The diagnostic performance of GeneXpert MTB/RIF in tuberculosis meningitis: A multicentre accuracy study

OBJECTIVES

To evaluate the performance of GeneXpert MTB/RIF (Xpert) for tuberculous meningitis (TBM) and to identify additional indicators to improve diagnostic accuracy.

METHODS

An accuracy study was conducted. During 2011-2019, 243 TBM with 140 non-TBM in three TB-designated facilities in China were enrolled. Microbiological evidence of M tuberculosis (Mtb) in CSF was used as the reference. Additional indicators were identified by Boosted-Classification and Regression Tree (CART), the improvement of diagnostic performance was evaluated by ROC.

RESULTS

The diagnostic sensitivity of Xpert was 71.1 % for definite TBM, and 5.5 % for probable/possible TBM. The positive rate of Xpert was improved with cerebrospinal fluid (CSF) increasing volume and was associated with CSF color (yellow). The additional indicators obtained by CART were CSF lactate and glucose and increased the sensitivity to 96.1 % (definite TBM) and 84.6 % (probable/possible TBM).

CONCLUSIONS

The diagnostic performance of Xpert was satisfactory in definite TBM and would significantly be improved by the additional use of CSF lactate and glucose.

Second-line antituberculosis drug exposure thresholds predictive of adverse events in multidrug-resistant tuberculosis treatment

OBJECTIVES

This study aimed to investigate the association between drug exposure and adverse events (AEs) during the standardized multidrug-resistant tuberculosis (MDR-TB) treatment, as well as to identify predictive drug exposure thresholds.

METHODS

We conducted a prospective, observational multicenter study among participants receiving standardized MDR-TB treatment between 2016 and 2019 in China. AEs were monitored throughout the treatment and their relationships to drug exposure (e.g., the area under the drug concentration-time curve from 0 to 24 h, AUC0-24 h) were analyzed. The thresholds of pharmacokinetic predictors of observed AEs were identified by boosted classification and regression tree (CART) and further evaluated by external validation.

RESULTS

Of 197 study participants, 124 (62.9%) had at least one AE, and 15 (7.6%) experienced serious AEs. The association between drug exposure and AEs was observed including bedaquiline, its metabolite M2, moxifloxacin and QTcF prolongation (QTcF >450 ms), linezolid and mitochondrial toxicity, cycloserine and psychiatric AEs. The CART-derived thresholds of AUC0-24 h predictive of the respective AEs were 3.2 mg·h/l (bedaquiline M2); 49.3 mg·h/l (moxifloxacin); 119.3 mg·h/l (linezolid); 718.7 mg·h/l (cycloserine).

CONCLUSIONS

This study demonstrated the drug exposure thresholds predictive of AEs for key drugs against MDR-TB treatment. Using the derived thresholds will provide the knowledge base for further randomized clinical trials of dose adjustment to minimize the risk of AEs.

Drug Exposure and Susceptibility of Pyrazinamide Correlate with Treatment Response in Pyrazinamide-Susceptible Patients with Multidrug-Resistant Tuberculosis

Exploring the influence of pyrazinamide exposure and susceptibility on treatment response is crucial for optimizing the management of multidrug-resistant tuberculosis (MDR-TB). This study aimed to investigate the association between pyrazinamide exposure, susceptibility, and response to MDR-TB treatment, as well as find clinical thresholds for pyrazinamide. A prospective multi-center cohort study of participants with MDR-TB using pyrazinamide was conducted in three TB-designated hospitals in China. Univariate and multivariate analyses were applied to investigate the associations. Classification and Regression Tree (CART) analysis was used to identify clinical thresholds, which were further evaluated by multivariate analysis and receiver operating characteristic (ROC) curves. The study included 143 patients with MDR-TB. The exposure/susceptibility ratio of pyrazinamide was associated with two-month culture conversion (adjusted risk ratio (aRR), 1.1; 95% confidence interval (CI), 1.07-1.20), six-month culture conversion (aRR, 1.1; 95% CI, 1.06-1.16), treatment success (aRR, 1.07; 95% CI, 1.03-1.10), as well as culture conversion time (adjusted hazard ratio (aHR) 1.18; 95% CI,1.14-1.23). The threshold for optimal improvement in sputum culture results at the sixth month of treatment was determined to be a pyrazinamide AUC0-24h/MIC ratio of 7.8. In conclusion, the exposure/susceptibility ratio of pyrazinamide is associated with the treatment response of MDR-TB, which may change in different Group A drug-based regimens.

Population pharmacokinetics and model-based dosing evaluation of bedaquiline in multidrug-resistant tuberculosis patients

Aims: Bedaquiline is now recommended to all patients in the treatment of multidrug-resistant tuberculosis (MDR-TB) using standard dosing regimens. As the ability to measure blood drug concentrations is very limited, little is known about drug exposure and treatment outcome. Thus, this study aimed to model the population pharmacokinetics as well as to evaluate the currently recommended dosage.

Methodology: A bedaquiline population pharmacokinetic (PK) model was developed based on samples collected from the development cohort before and 1, 2, 3, 4, 5, 6, 8, 12, 18, and 24 h after drug intake on week 2 and week 4 of treatment. In a prospective validation cohort of patients with MDR-TB, treated with bedaquiline-containing standardized regimen, drug exposure was assessed using the developed population PK model and thresholds were identified by relating to 2-month and 6-month sputum culture conversion and final treatment outcome using classification and regression tree analysis. In an exploratory analysis by the probability of target attainment (PTA) analysis, we evaluated the recommended dosage at different MIC levels by Middlebrook 7H11 agar dilution (7H11).

