Neoadjuvant nivolumab plus chemotherapy versus chemotherapy for resectable NSCLC: subpopulation analysis of Chinese patients in CheckMate 816

BACKGROUND

Neoadjuvant nivolumab plus chemotherapy significantly improved event-free survival (EFS) and pathologic complete response (pCR) versus chemotherapy alone in patients with resectable non-small-cell lung cancer (NSCLC) in the global phase III CheckMate 816 study. Here, we report post hoc exploratory efficacy, safety, and surgical outcomes in the Chinese subpopulation of this study.

METHODS

Adults with stage IB-IIIA resectable NSCLC were randomized to receive nivolumab 360 mg plus chemotherapy or chemotherapy alone every 3 weeks for three cycles followed by surgery. Primary endpoints included EFS and pCR (both per blinded independent review). EFS and pCR results were from 14 October 2022, and 16 September 2020, database locks, respectively.

RESULTS

The Chinese subpopulation comprised 97 patients (nivolumab plus chemotherapy, 44; chemotherapy, 53). At 38.2 months of minimum follow-up, median EFS was not reached [95% confidence interval (CI) 23.4 months-not reached] in the nivolumab plus chemotherapy arm and 13.9 months (95% CI 8.3-34.3 months) in the chemotherapy arm (hazard ratio 0.47, 95% CI 0.25-0.88). pCR rates were 25.0% (95% CI 13.2% to 40.3%) and 1.9% (95% CI 0.0% to 10.1%), respectively (odds ratio 11.05; 95% CI 1.41-86.49). Of 97 Chinese patients, 36 (82%) in the nivolumab plus chemotherapy arm and 41 (77%) in the chemotherapy arm underwent definitive surgery. Grade 3-4 treatment-related adverse events occurred in 18/43 patients (42%) treated with nivolumab plus chemotherapy and 22/53 patients (42%) treated with chemotherapy.

CONCLUSIONS

Consistent with findings in the global study population of CheckMate 816, neoadjuvant nivolumab plus chemotherapy improved EFS and pCR versus chemotherapy in the Chinese subpopulation without impacting treatment tolerability or the feasibility of surgery. These findings support the use of nivolumab plus chemotherapy as a standard neoadjuvant treatment option for Chinese patients with resectable NSCLC.

Antipsychotics and venous thromboembolism risk: a meta-analysis

BACKGROUND

Antipsychotics have been inconclusively implicated in susceptibility to venous thromboembolism (VTE).

OBJECTIVES AND METHODS

The aim of this study was to investigate the association between antipsychotic drugs and VTE risk by a meta-analysis. PubMed and EmBASE databases were searched for publications through to 10 October 2010. Statistical analysis was performed using Revman 4.2 and Stata 10.0 software.

RESULTS

7 case-control studies involving 31 095 cases and 143 472 controls were analyzed. The results indicate that antipsychotic exposure confers a 139 % increased risk of VTE (odds ratio [OR] = 2.39, 95 % confidence interval [CI]:1.71–3.35). Pooled estimates by drug type showed that use of low-potency antipsychotics (OR = 2.91, 95 % CI 1.80–4.71) is the most important risk factor for VTE, followed by atypical (OR = 2.20, 95 % CI 1.22–3.96), conventional (OR = 1.72, 95 % CI 1.31–2.24) and high-potency drugs (OR = 1.58, 95 % CI 1.50–1.67).

CONCLUSIONS

This meta-analysis suggests that antipsychotics are a risk factor for VTE. Additional studies in large cohorts are required to validate our findings. Future analyses should study potential eff ect modifications by different doses and durations of antipsychotic exposure in different populations.

Dermal fibroblast-associated gene induction by asiaticoside shown in vitro by DNA microarray analysis

BACKGROUND

Asiaticoside, isolated from Centella asiatica, promotes fibroblast proliferation and extracellular matrix (ECM) synthesis in wound healing. The precise mechanism, however, in molecular and gene expression levels is still unclear.

