A or B multi-nodular HCC (MNHCC) and stratified BCLC-B patients by the sum of tumor size and number (N + S). Overall survival (OS), recurrence-free survival (RFS), recur-rence-to-death survival (RTDS), recurrence patterns, and treatments after recurrence in BCLC-B patients in each subgroup were compared with those in BCLC-A patients.

RESULTS

In total, 143 patients who underwent curative LR for MNHCC with BCLC-A (n = 25) or BCLC-B (n = 118) were retrospectively analyzed. According to the N + S, patients with BCLC-B HCC were divided into two subgroups: BCLC-B1 (N + S ≤ 10, n = 83) and BCLC-B2 (N + S > 10, n = 35). Compared with BCLC-B2 patients, those with BCLC-B1 had a better OS (5-year OS rate: 67.4% vs 33.6%; P < 0.001), which was comparable to that in BCLC-A patients (5-year OS rate: 67.4% vs 74.1%; P = 0.250), and a better RFS (median RFS: 19 mo vs 7 mo; P < 0.001), which was worse than that in BCLC-A patients (median RFS: 19 mo vs 48 mo; P = 0.022). Further analysis of patients who developed recurrence showed that both BCLC-B1 and BCLC-A patients had better RTDS (median RTDS: Not reached vs 49 mo; P = 0.599), while the RTDS in BCLC-B2 patients was worse (median RTDS: 16 mo vs not reached, P < 0.001; 16 mo vs 49 mo, P = 0.042). The recurrence patterns were similar between BCLC-B1 and BCLC-A patients, but BCLC-B2 patients had a shorter recurrence time and a higher proportion of patients had recurrence with macrovascular invasion and/or extrahepatic metastasis, both of which were independent risk factors for RTDS.

CONCLUSION

BCLC-B HCC patients undergoing hepatectomy with N + S ≤ 10 had mild recurrence patterns and excellent OS similar to those in BCLC-A MNHCC patients, and LR should be considered in these patients.

Exploring synthetic lethal network for the precision treatment of clear cell renal cell carcinoma

The emerging targeted therapies have revolutionized the treatment of advanced clear cell renal cell carcinoma (ccRCC) over the past 15 years. Nevertheless, lack of personalized treatment limits the development of effective clinical guidelines and improvement of patient prognosis. In this study, large-scale genomic profiles from ccRCC cohorts were explored for integrative analysis. A credible method was developed to identify synthetic lethality (SL) pairs and a list of 72 candidate pairs was determined, which might be utilized to selectively eliminate tumors with genetic aberrations using SL partners of specific mutations. Further analysis identified BRD4 and PRKDC as novel medical targets for patients with BAP1 mutations. After mapping these target genes to the comprehensive drug datasets, two agents (BI-2536 and PI-103) were found to have considerable therapeutic potentials in the BAP1 mutant tumors. Overall, our findings provided insight into the overview of ccRCC mutation patterns and offered novel opportunities for improving individualized cancer treatment.

Hypothyroidism is a predictive factor of superior antitumour efficacy of programmed death 1 inhibitors in hepatocellular carcinoma

Programmed death 1 (PD-1) inhibitors are widely used for treatment of hepatocellular carcinoma (HCC). Hypothyroidism is commonly associated with this therapy, although the mechanism underlying this complication and effects on patient prognosis remain unclear. We retrospectively analysed the data of patients with HCC who received anti-PD-1 therapy at Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology between January 2018 and May 2020. Based on thyroid function evaluation, patients were categorised into hypothyroidism group and nonhypothyroidism group. Follow-up was completed on February 28, 2021. The primary endpoint of our study was progression free survival (PFS). The study included 74 patients, and the disease control rate was higher in hypothyroidism group (62.7%, 27/43) than in nonhypothyroidism group (36.4%, 11/31) (P = .020). The PFS was longer in hypothyroidism group (7.44 months) than in nonhypothyroidism group (5.68 months) (P = .006). Additionally, the PFS of patients with hypothyroidism before immunotherapy (6.27 months) was also longer than that in nonhypothyroidism group (5.68 months), although the difference was statistically nonsignificant (P = .527). Cox regression analysis showed that the hazard ratios of hypothyroidism, Child-Pugh grade B at initial admission and serum gamma-glutamyl transferase levels >71 U/L before immunotherapy were 0.404 (95% confidence interval [CI]: 0.207-0.791, P = .008), 2.753 (95%CI: 1.127-6.455, P = .026) and 2.469 (95%CI: 1.155-5.277, P = .020), respectively. Hypothyroidism was associated with prognosis in patients with HCC treated with PD-1 inhibitors, and prognosis was more favourable in patients with hypothyroidism than in those without hypothyroidism. Hypothyroidism and the Child-Pugh grade at initial admission were independently associated with patient prognosis.

