[A randomized controlled study on the long-term efficacy of intra-cervical lymphatic immunotherapy for adult allergic rhinitis]

Objective: To determine the long-term efficacy and safety of intra-cervical lymphatic immunotherapy (ICLIT) for adult allergic rhinitis (AR) by comparing it with subcutaneous immunotherapy (SCIT). Methods: A total of 100 adult AR patients with dust mite allergy in Department of Otorhinolaryngology, First People's Hospital of Foshan from Feb 2018 to Dec 2019 were randomly divided into two groups, 50 in SCIT group [including 42 males and 8 females, aging (32.55±9.72) years] and 50 in ICLIT group [including 45 males and 5 females, aging (31.33±9.84) years]. The changes in total symptom score (total system score, TSS), nasal symptom score (total nasal symptom score, TNSS), eye symptom score (total ocular scoring system, TOSS), drug score (total medication score, TMS), and quality of life score of the two groups of patients were evaluated before and after treatment, and the adverse reactions of all patients during the treatment period were recorded. The changes in the level of dust mite specific IgE (sIgE) in the serum were evaluated. GraphPad Prism 9.0 software was used for statistical analysis. Results: In the SCIT group, 38 patients completed treatment and follow-up, with a dropout rate of 24%. In the ICLIT group, 48 patients completed treatment and follow-up, with a dropout rate of only 4%. The scores of TSS, TNSS, TOSS, TMS, and quality of life in the ICLIT group before treatment were 32.1±3.0, 27.3±3.1, 4.8±2.8, 2.3±0.9, and 68.1±28.7, respectively; After 36 months of treatment, the scores were 21.8±11.4, 18.1±9.4, 3.7±2.9, 1.3±1.1, and 36.0±26.7, respectively, which were significantly lower than those before treatment (all P<0.001). After 36 months of treatment, the TSS of the ICLIT group improved by 10.3±11.2 compared to before, while the TSS of the SCIT group improved significantly by 21.9±11.0 compared to before, with statistically significant differences between the groups (P<0.001). No serious systemic adverse reactions occurred in both groups of patients. Conclusions: ICLIT treatment for adult AR has long-term efficacy, high safety, and high compliance, but its long-term efficacy is not as good as SCIT. ICLIT can be considered as a new complementary option for AR immunotherapy.

Muscle cytotoxicity and immuno-reactivity analysis of the porous carbon nanospheres fabricated by high temperature calcination

Carbon-based nanomaterials have a high specific surface area, biocompatibility, and controlled mesopore structures. These characteristics make carbon nanospheres excellent carriers for drugs, biological dyes, photosensitizers, etc. Nevertheless, little is known about the impact of topological features on the surface of carbon nanomaterials on their in vivo immunoreactivity. In this study, we fabricated mesoporous carbon nanoparticles (MCNs) and solvent-processable carbon vesicles (CVs) by high-temperature calcination. The hematoxylin and eosin (H&E) staining suggested CVs' relatively poor dispersion capacity compared to MCNs and carbon precursors (CPs), leading to more severe muscle inflammation and necrosis. Immunostaining and Fluorescence Activated Cell Sorter (FACS) analysis further showed that both MCNs and CVs triggered a transient immune response in transplanted muscle and muscle-draining lymph nodes, but did not alter muscle resistance to exogenous viruses. In conclusion, this study provides insights into how carbon nanoparticles modulate the activation of immune responses in vivo.

A novel FAM83H variant causes familial amelogenesis imperfecta with incomplete penetrance

Background

Amelogenesis imperfecta (AI) is known to be a monogenic genetic disease caused by a variety of genes demonstrating a wide spectrum of penetrance. FAM83H is reported to be involved in AI: however, whether FAM83H causes AI with incomplete penetrance is unclear.

Methods

Whole‐exome sequencing was performed on two patients with AI, and putative disease‐related variants were validated by Sanger sequencing. Bioinformatic and in vitro functional analyses were performed to functionally characterize the identified disease‐causing variants.

Results

We identified a novel heterozygous nonsense variant of FAM83H (NM_198488: c.1975G > T, p.Glu659Ter); in vitro functional analysis showed that this mutant produced mislocalized proteins and was deleterious. Surprisingly, the clinical manifestations of each of the six individuals carrying this variant were different, with one carrier appearing to be completely asymptomatic for AI.