OBJECTIVE

Using cDNA microarray technology, the alteration of gene expression profiles was determined for human dermal fibroblasts in vitro in the presence of asiaticoside (30 microg mL(-1)). Fifty-four genes, with known functions for cell proliferation, cell cycle progression and synthesis of ECM, were significantly upregulated in our 'genome-nest' expression profile at various time points. Furthermore, the mRNA levels and protein production of certain genes responsible for ECM synthesis (e.g. encoding type I and type III collagen proteins) were evaluated by Northern blot and radioimmunoassay, respectively.

RESULTS

We found that there is a close correlation between the gene profile, mRNA and protein production in the response of the cells to asiaticoside stimulation.

CONCLUSIONS

This information could be used for exploring the response of the target genes to asiaticoside in fibroblasts.

Adaptive approximation of the boundary surface of a neuron in confocal microscopy volumetric images

In biomedical visualisation, the isosurface is usually used to represent (approximate) the boundary surface of the structure within biomedical volumetric images. However, in many confocal microscopy volumetric images of neurons, the grey values of the object and/or background are usually uneven. Therefore a fixed isosurface is not suitable for use in approximating the boundary surface of the neuron. A method is proposed to construct the adaptively approximating surface of the boundary surface of the neuron. In this method, the boundary surface of the neuron could be locally and adaptively approximated with different surface patches in different local regions. Consequently, the approximation accuracy has been considerably improved.

A human homolog of the yeast gene encoding tRNA 2'-phosphotransferase: cloning, characterization and complementation analysis

The Saccharomyces cerevisiae TPT1 gene plays a role in removing the 2'-phosphate from ligated tRNA during the maturation of pre-tRNA. Here we reported the cloning and characterization of the human TRPT1 gene as a homolog of yeast TPT1. The TRPT1 gene is located at human chromosome 11q13 and encodes a polypeptide of 253 amino acids. BLAST searches with its amino acid sequence revealed the ubiquitous occurrence of TRPT1 homologs and their functional relationships with the presence of the DUF60/KptA domain. Northern analysis demonstrated that the gene is primarily expressed in heart and skeletal muscle, with lower or undetectable levels in other tissues studied. A plasmid-shuffling experiment showed that the human TRPT1 gene could complement the tpt1 mutation in S. cerevisiae

Isolation and characterization of a human novel RAB (RAB39B) gene

Rab proteins are small-molecular-weight GTPases that control vesicular trafficking in eukaryotic cells. During the large-scale sequencing analysis of a human fetal brain cDNA library, we isolated a cDNA clone encoding a novel Rab protein, which showed 74.2% identity with previously isolated Rab39A at the amino acid level. RAB39B was expressed in a variety of human tissues and located in human chromosome Xq28. It consisted of two exons spanning 3764 bp of human genomic DNA.

Molecular cloning and characterization of a novel Dehydrogenase/reductase (SDR family) member 1 genea from human fetal brain

Short-chain dehydrogenases/reductases (SDR) constitute a large protein family of NAD(P)(H)-dependent oxidoreductase. They are defined by distinct, common sequence motifs and show a wide range of substrate specialisms. By large-scale sequencing analysis of a human fetal brain cDNA library, we isolated a novel human SDR-type dehydrogenase/reductase gene named Dehydrogenase/reductase (SDR family) member 1 (DHRS1). The DHRS1 cDNA is 1411 base pair in length, encoding a 314-amino-acid polypeptide which has a SDR motif. Northern blot reveals two bands, of about 0.9 and 1.4 kb in size. These two forms are expressed in many tissues. The DHRS1 gene is localized on chromosome 14q21.3. It has 9 exons and spans 9.2 kb of the genomic DNA.

A novel human hydroxysteroid dehydrogenase like 1 gene (HSDL1) is highly expressed in reproductive tissues

We report the cloning and characterization of a novel human hydroxysteroid dehydrogenase like gene (HSDL1) located on human chromosome 16q24.2. The HSDL1 cDNA is 3407 base pair in length, encoding a 309 amino acid polypeptide related to human 17beta-HSD3. Northern blot reveals that the HSDL1 is highly expressed in testis and ovary. In situ hybridization indicates that the expression of HSDL1 is predominantly increased in the prostate cancer tissue compared with the normal prostate tissue, which suggests that the gene expression is important to the arising of prostate cancer.

