Risk factors for bacteremic pneumonia and mortality (28-day mortality) in patients with Acinetobacter baumannii bacteremia

BACKGROUND

Patients infected with Acinetobacter baumannii (AB) bacteremia in hospital have high morbidity and mortality. We analyzed the clinical characteristics of pneumonia and nonpneumonia-related AB bloodstream infections (AB BSIs) and explored the possible independent risk factors for the incidence and prognosis of pneumonia-related AB BSIs.

METHODS

A retrospective monocentric observational study was performed. All 117 episodes of hospital-acquired AB bacteremia sorted into groups of pneumonia-related AB BSIs (n = 45) and nonpneumonia-related AB BSIs (n = 72) were eligible. Univariate/multivariate logistic regression analysis was used to explore the independent risk factors. The primary outcome was the antibiotic susceptibility in vitro of pneumonia-related AB BSIs group. The secondary outcome was the independent risk factor for the pneumonia-related AB BSIs group.

RESULTS

Among 117 patients with AB BSIs, the pneumonia-related group had a greater risk of multidrug resistant A. baumannii (MDRAB) infection (84.44%) and carbapenem-resistant A. baumannii (CRAB) infection (80%). Polymyxin, minocycline and amikacin had relatively high susceptibility rates (> 80%) in the nonpneumonia-related group. However, in the pneumonia-related group, only polymyxin had a drug susceptibility rate of over 80%. Univariate analysis showed that survival time (day), CRAB, MDRAB, length of hospital stay prior to culture, length of ICU stay prior to culture, immunocompromised status, antibiotics used prior to culture (n > = 3 types), endotracheal tube, fiberoptic bronchoscopy, PITT, SOFA and invasive interventions (n > = 3 types) were associated with pneumonia-related AB bacteremia. The multivariate logistic regression analysis revealed that recent surgery (within 1 mo) [P = 0.043; 0.306 (0.098-0.962)] and invasive interventions (n > = 3 types) [P = 0.021; 0.072 (0.008-0.671)] were independent risk factors related to pneumonia-related AB bacteremia. Multivariate logistic regression analysis revealed that length of ICU stay prior to culture [P = 0.009; 0.959 (0.930-0.990)] and recent surgery (within 1 mo) [P = 0.004; 0.260 (0.105-0.646)] were independent risk factors for mortality in patients with pneumonia-related AB bacteremia. The Kaplan‒Meier curve and the timing test showed that patients with pneumonia-related AB bacteremia had shorter survival time compared to those with nonpneumonia-related AB bacteremia.

CONCLUSIONS

Our study found that A. baumannii had a high rate of antibiotic resistance in vitro in the pneumonia-related bacteremia group, and was only sensitive to polymyxin. Recent surgery was a significantly independent predictor in patients with pneumonia-related AB bacteremia.

Nanoparticle drug delivery systems responsive to tumor microenvironment: Promising alternatives in the treatment of triple-negative breast cancer

The conventional therapeutic treatment of triple-negative breast cancer (TNBC) is negatively influenced by the development of tumor cell drug resistant, and systemic toxicity of therapeutic agents due to off-target activity. In accordance with research findings, nanoparticles (NPs) responsive to the tumor microenvironment (TME) have been discovered for providing opportunities to selectively target tumor cells via active targeting or Enhanced Permeability and Retention (EPR) effect. The combination of the TME control and therapeutic NPs offers promising solutions for improving the prognosis of the TNBC because the TME actively participates in tumor growth, metastasis, and drug resistance. The NP-based systems leverage stimulus-responsive mechanisms, such as low pH value, hypoxic, excessive secretion enzyme, concentration of glutathione (GSH)/reactive oxygen species (ROS), and high concentration of Adenosine triphosphate (ATP) to combat TNBC progression. Concurrently, NP-based stimulus-responsive introduces a novel approach for drug dosage design, administration, and modification of the pharmacokinetics of conventional chemotherapy and immunotherapy drugs. This review provides a comprehensive examination of the strengths, limitations, applications, perspectives, and future expectations of both novel and traditional stimulus-responsive NP-based drug delivery systems for improving outcomes in the medical practice of TNBC. This article is categorized under: Therapeutic Approaches and Drug Discovery > Emerging Technologies Nanotechnology Approaches to Biology > Nanoscale Systems in Biology Therapeutic Approaches and Drug Discovery > Nanomedicine for Oncologic Disease.

Effects of reverse osmosis membrane replacement of pure water system on clinical chemistry and immunoassay in clinical laboratory

Introduction

Reverse osmosis (RO) membrane, key component of water-purifying equipment, is often stored in protection fluid containing substances such as glycerol, which may contaminate the water at replacement. This study aims to explore the effects of RO membrane replacement on clinical chemistry and immunoassay, particularly triglyceride (TG), providing reference for managing test interference caused by RO membrane replacement.

Materials and methods

The RO membrane of water-purifying equipment A, which provided water to C16000 biochemistry analyzer (Abbott Laboratories, Abbott Park, USA) and E801 electrochemiluminescence analyzer (Roche, Basel, Switzerland), was replaced. Water resistivity was recorded, and quality control (QC) tests were performed on C16000 and E801. Moreover, TG was measured in 29 of selected serum samples on C16000 at 0.5h and 10.5h after RO membrane replacement and on reference biochemistry analyzer BS2000M (Mindray Biomedical Electronics Co., Shenzhen, China), which was connected to water-purifying equipment B without RO membrane replacement. Finally, blank, calibrator 1 and calibrator 2 of TG reagent were measured on C16000 before and at 0.5h, 2.5h and 10.5h after RO membrane replacement. All statistical analyses of data were done using GraphPad Prism (GraphPad Software Inc., San Diego, USA), and a value of P < 0.05 was considered statistically significant.

Results

After RO membrane replacement, all QC results of clinical chemistry and immune tests passed except TG that showed positive bias of 536% and 371% at two levels, respectively. Moreover, TG results of the same serum samples were significantly higher at 0.5h than 10.5h after RO membrane replacement. Meanwhile, there was worse agreement and correlation of TG results between C16000 and BS2000M at 0.5h than 10.5h after replacement. Furthermore, the absorbance of TG blank, calibrator 1 and calibrator 2 was significantly higher at 0.5h and 2.5h after replacement than before replacement, and the absorbance gradually returned to normal value at 10.5h after replacement.