Conclusion

Our findings expand the variant spectrum for FAM83H and the phenotypic spectrum for FAM83H‐associated AI and suggest that FAM83H‐mediated AI exhibits incomplete penetrance.

The monomer derivative of paeoniflorin inhibits macrophage pyroptosis via regulating TLR4/ NLRP3/ GSDMD signaling pathway in adjuvant arthritis rats

OBJECTIVE

This study was aimed to investigate the effect of monomer derivative of paeoniflorin (MDP) on macrophage pyroptosis mediated by TLR4/NLRP3/GSDMD signaling pathway in adjuvant arthritis (AA) rats.

METHOD

Wistar rats were divided into normal group, AA model group, MDP (50 mg/kg) group and MTX (0.5 mg/kg) group. The expression of TLR4, NLRP3 and GSDMD in macrophage were detected by immunofluorescence assay. The expression of TLR4 and the ratio of macrophage pyroptosis were analyzed by flow cytometry. Cell morphology was observed by scanning electron microscopy. The cytokine levels of IL-18 and IL-1β were detected by ELISA. The expressions of proteins related to macrophage pyroptosis were detected by western blot.

RESULTS

MDP has a therapeutic effect on rats AA by reducing the secondary inflammation and improving pathological changes. The results of X-ray imaging and ultrasound images showed that MDP could inhibit bone erosion, soft tissue swelling, and joint space narrowing. Macrophage pyroptosis was found in secondary inflammation of AA rats. The expressions of TLR4, MyD88, NLRP3, Caspase-1, ASC, and GSDMD-N in macrophage were increased, the levels of IL-18 and IL-1β were enhanced, and the morphology of pyroptosis could be observed. MDP could inhibit macrophage polarization and macrophage pyroptosis, and down-regulated the cytokine levels of IL-18 and IL-1β in AA rats. MDP could regulate the M1/M2 ratio, decreased the ratio of macrophage pyroptosis and down-regulated the expressions of TLR4, MyD88, NLRP3, Caspase-1, ASC, and GSDMD-N in vivo and in vitro.

CONCLUSION

Abnormal activation of TLR4/NLRP3/GSDMD signaling pathway may be involved in macrophage pyroptosis in AA rats. The therapeutic effect of MDP on AA rats is related to the inhibition of macrophage pyroptosis by regulating the TLR4/NLRP3/GSDMD signaling pathway.

Nomograms for predicting progression-free survival and overall survival after surgery and concurrent chemoradiotherapy for glioblastoma: a retrospective cohort study

Background

Glioblastoma (GBM) is the most common malignant brain tumor in adults. The prognosis of GBM patients is poor. Even with active standard treatment, the median overall survival is only 14.6 months. It is therefore critical to ascertain recurrence and search for factors that influence the prognosis of GBM. This study aimed to screen the variables related to the progression-free survival (PFS) and overall survival (OS) of GBM patients undergoing surgery and concurrent chemoradiotherapy, as well as propose a nomogram for individual risk prediction based on preoperative imaging parameters and clinicopathological variables readily available in clinical practice.

Methods

We retrospectively analyzed 114 consecutive patients with GBM who underwent surgery and concurrent chemoradiotherapy at the Second Affiliated Hospital, Zhejiang University School of Medicine from January 1st, 2015, to June 1st, 2018. Twenty-four preoperative magnetic resonance imaging (MRI) parameters were extracted manually from the Picture Archiving and Communication System (PACS). Clinicopathological factors were extracted from the electronic medical record system (EMRS). Least absolute shrinkage and selection operator (LASSO) regression and Cox regression were used for feature selection and model prediction, respectively. The models were presented using nomograms, which were applied to identify the risk of recurrence and survival according to the score. The performance of the nomograms to predict PFS and OS was tested with C-statistics, calibration plots, and Kaplan-Meier curves.

Results

The results revealed that sex, Karnofsky performance score (KPS), O6-methylglucamine-DNA methyltransferase (MGMT) protein expression, number of adjuvant chemotherapy cycles with temozolomide (TMZ), and the MRI signature effectively predicted PFS; and sex, KPS, extent of surgery, number of TMZ cycles, and MRI signature effectively predicted OS. The nomogram revealed good discriminative ability (C-statistics: 0.81 for PFS and 0.79 for OS). In the nomogram of PFS, patients with a score greater than 122 were considered to have a high risk of recurrence. In the nomogram of OS, the cutoff score were 115 and 145, and then patients were classified as low, medium, and high risk.