Identification of dopamine responsive mRNAs in glial cells by suppression subtractive hybridization

Recent studies have established that glial cells are important targets of the neurotransmitter dopamine (DA), but the regulatory effects of DA on glial cells have not been extensively studied. In the present study, we have investigated the influence of DA on gene transcription in glial cells. Two-directional (forward and backward) suppression subtraction hybridization (SSH) was performed on astrocytes cultured from rat cerebral tissues in standard media or in culture media treated with DA. PCR-select differential screening was used to further verify the differentially expressed cDNA clones, positive clones were sequenced, and the mRNAs were re-examined on Northern blots. Fourteen sequences were identified of which eleven are homologous to known genes, three are homologous to expressed sequence tags (ESTs). Three novel full-length cDNAs were isolated using the EST fragments as probes to screen a cDNA library constructed from human brain. Analysis of these sequences suggested that complex intracellular signaling pathways, involving crosstalk with growth factor pathways, steroid hormone pathways, and an interferon-regulated 2-5 A pathway, are responsive to DA in astrocytes. The responsive proteins downstream from the signaling pathways were found to fall into at least three groups, including a series of metabolic enzymes, stress proteins, transfer proteins, etc. In addition, several of them have established their relationships with specific neurodegenerative diseases, showing that there is overlap in the pathogenic mechanisms of different diseases. Our results have provided a foundation for better understanding of the molecular basis of glial cell functions in dopaminergic transmission and an approach to find possible medication for the related disorders.

Molecular cloning and characterization of a novel peptidylprolyl isomerase (cyclophilin)-like gene (PPIL3) from human fetal brain

During the large-scale sequencing analysis of a human fetal brain cDNA library, we isolated two cDNA clones encoding two novel proteins, which show 52% and 72% identity to the cyclophilin isoform 10 of C. elegans, respectively. Sequence analysis revealed these two cDNA clones are two different splicing variants of a novel cyclophilin-like gene (PPIL3). The PPIL3 gene was identified on a completely sequenced BAC (GenBank accession AC005037) from chromosome 2q33 between STS markers stSG2762 (proximal) and SHGC-3074 (distal), oriented toward the telomere. The PPIL3 gene consisted of eight exons spanning more than 18 kb of genomic DNA. RT-PCR analysis indicated that PPIL3 was ubiquitously expressed in adult human tissues.

Cloning and characterization of KLHL5, a novel human gene encoding a kelch-related protein with a BTB domain

Most kelch family proteins contain two conserved domains, the BTB domain and the kelch repeat domain. Here we describe the cloning and characterization of a novel human KLHL5 gene. The 3488 bp cDNA encodes a kelch family protein homologous to the Drosophila kelch protein. It also contains the two conserved domains. Northern blot analysis reveals a single transcript. It is abundantly expressed in ovary, adrenal gland, and thyroid and less abundantly expressed in trachea, prostate, testis, lymph node, and spinal cord. KLHL5 was mapped to 4p13-4p15.1.

PDZ-binding kinase participates in spermatogenesis

A cDNA clone denoted SPK (spermatogenesis-related protein kinase) was isolated from human fetal brain cDNA library. The deduced protein was 99% identical to human PDZ-binding kinase (PBK), which is a mitotic kinase. Its isoform, which is about 300 bp longer at 3' end, was also isolated in this study. SPK gene was assigned to human chromosome 8p21.2 by radiation hybrid. Northern blot analysis indicated that SPK mRNA was predominantly expressed in testis. SPK mRNA was localized to the outer cell layer of seminiferous tubules by in situ hybridization, suggesting involvement of it in the process of spermatogenesis.