Conclusions

Replacement of RO membrane could cause significant interference to TG test while have no effects on other laboratory tests performed in the study, which may be due to glycerol contamination. Our data provides important reference for management of test interference caused by RO membrane replacement. Clinical laboratory should observe the effects of RO membrane replacement on laboratory tests through both water quality monitoring and QC detection.

The mutual interactions among Helicobacter pylori, chronic gastritis, and the gut microbiota: a population-based study in Jinjiang, Fujian

Objectives

Helicobacter pylori (H. pylori) is a type of bacteria that infects the stomach lining, and it is a major cause of chronic gastritis (CG). H. pylori infection can influence the composition of the gastric microbiota. Additionally, alterations in the gut microbiome have been associated with various health conditions, including gastrointestinal disorders. The dysbiosis in gut microbiota of human is associated with the decreased secretion of gastric acid. Chronic atrophic gastritis (CAG) and H. pylori infection are also causes of reduced gastric acid secretion. However, the specific details of how H. pylori infection and CG, especially for CAG, influence the gut microbiome can vary and are still an area of ongoing investigation. The incidence of CAG and infection rate of H. pylori has obvious regional characteristics, and Fujian Province in China is a high incidence area of CAG as well as H. pylori infection. We aimed to characterize the microbial changes and find potential diagnostic markers associated with infection of H. pylori as well as CG of subjects in Jinjiang City, Fujian Province, China.

Participants

Enrollment involved sequencing the 16S rRNA gene in fecal samples from 176 cases, adhering to stringent inclusion and exclusion criteria. For our study, we included healthy volunteers (Normal), individuals with chronic non-atrophic gastritis (CNAG), and those with CAG from Fujian, China. The aim was to assess gut microbiome dysbiosis based on various histopathological features. QIIME and LEfSe analyses were performed. There were 176 cases, comprising 126 individuals who tested negative for H. pylori and 50 who tested positive defined by C14 urea breath tests and histopathological findings in biopsies obtained through endoscopy. CAG was also staged by applying OLGIM system.

Results

When merging the outcomes from 16S rRNA gene sequencing results, there were no notable variations in alpha diversity among the following groups: Normal, CNAG, and CAG; OLGIM I and OLGIM II; and H. pylori positive [Hp (+)] and H. pylori negative [Hp (-)] groups. Beta diversity among different groups show significant separation through the NMDS diagrams. LEfSe analyses confirmed 2, 3, and 6 bacterial species were in abundance in the Normal, CNAG, and CAG groups; 26 and 2 species in the OLGIM I and OLGIM II group; 22 significant phylotypes were identified in Hp (+) and Hp (-) group, 21 and 1, respectively; 9 bacterial species exhibited significant differences between individuals with CG who were Hp (+) and those who were Hp (-).

Conclusion

The study uncovered notable distinctions in the characteristics of gut microbiota among the following groups: Normal, CNAG, and CAG; OLGIM I and OLGIM II; and Hp (+) and Hp (-) groups. Through the analysis of H. pylori infection in CNAG and CAG groups, we found the gut microbiota characteristics of different group show significant difference because of H. pylori infection. Several bacterial genera could potentially serve as diagnostic markers for H. pylori infection and the progression of CG.

RNA Nanomedicine: Delivery Strategies and Applications

Delivery of RNA using nanomaterials has emerged as a new modality to expand therapeutic applications in biomedical research. However, the delivery of RNA presents unique challenges due to its susceptibility to degradation and the requirement for efficient intracellular delivery. The integration of nanotechnologies with RNA delivery has addressed many of these challenges. In this review, we discuss different strategies employed in the design and development of nanomaterials for RNA delivery. We also highlight recent advances in the pharmaceutical applications of RNA delivered via nanomaterials. Various nanomaterials, such as lipids, polymers, peptides, nucleic acids, and inorganic nanomaterials, have been utilized for delivering functional RNAs, including messenger RNA (mRNA), small interfering RNA, single guide RNA, and microRNA. Furthermore, the utilization of nanomaterials has expanded the applications of functional RNA as active pharmaceutical ingredients. For instance, the delivery of antigen-encoding mRNA using nanomaterials enables the transient expression of vaccine antigens, leading to immunogenicity and prevention against infectious diseases. Additionally, nanomaterial-mediated RNA delivery has been investigated for engineering cells to express exogenous functional proteins. Nanomaterials have also been employed for co-delivering single guide RNA and mRNA to facilitate gene editing of genetic diseases. Apart from the progress made in RNA medicine, we discuss the current challenges and future directions in this field.

Flexible, Flame-Resistant, and Anisotropic Thermally Conductive Aerogel Films with Ionic Liquid Crystal-Armored Boron Nitride

With the rapid development of miniaturization and high-power portable electronics, the accumulation of undesired heat can degrade the performance of electronic devices and even cause fires. Therefore, multifunctional thermal interface materials that combine high thermal conductivity and flame retardancy remain a challenge. Herein, an ILC (ionic liquids crystal)-armored boron nitride nanosheet (BNNS) with flame retardant functional groups was first developed. The high in-plane orientation structure aerogel film made of such an ILC-armored BNNS and aramid nanofiber and polyvinyl alcohol matrix through directional freeze-drying and mechanical pressing exhibits strong anisotropy thermal conductivity (λ_// of 17.7 W m^-1 K^-1 and λ_⊥ of 0.98 W m^-1 K^-1). In addition, the highly oriented IBAP aerogel films have excellent flame retardancy (peak heat release rate = 44.5 kW/m² and heat release rate = 0.8 MJ/m²) due to the physical barrier effect and catalytic carbonization effect of ILC-armored BNNS. Meanwhile, IBAP aerogel films exhibit good flexibility and mechanical properties, even in harsh environments such as acids and bases. Further, IBAP aerogel films can also be used as a substrate for paraffin phase change composites. The ILC-armored BNNS provides a practical way to produce flame-resistant polymer composites with high thermal conductivity for TIMs in modern electronic devices.