Conclusions

In conclusion, our nomograms can effectively predict the risk of recurrence and survival of GBM patients and thus can be a good guide for clinical practice.

The Definition and Delineation of the Target Area of Radiotherapy Based on the Recurrence Pattern of Glioblastoma After Temozolomide Chemoradiotherapy

Radiotherapy is an important treatment for glioblastoma (GBM), but there is no consensus on the target delineation for GBM radiotherapy. The Radiation Therapy Oncology Group (RTOG) and European Organisation for Research and Treatment of Cancer (EORTC) each have their own rules. Our center adopted a target volume delineation plan based on our previous studies. This study focuses on the recurrence pattern of GBM patients whose target delineations did not intentionally include the T2/fluid-attenuated inversion recovery (FLAIR) hyperintensity area outside of the gross tumor volume (GTV). We prospectively collected 162 GBM cases and retrospectively analysed the clinical data and continuous dynamic magnetic resonance images (MRI) of 55 patients with recurrent GBM. All patients received concurrent radiotherapy and chemotherapy with temozolomide (TMZ). The GTV that we defined includes the postoperative T1-weighted MRI enhancement area and resection cavity. Clinical target volume 1 (CTV1) and CTV2 were defined as GTVs with 1 and 2 cm margins, respectively. Planning target volume 1 (PTV1) and PTV2 were defined as CTV1 and CTV2 plus a 3 mm margin with prescribed doses of 60 and 54 Gy, respectively. The first recurrent contrast-enhanced T1-weighted MRI was introduced into the Varian Eclipse radiotherapy planning system and fused with the original planning computed tomography (CT) images to determine the recurrence pattern. The median follow-up time was 15.8 months. The median overall survival (OS) and progression-free survival (PFS) were 17.7 and 7.0 months, respectively. Among the patients, 44 had central recurrences, two had in-field recurrences, one had marginal recurrence occurred, 11 had distant recurrences, and three had subependymal recurrences. Five patients had multiple recurrence patterns. Compared to the EORTC protocol, target delineation that excludes the adjacent T2/FLAIR hyperintensity area reduces the brain volume exposed to high-dose radiation (P = 0.000) without an increased risk of marginal recurrence. Therefore, it is worthwhile to conduct a clinical trial investigating the feasibility of intentionally not including the T2/FLAIR hyperintensity region outside of the GTV.

Effects of a contusion load on spinal cord with different curvatures

The cervical spine injury is a complicated procedure in the combination of different injury loads and postures. The aim of this study is to investigate the injury mechanism considering different types of cervical curvatures subjected to contusion loads. A finite element model of a cervical spinal cord was constructed. Gray matter, white matter and pia matter were modeled and hyperelastic material properties were assigned. Convergence analysis and validation analysis were carried out. The model was simulated in 3 different spinal curvatures and loaded by 2 directions with 4 compression degrees. The maximum von Mises stress in the whole model was concentrated in the pia matter in all loading cases. When investigating spinal cord injury, the pia matter must be considered. For all three curvatures, the stress in the gray matter and white matter was higher in front-to-back loading condition than that in back-to-front loading condition. The front-to-back impact may cause a larger damage. A back-to-front load damaged the structure around the central canal and a front-to-back contusion load damaged the anterior horn of the spinal cord at most time. From the view of the maximum stress, the lordotic curvature did not show significant buffering effect. However, the pathological curvature had large areas affected and the lordotic curvature showed some benefits to some degree from the view of stress distribution.