Cloning, expression, and characterization of a human inosine triphosphate pyrophosphatase encoded by the itpa gene

ITP and dITP exist in all cells. dITP is potentially mutagenic, and the levels of these nucleotides are controlled by inosine triphosphate pyrophosphatase (EC ). Here we report the cloning, expression, and characterization of a 21.5-kDa human inosine triphosphate pyrophosphatase (hITPase), an enzyme whose activity has been reported in many animal tissues and studied in populations but whose protein sequence has not been determined before. At the optimal pH of 10.0, recombinant hITPase hydrolyzed ITP, dITP, and xanthosine 5'-triphosphate to their respective monophosphates whereas activity with other nucleoside triphosphates was low. K(m) values for ITP, dITP, and xanthosine 5'-triphosphate were 0.51, 0.31, and 0.57 mm, respectively, and k(cat) values were 580, 360, and 640 s(-1), respectively. A divalent cation was absolutely required for activity. The gene encoding the hITPase cDNA sequence was localized by radiation hybrid mapping to chromosome 20p in the interval D20S113-D20S97, the same interval in which the ITPA inosine triphosphatase gene was previously localized. A BLAST search revealed the existence of many similar sequences in organisms ranging from bacteria to mammals. The function of this ubiquitous protein family is proposed to be the elimination of minor potentially mutagenic or clastogenic purine nucleoside triphosphates from the cell.

Cloning and expression pattern of the human NDRG3 gene

We report the cloning and expression pattern of a novel N-myc downstream-regulated gene 3 (NDRG3), located on human chromosome 20q11.21-11.23. The NDRG3 cDNA is 2588 base pair in length, encoding a 363 amino acid polypeptide highly related to mouse Ndr3 protein. Northern blot reveals that NDRG3 is highly expressed in testis, prostate and ovary. By in situ hybridization, the NDRG3 mRNA was localized to the outer layers of seminiferous epithelium, indicating that it may play a role in spermatogenesis.

Cloning and characterization of a human lysyl oxidase-like 3 gene (hLOXL3)

Using the PCR primers generated from human expressed sequence tag (EST), the cDNA of lysyl oxidase-like gene 3 (LOXL3), a new member of human lysyl oxidases gene family, was cloned from the human fetal brain mRNA. The predicted amino acid sequence of the hLOXL3 gene was highly homologous to mLOR2. Bioinformatics analysis shows that hLOXL3 protein is also a member of the scavenger receptor cysteine-rich family, which contains a 25 amino acids signal peptide. The hLOXL3 gene was mapped to human 2p13 locus by BLAST search and at least 14 exons were found. Expression of the hLOXL3 gene was detected in several human tissues and especially high in spleen and testis.

Identification of a human LNX protein containing multiple PDZ domains

Recently PDZ domains have been recognized as crucial organizers of protein complexes at the plasma membrane. Here we report the cloning of a novel 3.7-kb cDNA LNX from a human fetal brain cDNA library. The deduced amino acid sequence shares about 88% identity with the p70 form of Lnx, which is the mouse ligand of Numb protein X. Motif analysis reveals five protein-interaction modules conservative to those in the Lnx protein, including four PDZ domains and a NPXY motif for binding of the Numb PTB domain. Northern blot analysis shows that the length of the transcript in brain is distinct from those in other tissues. By radiation hybrid mapping, we localize the LNX gene to human chromosome 4q12 between marker D4S1577 and marker D4S1594. We predict that LNX may be important for the organization of signaling complexes in Numb-involved pathways or pathways regulated by other PTB-containing proteins.

Molecular cloning, mapping and characterization of the human neurocalcin delta gene (NCALD)

We identified a new human gene that encodes a cognate of the bovine neurocalcin delta from a human fetal brain cDNA library; hence we named it human neurocalcin delta (NCALD) gene. The deduced polypeptide product of the cDNA is 22 kDa in size, and its amino acid sequence is 100% and 99% identical to that of the bovine and chicken neurocalcin, respectively. Northern blots showed that the NCALD gene is more abundantly expressed in brain, testis, ovary and small intestine. Tissue in situ hybridization confirmed the existence of the NCALD mRNA in the adult human testis. Radiation hybrid panel mapping localized the gene to chromosome 8 between molecular markers D8S270 and D8S257.