Efficient Generation of Paired Single-Cell Multiomics Profiles by Deep Learning

Recent advances in single-cell sequencing technology have made it possible to measure multiple paired omics simultaneously in a single cell such as cellular indexing of transcriptomes and epitopes by sequencing (CITE-seq) and single-nucleus chromatin accessibility and mRNA expression sequencing (SNARE-seq). However, the widespread application of these single-cell multiomics profiling technologies has been limited by their experimental complexity, noise in nature, and high cost. In addition, single-omics sequencing technologies have generated tremendous and high-quality single-cell datasets but have yet to be fully utilized. Here, single-cell multiomics generation (scMOG), a deep learning-based framework to generate single-cell assay for transposase-accessible chromatin (ATAC) data in silico is developed from experimentally available single-cell RNA-seq measurements and vice versa. The results demonstrate that scMOG can accurately perform cross-omics generation between RNA and ATAC, and generate paired multiomics data with biological meanings when one omics is experimentally unavailable and out of training datasets. The generated ATAC, either alone or in combination with measured RNA, exhibits equivalent or superior performance to that of the experimentally measured counterparts throughout multiple downstream analyses. scMOG is also applied to human lymphoma data, which proves to be more effective in identifying tumor samples than the experimentally measured ATAC data. Finally, the performance of scMOG is investigated in other omics such as proteomics and it still shows robust performance on surface protein generation.

Activating caspase-8/Bid/ROS signaling to promote apoptosis of breast cancer cells by folate-modified albumin baicalin-loaded nanoparticles

Abnormal apoptosis can lead to uncontrolled cell growth, aberrant homeostasis or the accumulation of mutations. Therapeutic agents that re-establish the normal functions of apoptotic signaling pathways offer an attractive strategy for the treatment of breast cancer. Baicalin (BA) is one of the natural compounds with anti-proliferation and pro-apoptosis activities against numerous tumor cells. However, low bioavailability restricts the clinical application of BA. In order to improve its therapeutic efficacy and study the mechanism of actions, active targeting delivery systems were developed for targeting tumor environment and selective cell killing effects. It emphasized on the construction of folate-conjugated albumin nanoparticles loaded with baicalin (FA-BSANPs/BA) and mechanisms of which on the promotion of breast cancer apoptosis. The physicochemical properties and structural characteristics of FA-BSANPs/BA were investigated. Cell experiments were carried out to study the targeted anti-breast cancer effects of FA-BSANPs/BA and its mechanism. The results showed that FA-BSANPs/BA was successfully constructed with stable structural characteristics and sustained release effects. Cellular uptake and MTT showed that it increased targeted uptake efficiency and cytotoxicity. Flow cytometry and western blot confirmed that it promoted apoptosis by increasing the expression of caspase-8 and ROS, and decreasing the level of Bid. It is suggested that the pro-apoptotic mechanism of FA-BSANPs/BA is related to regulation of key proteins in extrinsic apoptotic pathway. In conclusion, FA-BSANPs/BA is a good delivery carrier and significantly inhibits the breast cancer growth compared with free BA. The mechanism of FA-BSANPs/BA promoting apoptosis of breast cancer may be due to its action on the caspase-8/Bid/ROS pathway.

Baicalin-loaded folic acid-modified albumin nanoparticles (FA-BSANPs/BA) induce autophagy in MCF-7 cells via ROS-mediated p38 MAPK and Akt/mTOR pathway

Background

Breast cancer is the most frequently occurring cancer among women. Baicalin has been shown to inhibit breast cancer proliferation, but poor aqueous solubility and unknown mechanism of action limit its application. This study aimed to investigate the antiproliferative effects of baicalin-loaded folic acid-modified albumin nanoparticles (FA-BSANPs/BA) in breast cancer MCF-7 cells and its relationship with autophagy and ROS-mediated p38 MAPK and Akt/mTOR signaling pathways. Cell viability was detected by MTT assay. Flow cytometry and fluorescence microscopy were used to detect cell cycle, apoptosis and autophagy. Western blot was used to detect protein expression.

Results

Compared with the control and free baicalin groups, FA-BSANPs/BA inhibited viability of MCF-7 cells and increased cells in S phase, apoptotic bodies, pro-apoptotic proteins, autophagy markers and autophagosomes. These effects could be reversed when combined with the autophagy inhibitor 3-methyladenine. FA-BSANPs/BA increased the levels of phosphorylated p38 MAPK, inhibited the levels of phosphorylated Akt and mTOR, and increased the level of ROS in MCF-7 cells. The effects of FA-BSANPs/BA could be reversed or enhanced using inhibitors of Akt, mTOR, p38 MAPK and ROS scavengers.

Conclusions

Encapsulation in folate albumin nanoparticles improved the antiproliferative activity of baicalin. FA-BSANPs/BA induced autophagy and apoptosis via ROS-mediated p38 MAPK and Akt/mTOR signaling pathways in human breast cancer cells.

Study the mechanism of peimisine derivatives on NF-κB inflammation pathway on mice with acute lung injury induced by lipopolysaccharide

Peimisine is one of the alkaloids in Fritillariae ussuriensis Bulbus, which has anti-acute lung injury effect. In order to obtain compounds with superior bio-activity, 14 new derivatives were obtained from peimisine, and the better activity compounds were screened by MTT method. It was found that boc-leucine mono peimisine ester monoamide (compound G, 25 μg/ml) had increased cell survival rate and reduced the TNF-α, IL-1β, IL-6, and iNOS levels in RAW 264.7 by lipopolysaccharide (LPS)-stimulated. In vivo, LPS (10 mg/kg) was given intraperitoneally to establish ALI model, and compound G (2.5 or 10 mg/kg) was injected into mice as the experimental group. The results showed that after the compound G (10 mg/kg) treatment, the Wet / Dry ratio of the lung was reduced, and the expression of TNF-α, IL-1β, IL-6 and iNOS was inhibited. Meanwhile, compound G (10 mg/kg) could increase the content of IκB protein and reduce the content of p65 protein in lung tissue by Western blot analysis, which may play an anti-acute lung injury role by inhibiting the activity of NF-κB signaling pathway. In conclusion, compound G could attenuate LPS-induced ALI in mice and it may become a new approach to treat ALI.

Long-term Follow-up of Pulsed Radiofrequency Treatment for Trigeminal Neuralgia: Kaplan-Meier Analysis in a Consecutive Series of 149 Patients

BACKGROUND

At present, there is no ideal method for the treatment of trigeminal neuralgia (TN). The need for an easy, safe, non- or micro-neurodestructive, repeatable treatment, with a fairly satisfactory rate of pain relief, is paramount. Pulsed radiofrequency (PRF) as a minimally invasive and microdestructive technique has been reported to be an option for TN; however, no study has reported the long-term outcome of TN in a large case series.