A novel approach for monitoring TGF-β signaling in vivo in colon cancer

The TGF-β receptor kinase inhibitors (TRKI) have been reported to inhibit tumorigenicity in colon cancer. However, there is no direct evidence showing that these inhibitors function through inhibiting the TGF-β- mediated tumor-promoting effects in vivo. We established a TGF-β inducible reporter system by inserting a luciferase reporter gene to the vector downstream of TGF-β-inducible promoter elements, and transfected it into colon cancer cell lines. TRKIs SB431542 and LY2109761 were used to treat TGF-β inducible cells in vitro and in vivo. The luciferase activity was induced 5.24-fold by TGF-β in CT26 inducible cells, while it was marginally changed in MC38 inducible cells lacking Smad4 expression. Temporary treatment of mice with SB431542 inhibited the TGF-β pathway and TGF-β induced bioluminescence activity in vivo. Long-term treatment with LY2109761 inhibited tumorigenicity and liver metastasis in vivo in concomitant with reduced luciferase activity in the tumor. In this study, we established a model to monitor the TGF-β pathway in vivo and to compare the antitumor effects of TRKIs. Based on this novel experimental tool, we provided direct evidences that LY2109761 inhibits tumorigenicity and liver metastasis by blocking the pro-oncogenic functions of TGF-β in vivo.

Preoperative circulating tumor cells to predict microvascular invasion and dynamical detection indicate the prognosis of hepatocellular carcinoma

Background

This study explored the diagnostic power of preoperative circulating tumor cells (CTCs) for the presence of microvascular invasion (MVI) and the relationship between dynamic changes in postoperative CTCs and prognosis.

Methods

A total of 137 patients were recruited for the study. Preoperative blood samples were collected from all patients to detect CTCs. The time points for blood collection were before the operation, during the operation, and at 1 week, 1 month, 2 months, 3 months, 6 months, and 1 year after surgery. The predictive power of CTC count for the presence of MVI was analyzed by receiver operating characteristic (ROC) curve analysis. According to recurrence status, 137 patients were divided into three groups: no recurrence, early recurrence, and non-early recurrence groups.

Results

A threshold CTC count of 5 showed the most significant power for predicting the existence of MVI. In multivariate analysis, the parameters of preoperative CTC count, alpha-fetoprotein (AFP) and tumor diameter were independent predictors of MVI (P <  0.05). A CTC count greater than or equal to 5 had better predictive value than AFP > 400 μg/L and tumor diameter > 5 cm. The number of intraoperative CTCs in the three groups did not increase compared to that before surgery (P > 0.05). The number of CTCs in the nonrecurrence group and the non-early recurrence group decreased significantly 1 week after surgery compared with the intraoperative values (P <  0.001), although there was no significant difference in the early recurrence group (P = 0.95). Patients with mean CTC count ≥5 had significantly worse long-term outcomes than those with mean CTC count < 5 (P <  0.001).

Conclusion

The preoperative CTC counts in the peripheral blood of patients with HCC are closely correlated with MVI. The intraoperative manipulation of the lesion by the surgeon does not increase the number of CTCs in peripheral blood. Surgical removal of the tumor decreases the number of CTCs. The persistence of CTCs at a high level (≥ 5) after surgery suggests a risk of early recurrence.

Clinical trial registration

Registration number is ChiCTR-OOC-16010183, date of registration is 2016-12-18.

From chaos to a new norm: The Birmingham experience of restructuring the largest plastics department in the UK in response to the COVID-19 pandemic

The coronavirus disease 2019 (COVID-19) pandemic presented unprecedented challenges for healthcare systems worldwide. The Queen Elizabeth Hospital, Birmingham, has one of the largest burns, hands and plastics department in the UK, totalling 83 doctors. Our response to the COVID-19 response was uniquely far reaching, with our department being given responsibility of an entire 36 bed medical COVID-19 ward in addition to our commitment to specialty-specific work, and saw half of our work force re-deployed to Intensive Treatment Unit (ITU). Our aim was to exploit the high calibre of doctors found in plastic surgery, and to demonstrate, we were able to support the COVID-19 effort beyond our normal scope of practice.

In order to achieve this aim, the department underwent significant structural and leadership changes. Factors considered included: rota and shift pattern changes to implement depth and resilience to sudden fluctuations in staffing levels; a preparatory phase for focussed upskilling and relevant training packages to be delivered; managing the COVID-19 ward cover and ITU deployment; adjustments to our front of house and elective specialty-specific service, including developing alternative and streamlined patient pathways; mitigating the effects on plastic surgical training during the pandemic; the importance of communications for patient care and physician wellbeing; and leadership techniques and styles we considered important.

By sharing our experience during this pandemic, we hope to reflect on and share lessons learned, as well as to demonstrate that it is possible to rapidly mobilise and retrain plastic surgeons at all levels to contribute safely and productively beyond a specialty-specific scope of care.