Cloning and characterization of a novel human leptin receptor overlapping transcript-like 1 gene (LEPROTL1)

A new full-length cDNA encoding a novel protein was isolated from our human fetal brain cDNA library. The cDNA consists of 2701 bp and has a putative open reading frame encoding 131 amino acids which possesses a JAK binding site (Pro(46)-Ile-Pro(48) which is preceded by a cluster of hydrophobic residues) and is highly homologous to the leptin receptor gene-related protein (OB-RGRP). Northern blot analysis showed that this new gene is widely expressed in human tissues and radiation hybrid mapping placed the gene to human chromosome 8p21.1-8p21.2.

[Study on the expression of pig zona pellucida-3 beta excluding N-terminus signal peptide and C-terminus transmembrance-like domain in Escherichia coli]

Pig oocytes are surrounded by an acellular translucent envelope-zona pellucida(pZP), which is comprised of three biochemically and immunologically distinct glycoproteins(pZP1, pZP3 alpha and pZP3 beta). Due to the cross-reactivity of anti-pZP3 beta antibodies with human ZP in vitro, pZP3 beta has been considered as potential one of immunogens for developing human contraceptive vaccine. In order to express pZP3 beta directly in E. coli; we amplified the core fragment of pZP3 beta cDNA by PCR that was deleted 5'- and 3'-terminal sequences of coding for signal peptide and transmembrane-like domain. The DNA sequenced EcoRI and SalI restriced core fragment was cloned in a frame downstream of PRPL promoter in the pBV221 vector. SDS-PAGE analysis showed that pZP3 beta protein was expressed especially in E. coli after thermal induction, which the expression band displayed the molecular weight of about 38 kD matching with its deduced molecular weight(36.5 kD). In addition, the specially expressed protein band on SDS-PAGE gel showed specific immunological reaction with anti-pig ZP IgGs of rabbit in Western blot.

[Inhibitory effects of recombinant human neurotrophin-4/5 protein on neurotoxicity caused by arsenic trioxide]

OBJECTIVE

To study preliminarily the inhibitory effects of recombinant human neurotrophin (hNT)-4/5 protein on neurotoxicity caused by arsenic trioxide (As(2)O(3)).

METHODS

Nerve cells of the chicken embryonic forebrain and PC12 cells were co-cultured with recombinant hNT-4/5 protein and As(2)O(3) (0 - 16 micromol/L) for 24 and 48 hours, respectively, to observe the survival of nerve cells and the outgrowth of PC12 cells, with clone expression and recombination techniques.

RESULTS

There was significant difference in survival rate of nerve cells between the experimental and control groups (P < 0.01) after co-culture for 48 hours, and survival rate and number of neuron outgrowth increased with the concentration of hNT-4/5 protein.

CONCLUSION

Recombinant hNT-4/5 protein could inhibit neurotoxicity caused by As(2)O(3), which provided a basis to find an anti-toxic factor in the environment by genetic engineering.

[Development and clinical application of dental spot weld & heat-treat tri-uses device]

A spot weld & heating treatment tri-uses device based on modern mechanical-electric technique, was developed for dental spot weld, stainless steel orthodontic wire heating-reversion and Ni-Ti orthodontic wire heating-overload metamorphism. The device will be very helpful instrument in orthodontic clinic. The paper not only described the operating methods of the device, but also discussed the Performance-improved principles of stainless steel orthodontic wire and the principles of heating overload metamorphism of Ni-Ti orthodontic wire.

[Detection of telomerase activity in bronchoscopic brush-off cells in lung cancer patients]

OBJECTIVE

To investigate the diagnostic significance of the detection of telomerase activity in the exfoliated cells obtained from fiberobronchoscopic brushing.

METHODS

The techniques of TRAP-PCR-ELISA and TRAP-silver staining were employed to detecte telomerase activity in 57 cases with pulmonary diseases.

RESULTS

Telomerase activity in the lesion side of lung cancer patients (N = 23) was significantly higher than that in the contralateral side of the same patient (P < 0.05), and in patients with pneumonia (P < 0.05). Positive rate of telomerase activity detection in lung cancer patients (91.3%) was significantely higher than that of cytological examination (52.3%, P < 0.05). In 83.3% of the cases examined, exfoliated cells showing cytological dysplasia were found to be telomerase activity positive.