Results: Bedaquiline pharmacokinetic data from 55 patients with MDR-TB were best described by a three-compartment model with dual zero-order input. Body weight was a covariate of the clearance and the central volume of distribution, albumin was a covariate of the clearance. In the validation cohort, we enrolled 159 patients with MDR-TB. The 7H11 MIC mode (range) of bedaquiline was 0.06 mg (0.008–0.25 mg/L). The study participants with AUC0-24h/MIC above 175.5 had a higher probability of culture conversion after 2-month treatment (adjusted relative risk, aRR:16.4; 95%CI: 5.3–50.4). Similarly, those with AUC0-24h/MIC above 118.2 had a higher probability of culture conversion after 6-month treatment (aRR:20.1; 95%CI: 2.9–139.4), and those with AUC0-24h/MIC above 74.6 had a higher probability of successful treatment outcome (aRR:9.7; 95%CI: 1.5–64.8). Based on the identified thresholds, simulations showed that the WHO recommended dosage (400 mg once daily for 14 days followed by 200 mg thrice weekly) resulted in PTA >90% for the majority of isolates (94%; MICs ≤0.125 mg/L).

Conclusion: We established a population PK model for bedaquiline in patients with MDR-TB in China. Based on the thresholds and MIC distribution derived in a clinical study, the recommended dosage of bedaquiline is sufficient for the treatment of MDR-TB.

Analysis of a Sabin-Strain Inactivated Poliovirus Vaccine Response to a Circulating Type 2 Vaccine-Derived Poliovirus Event in Sichuan Province, China 2019-2021

IMPORTANCE

The Sabin-strain inactivated poliovirus vaccine (IPV) may be a tool for polio outbreak response in certain situations.

OBJECTIVE

To investigate the response to a type 2 vaccine-derived poliovirus (VDPV2) outbreak.

DESIGN, SETTING, AND PARTICIPANTS

This case series was conducted in China after a VDPV2 was detected in stool specimens from a child with acute flaccid paralysis (AFP) in Sichuan Province in 2019, 3 years after the global withdrawal of live, attenuated type 2 oral poliovirus vaccine (OPV). Investigation followed National Health Commission and World Health Organization guidance and included searching hospitals for unreported AFP cases; testing stool specimens from the child, his contacts, and local children; enhanced environmental surveillance for VDPV2s in wastewater; and measuring vaccination coverage. Sabin-strain IPV campaigns were conducted in a wide geographic area.

MAIN OUTCOMES AND MEASURES

Any VDPV2 detection after completion of the supplementary immunization activities.

RESULTS

A 28-nucleotide-change VDPV2 was isolated from a young boy. Three VDPV2s were detected in healthy children; 2 were contacts of the original child, and none had paralysis. A search of 31 million hospital records found 10 unreported AFP cases; none were polio. No type 2 polioviruses were found in wastewater. Prior to the event, polio vaccine coverage was 65% among children younger than 5 years. Sabin-strain IPV campaigns reached more than 97% of targeted children, administering 1.4 million doses. No transmission source was identified. More than 1 year of enhanced poliovirus environmental and AFP surveillance detected no additional VDPVs.

CONCLUSIONS AND RELEVANCE

These findings suggest that the circulating VPDV2 outbreak in 2019 was associated with low vaccine coverage. An investigation discovered 3 infected but otherwise healthy children and no evidence of the virus in wastewater. Following Sabin-strain IPV-only campaigns expanding from county to prefecture, the poliovirus was not detected, and the outbreak response was considered by an expert panel and the World Health Organization to have been successful. This success suggests that the Sabin-strain IPV may be a useful tool for responding to circulating VDPV2 outbreaks when high-quality supplementary immunization activities can be conducted and carefully monitored in settings with good sanitation.

Dexmedetomidine inhibits cerebral nerve cell apoptosis after cerebral hemorrhage in rats via the Nrf2/HO-1/NQO1 signaling pathway

OBJECTIVE

To investigate the effect of dexmedetomidine on the apoptosis of cerebral nerve cells after cerebral hemorrhage (CH) in rats and its molecular mechanism.

MATERIALS AND METHODS

The rat model of CH was established by autologous blood injection. A total of 60 specific pathogen-free (SPF)-grade rats were randomly divided into sham-operation group, model group and dexmedetomidine group, and each group involved 20 rats. Rat brain water content was compared among the three groups. Besides, rat neurological function of the three groups was evaluated at 3, 5 and 7 d after operation by neurological function scoring. Western blotting assay was adopted to detect protein levels of apoptosis-related genes [B-cell lymphoma-2 (Bcl-2) and Bcl-2-associated X protein (Bax)] in rat brain tissues in the three groups. Moreover, the apoptosis level in the brain tissues in the groups was measured through terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay. Biochemical tests were conducted to determine activities of reduced glutathione (GSH), superoxide dismutase (SOD) and malondialdehyde (MDA) in the brain tissues among the three groups. Furthermore, the activation of the nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1)/NAD(P)H quinone oxidoreductase 1 (NQO1) signaling pathway in the brain tissues of the three groups of rats was examined via Western blotting assay. An in vitro oxygen-glucose deprivation (OGD) model was prepared using SH-SY5Y cells. In addition, Nrf2 was intervened in SH-SY5Y cells by small hairpin ribonucleic acid (shRNA) transfection. Finally, flow cytometry and Annexin V/PI assay were performed to detect the response of cells to dexmedetomidine in OGD + dexmedetomidine + sh-Nrf2 group.

RESULTS

The brain water content and the neurological function score at 3, 5 and 7 d after operation were remarkably reduced in dexmedetomidine group compared with those in model group. The results of Western blotting and TUNEL assays indicated that dexmedetomidine group had a notably lowered apoptosis level in the brain tissues. Additionally, the biochemical test results manifested that activities of GSH and SOD were enhanced and that of MDA decreased in the brain tissues of dexmedetomidine group. Protein levels of Nrf2, HO-1 and NQO1 in the brain tissues were distinctly higher in dexmedetomidine group than those in model group. According to the results of flow cytometry, the apoptosis rate in OGD + dexmedetomidine + sh-Nrf2 group rose prominently compared with that in OGD + dexmedetomidine group.