Evidence of a Resonant Structure in the e^{+}e^{-}→π^{+}D^{0}D^{*-} Cross Section between 4.05 and 4.60 GeV

The cross section of the process e^{+}e^{-}→π^{+}D^{0}D^{*-} for center-of-mass energies from 4.05 to 4.60 GeV is measured precisely using data samples collected with the BESIII detector operating at the BEPCII storage ring. Two enhancements are clearly visible in the cross section around 4.23 and 4.40 GeV. Using several models to describe the dressed cross section yields stable parameters for the first enhancement, which has a mass of 4228.6±4.1±6.3  MeV/c^{2} and a width of 77.0±6.8±6.3  MeV, where the first uncertainties are statistical and the second ones are systematic. Our resonant mass is consistent with previous observations of the Y(4220) state and the theoretical prediction of a DD[over ¯]_{1}(2420) molecule. This result is the first observation of Y(4220) associated with an open-charm final state. Fits with three resonance functions with additional Y(4260), Y(4320), Y(4360), ψ(4415), or a new resonance do not show significant contributions from either of these resonances. The second enhancement is not from a single known resonance. It could contain contributions from ψ(4415) and other resonances, and a detailed amplitude analysis is required to better understand this enhancement.

Measurement of the Absolute Branching Fraction of the Inclusive Semileptonic Λ_{c}^{+} Decay

Using a data sample of e^{+}e^{-} collisions corresponding to an integrated luminosity of 567  pb^{-1} collected at a center-of-mass energy of sqrt[s]=4.6  GeV with the BESIII detector, we measure the absolute branching fraction of the inclusive semileptonic Λ_{c}^{+} decay with a double-tag method. We obtain B(Λ_{c}^{+}→Xe^{+}ν_{e})=(3.95±0.34±0.09)%, where the first uncertainty is statistical and the second systematic. Using the known Λ_{c}^{+} lifetime and the charge-averaged semileptonic decay width of nonstrange charmed mesons (D^{0} and D^{+}), we obtain the ratio of the inclusive semileptonic decay widths Γ(Λ_{c}^{+}→Xe^{+}ν_{e})/Γ[over ¯](D→Xe^{+}ν_{e})=1.26±0.12.

Small hepatocellular carcinoma suppressed by chemotherapy for synchronous gastric carcinoma after laparoscopy-assisted radical distal gastrectomy: A case report and literature review

RATIONALE

Synchronous gastric carcinoma and hepatocellular carcinoma (HCC) is rare. It is hard to distinguish synchronous HCC from metastatic liver cancer in this condition. The treatment and prognosis is quite different for synchronous HCC of gastric carcinoma and liver metastasis of gastric carcinoma.

PATIENT CONCERNS

A 68-year-old man with a chief complaint of epigastric pain for 1 year, accompanied by reflux and belching. The patient was diagnosed with gastric carcinoma (cT4NxM0) and laparoscopy-assisted radical distal gastrectomy was performed. This was followed by chemotherapy of FOLFOX regimen. However, a liver nodule growth was observed after postoperative systemic treatment.

DIAGNOSIS

The initial diagnosis was liver metastasis of gastric carcinoma. However after hepatectomy of segment VI and VII as well as thrombectomy of right hepatic vein, histology revealed intermediate to poor differentiated HCC. Hence this case was diagnosed as synchronous gastric carcinoma and HCC.

INTERVENTIONS

A preventive transcatheter arterial chemoembolization (TACE) was conducted at 4 weeks after hepatectomy. Another FOLFOX regimen was suggested, but was refused by the patient.

OUTCOMES

The patient survived without tumor recurrence for 9 months after the second surgery.

LESSONS

Synchronous HCC should be routinely distinguished from gastric carcinoma liver metastasis, especially for patients with hepatitis B virus (HBV) infection. The FOLFOX4 regimen for treating gastric carcinoma liver metastasis may have inhibited the progression of primary HCC in this case. This patient with HCC benefited from liver resection, inspite of hepatic vein tumor thrombosis.

Measurement of the Branching Fraction For the Semileptonic Decay D^{0(+)}→π^{-(0)}μ^{+}ν_{μ} and Test of Lepton Flavor Universality