[Epidemiological analysis of allergic diseases in primary and middle school students of Foshan]

Objective:To investigate the prevalence and state of allergic rhinitis, asthma, eczema, allergic conjunctivitis, and food allergy of students in primary and middle schools of Foshan, and to analyze the characteristics of each disease and correlation of the five diseases, in order to provide epidemiology evidence for management of allergic diseases. Method:Ten primary schools and 10 junior middle schools were sampled from 5 districts of Foshan, then students in grade one and grade seven from sampled schools were investigated by electronic questionnaire method formulated by the International Study of Asthma and Allergies in Childhood and the Europrevall Project Commission. Students and their parents answered and uploaded electronic questionnaires with the consent of parents, and then team members collected and analyzed uploaded data. Result:Four thousand one hundred and sixty-six effective questionnaires were collected, and the response rate was 95.77％. During the five districts, 13.97%, 2.01%, 29.29%, 5.19%, and 7.28% of the respondents in grade one had previously diagnosed with allergic rhinitis, asthma, eczema, allergic conjunctivitis, and food allergy respectively, and the correspondent rates in grade seven were 15.99%, 2.89%, 16.73%, 2.46%, and 6.97%. The prevalence rates of the five diseases in boys were higher than that in girls in both two grades. 67.27% students with asthma kept coughing and wheezing in the last 12 months, and 24.85% non-asthma students had the same respiratory symptoms. The most common allergenic food were shrimp and crabs, followed by milk and milk products, eggs, and shellfish. Cutaneous symptoms and oral allergy symptoms were predominant clinical manifestations in all students with food allergy. The prevalence of the above allergic diseases of children with atopic family history was higher than that of children without family history, and the prevalence of the 5 diseases of children living in city was higher than that of children living in rural areas. The prevalence rate of asthma of children with allergic rhinitis in both grades was higher than that of children without allergic rhinitis, and the same happened to children with eczema, allergic conjunctivitis, and food allergy. Conclusion:Prevalence rates of allergic rhinitis and asthma in primary and middle school students of Foshan increased as children grew, while the prevalence rates of eczema, allergic conjunctivitis and food allergy decreased with age. The most common allergenic food were shrimp and crabs, milk and milk products, and eggs. 67.27% students with asthma had poor respiratory control in the last 12 months. The prevalence of allergic diseases of children living in city and with atopic family history was higher than that of children living in rural areas and without family history. Students with allergic conjunctivitis, food allergy, allergic rhinitis and eczema had high risk of asthma.

[Clinical efficacy and safety of specific immunotherapy for allergic rhinitis with cervical lymph node injection]

Objective: To evaluate the clinical efficacy and safety of intralymphatic immunotherapy with cervical lymph node injection for allergic rhinitis. Method: A retrospective analysis of 81 patients with allergic rhinitis(AR) who had received specific immunotherapy with cervical lymph node injection in 2016 in the first people's Hospital of Foshan was conducted. The neck lymph node immunotherapy under the guidance of color Doppler ultrasound consisted of three sessions, and in each session 50 Tu(Arog) was delivered. The scores of nasal and ocular symptoms, drug score and adverse reactions during treatment were recorded before and after treatment, and the efficacy and safety were observed. Result: Before treatment, the nasal symptoms score of 81 AR cases of mite allergy was 7.00±1.65. After 1,2 and 3 sessions of cervical lymph node immune therapy and 1 year after completion of treatment, the nasal symptom scores were 4.37±1.88, 4.26±1.80, 4.22±1.80, and 4.09±2.10,respectively, which were significantly lower than that before treatment(P<0.01). The quality of life score was 53.68±9.28 before treatment, which decreased to 23.01±13.28 one year after treatment, and the difference was statistically significant(P<0.01). The drug score was 3.27±1.17 before treatment, which decreased to 1.00±1.05 1 years after treatment, and the difference was statistically significant(P<0.01). During treatment and 1-year follow-up, only 8 cases had mild local reactions, and no systemic adverse reactions occurred. Conclusion: Cervical lymph node injection specific immunotherapy can significantly relieve the symptoms of dust mite allergic rhinitis. The treatment is effective and safe, and greatly shortens the duration of immune treatment.

[Relationship between the choroid plexus cyst and the aneuploidy]