CONCLUSIONS

Dexmedetomidine inhibits the nerve cell apoptosis in rat brain tissues by activating the Nrf2/HO-1/NQO1 signaling pathway in rat CH models.

The efficacy of nutritional supplements for the adjunctive treatment of schizophrenia in adults: A systematic review and network meta-analysis

Nutritional supplementations have been widely used as adjunctive treatments for schizophrenia. However, among these supplementations, of which the most beneficial is currently unknown. This study aimed to compare and rank the effectiveness of nutritional supplementations in the adjunctive treatments of schizophrenia. The four nutritional supplementations evaluated were: 1) folate acid or vitamin B12; 2) vitamin D; 3) N-acetyl cysteine (NAC); 4) Omega-3 polyunsaturated fatty acid, including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). 17 eligible RCTs with 1165 participants were included in this network meta-analysis based on study criteria. NAC supplementation was significantly more efficacious than folic acid or vitamin B12 [MD (95% CI): -6.6 (-10.8, -2.4)] and omega-3 polyunsaturated fatty acid [MD (95% CI): -5.1(-9.9, -0.8)] supplementation in the term of PANSS score changes. There were no significant differences in the PANSS score changes between NAC and vitamin D [MD (95% CI): -5.2 (-10.9, 0.5)] supplementations. The estimated ranking probabilities of treatments showed that NAC might be the most effective adjunctive intervention over all nutritional supplementations. These results indicate that NAC could improve PANSS score and it may be among the most effective nutritional supplementations in schizophrenia patients.

Genome-wide identification studies - A primer to explore new genes in plant species

Genome data have accumulated rapidly in recent years, doubling roughly after every 6 months due to the influx of next-generation sequencing technologies. A plethora of plant genomes are available in comprehensive public databases. This easy access to data provides an opportunity to explore genome datasets and recruit new genes in various plant species not possible a decade ago. In the past few years, many gene families have been published using these public datasets. These genome-wide studies identify and characterize gene members, gene structures, evolutionary relationships, expression patterns, protein interactions and gene ontologies, and predict putative gene functions using various computational tools. Such studies provide meaningful information and an initial framework for further functional elucidation. This review provides a concise layout of approaches used in these gene family studies and demonstrates an outline for employing various plant genome datasets in future studies.

MicroRNA-15a inhibits inflammatory response and apoptosis after spinal cord injury via targeting STAT3

OBJECTIVE

To clarify the function of microRNA-15a in the spinal cord injury (SCI) and its potential mechanism.

PATIENTS AND METHODS

The plasma levels of microRNA-15a and signal transducer and activator of transcription 3 (STAT3) in SCI patients were determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The correlation between the expressions of microRNA-15a and STAT3 was analyzed. The in vitro SCI model was established in H2O2-induced C8-D1A and C8B4 cells, and in vivo SCI model was established in mice by hitting T10. The mRNA and protein expressions of tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6) were detected in the SCI model. The apoptosis was examined by flow cytometry or TUNEL staining, respectively. The motor function of mouse hindlimb was evaluated using the Basso Beattie Bresnahan (BBB) standard scale. The target gene of microRNA-15a was predicted by bioinformatics and further verified by dual-luciferase reporter gene assay. The expression changes of target genes in C8-D1A and C8B4 cells with microRNA-15a overexpression or knockdown were examined by qRT-PCR and Western blot. Finally, rescue experiments were performed to evaluate the regulatory effects of microRNA-15a and STAT3 on cell apoptosis.

RESULTS

MicroRNA-15a was lowly expressed in plasma of SCI patients, while STAT3 was highly expressed with a negative correlation to microRNA-15a. Identically, microRNA-15a was lowly expressed in H2O2-induced C8-D1A and C8B4 cells, and STAT3 was highly expressed. MicroRNA-15a overexpression downregulated mRNA and protein levels of TNF-α and IL-6 in C8-D1A and C8B4 cells. BBB score was markedly low in SCI mice relative to controls. SCI mice injected with microRNA-15a mimics had higher BBB score than those injected with negative control. Besides, SCI mice with microRNA-15a overexpression had downregulated expressions of STAT3, TNF-α, and IL-6 in the impaired spinal cord tissues, as well as lower apoptotic rate. Through bioinformatics, we found binding sites between STAT3 and microRNA-15a. Their binding conditions were further verified by dual-luciferase reporter gene assay. Moreover, STAT3 expression was negatively regulated by microRNA-15a. Finally, rescue experiments showed that STAT3 overexpression could reverse the regulatory effects of microRNA-15a on expressions of TNF-α and IL-6, as well as apoptosis.

CONCLUSIONS

MicroRNA-15a expression decreases in the SCI model, which participates in the process of SCI by regulating inflammatory response and cell apoptosis via targeting STAT3.

Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia

BACKGROUND

The initial cases of novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP.

METHODS

We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number.

RESULTS

Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9).

CONCLUSIONS

On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.).