Using a data sample corresponding to an integrated luminosity of 2.93  fb^{-1} taken at a center-of-mass energy of 3.773 GeV with the BESIII detector operated at the BEPCII collider, we perform an analysis of the semileptonic decays D^{0(+)}→π^{-(0)}μ^{+}ν_{μ}. The branching fractions of D^{0}→π^{-}μ^{+}ν_{μ} and D^{+}→π^{0}μ^{+}ν_{μ} are measured to be (0.272±0.008_{stat}±0.006_{syst})% and (0.350±0.011_{stat}±0.010_{syst})%, respectively, where the former is of much improved precision compared to previous results and the latter is determined for the first time. Using these results along with previous BESIII measurements of D^{0(+)}→π^{-(0)}e^{+}ν_{e}, we calculate the branching fraction ratios to be R^{0}≡B_{D^{0}→π^{-}μ^{+}ν_{μ}}/B_{D^{0}→π^{-}e^{+}ν_{e}}=0.922±0.030_{stat}±0.022_{syst} and R^{+}≡B_{D^{+}→π^{0}μ^{+}ν_{μ}}/B_{D^{+}→π^{0}e^{+}ν_{e}}=0.964±0.037_{stat}±0.026_{syst}, which are compatible with the theoretical expectation of lepton flavor universality within 1.7σ and 0.5σ, respectively. We also examine the branching fraction ratios in different four-momentum transfer square regions, and find no significant deviations from the standard model predictions.

Measurement of the Absolute Branching Fraction of the Inclusive Decay Λ_{c}^{+}→Λ+X

Based on an e^{+}e^{-} collision data sample corresponding to an integrated luminosity of 567  pb^{-1} taken at the center-of-mass energy of sqrt[s]=4.6  GeV with the BESIII detector, we measure the absolute branching fraction of the inclusive decay Λ_{c}^{+}→Λ+X to be B(Λ_{c}^{+}→Λ+X)=(38.2_{-2.2}^{+2.8}±0.9)% using the double-tag method, where X refers to any possible final state particles. In addition, we search for direct CP violation in the charge asymmetry of this inclusive decay for the first time, and obtain A_{CP}≡[B(Λ_{c}^{+}→Λ+X)-B(Λ[over ¯]_{c}^{-}→Λ[over ¯]+X)]/[B(Λ_{c}^{+}→Λ+X)+B(Λ[over ¯]_{c}^{-}→Λ[over ¯]+X)]=(2.1_{-6.6}^{+7.0}±1.6)%, a statistically limited result with no evidence of CP violation.

Observation of a_{0}^{0}(980)-f_{0}(980) Mixing

We report the first observation of a_{0}^{0}(980)-f_{0}(980) mixing in the decays of J/ψ→ϕf_{0}(980)→ϕa_{0}^{0}(980)→ϕηπ^{0} and χ_{c1}→a_{0}^{0}(980)π^{0}→f_{0}(980)π^{0}→π^{+}π^{-}π^{0}, using data samples of 1.31×10^{9}  J/ψ events and 4.48×10^{8}  ψ(3686) events accumulated with the BESIII detector. The signals of f_{0}(980)→a_{0}^{0}(980) and a_{0}^{0}(980)→f_{0}(980) mixing are observed at levels of statistical significance of 7.4σ and 5.5σ, respectively. The corresponding branching fractions and mixing intensities are measured and the constraint regions on the coupling constants, g_{a_{0}K^{+}K^{-}} and g_{f_{0}K^{+}K^{-}}, are estimated. The results improve the understanding of the nature of a_{0}^{0}(980) and f_{0}(980).

Precision Study of η^{'}→γπ^{+}π^{-} Decay Dynamics

Using a low background data sample of 9.7×10^{5}  J/ψ→γη^{'}, η^{'}→γπ^{+}π^{-} events, which are 2 orders of magnitude larger than those from the previous experiments, recorded with the BESIII detector at BEPCII, the decay dynamics of η^{'}→γπ^{+}π^{-} are studied with both model-dependent and model-independent approaches. The contributions of ω and the ρ(770)-ω interference are observed for the first time in the decays η^{'}→γπ^{+}π^{-} in both approaches. Additionally, a contribution from the box anomaly or the ρ(1450) resonance is required in the model-dependent approach, while the process specific part of the decay amplitude is determined in the model-independent approach.

Determination of the Spin and Parity of the Z_{c}(3900)

The spin and parity of the Z_{c}(3900)^{±} state are determined to be J^{P}=1^{+} with a statistical significance larger than 7σ over other quantum numbers in a partial wave analysis of the process e^{+}e^{-}→π^{+}π^{-}J/ψ. We use a data sample of 1.92  fb^{-1} accumulated at sqrt[s]=4.23 and 4.26 GeV with the BESIII experiment. When parametrizing the Z_{c}(3900)^{±} with a Flatté-like formula, we determine its pole mass M_{pole}=(3881.2±4.2_{stat}±52.7_{syst})  MeV/c^{2} and pole width Γ_{pole}=(51.8±4.6_{stat}±36.0_{syst})  MeV. We also measure cross sections for the process e^{+}e^{-}→Z_{c}(3900)^{+}π^{-}+c.c.→J/ψπ^{+}π^{-} and determine an upper limit at the 90% confidence level for the process e^{+}e^{-}→Z_{c}(4020)^{+}π^{-}+c.c.→J/ψπ^{+}π^{-}.