OBJECTIVES

We aimed to investigate the efficacy, safety, and the long-term outcomes of PRF treatment for patients with TN.

STUDY DESIGN

This was a long-term, large case series, retrospective study.

SETTING

The study was conducted at Tiantan hospital,Beijing.

METHODS

We retrospectively analyzed medical databases and follow-up data of 149 patients with TN from January 2008 through March 2021, who underwent PRF treatment, with a median follow-up time of 71.0 months (interquartile range, 20.0 months to 112.0 months). Baseline characteristics and intraoperative data of patients were retrospectively extracted; data about complications and side effects were also collected. The follow-up data were composed of the postoperative Barrow Neurological Institute Pain Intensity Score  pain intensity at a different time, the onset time of PRF treatment, and the time when pain was recurrent.

RESULTS

The initial pain relief rate was 75.17% after the procedure. The cumulative recurrence-free survival after the procedure was 75.00% at one month; 72.87% at 6 months; 70.59% at 12 months; 65.39% at 24 months; 61.63% 48 months; 56.73% at 96 months; and 49.64% at 144 months. The median recurrence-free time was 118 months according to the Kaplan-Meier estimator. Nineteen patients had pain recurrence with a median time of 15 months (range, 1.0 months to 96.0 months), among whom, 12 underwent a second PRF procedure and 9 patients experienced satisfactory pain relief. No serious complications or side effects occurred after the procedure.

LIMITATIONS

This was a single-center, retrospective study. Our study failed to conduct a stratified analysis on the effect of PRF treatment for classic and idiopathic TN. The most efficacious parameters of PRF applied for TN and studies trying to identify positive predictive factors of pain relief before PRF treatment have yet to be investigated.

CONCLUSIONS

The results of this study show the promising long-term effect of PRF on primary TN. The safety and repeatability might be more easily accepted by patients with TN and should be considered a preferred treatment option before choosing neurodestructive or more invasive methods.

Psoralen-loaded polymeric lipid nanoparticles combined with paclitaxel for the treatment of triple-negative breast cancer

Background: Chemotherapeutic drugs are associated with toxic effects. Metastasis is the leading cause of death in breast cancer patients. Aim: To evaluate the antitumor effect of paclitaxel (PTX) combined with psoralen-loaded polymeric lipid nanoparticles (PSO-PLNs) in triple-negative breast cancer. Methods: After treatment of samples, cell viability, apoptosis, migration, invasion, expression of proteins in the IRAK1/NF-κB/FAK signal pathway, biodistribution and pathological characteristics were detected. Results: Compared with the control group, the PTX + PSO-PLNs group showed increased apoptosis and reduced migration, invasion and expression of phosphorylated IRAK1 and NF-κB, with significant inhibition of tumor growth and lung metastases and no obvious toxicity. Conclusion: Combined administration of PTX and PSO-PLNs exerted a synergistic effect and significantly inhibited the growth and metastasis of triple-negative breast cancer.

Emodin-loaded polymer-lipid hybrid nanoparticles enhance the sensitivity of breast cancer to doxorubicin by inhibiting epithelial–mesenchymal transition

Background

The role of epithelial–mesenchymal transition (EMT) involved in breast cancer metastasis and chemoresistance has been increasingly recognized. However, it is necessary to search for more effective strategies to inhibit EMT thereby increase the sensitivity of breast cancer cells to chemotherapy drugs. Emodin has a potential in overcoming tumor drug resistance and restraining the development of EMT, but the poor internalization into breast cancer cells limited the application.

Results

MCF-7/ADR cells have more EMT characteristics than MCF-7 cell. EMT in MCF-7/ADR cells promotes the development of drug resistance via apoptosis resistance and facilitating the expression of P-gp. The anti-cancer effect of DOX enhanced by the decreasing of drug resistance protein P-gp and apoptosis-related proteins after EMT inhibited in MCF-7/ADR cells. E-PLNs increase the cellular uptake of EMO and restore DOX sensitivity in MCF-7/ADR cells by inhibiting EMT.

Conclusion

E-PLNs inhibit EMT to enhance the sensitivity of breast cancer to DOX. The combination of E-PLNs and DOX can improve the efficacy of DOX in the treatment of breast cancer, which provides a new method to prevent or delay clinical drug resistance.

A review of nanoparticle drug delivery systems responsive to endogenous breast cancer microenvironment

Breast cancer, as a malignant disease that seriously threatens women's health, urgently needs to be researched to develop effective and safe therapeutic drugs. Nanoparticle drug delivery systems (NDDS), provide a powerful means for drug targeting to the breast cancer, enhancing the bioavailability and reducing the adverse effects of anticancer drug. However, the breast cancer microenvironment together with heterogeneity of cancer, impedes the tumor targeting effect of NDDS. Breast cancer microenvironment, exerts endogenous stimuli, such as hypoxia, acidosis, and aberrant protease expression, shape a natural shelter for tumor growth, invasion and migration. On the basis of the ubiquitous of endogenous stimuli in the breast cancer microenvironment, researchers exploited them to design the stimuli-responsive NDDS, which response to endogenous stimulus, targeted release drug in breast cancer microenvironment. In this review, we highlighted the effect of the breast cancer microenvironment, summarized innovative NDDS responsive to the internal stimuli in the tumor microenvironment, including the material, the targeting groups, the loading drugs, targeting position and the function of stimuli-responsive nanoparticle drug delivery system. The limitations and potential applications of the stimuli-responsive nanoparticle drug delivery systems for breast cancer treatment were discussed to further the application.

Knockdown of p66ShcA activates Nrf2 pathway to protect cardiomyocytes from oxidative stress and inflammation induced by H2O2

OBJECTIVE

Oxidative stress and inflammation are the most common causes of myocardial ischemia and hypoxia. This article focuses on the effect of p66ShcA on H2O2-induced cardiomyocytes.

MATERIALS AND METHODS

The p66ShcA knockdown model of H9c2 cells was constructed by plasmid transfection. After treatment of different groups with H2O2, oxidative stress-related factors and inflammatory factors were detected.

RESULTS

The expressions of SOD1, SOD2, GPX1, and GPX3 in H2O2 cells were significantly decreased, IL-1β and IL-6 expression were significantly increased, while p66ShcA siRNA negative group could promote the expression of SOD1, SOD2, GPX1, and GPX3, inhibit the expression of IL-1β and IL-6 significantly, and activates the Keap1/Nrf2 pathways.