Protein arginine methyltransferase 5 functions as an epigenetic activator of the androgen receptor to promote prostate cancer cell growth

Protein arginine methyltransferase 5 (PRMT5) is an emerging epigenetic enzyme that mainly represses transcription of target genes via symmetric dimethylation of arginine residues on histones H4R3, H3R8 and H2AR3. Accumulating evidence suggests that PRMT5 may function as an oncogene to drive cancer cell growth by epigenetic inactivation of several tumor suppressors. Here, we provide evidence that PRMT5 promotes prostate cancer cell growth by epigenetically activating transcription of the androgen receptor (AR) in prostate cancer cells. Knockdown of PRMT5 or inhibition of PRMT5 by a specific inhibitor reduces the expression of AR and suppresses the growth of multiple AR-positive, but not AR-negative, prostate cancer cells. Significantly, knockdown of PRMT5 in AR-positive LNCaP cells completely suppresses the growth of xenograft tumors in mice. Molecular analysis reveals that PRMT5 binds to the proximal promoter region of the AR gene and contributes mainly to the enriched symmetric dimethylation of H4R3 in the same region. Mechanistically, PRMT5 is recruited to the AR promoter by its interaction with Sp1, the major transcription factor responsible for AR transcription, and forms a complex with Brg1, an ATP-dependent chromatin remodeler, on the proximal promoter region of the AR gene. Furthermore, PRMT5 expression in prostate cancer tissues is significantly higher than that in benign prostatic hyperplasia tissues, and PRMT5 expression correlates positively with AR expression at both the protein and mRNA levels. Taken together, our results identify PRMT5 as a novel epigenetic activator of AR in prostate cancer. Given that inhibiting AR transcriptional activity or androgen synthesis remains the major mechanism of action for most existing anti-androgen agents, our findings also raise an interesting possibility that targeting PRMT5 may represent a novel approach for prostate cancer treatment by eliminating AR expression.

The role of video-assisted thoracoscopic surgery in management of the multiple ground-glass nodules

OBJECTIVE

We investigated the outcomes of patients with multiple ground-glass nodules (GGNs) to identify the role of video-assisted thoracoscopic surgery (VATS) in diagnosis and treatment.

PATIENTS AND METHODS

We included patients with multiple GGNs who were qualified for thoracoscopic surgery resection and analyzed the statistics.

RESULTS

Fifty-one GGNs were detected in 21 patients. There were 40 pure GGNs and 11 part-solid ones. Around 46 of the 51 lesions were resected via VATS. Four pure GGNs <10 mm and deep in the lung were proceeded with continuous follow-up. One pure GGN measuring 16 mm considered as subnodule and also deep in the lung underwent stereotactic ablative radiotherapy. Resection methods included lobectomy (1), segmentectomy (1), lobectomy + segmentectomy (6), lobectomy + wedge resection (10), and segmentectomy + wedge resection (3). Of the 46 resected lesions, 4 (8.7%) were atypical adenomatous hyperplasia (AAH), 23 (50%) were adenocarcinoma in situ(AIS), 15 (32.7%) were minimally invasive adenocarcinoma (MIA), 2 (4.3%) were invasive adenocarcinoma, one was pulmonary sclerosing hemangioma, and one was nonspecific fibrosis. Intersegmental lymph node metastasis was found in one of the 21 patients. No postoperational complication occurred in any of the patients.

CONCLUSION

Multiple GGNs were generally independent primary lung cancers, mainly including AAH, AIS, MIA, rather than intrapulmonary metastasis. VATS was superior to thoracotomy for less invasive and shorter hospital stay.

Anti-inflammatory effects of three kinds of traditional Mongolian medicine monomer and its combination on LPS-stimulated RAW264.7 macrophages

OBJECTIVE

Traditional Mongolian Medicine (TMM) exhibits useful biological activities including antifungal, antibacterial, and anti-inflammatory actions. The mechanisms of TMM in anti-inflammation were still unclear. The aim of this study was to investigate the effects of the three main monomers (geniposide, gallate, berberine hydrochloride and a mixture of them) of a traditional Mongolian medicine on cell survival and the proinflammatory cytokines signaling pathways which are activated by bacterial lipopolysaccharides (LPS).

MATERIALS AND METHODS

Mouse macrophage-like cell line RAW264.7 was used as a model of inflammation to investigate the anti-inflammatory effects of three TMM momomers and their combination. RT-PCR and Western blot was used to quantify the change of mRNA and protein levels of cytokines, Toll-like receptor-4 (TLR4) and Nuclear Factor-κB (NF-κB) and its inhibitor IκB. The non-radioactive electrophoresis mobility shift assay (EMSA) was used to evaluate the binding activity of NF-κB.

RESULTS

The monomers and their combination exhibited a potent anti-inflammatory effect for suppressing the LPS-evoked secretion of proinflammatory cytokines IL-1β, IL-6 and TNFα. Furthermore, the monomers and their combination attenuated activation of NF-κB and expression of TLR4 at both mRNA and protein levels, the upstream player of the LPS-TLR4-cytokines/ NF-κB signaling pathway.

CONCLUSIONS

The Mongolia herbal compound exerts a potent anti-inflammatory effect and could potentially be developed as a useful agent for the chemo-prevention of inflammatory diseases.

Complex doping chemistry owing to Mn incorporation in nanocrystalline anatase TiO2 powders

Mn-doped TiO2 powders with a wide range of nominal doping levels were fabricated using a one-step hydrothermal method followed by 400 °C annealing. Anatase powders with a uniform size distribution below 10 nm were obtained. The maximum solubility of Mn in the TiO2 lattice was around 30%, beyond which the Mn3O4 compound appeared as a secondary phase. The optical absorption edges for Mn-doped anatase TiO2 were red-shifted effectively through increasing Mn content. Alloying chemistry and associated elemental valences were elaborated through combining X-ray photoelectron spectroscopy (XPS), X-ray absorption spectroscopy (XAS), and theoretical simulation in the framework of density functional theory (DFT). The results showed that the Mn species exhibited mixed valence states of 3+ and 4+ in anatase TiO2, with the latter being the key to remarkable photocatalytic performance.