Observation of Λ_{c}^{+}→nK_{S}^{0}π^{+}

We report the first direct measurement of decays of the Λ_{c}^{+} baryon involving the neutron. The analysis is performed using 567  pb^{-1} of e^{+}e^{-} collision data collected at sqrt[s]=4.599  GeV with the BESIII detector at the BEPCII collider. We observe the decay Λ_{c}^{+}→nK_{S}^{0}π^{+} and measure the absolute branching fraction to be B(Λ_{c}^{+}→nK_{S}^{0}π^{+})=[1.82±0.23(stat)±0.11(syst)]%. A comparison to B[Λ_{c}^{+}→p(K[over ¯]π)^{0}] provides an important test of isospin symmetry and final state interactions.

Precise Measurement of the e^{+}e^{-}→π^{+}π^{-}J/ψ Cross Section at Center-of-Mass Energies from 3.77 to 4.60 GeV

The cross section for the process e^{+}e^{-}→π^{+}π^{-}J/ψ is measured precisely at center-of-mass energies from 3.77 to 4.60 GeV using 9  fb^{-1} of data collected with the BESIII detector operating at the BEPCII storage ring. Two resonant structures are observed in a fit to the cross section. The first resonance has a mass of (4222.0±3.1±1.4)  MeV/c^{2} and a width of (44.1±4.3±2.0)  MeV, while the second one has a mass of (4320.0±10.4±7.0)  MeV/c^{2} and a width of (101.4_{-19.7}^{+25.3}±10.2)  MeV, where the first errors are statistical and second ones are systematic. The first resonance agrees with the Y(4260) resonance reported by previous experiments. The precision of its resonant parameters is improved significantly. The second resonance is observed in e^{+}e^{-}→π^{+}π^{-}J/ψ for the first time. The statistical significance of this resonance is estimated to be larger than 7.6σ. The mass and width of the second resonance agree with the Y(4360) resonance reported by the BABAR and Belle experiments within errors. Finally, the Y(4008) resonance previously observed by the Belle experiment is not confirmed in the description of the BESIII data.

Evidence of Two Resonant Structures in e^{+}e^{-}→π^{+}π^{-}h_{c}

The cross sections of e^{+}e^{-}→π^{+}π^{-}h_{c} at center-of-mass energies from 3.896 to 4.600 GeV are measured using data samples collected with the BESIII detector operating at the Beijing Electron Positron Collider. The cross sections are found to be of the same order of magnitude as those of e^{+}e^{-}→π^{+}π^{-}J/ψ and e^{+}e^{-}→π^{+}π^{-}ψ(2S), but the line shape is inconsistent with the Y states observed in the latter two modes. Two structures are observed in the e^{+}e^{-}→π^{+}π^{-}h_{c} cross sections around 4.22 and 4.39  GeV/c^{2}, which we call Y(4220) and Y(4390), respectively. A fit with a coherent sum of two Breit-Wigner functions results in a mass of (4218.4_{-4.5}^{+5.5}±0.9)  MeV/c^{2} and a width of (66.0_{-8.3}^{+12.3}±0.4)  MeV for the Y(4220), and a mass of (4391.5_{-6.8}^{+6.3}±1.0)  MeV/c^{2} and a width of (139.5_{-20.6}^{+16.2}±0.6)  MeV for the Y(4390), where the first uncertainties are statistical and the second ones systematic. The statistical significance of Y(4220) and Y(4390) is 10σ over one structure assumption.

Amplitude Analysis of the Decays η^{'}→π^{+}π^{-}π^{0} and η^{'}→π^{0}π^{0}π^{0}

Based on a sample of 1.31×10^{9}  J/ψ events collected with the BESIII detector, an amplitude analysis of the isospin-violating decays η^{'}→π^{+}π^{-}π^{0} and η^{'}→π^{0}π^{0}π^{0} is performed. A significant P-wave contribution from η^{'}→ρ^{±}π^{∓} is observed for the first time in η^{'}→π^{+}π^{-}π^{0}. The branching fraction is determined to be B(η^{'}→ρ^{±}π^{∓})=(7.44±0.60±1.26±1.84)×10^{-4}, where the first uncertainty is statistical, the second systematic, and the third model dependent. In addition to the nonresonant S-wave component, there is a significant σ meson component. The branching fractions of the combined S-wave components are determined to be B(η^{'}→π^{+}π^{-}π^{0})_{S}=(37.63±0.77±2.22±4.48)×10^{-4} and B(η^{'}→π^{0}π^{0}π^{0})=(35.22±0.82±2.54)×10^{-4}, respectively. The latter one is consistent with previous BESIII measurements.