Objective: Using the method of the ultrasound and the noninvasive DNA to find the relationship between the choroid plexus cyst and the aneuploidy, and to provide the meaningful data for prenatal consultant. Methods: A total of 112 cases, that the gestational age were between 13 and 20 weeks, which were diagnosed with choroid plexus cyst in the Department of Gynecology and Obstetrics of the Second Hospital of Jilin University from January. 2016 to July. 2017 were tested by ultrasonography. They all accepted the noninvasive DNA. At the same time, a total of 100 normal fetuses were randomly involved in the control group by the combination of gestational age and the age of the pregnant woman, all of them had taken the non-invasive DNA examination and followed up until the birth. Those fetuses who combined with other malformations were induced labor in the two groups. If the results of noninvasive DNA indicated the high-risk, invasive examination for karyotype analysis were recommended. If the results were aneuploidy, they chose induced labor. The rest cases followed up until the birth. Results: Five cases of the 112 fetuses in the case group were found with obvious malformation (3 of them were found in the early trimester, 2 of them were found in the middle trimester). The numbers of high risk results of noninvasive DNA were 7, and 5 of them underwent the invasive karyotype analysis. When the aneuploidy had diagnosed definitely, induced labor had been taken. One case was found to be the aneuploidy in the control group, and took the induced labor. One case was diagnosed as right side aortic arch by ultrasound in the control group, with a good prognosis. The other cases were followed up until the birth with a good prognosis. Conclusions: (1)In the early trimester, the fetus with choroid plexus cyst has an increasing risk of aneuploidy. (2)When the maximum diameter of choroid plexus cyst is less than 1 cm and the cyst was single, most of them could disappear in the middle trimester, it has no effect on the fetus. (3)Noninvasive DNA test has a high accuracy, which can improve the positive rate of invasive examination.

[Correlation between fetal intracardiac echogenic foci and chromosome and heart function]

Objective: To study the relationship between the intracardiac echogenic foci and the abnormal chromosome and the changes of Cardiac function. Methods: A total of 2645 cases with the gestational age between 14 to 22 weeks were tested in the department of gynecology and obstetrics of the Second Hospital of Jilin University from Jan.2016 to Dec.2017.Seventy-nine of them existed the intracardiac echogenic foci, and the patient's imaging data in details were recorded.All of them have taken the non-invasive DNA examination.Fetal echocardiography was performed at 22-24 weeks.Karyotype analysis was performed using amniocentesis and umbilical cord blood puncture.Inducing labor was performed for fetuses that has been identified as a haploid or had a severely malformation during pregnancy.The other fetuses were followed up to the birth.Echocardiography was performed on neonates. Results: The detection rate of intracardiac echogenic focus was 3.0% in early pregnancy, 92% in the left ventricle, 4% in the right ventricle, and 4% in double ventricle.There were 5 cases of haploid fetus induced labor, 2 cases of induced labor due to fatal malformation.Fetal echocardiography revealed tricuspid regurgitation in 7 cases.One of them was induced labor in consideration of heart failure. Conclusions: 1.The risk of chromosomal abnormality in the fetus of isolated left intracardiac echogenic focus is lower.Non-invasive DNA examination has a high reliability that could be an important reference before an invasive antenatal diagnosis.2.A higher rate of fetal malformation will be found when the foci located in the right or double ventricle.3.The relationship between fetal intracardiac echogenic foci and fetal cardiac dysfunction needs to be further clarified.

[Relationship between sonographic markers and fetal chromosome abnormality during 16-18 weeks of pregnancy]

Objective: To analysis of fetal ultrasound soft index positive cases during 16-18 weeks of pregnancy, and to explore the relationship with chromosomal abnormalities in order to increase the positive rate of invasive prenatal diagnosis and reduce the rate of missed diagnosis. Methods: A total of 569 cases which were diagnosed with positive soft markers in the department of gynecology and obstetrics of the Second Hospital of Jilin University from Jan.2016 to Jan.2017 were studied by ultrasonography. Twenty-five cases were lost in follow-up and finally 544 cases were included as group A. Those fetuses who combined with other malformations were induced labor. Non-invasive DNA examination was recommended for continued pregnant women, and those pregnant women whose results were high risk underwent the amniotic cavity puncture. When the fetal aneuploidy was confirmed, they chose induced labor. We followed the rest of those patients until postnatal half year. Randomly selected 544 cases during 16-18 weeks of pregnancy without obvious abnormalities into group B, followed up to half a year after birth. Results: In group A, 7 of the 544 cases were combined with other severe malformation in the beginning, among the remaining 537 patients, 273 of them received non-invasive DNA examination. Ten cases were high risk results, all of them underwent the amniotic cavity puncture with the result of chromosome abnormality, and they chose induced labor. Six cases were found other malformation in the second trimester who chose induced labor, and the rest 521 cases followed until the fetuses was born after half year had a favorable prognosis. In group B, 1 cases of severe deformities and 1 cases of haploid fetuses were found in 544 fetuses. The incidence of haploid fetus in group A and group B were 1.8% and 0.2%, respectively, with statistically significant (P<0.05). The incidence of severe malformation in group A and group B were 2.3% and 0.2%, respectively, with statistically significant (P<0.05). Conclusions: During 16-18 weeks of pregnancy, sonographic markers may indicate an increased risk in fetal chromosomal abnormalities. The risk of serious malformation was increased in the fetuses with ultrasonic soft marker positive, but there was no specificity.