CONCLUSIONS

Knockdown of p66ShcA can activate Keap1/Nrf2 pathway, which inhibits H2O2-induced oxidative stress and inflammation in H9c2 cells.

Role of inflammatory microenvironment: potential implications for improved breast cancer nano-targeted therapy

Tumor cells, inflammatory cells and chemical factors work together to mediate complex signaling networks, which forms inflammatory tumor microenvironment (TME). The development of breast cancer is closely related to the functional activities of TME. This review introduces the origins of cancer-related chronic inflammation and the main constituents of inflammatory microenvironment. Inflammatory microenvironment plays an important role in breast cancer growth, metastasis, drug resistance and angiogenesis through multifactorial mechanisms. It is suggested that inflammatory microenvironment contributes to providing possible mechanisms of drug action and modes of drug transport for anti-cancer treatment. Nano-drug delivery system (NDDS) becomes a popular topic for optimizing the design of tumor targeting drugs. It is seen that with the development of therapeutic approaches, NDDS can be used to achieve drug-targeted delivery well across the biological barriers and into cells, resulting in superior bioavailability, drug dose reduction as well as off-target side effect elimination. This paper focuses on the review of modulation mechanisms of inflammatory microenvironment and combination with nano-targeted therapeutic strategies, providing a comprehensive basis for further research on breast cancer prevention and control.

Effects of immune cells and cytokines on inflammation and immunosuppression in the tumor microenvironment

Chronic inflammation and immune responses are two core element that characterize the tumor microenvironment. A large number of immune/inflammatory cells (including tumor associated macrophages, neutrophils and myeloid derived suppressor cells) as well as cytokines (such as IL-6, IL-10, TGF-β) are present in the tumor microenvironment, which results in both a chronic inflammatory state and immunosuppression. As a consequence tumor cell migration, invasion, metastasis and anticancer drug sensitivity are modulated. On the one hand, secreted cytokines change the function of cytotoxic T lymphocytes and antigen presenting cells, thereby inhibiting tumor specific immune responses and consequently inducing a special immunosuppressive microenvironment for tumor cells. On the other hand, tumor cells change the differentiation and function of immune/inflammatory cells in the tumor microenvironment especially via the NF-κB and STAT3 signaling pathways. This may promote proliferation of tumor cells. Here we review these double edged effects of immune/inflammatory cells and cytokines on tumor cells, and explored their interactions with inflammation, hypoxia, and immune responses in the tumor microenvironment. The tumor inflammatory or immunosuppressive reactions mediated by the high activity of NF-κB or STAT3 can occur alone or simultaneously, and there is a certain connection between them. Inhibiting the NF-κB or STAT3 signaling pathway is likely to curb the growth of tumor cells, reduce the secretion of pro-inflammatory factors, and enhance the anti-tumor immune response.

Abstract S07-02: Patient-reported outcomes of breast cancer patients during the COVID-19 outbreak in the epicenter of China: A cross-sectional survey study

Purpose: We aimed to analyze the psychological status of breast cancer (BC) patients in the epicenter of the COVID-19 pandemic.

Patients and Methods: A total of 658 individuals were recruited from multiple breast cancer centers in Hubei Province. Online questionnaires were conducted and included demographic information, clinical features, and four patient-reported outcomes (PROs) scales (GAP-7, PHQ-9, ISI, and IES-R). Multivariable logistic regression analysis was designed to identify potential factors on mental health outcomes.

Results: Questionnaires were collected from February 16 to 19, 2020, the peak time point of COVID-19 outbreak in China. 46.2% of BC patients had to modify planned necessary anticancer treatment during the outbreak. 8.9% and 9.3% of patients reported severe anxiety and severe depression, respectively. 20.8% and 4.0% of patients showed severe distress and insomnia, respectively. Multivariable logistic regression analysis demonstrated poor general condition, shorter duration after BC diagnosis, aggressive BC molecular subtypes, and close contact with COVID-19 patients as independent factors associated with anxiety. Poor general condition and CVC (central venous catheter) flushing delay were factors independently associated with depression. In terms of insomnia, poor general condition was the only associated independent factor. Poor physical condition and treatment discontinuation were underlying risk factors for distress based on multivariable analysis.

Conclusion: High rates of anxiety, depression, distress, and insomnia were observed in patients with breast cancer during the COVID-19 outbreak. Special attention should be paid to the psychological status of breast cancer patients, especially those with poor general condition, treatment discontinuation, aggressive molecular subtypes, and metastatic breast cancer.

Citation Format: Juanjuan Li, Cesar Augusto Santa-Maria, Hongfang Feng, Lingcheng Wang, Pengcheng Zhang, Yuangbing Xu, Yuyan Tan, Zhongchun Liu, Bo Du, Meng Lan, Qingfeng Yang, Feng Yao, Yi Tu, Shengrong Sun, Xingrui Li, Chuang Chen. Patient-reported outcomes of breast cancer patients during the COVID-19 outbreak in the epicenter of China: A cross-sectional survey study [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr S07-02.

Bismuth-rich bismuth oxyiodide microspheres with abundant oxygen vacancies as an efficient photocatalyst for nitrogen fixation

A combined bismuth-rich and defect introduction strategy was used to prepare the H-Bi₅O₇I with abundant oxygen vacancies, which can effectively yield ammonia under visible light without any organic scavengers or noble-metal cocatalysts.

Antioxidant, Anti-inflammatory and Cytotoxic Activities of Polyphenols Extracted from Chroogomphus rutilus

Chroogomphus rutilus is a rare fungal species that grows under pine trees and is now widely used as a functional food and pharmaceutical product. However, the chemical constituents and biological activities of Chroogomphus rutilus have been relatively limited. The present study aimed at determining the total polyphenols and flavonoids contents, biological activities and main phenolic compounds of Chroogomphus rutilus from different geographical origins at the stipe and pileus. The results suggested that Chroogomphus rutilus polyphenol extracts revealed a higher antioxidant, anti-inflammatory, and cytotoxic activities, and there were significant differences between samples from different locations and regions. Correlation analysis showed that the contents of total polyphenols and flavonoids were significantly correlated with antioxidant and anti-inflammatory activities. However, only the content of total flavonoids was significantly correlated with cytotoxicity, which means that the cytotoxicity of Chroogomphus rutilus polyphenol extracts may be regulated by flavonoids or other compounds. HPLC-DAD analysis revealed that the main phenolic compound was protocatechuic acid, followed by baicalin, p-hydroxyphenylacetic acid and p-hydroxybenzoic acid, but comparing with the pileus extracts, the stipe extracts can be considered as a higher concentration of phenolic compounds. Therefore, antioxidant, anti-inflammatory and cytotoxic activities of Chroogomphus rutilus polyphenol extracts could be due to the identified compounds. This study investigated a deep knowledge about the constituents and activities of Chroogomphus rutilus and provided the reference for its application in food and pharmaceutical.