Measurement of Singly Cabibbo Suppressed Decays Λ_{c}^{+}→pπ^{+}π^{-} and Λ_{c}^{+}→pK^{+}K^{-}

Using 567  pb^{-1} of data collected with the BESIII detector at a center-of-mass energy of sqrt[s]=4.599  GeV, near the Λ_{c}^{+}Λ[over ¯]_{c}^{-} threshold, we study the singly Cabibbo-suppressed decays Λ_{c}^{+}→pπ^{+}π^{-} and Λ_{c}^{+}→pK^{+}K^{-}. By normalizing with respect to the Cabibbo-favored decay Λ_{c}^{+}→pK^{-}π^{+}, we obtain ratios of branching fractions: [B(Λ_{c}^{+}→pπ^{+}π^{-})/B(Λ_{c}^{+}→pK^{-}π^{+})]=(6.70±0.48±0.25)%, [B(Λ_{c}^{+}→pϕ)/B(Λ_{c}^{+}→pK^{-}π^{+})]=(1.81±0.33±0.13)%, and [B(Λ_{c}^{+}→pK^{+}K_{non-ϕ}^{-})/B(Λ_{c}^{+}→pK^{-}π^{+})]=(9.36±2.22±0.71)×10^{-3}, where the uncertainties are statistical and systematic, respectively. The absolute branching fractions are also presented. Among these measurements, the decay Λ_{c}^{+}→pπ^{+}π^{-} is observed for the first time, and the precision of the branching fraction for Λ_{c}^{+}→pK^{+}K_{non-ϕ}^{-} and Λ_{c}^{+}→pϕ is significantly improved.

Identification of Natural Infections in Sheep/Goats with HoBi-like Pestiviruses in China

The natural infections of HoBi-like pestiviruses in cattle have been reported in South America, Europe and Asia. In China, although the detections of HoBi-like pestivirus have been reported, the epidemiological investigation was limited. From January 2014 to October 2015, several flocks of sheep/goats in Henan province in central China suffered respiratory diseases which were recovered slowly after antibiotics treatment. To test whether it is the HoBi-like pestivirus caused this symptom, 49 serum samples and 22 nasal swabs were then collected for analysis by serology and RT-PCR. Serological result revealed that prevalence of pestivirus in small ruminants was 12.2% (6/49) in central China. Sequence analysis of partial 5'-UTR nucleotides of pestivirus-positive samples suggested that HoBi-like pestivirus might have circulated in sheep/goats of China for a period and have evolved into new genotype clusters. It is apparent that the study provides the molecular evidence of natural infections in goat/sheep species with HoBi-like pestiviruses in China.

Observation of an Anomalous Line Shape of the η^{'}π^{+}π^{-} Mass Spectrum near the pp[over ¯] Mass Threshold in J/ψ→γη^{'}π^{+}π^{-}

Using 1.09×10^{9} J/ψ events collected by the BESIII experiment in 2012, we study the J/ψ→γη^{'}π^{+}π^{-} process and observe a significant abrupt change in the slope of the η^{'}π^{+}π^{-} invariant mass distribution at the proton-antiproton (pp[over ¯]) mass threshold. We use two models to characterize the η^{'}π^{+}π^{-} line shape around 1.85  GeV/c^{2}: one that explicitly incorporates the opening of a decay threshold in the mass spectrum (Flatté formula), and another that is the coherent sum of two resonant amplitudes. Both fits show almost equally good agreement with data, and suggest the existence of either a broad state around 1.85  GeV/c^{2} with strong couplings to the pp[over ¯] final states or a narrow state just below the pp[over ¯] mass threshold. Although we cannot distinguish between the fits, either one supports the existence of a pp[over ¯] moleculelike state or bound state with greater than 7σ significance.

Observation of h_{c} Radiative Decay h_{c}→γη^{'} and Evidence for h_{c}→γη

A search for radiative decays of the P-wave spin singlet charmonium resonance h_{c} is performed based on 4.48×10^{8} ψ^{'} events collected with the BESIII detector operating at the BEPCII storage ring. Events of the reaction channels h_{c}→γη^{'} and γη are observed with a statistical significance of 8.4σ and 4.0σ, respectively, for the first time. The branching fractions of h_{c}→γη^{'} and h_{c}→γη are measured to be B(h_{c}→γη^{'})=(1.52±0.27±0.29)×10^{-3} and B(h_{c}→γη)=(4.7±1.5±1.4)×10^{-4}, respectively, where the first errors are statistical and the second are systematic uncertainties.

Observation of the Singly Cabibbo-Suppressed Decay D^{+}→ωπ^{+} and Evidence for D^{0}→ωπ^{0}

Based on 2.93  fb^{-1} e^{+}e^{-} collision data taken at center-of-mass energy of 3.773 GeV by the BESIII detector, we report searches for the singly Cabibbo-suppressed decays D^{+}→ωπ^{+} and D^{0}→ωπ^{0}. A double tag technique is used to measure the absolute branching fractions B(D^{+}→ωπ^{+})=(2.79±0.57±0.16)×10^{-4} and B(D^{0}→ωπ^{0})=(1.17±0.34±0.07)×10^{-4}, with statistical significances of 5.5σ and 4.1σ, where the first and second uncertainties are statistical and systematic, respectively.