K63-linked ubiquitination of FANCG is required for its association with the Rap80-BRCA1 complex to modulate homologous recombination repair of DNA interstand crosslinks

DNA interstrand crosslinks (ICLs) are extremely deleterious lesions that are repaired by homologous recombination (HR) through coordination of Fanconi anemia (FA) proteins and breast cancer susceptibility gene 1 (BRCA1) product, but the exact role these proteins have remains unclear. Here we report that FANCG was modified by the addition of lysine63-linked polyubiquitin chains (K63Ub) in response to DNA damage. We show that FANCG K63Ub was dispensable for monoubiquitination of FANCD2, but was required for FANCG to interact with the Rap80-BRCA1 (receptor-associated protein 80-BRCA1) complex for subsequent modulation of HR repair of ICLs induced by mitomycin C. Mutation of three lysine residues within FANCG to arginine (K182, K258 and K347, 3KR) reduced FANCG K63Ub modification, as well as its interaction with the Rap80-BRCA1 complex, and therefore impeded HR repair. In addition, we demonstrated that K63Ub-modified FANCG was deubiquitinated by BRCC36 complex in vitro and in vivo. Inhibition of BRCC36 resulted in increased K63Ub modification of FANCG. Taken together, our results identify a new role of FANCG in HR repair of ICL through K63Ub-mediated interaction with the Rap80-BRCA1 complex.

Analysis of survival factors in patients with intermediate-advanced hepatocellular carcinoma treated with transcatheter arterial chemoembolization combined with sorafenib

PURPOSE

To retrospectively analyze the efficacy and safety of transcatheter arterial chemoembolization (TACE) in combination with sorafenib for the treatment of patients with intermediate-advanced hepatocellular carcinoma (HCC) and assess the prognostic impact of baseline characteristics.

METHODS

Patients with intermediate-advanced HCC received TACE combined with sorafenib in this Phase 2 clinical trial. The primary outcome was median time to disease progression (mTTP). Secondary outcomes were median overall survival (mOS), the disease benefit rate and the sorafenib-related adverse events (AEs). Baseline characteristics' impacts on prognosis were analyzed by univariate COX proportional hazards regression model.

RESULTS

From June 2008 to June 2013, 75 patients were enrolled. At the end of the study, 54 patients were dead or lost to follow-up and 21 patients survived. This combination therapy resulted in a mTTP of 7.09 months (95 % CI, 1.5-45 months) and a mOS of 11.44 months (95 % CI, 1.5-45 months). The disease benefit rate was 88 %. Child-Pugh score (P = 0.000), Eastern Cooperative Oncology Group performance status (P = 0.001), Barcelona Clinic Liver Cancer stage (P = 0.000), sorafenib treatment regimen (P = 0.001), presence of extrahepatic metastasis (P = 0.002), and type of tumor (P = 0.027) were significantly correlated with OS. Multivariate analysis revealed Child-Pugh score (P = 0.001) and BCLC stage (P = 0.002) as significant independent prognostic predictors for OS. AEs were HFSR (18.7 %), gastrointestinal reactions (13.3 %), liver dysfunction (6.7 %), myelosuppression (5.3 %), fatigue (4 %), and hypertension (1.3 %).

CONCLUSIONS

TACE in combination with sorafenib might have acceptable safety and efficiency in the treatment of intermediate-advanced HCC.

Novel ZnO nanorod films by chemical solution deposition for planar device applications

Smooth and continuous ZnO films consisting of densely packed ZnO nanorods (NRs), which can be used for electronic device fabrication, were synthesized using a hydro-thermo-chemical solution deposition method. Such devices would have the novelty of high performance, benefiting from the inherited unique properties of the nanomaterials, and can be fabricated on these smooth films using a conventional, low cost planar process. Photoluminescence measurements showed that the NR films have much stronger shallow donor to valence band emissions than those from discrete ZnO NRs, and hence have the potential for the development of ZnO light emission diodes and lasers, etc. The NR films have been used to fabricate large area surface acoustic wave devices by conventional photolithography. These demonstrated two well-defined resonant peaks and their potential for large area device applications. The chemical solution deposition method is simple, reproducible, scalable and economic. These NR films are suitable for large scale production on cost-effective substrates and are promising for various fields such as sensing systems, renewable energy and optoelectronic applications.

Abstract P6-04-12: Novel selective estrogen receptors degraders regress tumors in pre-clinical models of endocrine-resistant breast cancer

80% of all breast cancers express the estrogen receptor alpha (ERα) and thus are treated with anti-hormonal therapies that directly block ER function (e.g. Tamoxifen) or hormone synthesis (Aromatase Inhibitors). While these therapies are initially effective, acquired resistance invariably emerges. Importantly, the majority of these tumors continue to depend on ERα for growth and survival. The emerging evidence that ERα can signal in both a ligand-dependent and ligand-independent manner supports the development of agents that are not only competitive ERα antagonists but also reduce steady state levels of the receptor and thus limit both modes of signaling.

We have identified novel, non-steroidal ERα antagonists that induce degradation of ERα in breast cancer cell lines at picomolar concentrations resulting in significant reduction in steady state ERα protein levels. Using peptide-based conformational profiling, we show that these Selective Estrogen Receptor Degraders (SERDs) induce estrogen receptor conformations that are distinct from both fulvestrant and tamoxifen indicating a unique mechanism of action. This unique biological profile coupled with good oral pharmacokinetics produces tumor regressions in both tamoxifen-sensitive and -resistant models of breast cancer in vivo. Recent pre-clinical and clinical data indicate that PI3K pathway signaling can contribute to the endocrine resistant state. In a preclinical model of tamoxifen resistant breast cancer in which SERD monotherapy only produces tumor growth inhibition, SERD therapy in combination with torc1/2 inhibition results in frank tumor regressions. These orally bioavailable SERDs hold promise as a next generation therapy for the treatment of ER+ breast cancer as monotherapy, as well as in combination with agents that target other pathways involved in both intrinsic and acquired endocrine resistance.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P6-04-12.