[Comparative study on visual fatigue caused by watching liquid crystal display and projection display]

Objective: To explore the effect of different types of visual display terminals (VDT) on visual fatigue. Methods: A total of 68 subjects were enrolled and divided into flat screen group, metal screen group and glass bead screen group. The subjects watched a video in the same environment for 60 minutes. Before and after watching, they were asked to fill in a visual fatigue rating scale and underwent visual function examinations. The blink rate of subjects was recorded during the experiment. Results: After watching the video, for the metal screen, glass bead screen, and flat screen group respectively: (1)The median (interquartile range, IQR) of visual fatigue rating increased significantly (before: 1.0 (1.2), 1.3 (1.6), 0.5 (0.9); after: 2.1 (1.9), 2.1 (1.7), 1.2 (1.0); Z=-4.72, -4.83, -3.75; all P<0.05). (2) The median (IQR) of blink frequency increased significantly (before: 11.5 (10.6), 15.3 (11.9), 7.0 (13.0) times/minute; after: 15.0 (13.0), 17.0 (16.0), 15.0 (12.0) times/minute; Z=-2.64, -2.74, -4.12; all P<0.05). (3) The mean (±standard deviation) of critical flicker fusion frequency (CFF) decreased significantly [before: (35.76±2.98), (35.84±2.79), (35.44±2.21) Hz; after: (35.09±2.78), (34.94±2.67), (34.57±2.33) Hz; t=-2.64, -2.38, -4.12; all P<0.05). (4)The median (IQR) of near point of convergence (NPC) became significantly larger [before: 3.9 (2.6), 4.0 (2.5), 4.3 (2.7) cm; after 5.4 (3.8), 4.8 (2.7), 6.1 (3.9) cm; Z=-3.39, -2.27, -3.36; all P<0.05]. (5)The median of negative relative accommodation (NRA) reduced significantly [before: 2.00 (0.50), 2.00 (0.56), 2.00 (0.25) cm; after 1.75 (0.50), 1.75 (0.25), 1.75 (0.50) cm; Z=-1.98, -2.09, -2.53; all P<0.05]. Meanwhile, no significant changes were found for the positive relative accommodation (PRA), accommodative amplitude, accommodative response, negative relative vergence in all groups after watching the video. The comparisons between the three groups showed that, after watching the video, the participants in the two kinds of projection screen group (the metal and glass bead screen group) had more subjective visual fatigue than those in the flat screen group respectively (Z=-2.09, -2.21; all P<0.05), while there was no significant difference in subjective visual fatigue between the two projection screen groups (P>0.05). In addition, positive fusional vergence recovery point and break point decreased after watching the video in the metal screen and glass bead screen group, respectively (t=4.15, 2.07; all P<0.05). However, no such change was found in the flat screen group. Conclusions: Short-term and long-distance VDT operations have significant effects on visual fatigue, which may be due to the decreased positive convergence ability. VDT operations over projection screens may result in more visual fatigue than LED flat panel display, while the effect of different projection screen types have insignificant influences on visual fatigue. (Chin J Ophthalmol, 2019, 55:595-600).

Efficacy and safety of CT-guided percutaneous pulsed radiofrequency treatment of the Gasserian ganglion in patients with medically intractable idiopathic trigeminal neuralgia

Background

There is a lack of prospective studies for the long-term results of percutaneous pulsed radiofrequency (PRF) of the Gasserian ganglion in the treatment of patients with medically refractory trigeminal neuralgia (TN).

Methods and results

We prospectively observed the outcomes of 28 idiopathic TN patients (between July 2013 and July 2016) who received CT-guided percutaneous PRF treatment of the Gasserian ganglion. All of the patients had stopped responding to drug therapy before PRF treatment. The effective treatment standard was a reduction in the pain numeric rating scale (NRS) by ≥50% after the procedure. The postoperative NRS score decreased gradually from preoperative 7.6±0.8 months to 1.5±2.4, 0.2±0.4, 0.2±0.4, 0.1±0.4, and 0.1±0.4 at 1, 3, and 6 months and 1 and 2 years after the PRF treatment. The response rates at 1, 3, and 6 months were 85.7%, and the rates at 12 months and 2 years were maintained at 78.6%. No serious side effects were observed.

Conclusion

CT-guided PRF invention is an effective and safe technique for medically intractable idiopathic TN patients. This minimally invasive alternative treatment has the potential as a first-line therapy for TN.

A thermal protective urethral heater applied to modulate the prostate cryoablation area

BACKGROUND

Urethral warmer and cryoheater are invented and applied in cryoablation to overcome urethral cryoinjury, but these devices cannot be fixed and precisely control the released heat which excessively reduces the effective ablation area. Current warmers enlarge the operation difficulty and decrease the precision in temperature control.

OBJECTIVE

A reformed catheter termed urethral heater aims to protect the urethra and simultaneously control the released heat so as to meet the aid of doctors' convenient operation in effective therapy, device fixation and precise heat controllability.

MATERIALS AND METHODS

In this paper, the temperature controller combined with temperature monitor was used to control the heating behavior of the urethral heater with the initial active temperature. The controllability and thermal protection of the urethral heater was simulated and tested, which compared with that of urethral warmer.

RESULTS

During the trials in vitro, the lowest temperature at the urethra surface is -3.7 degree C when one cryoprobe was introduced in the cryoablation for 15 min and -15.3 degree C with two cryoprobes. Above all, the effective cryoablation area increased with the decline of initial active temperatures.

CONCLUSION

The urethral heater is able to prevent the urethra from irreversible damage and modulate the ablation area. The delay of heat is a new way to decline the recurrence rate and facilitate the desire of aconuresis during the cryoablation.