Measurements of Absolute Hadronic Branching Fractions of the Λ_{c}^{+} Baryon

We report the first measurement of absolute hadronic branching fractions of Λ_{c}^{+} baryon at the Λ_{c}^{+}Λ[over ¯]_{c}^{-} production threshold, in the 30 years since the Λ_{c}^{+} discovery. In total, 12 Cabibbo-favored Λ_{c}^{+} hadronic decay modes are analyzed with a double-tag technique, based on a sample of 567  pb^{-1} of e^{+}e^{-} collisions at sqrt[s]=4.599  GeV recorded with the BESIII detector. A global least-squares fitter is utilized to improve the measured precision. Among the measurements for twelve Λ_{c}^{+} decay modes, the branching fraction for Λ_{c}^{+}→pK^{-}π^{+} is determined to be (5.84±0.27±0.23)%, where the first uncertainty is statistical and the second is systematic. In addition, the measurements of the branching fractions of the other 11 Cabibbo-favored hadronic decay modes are significantly improved.

Measurement of Azimuthal Asymmetries in Inclusive Charged Dipion Production in e^{+}e^{-} Annihilations at sqrt[s]=3.65 GeV

We present a measurement of the azimuthal asymmetries of two charged pions in the inclusive process e^{+}e^{-}→ππX, based on a data set of 62  pb^{-1} at the center-of-mass energy of 3.65 GeV collected with the BESIII detector. These asymmetries can be attributed to the Collins fragmentation function. We observe a nonzero asymmetry, which increases with increasing pion momentum. As our energy scale is close to that of the existing semi-inclusive deep inelastic scattering experimental data, the measured asymmetries are important inputs for the global analysis of extracting the quark transversity distribution inside the nucleon and are valuable to explore the energy evolution of the spin-dependent fragmentation function.

Observation of a Neutral Structure near the DD[over ¯]^{*} Mass Threshold in e^{+}e^{-}→(DD[over ¯]^{*})^{0}π^{0} at sqrt[s]=4.226 and 4.257 GeV

A neutral structure in the DD[over ¯]^{*} system around the DD[over ¯]^{*} mass threshold is observed with a statistical significance greater than 10σ in the processes e^{+}e^{-}→D^{+}D^{*-}π^{0}+c.c. and e^{+}e^{-}→D^{0}D[over ¯]^{*0}π^{0}+c.c. at sqrt[s]=4.226 and 4.257 GeV in the BESIII experiment. The structure is denoted as Z_{c}(3885)^{0}. Assuming the presence of a resonance, its pole mass and width are determined to be [3885.7_{-5.7}^{+4.3}(stat)±8.4(syst)]  MeV/c^{2} and [35_{-12}^{+11}(stat)±15(syst)]  MeV, respectively. The Born cross sections are measured to be σ[e^{+}e^{-}→Z_{c}(3885)^{0}π^{0},Z_{c}(3885)^{0}→DD[over ¯]^{*}]=[77±13(stat)±17(syst)]  pb at 4.226 GeV and [47±9(stat)±10(syst)]  pb at 4.257 GeV. The ratio of decay rates B[Z_{c}(3885)^{0}→D^{+}D^{*-}+c.c.]/B[Z_{c}(3885)^{0}→D^{0}D[over ¯]^{*0}+c.c.] is determined to be 0.96±0.18(stat)±0.12(syst), consistent with no isospin violation in the process, Z_{c}(3885)^{0}→DD[over ¯]^{*}.

Measurement of the Absolute Branching Fraction for Λ_{c}^{+}→Λe^{+}ν_{e}

We report the first measurement of the absolute branching fraction for Λ_{c}^{+}→Λe^{+}ν_{e}. This measurement is based on 567  pb^{-1} of e^{+}e^{-} annihilation data produced at sqrt[s]=4.599  GeV, which is just above the Λ_{c}^{+}Λ[over ¯]_{c}^{-} threshold. The data were collected with the BESIII detector at the BEPCII storage rings. The branching fraction is determined to be B(Λ_{c}^{+}→Λe^{+}ν_{e})=[3.63±0.38(stat)±0.20(syst)]%, representing a significant improvement in precision over the current indirect determination. As the branching fraction for Λ_{c}^{+}→Λe^{+}ν_{e} is the benchmark for those of other Λ_{c}^{+} semileptonic channels, our result provides a unique test of different theoretical models, which is the most stringent to date.