Investigation of the hydrogen bonding in ice Ih by first-principles density function methods

It is a well recognized difficult task to simulate the vibrational dynamics of ices using the density functional theory (DFT), and there has thus been rather limited success in modelling the inelastic neutron scattering (INS) spectra for even the simplest structure of ice, ice Ih, particularly in the translational region below 400 cm(-1). The reason is partly due to the complex nature of hydrogen bonding (H-bond) among water-water molecules which require considerable improvement of the quantum mechanical simulation methods, and partly owing to the randomness of protons in ice structures which often requires simulation of large super-lattices. In this report, we present the first series of successful simulation results for ice Ih using DFT methods. On the basis of the recent advancement in the DFT programs, we have achieved for the first time theoretical outcomes that not only reproduce the rotational frequencies between 500 to 1200 cm(-1) for ice Ih, but also the two optic peaks at ∼240 and 320 cm(-1) in the translational region of the INS spectra [J. C. Li, J. Chem. Phys 105, 6733 (1996)]. Besides, we have also investigated the impact of pairwise configurations of H(2)O molecules on the H-bond and found that different proton arrangements of pairwise H(2)O in the ice Ih crystal lattice could not alter the nature of H-bond as significantly as suggested in an early paper [J. C. Li and D. K. Ross, Nature (London) 365, 327 (1993)], i.e., reproducing the two experimental optic peaks do not need to invoke the two H-bonds as proposed in the previous model which led to considerable debates. The results of this work suggest that the observed optic peaks may be attributed to the coupling between the two bands of H-O stretching modes in H(2)O. The current computational work is expected to shed new light on the nature of the H-bonds in water, and in addition to offer a new approach towards probing the interaction between water and biomaterials for which H-bond is essential.

Expression of SP-C and Ki67 in lungs of preterm infants dying from respiratory distress syndrome

This study aimed at exploring the expression of Surfactant protein-C (SP-C) and Ki67 in autopsy lung tissues of premature infants dying from respiratory distress syndrome (RDS) who were exposed to mechanical ventilation and elevated oxygen concentrations. The possible influence of pulmonary surfactant (PS) on the expression of SP-C and Ki67 was also investigated. Thirty preterm infants were selected who were histologically and clinically diagnosed as RDS. Preterm infants with RDS were divided into 4 groups, according to the time of death: infants ventilated for 1–3 days, 4–8 days, 9–16 days and >6 days. Five premature infants died within 1 day after delivery for non- pulmonary reasons served as controls. The expression of SP-C and Ki67 in lungs was detected by immunohistochemistry. Compared with the control group, the expression of SP-C and Ki67 in RDS infants decreased significantly after 1–3 days of ventilation, but increased after 4 days and reached peak value after 9–16 days. No significant difference in the expression of SP-C and Ki67 was found between infants treated with PS and those without. Thus our results suggest SP-C and Ki67 may have participated in the pulmonary pathological process in ventilated/oxygen treated preterm infants with RDS, and exogenous surfactant had no effect on the expression of SP-C and Ki67 in the lungs of ventilated/oxygen treated preterm infants with RDS.

Metastable Phase Transformations in Ti-40Al-10V Alloy

The microstructures in arc melted ingots and melt spun ribbons have been investigated by electron microscopy and thermodynamic modelling has been used to study the phase transformations. In the ingot, solidification starts with the bcc β phase and at room temperature the structure consists of B2, ωordered, γ and α2 phases. The calculated equilibrium phase transformation sequence during cooling is L → L+ β→β→β + α→β2+α → α+β2+γ → α2+γ + B2. The phase transformation sequence is dramatically changed by rapid quenching from the melt. Athermal ordered w phase is formed in metastable B2 and the α→α2 ordering process is completely suppressed in the melt spun ribbons. The volume fraction of the α precipitates is also dependent on cooling rates.

Calculation of Phase Competition and Selection in Solidification Using a Combined Nucleation and Calphad Approach

Thermodynamic data derived by the CALPHAD method has been extended to undercooled melts to study phase competition and the role of time dependent and steady state nucleation in rapidly solidified materials. The theoretical predictions made about phase competition between hcp α, bcc β and Ll0 γ in some Al(Ti,V) alloys are compared with experimental results. It is shown that high melt cooling rates introduce significant transient nucleation effects on phase nucleation.

Use of chemical characteristics to predict the relative bioavailability of supplemental organic manganese sources for broilers1

Twelve organic Mn sources and MnSO4 were evaluated by polarographic analysis and via solubility in buffers (pH 5 and 2) and deionized water. Fractions from solubility tests were evaluated by gel filtration chromatography for structural integrity. Organic Mn sources included five Mn methionine complexes (Mn Met A to Mn Met E), two Mn proteinates (Mn Pro A and Mn Pro B), and five Mn amino acids (Mn AA A to Mn AA E). Sources varied considerably in chemical characteristics. Chelation strength (Qf) ranged from weak (1.9 Qf-values) to strong complexes (115.4 Qf-values). No complexed Mn was found in filtrates at pH 2.0 or 5.0. A 42-d bioassay was used to estimate relative bioavailability of Mn sources for chicks fed diets supplemented with 60, 120, or 180 mg Mn/kg. Bone Mn, heart Mn, heart manganese-superoxide dismutase activity (MnSOD), and heart MnSOD mRNA increased (P < 0.001) as dietary Mn increased. Only heart MnSOD mRNA tended (P < 0.10) to differ among dietary Mn sources. For bioassays of Mn, the MnSOD mRNA level in heart was more sensitive than the MnSOD activity in heart or other indices. Relative to MnSO4 (assigned 100%), slope ratios of MnSOD mRNA levels in heart gave bioavailabilities of 99, 132, and 113% for Mn Met E, Mn AA B, and Mn AA C sources with weak, moderate, and strong chelation strength, respectively. The bioavailability of Mn was more closely related to chelation strength as measured by polarography than to chemical traits assessed by solubility or structural integrity.