Reversal of multidrug resistance of gastric cancer cells by down-regulation of ZNRD1 with ZNRD1 siRNA

The over-expression of a new zinc ribbon (ZNRD1) gene has been shown previously to promote a multidrug-resistant phenotype in gastric cancer cells through the up-regulation of permeability-glycoprotein (P-gp). In the present study, siRNA eukaryotic expression vectors of ZNRD1 are constructed and transfected into SGC7901/VCR cells to examine whether or not down-regulation of ZNRD1 increases cell sensitivity towards chemotherapeutic drugs. After transfection, ZNRD1 expression decreased dramatically in ZNRD1 siRNA transfectants compared with that in parental cells and empty vector control cells. Down-regulation of ZNRD1 significantly enhanced the sensitivity of SGC7901/VCR cells to vincristine, adriamycin and etoposide, but not to 5-fluorouracil and cisplatin. Cell capacity to efflux adriamycin decreased markedly in ZNRD1 siRNA transfectants, and correlation between ZNRD1 down-regulation and increased multidrug resistance 1 (MDR1) gene transcriptional activity was observed. These results suggest that the ZNRD1 siRNA constructs down-regulate the expression of ZNRD1 effectively and reverse the resistant phenotype of gastric cancer cells. Furthermore, ZNRD1 might influence transcription of the MDR1 gene and thus play an important role in multidrug resistance in gastric carcinoma.

Computerized tomography-guided sphenopalatine ganglion pulsed radiofrequency treatment in 16 patients with refractory cluster headaches: Twelve- to 30-month follow-up evaluations

BACKGROUND

Sphenopalatine ganglion percutaneous radiofrequency thermocoagulation treatment can improve the symptoms of cluster headaches to some extent. However, as an ablation treatment, radiofrequency thermocoagulation treatment also has side effects.

OBJECTIVE

To preliminarily evaluate the efficacy and safety of a non-ablative computerized tomography-guided pulsed radiofrequency treatment of sphenopalatine ganglion in patients with refractory cluster headaches.

METHODS

We included and analysed 16 consecutive cluster headache patients who failed to respond to conservative therapy from the Pain Management Center at the Beijing Tiantan Hospital between April 2012 and September 2013 treated with pulsed radiofrequency treatment of sphenopalatine ganglion.

RESULTS

Eleven of 13 episodic cluster headaches patients and one of three chronic cluster headaches patient were completely relieved of the headache within an average of 6.3 ± 6.0 days following the treatment. Two episodic cluster headache patients and two chronic cluster headache patients showed no pain relief following the treatment. The mean follow-up time was 17.0 ± 5.5 months. All patients enrolled in this study showed no treatment-related side effects or complications.

CONCLUSION

Our data show that patients with refractory episodic cluster headaches were quickly, effectively and safely relieved from the cluster period after computerized tomography-guided pulsed radiofrequency treatment of sphenopalatine ganglion, suggesting that it may be a therapeutic option if conservative treatments fail.

Absolute configuration and chiral self-assembly of rubrene on Bi(111)

We investigated the chiral self-assembly of rubrene molecules on a semi-metallic Bi(111) surface using low-temperature scanning tunneling microscopy.

Enhanced visible-light-induced photocatalytic performance of a novel ternary semiconductor coupling system based on hybrid Zn–In mixed metal oxide/g-C3N4 composites

Ternary semiconductor coupling system based on hybrid Zn–In mixed metal oxide/g-C₃N₄ composites exhibited significantly enhanced visible-light-induced photocatalytic performance.

Mitochondrial SIRT3 and its target glutamate dehydrogenase are altered in follicular cells of women with reduced ovarian reserve or advanced maternal age

STUDY QUESTION

Is the activity of sirtuin 3 (SIRT3) altered in granulosa and cumulus cells from young women with reduced ovarian reserve or women of advanced maternal age?

SUMMARY ANSWER

SIRT3 mRNA and active protein in granulosa and cumulus cells were decreased in women with reduced ovarian reserve and advanced maternal age.

WHAT IS KNOWN ALREADY

Young women with reduced ovarian reserve or women of advanced maternal age have reduced oocyte viability, possibly due to altered granulosa and cumulus cell metabolism. The mitochondrial SIRT3 protein may be implicated in these processes as it is able to sense the metabolic state of the cell and alter mitochondrial protein function post-translationally.

STUDY DESIGN, SIZE, DURATION

This is a prospective cohort study, in which women (n = 72) undergoing routine IVF/ICSI were recruited and allocated to one of three cohorts based on age and ovarian reserve (as assessed by serum anti-Mullerian hormone level). Women were classified as young (≤35 years) or of advanced maternal age (≥40 years).

PARTICIPANTS/MATERIALS, SETTING, METHODS

Granulosa and cumulus cells were collected. SIRT3 mRNA and protein levels and protein activity was analysed in granulosa and cumulus cells via quantitative PCR, immunohistochemistry and western blotting, and deacetylation activity, respectively. Activity of the glutamate dehydrogenase (GDH) enzyme, a known target of SIRT3, was assessed, and acetylated proteins in mitochondria isolated from granulosa and cumulus cells were separated by immunoprecipitation and acetylation of GDH assessed by western blotting. Data for women with good prognosis (young women with normal ovarian reserve) were compared with those from young women with reduced ovarian reserve and those of advanced maternal age.

MAIN RESULTS AND THE ROLE OF CHANCE

SIRT3 mRNA and active protein were present in granulosa and cumulus cells and co-localized to the mitochondria. SIRT3 mRNA in granulosa cells was decreased in young women with reduced ovarian reserve and advanced maternal age versus young women with normal ovarian reserve (P < 0.05). SIRT3 mRNA in cumulus cells was decreased in women of advanced maternal age versus young women with normal ovarian reserve only (P < 0.05). Granulosa cell GDH activity was decreased in young women with reduced ovarian reserve and in women of advanced maternal age (P < 0.05), whereas cumulus cell GDH activity was reduced in the advanced maternal age group only (P < 0.05). The acetylation profile of GDH in mitochondria revealed increased acetylation of GDH in granulosa and cumulus cells from women of advanced maternal age (P < 0.05) while young women with reduced ovarian reserve had increased GDH acetylation in granulosa cells only (P < 0.05).

LIMITATIONS, REASONS FOR CAUTION

Although patients were allocated to groups based on maternal age and ovarian reserve and matched for BMI, other maternal factors may also alter the 'molecular health' of ovarian cells.