Observation of a Neutral Charmoniumlike State Z_{c}(4025)^{0} in e^{+}e^{-}→(D^{*}D[over ¯]^{*})^{0}π^{0}

We report a study of the process e^{+}e^{-}→(D^{*}D[over ¯]^{*})^{0}π^{0} using e^{+}e^{-} collision data samples with integrated luminosities of 1092 pb^{-1} at sqrt[s]=4.23 GeV and 826 pb^{-1} at sqrt[s]=4.26 GeV collected with the BESIII detector at the BEPCII storage ring. We observe a new neutral structure near the (D^{*}D[over ¯]^{*})^{0} mass threshold in the π^{0} recoil mass spectrum, which we denote as Z_{c}(4025)^{0}. Assuming a Breit-Wigner line shape, its pole mass and pole width are determined to be (4025.5_{-4.7}^{+2.0}±3.1) MeV/c^{2} and (23.0±6.0±1.0) MeV, respectively. The Born cross sections of e^{+}e^{-}→Z_{c}(4025)^{0}π^{0}→(D^{*}D[over ¯]^{*})^{0}π^{0} are measured to be (61.6±8.2±9.0) pb at sqrt[s]=4.23 GeV and (43.4±8.0±5.4) pb at sqrt[s]=4.26 GeV. The first uncertainties are statistical and the second are systematic.

Observation of Z_{c}(3900)^{0} in e^{+}e^{-}→π^{0}π^{0}J/ψ

Using a data sample collected with the BESIII detector operating at the BEPCII storage ring, we observe a new neutral state Z_{c}(3900)^{0} with a significance of 10.4σ. The mass and width are measured to be 3894.8±2.3±3.2  MeV/c^{2} and 29.6±8.2±8.2  MeV, respectively, where the first error is statistical and the second systematic. The Born cross section for e^{+}e^{-}→π^{0}π^{0}J/ψ and the fraction of it attributable to π^{0}Z_{c}(3900)^{0}→π^{0}π^{0}J/ψ in the range E_{c.m.}=4.19-4.42  GeV are also determined. We interpret this state as the neutral partner of the four-quark candidate Z_{c}(3900)^{±}.

Observation and Spin-Parity Determination of the X(1835) in J/ψ→γK_{S}^{0}K_{S}^{0}η

We report an observation of the process J/ψ→γX(1835)→γK_{S}^{0}K_{S}^{0}η at low K_{S}^{0}K_{S}^{0} mass with a statistical significance larger than 12.9σ using a data sample of 1.31×10^{9} J/ψ events collected with the BESIII detector. In this region of phase space the K_{S}^{0}K_{S}^{0} system is dominantly produced through the f_{0}(980). By performing a partial wave analysis, we determine the spin parity of the X(1835) to be J^{PC}=0^{-+}. The mass and width of the observed X(1835) are 1844±9(stat)_{-25}^{+16}(syst)  MeV/c^{2} and 192_{-17}^{+20}(stat)_{-43}^{+62}(syst)  MeV, respectively, which are consistent with the results obtained by BESIII in the channel J/ψ→γπ^{+}π^{-}η^{'}.

Observation of the ψ(1 3D2) State in e+e-→π+π-γχc1 at BESIII

We report the observation of the X(3823) state in the process e+e-→π+π-X(3823)→π+π-γχc1 with a statistical significance of 6.2σ, in data samples at center-of-mass energies sqrt[s]=4.230, 4.260, 4.360, 4.420, and 4.600 GeV collected with the BESIII detector at the BEPCII electron positron collider. The measured mass of the X(3823) state is (3821.7±1.3±0.7)  MeV/c2, where the first error is statistical and the second systematic, and the width is less than 16 MeV at the 90% confidence level. The products of the Born cross sections for e+e-→π+π-X(3823) and the branching ratio B[X(3823)→γχc1,c2] are also measured. These measurements are in good agreement with the assignment of the X(3823) state as the ψ(1 3D2) charmonium state.

An assessment survey of anti-tuberculosis drug management in Cambodia

SETTING

One hundred and seven public health facilities with tuberculosis (TB) service and 66 private pharmacies in 14 provinces.

OBJECTIVES

To assess the knowledge, attitudes and practices (KAP) of TB service providers, new smear-positive pulmonary TB out-patients and drug storekeepers, to document practices in the public sector TB drug procurement system, to measure TB drug availability in private pharmacies and to compare public and private sector TB drug prices with international prices.

DESIGN

Documents and treatment record reviews, inventory checks and structured interviews.

RESULTS

The prescribing practices of the TB service providers were acceptable. The level of new smear-positive TB out-patients' knowledge of TB treatment was high. The storekeepers' inventory practices for TB drugs indicated a need for improvement. Various TB drugs were available in the private pharmacies. TB drug prices in the public sector were similar to international reference prices, although they were higher than the Global TB Drug Facility prices.

CONCLUSIONS

An indicator-based anti-tuberculosis drug management assessment survey can measure the current situation and quality of DOTS, identify any weaknesses or changes in practice from the norm, and simultaneously serve as a basis for training of TB service providers and storekeepers.