[Imaging evaluation and interventional therapy of hepatic metastases from small intestinal leiomyosarcoma]

OBJECTIVE

To evaluate the imaging appearances and the short-term curative effect of hepatic metastases from small intestine leiomyosarcoma treated by interventional methods.

METHODS

Seven cases with 46 lesions of hepatic metastases from small intestinal leiomyosarcoma were analyzed retrospectively. The diameters of the metastases were from 2 cm to 18 cm. CT triphasic scan and hepatoarterial angiography were performed in all cases. The interventional therapy methods included transcatheter arterial chemoembolization (TACE) (all 7 cases), percutaneous left subclavian artery port-catheter system implantation (PCS) (1 case). Three cases were also treated with percutaneous tumor necrosis drainage (PTND) because of obvious liquefaction necrosis within the tumor.

RESULTS

The lesions were substantial occupation and some were mixed density with cystic component. The cystic component increased in the larger tumor. The hepatic metastases were enhanced remarkably during the hepatic arterial-dominant phase scan and had abundant tumor vascular and tumor stain on hepatoarterial angiography. The size of tumor in 4 cases was reduced after TACE. The tumor in the patient who was treated with PCS had no changed. The size of the tumor in 3 cases was slightly enlarged. The tumors in the 3 patients treated with PTND were reduced remarkably.

CONCLUSIONS

The predominant blood-supply of the hepatic metastases from small intestinal leiomyosarcoma is the hepatic artery abundant in blood vessels. TACE, PCS and PTND are effective methods to treat hepatic metastases from small intestinal leiomyosarcoma.

Ligand-dependent degradation of retinoid X receptors does not require transcriptional activity or coactivator interactions

Cells utilize ubiquitin-mediated proteolysis to regulate the activity of numerous proteins involved in signal transduction, cell cycle control, and transcriptional regulation. For a number of transcription factors, there appears to be a direct correlation between transcriptional activity and protein instability, suggesting that cells use targeted destruction as one method to down-regulate or attenuate gene expression. In this report we demonstrate that retinoid X receptors (RXRs) which function as versatile mediators of nuclear hormone-dependent gene expression are marked for destruction upon binding agonist ligands. Interestingly, when RXR serves as a heterodimeric partner for retinoic acid (RAR) or thyroid hormone (TR) receptors, binding of agonists by RAR or TR leads to degradation of both the transcriptionally active RAR or TR subunits as well as the transcriptionally inactive RXR subunit. Furthermore, using a series of mutants in the ligand-dependent activation domain (activation function 2), we demonstrate that agonist-stimulated degradation of RXR does not require corepressor release, coactivator binding, or transcriptional activity. Taken together, the data suggest a model for targeted destruction of transcription factors based on structural or conformational signals as opposed to functional coupling with gene transcription.

An efficient room-temperature silicon-based light-emitting diode

There is an urgent requirement for an optical emitter that is compatible with standard, silicon-based ultra-large-scale integration (ULSI) technology. Bulk silicon has an indirect energy bandgap and is therefore highly inefficient as a light source, necessitating the use of other materials for the optical emitters. However, the introduction of these materials is usually incompatible with the strict processing requirements of existing ULSI technologies. Moreover, as the length scale of the devices decreases, electrons will spend increasingly more of their time in the connections between components; this interconnectivity problem could restrict further increases in computer chip processing power and speed in as little as five years. Many efforts have therefore been directed, with varying degrees of success, to engineering silicon-based materials that are efficient light emitters. Here, we describe the fabrication, using standard silicon processing techniques, of a silicon light-emitting diode (LED) that operates efficiently at room temperature. Boron is implanted into silicon both as a dopant to form a p-n junction, as well as a means of introducing dislocation loops. The dislocation loops introduce a local strain field, which modifies the band structure and provides spatial confinement of the charge carriers. It is this spatial confinement which allows room-temperature electroluminescence at the band-edge. This device strategy is highly compatible with ULSI technology, as boron ion implantation is already used as a standard method for the fabrication of silicon devices.

[Relationship between CYP1A1, GSTM1 genetic polymorphisms and susceptibility to esophageal squamous cell carcinoma]

OBJECTIVE

To investigate the association between susceptibility of esophageal squamous cell carcinoma and the genetic polymorphisms of CYP1A1 and GSTM1.

METHODS

Subjects were comprised of 107 esophageal cancer patients and 111 healthy controls. Genotyping of both CYP1A1 and GSTM1 were performed in cancer tissues of all 107 patients and peripheral blood leukocytes taken from the controls by polymerase chain reaction.

RESULTS

There were no significant differences in the frequency distribution of CYP1A1 polymorphisms between esophageal cancer patients and healthy controls although the frequency of CYP1A1 with at least one allele of Val showed slightly higher in individuals with esophageal cancer. However, significant difference was observed in the frequency of GSTM1-nulled individuals with esophageal cancer comparing with the controls (P < 0.05). When subjects were categorized by both CYP1A1 genotype and GSTM1 genotype, GSTM1 (-) became markedly expressed in patients with CYP1A1 (I/I) than in the corresponding controls (67% versus 40%, P < 0.01). The frequency of CYP1A1 genotype with at least one allele of Val (I/V and V/V) was also statistically higher in patients with GSTM1 (+), comparing to the corresponding controls (64% versus 41%, P < 0.05).