WIDER IMPLICATIONS OF THE FINDINGS

Our data suggest that SIRT3 post-translational modification of mitochondrial enzymes in human granulosa and cumulus cells may regulate GDH activity, thus altering the metabolic milieu surrounding the developing oocyte. Owing to the association between the decline in oocyte quality and pregnancy rates in women of advanced maternal age and the possible association with reduced ovarian reserve, knowledge of perturbed SIRT3 function in granulosa and cumulus cells may lead to novel therapies to improve mitochondrial metabolism in the oocyte and follicular cells in women undergoing IVF treatment.

STUDY FUNDING/COMPETING INTEREST(S)

No conflicts of interest to declare. Research was funded by an NHMRC project grant.

3D CT-guided pulsed radiofrequency treatment for trigeminal neuralgia

Trigeminal neuralgia (TN) is a pain syndrome characterized by pain in the trigeminal area often accompanied by a brief facial spasm or tic. The purpose of our study was to investigate the efficacy and clinical utility of CT-guided pulsed radiofrequency (PRF) for treatment of TN. Patients who were diagnosed with severe TN between September 2010 and October 2010 at Beijing Tiantan Hospital were included. Pulsed radiofrequency treatment (PRFT) was employed to treat TN. To verify the accurate needle position, a thin-section cranial CT scan was performed by using a multidetector CT scanner. Three-dimensional reconstruction was performed to visualize the location of the needle and the foramen ovale. A total of 20 patients were included in the study. Seven patients (35%) had favorable outcome 1 year after the PRFT. The numeric rating scale in the 7 patients with good outcome was significantly lower than the 13 patients with bad outcome at 1 day, 1 week, and 2 weeks after the treatment. The remaining 13 patients had residual pain 2 weeks after the PRFT and had to receive radiofrequency thermocoagulation (RFTC). In conclusion, the results of our study demonstrate that CT-guided PRFT is not an effective method of pain treatment for idiopathic TN as compared with conventional RFTC. However, CT-guided PRFT is associated with less complication than RFTC.

Chiral pinwheel clusters lacking local point chirality

The supramolecular pinwheel cluster is a unique chiral structure with evident handedness. Previous studies reveal that the chiral pinwheels are composed of chiral or achiral molecules with polar groups, which result in strong intermolecular interactions such as hydrogen-bonding or dipole interactions. Herein, it is shown that the simple linear aromatic molecule, pentacene, can be self-assembled into large chiral pinwheel clusters on the semimetal Bi(111) surface, due to enhanced intermolecular interactions. The pentacene pinwheels reveal two levels of organizational chirality: the chiral hexamers resulting from asymmetric shifting along the long molecular axis, and chiral arrangement of six hexamers with a rotor motif. Furthermore, a new relation between the local point chirality and organizational chirality is identified from the pinwheels: the former is not essential for the latter in 2D pinwheel clusters of the pentacene molecule.

Clonal Status and Clinicopathological Features of Langerhans Cell Histiocytosis

Some studies have demonstrated that Langerhans cell histiocytosis (LCH) is a neoplastic hyperplasia of Langerhans cells, however some researchers consider that clonality should be assessed in more patients with LCH, both at disease presentation and during the disease course. Monoclonality is a major characteristic of most tumours, whereas normal tissue and reactive hyperplasia are polyclonal. To elucidate the nature of Langerhans cells further, the present study investigated the clinicopathological features and clonality of three cases of LCH in female patients using laser microdissection and a clonality assay, based on X-chromosomal inactivation mosaicism in somatic tissues and polymorphism of the androgen receptor gene. The results indicated that LCH was composed of Langerhans cells with a characteristic morphological appearance, eosinophils, giant cells, neutrophils and foamy cells. Immunohistochemically, the Langerhans cells were positive for CD1a, S-100 protein and vimentin. The clonality assay demonstrated that the Langerhans cells formed a monoclonal population, showing that LCH is neoplastic. We conclude that LCH is characterized by clonal proliferation, although additional studies with larger sample sizes are required to prove this conclusively.

Overexpression of PrPC and its antiapoptosis function in gastric cancer

Cellular prion protein (PrP(C)), a glycosylphosphatidylinositol-anchored membrane protein, was found in our lab to be widely expressed in gastric cancer cell lines. In order to evaluate its biological significance in human gastric cancer, we investigated its expression in a large series of gastric tissue samples (n = 124) by immuno histochemical staining with the monoclonal antibody 3F4. Compared with normal tissues, gastric adenocarcinoma showed increased PrP(C) expression, correlated with the histopathological differentiation (according to the WHO and Lauren classifications) and tumor progression (as documented by pTNM staging). To better understand the underlying mechanism, we introduced the PrP(C) and two pairs of RNAi into the poorly differentiated gastric cancer cell line AGS and found that PrP(C) suppressed ROS and slowed down apoptosis in transfected cells. Further study proved that the apoptosis-related protein Bcl-2 was upregulated whereas p53 and Bax were downregulated in the PrP(C)-transfected cells. A reverse effect was observed in PrP(C) siRNA-transfected cells. These results strongly suggested that PrP(C) might play a role as an effective antiapoptotic protein through Bcl-2-dependent apoptotic pathways in gastric cancer cells. Further study into the mechanism of these relationships might enrich the knowledge of PrP, better our understanding of the nature of gastric carcinoma, and further develop possible strategies to block or reverse the development of gastric carcinoma.

[Blood lipid adsorption of polyethylene glycol/montmorillonite nanocomposite]

OBJECTIVE

To evaluate the effect of polyethylene glycol/montmorillonite (PEG/MMT) nanocomposite material in adsorption of triglyceride (TG), cholesterin and low-density lipoprotein-cholesterol (LDL-C).

METHODS

The structure of PEG/MMT nanocomposite was analyzed by means of X ray diffraction and its effect of blood lipid and albumin adsorption was evaluated in comparison with Na-MMT.

RESULTS

The interval distance was larger when the PEG of greater molecular weight was used for preparing the nanocomposite, and PEG/MMT nanocomposite had greater adsorption rate of TG, cholesterin and LDL-C in serum than that of serum albumin. MMT material had poor adsorption effect.

CONCLUSION

PEG/MMT nanocomposite possesses the potential as a novel adsorbent of blood lipid for clinical use.