CONCLUSION

Detection of telomerase activity in the exfoliated cells obtained from fiberobronchoscopic brushing may be an effective and sensitive method in the diagnosis of pulmonary malignant diseases.

Adaptive filtering for high resolution magnetic resonance images

We present a study of least mean square (LMS) based adaptive filters for high resolution magnetic resonance (MR) images to improve signal-to-noise ratio (SNR) while maintaining sharp edges. Five variations of a new technique that senses the type of noise or the presence of an edge in the filtering window, called adaptive filtering with noise estimation (AFEN) are presented and compared with the basic two-dimensional LMS (TDLMS) algorithm, adaptive filtering with a mean estimator (AFLME), a two-dimensional averaged LMS (TDALMS) algorithm, and a two-dimensional median weighted LMS (TDMLMS) algorithm. Although TDLMS, TDALMS, and TDMLMS filters give better SNR improvement when applied uniformly to an image, they significantly blur edges. The AFLME and AFEN filters both show approximately a factor of 2 SNR improvement with much better retention of edges, with AFEN showing slightly better performance for both SNR and edge sharpness in phantom and in vivo inner ear images.

Echo-time reduction for submillimeter resolution imaging with a 3D phase encode time reduced acquisition method

To achieve optimal image quality and highest spatial resolution for inner ear imaging with a 3D gradient echo sequence, it is necessary to minimize susceptibility dephasing effects by using very short TE. Fractional RF pulses and echoes can yield short TE for moderate spatial resolution; however, for voxel size of less than 1 mm, TE is limited by the phase encode gradients. We present a method to obtain very short effective TE by using short triangular shaped phase encode gradients to sample the central portions of k-space and progressively longer trapezoidal gradients for the outer portions of k-space. A 3D pulse sequence employing the modified phase encoding scheme for both in-plane and slice phase encoding directions was implemented and tested on phantoms and in vivo. The effective TE equals the minimal TE used for the central k-space portions. Submillimeter resolution (0.35 x 0.35 x 0.7 mm3) images of the inner ear were obtained with effective TE of 3.2 ms and were compared with standard 3D images with TE of 8 ms. With this pronounced TE reduction, the susceptibility artifacts at air/fluid interfaces are significantly reduced.

Optimization of submillimeter-resolution MR imaging methods for the inner ear

Submillimeter-resolution magnetic resonance (MR) imaging of the inner ear is valuable for diagnosis and treatment planning. Its main advantage for investigations of underlying disease is that it can directly depict the fluid spaces of the membranous labyrinth rather than define only the bony canal, as does computed tomography. A systematic evaluation of factors influencing high-resolution three-dimensional (3D) gradient-echo imaging of the inner ear with a standard clinical MR system is presented. This includes the evaluation of various radio-frequency coils, the design of steady-state pulse sequences, and the optimization of acquisition parameters. A quantitative analysis was facilitated by computer simulations and image processing. The highest signal-to-noise ratio for the membranous labyrinth was obtained with a single 3-inch (7.6-cm) receiver coil and a 3D GRASS (gradient-recalled acquisition in the steady state) sequence with the minimal achievable TR msec/TE msec of 25/7 and a 40 degrees--60 degrees flip angle, which yielded acceptable images with minimal voxel volumes of 0.1 mm3 in 14 minutes.

Cardiovascular responses to external counterpulsation: a computer simulation

A mathematical model of the human cardiovascular system is presented which includes a simulation of cardiac assistance by external counterpulsation. The model was established to study the effects of external counterpulsation on cardiovascular haemodynamics. The closed simulation includes both the left and the right heart and the pulmonary circulation. The model is able to provide data for the behaviour of the system under varying modes of assistance. Our results suggest that control of external counterpulsation is more difficult than control of the intra-aortic balloon pump and requires regulation of a larger number of variables. The results also suggest that a tradeoff exists between improved oxygen delivery to the heart and reduction in the oxygen consumption of the myocardium, an observation similar to that reported for the intra-aortic balloon pump.