CONCLUSIONS

It was suggested that: genetic polymorphisms of CYP1A1 and GSTM1 were susceptible to esophageal cancer; individuals who are GSTM1-null have an increased risk of developing esophageal cancer; individuals with combined CYP1A1 (I/I) and GSTM1 (-) or with combined CYP1A1 (I/V, V/V) and GSTM1 (+) were more susceptible, when comparing to those with combined CYP1A1 (I/I) and GSTM1 (+).

Three amino acids specify coactivator choice by retinoid X receptors

Binding of agonists to nuclear receptors results in a conformational change in receptor structure that promotes interaction between activated receptors and coactivators. Receptor-coactivator interactions are mediated by the agonist-dependent formation of a hydrophobic pocket on the part of receptors, and short leucine-rich sequences termed LxxLL motifs or nuclear receptor boxes present in coactivators. RXR-PPARgamma (retinoid X receptor-peroxisome proliferator-activated receptor-gamma) heterodimers play important roles in adipocyte and macrophage differentiation and have been implicated as therapeutic targets in diabetes, atherosclerosis, and cancer. Analysis of interactions between RXR-PPARgamma heterodimers and coactivator nuclear receptor boxes suggests that RXR and PPARgamma can distinguish among coactivators by recognizing distinct structural features of nuclear receptor boxes. The results also indicate that coactivator choice by RXR is mediated by three nonconserved amino acids of the nuclear receptor box. The ability of an optimized seven-amino acid nuclear receptor box to specifically interact with RXR and function as a selective inhibitor suggests the coactivator-binding pocket may serve as a new target for drug discovery.

China's forest policy for the 21st century

A half-century policy of forest exploitation and monoculture in China has led to disastrous consequences, including degradation of forests and landscapes, loss of biodiversity, unacceptable levels of soil erosion, and catastrophic flooding. A new forest policy had been adopted in China called the Natural Forest conservation Program (NFCP), which emphasizes expansion of natural forests and increasing the productivity of forest plantations. Through locally focused management strategies, biodiversity and forest resources will be sustained, and downstream regions will be better protected from flooding. This new policy is being implemented with a new combination of policy tools, including technical training and education, land management planning, mandatory conversion of marginal farmlands to forest, resettlement and retaining of forest dwellers, share in private ownership, and expanded research. These policy tools may have wider relevance for other countries, particularly developing countries.

Screening of anti-hypoxia/reoxygenation agents by an in vitro model. Part 1: Natural inhibitors for protein tyrosine kinase activated by hypoxia/reoxygenation in cultured human umbilical vein endothelial cells

Protein tyrosine kinase (PTK) signaling pathways play important roles in ischemia/reperfusion (I/R) or hypoxia/reoxygenation (H/R) injuries. Inhibition of PTK activation can protect against I/R- or H/R-induced damages. As one part of our work for seeking bioactive compounds from natural sources against I/R or H/R, in the present study we examined the effects of 54 compounds purified from various traditional Chinese herbs on H/R-induced PTK activation by means of an in vitro H/R model in cultured human umbilical vein endothelial cells (HUVEC). The results demonstrated that an increase in PTK activation was induced after 2 h of reoxygenation. Compounds 2 (macrostemososide A), 3 (laxogenin-3-O-beta-D-xylopyranosyl-(1-->4)-alpha-L-arabinopyra nosyl- (1-->6)-beta-D-glucopyranoside), 4 (chinenoside II), 7 (ginsenoside-Rd), 52 (icariin), 53 (icariside), and 54 (icaritin) showed relatively obvious inhibition on this H/R-induced PTK activation. Compounds 5 (beta-sitosterol) and 6 (daucosterine), especially 5, completely blocked such an increased activation of PTK induced by H/R. On the contrary, compound 29 (isocumarine) significantly promoted PTK activation further. Moreover, the effects of these compounds on PTK activation were dose-dependent.

Screening of anti-hypoxia/reoxygenation agents by an in vitro method. Part 2: Inhibition of tyrosine kinase activation prevented hypoxia/reoxygenation-induced injury in endothelial gap junctional intercellular communication

In this study, we demonstrated that hypoxia/reoxygenation (H/R) induced an injury in gap junctional intercellular communication (GJIC) after 2 h of reoxygenation in cultured HUVEC. Free radical scavenger (DMSO) and antioxidant (SOD) did not prevent this GJIC injury at all. Protein kinase C inhibitor (calphostin C) partly blocked this injury. However, the protein tyrosine kinase (PTK) inhibitor genistein completely inhibited this GJIC injury. Compounds 1 [laxogenin-3-O-alpha-L-arabinosyl-(1-->6)- beta-D-glucopyranoside], 2 (macrostemososide A), 3 [laxogenin-3-O-beta-D-xylopyranosyl-(1-->4)-alpha- L-arabinopyranosyl-(1-->6)-beta-D-glucopyranoside], 4 (chinenoside II), 5 (beta-sitosterol), 6 (daucosterine), 7 (ginsenoside-Rd), 29 (isocumarine), 52 (icariin), 53 (icariside), and 54 (icaritin), which showed obvious influence on H/R-induced PTK activation as stated in Part 1 (except 1), were explored for their effects on GJIC. The results showed that compounds 2-7 and 52-57 partly protected H/R-induced GJIC injury. Compounds 5 and 6 (especially 5), which showed the strongest inhibitory effects on PTK activation, completely blocked H/R-provoked GJIC injury. Compound 1, which did not influence PTK activation, failed to prevent this GJIC injury. In contrast, compound 29, which significantly promoted PTK activation, enhanced this H/R-induced GJIC injury further. Western blotting of connexin 43, an important gap junctional protein for modulating GJIC in HUVEC, revealed that interference with the gap junctional protein might be the most direct mechanism for compounds 2, 5, 29, and 53 to affect H/R-injured GJIC.