Degradation of the In-plane Shear Modulus of Structural BFRP Laminates Due to High Temperature

The behavior of fiber reinforced polymer (FRP) composites at high temperature is a critical issue that needs to be clearly understood for their structural uses in civil engineering. However, due to technical difficulties during testing at high temperature, limited experimental investigations have been conducted regarding the thermal behavior of basalt fiber reinforced polymer (BFRP) composites, especially for the in-plane shear modulus of BFRP laminates. To this end, both an analytical derivation and an experimental program were carried out in this work to study the in-plane shear modulus of BFRP laminates. After the analytical derivation, the in-plane shear modulus was investigated as a function of the elastic modulus in different directions (0°, 45° and 90° of the load-to-fiber angle) and Poisson's ratio in the fiber direction. To obtain the in-plane shear modulus, the four parameters were tested at different temperatures from 20 to 250 °C. A novel non-contacting digital image correlation (DIC) sensing system was adopted in the high-temperature tests to measure the local strain field on the FRP samples. Based on the test results, it was found that the elastic moduli in different directions were reduced to a very low level (less than 20%) from 20 to 250 °C. Furthermore, the in-plane shear modulus of BFRP at 250 °C was only 3% of that at 20 °C.

[Effect of different sandblasting conditions on the metal-ceramic bonding strength of Co-Cr alloy fabricated by selective laser melting technology]

OBJECTIVE

To investigate the effect of different sandblasting conditions on the metal-ceramic bonding strength of Co-Cr alloy fabricated by selective laser melting (SLM) technology.

METHODS

A total of 63 specimens of Co-Cr alloy fabricated by SLM were prepared and randomly divided into nine groups (n=7). Each group was treated with different powder particles (A1=50 µm, A2=100 µm, and A3=150 µm) and pressures (B1=0.2 MPa, B2=0.4 MPa, and B3=0.6 MPa) in sandblasting. One sample was randomly selected from each group for microstructure observation by scanning electron microscope (SEM). Ceramic was fired at the center of the specimens. Metal-ceramic bonding strength was measured with universal testing machine. Results were statistically analyzed with SPSS 17.0 software.

RESULTS

The mean bond strengths were as follows: Group A1B1: 27.22 MPa±0.95 MPa, Group A1B2: 27.58 MPa±0.47 MPa, Group A1B3: 26.80 MPa±0.71 MPa, Group A2B1: 27.54 MPa±0.78 MPa, Group A2B2: 30.75 MPa±0.43 MPa, Group A2B3: 26.93 MPa±0.88 MPa, Group A3B1: 28.18 MPa±0.93 MPa, Group A3B2: 29.55 MPa±0.57 MPa, and Group A3B3: 28.11 MPa±0.91 MPa. The particle factor of Al₂O₃ and the pressure factor of blasting showed statistical significance (P<0.05). An interaction was observed between the factors of particle and pressure (P<0.05). Mixed fracture mode of all specimens was observed after the shear strength test.

CONCLUSIONS

In conclusion, metal-ceramic bonding strength reaches the maximum when specimens are sandblasted with 100 µm alumina oxide at 0.4 MPa pressure.

[Evaluation of pelvic floor function of postpartum pelvic floor ultrasound in pregnant women with multiple pregnancies]

Objective: To probe the effect of multiple pregnancy on pelvic floor function of pregnant women, Pelvic floor ultrasonography was performed on the 42 day postpartum women.And the bladder neck mobility, bladder and urethral posterior angle and pelvic diaphragmatic hiatus area were measured. Methods: Collect 200 cases 42 day postpartum women who visited the second hospital of Jilin University from July 2015 to June 2017, of which 100 cases of primipara belong to group A, 100 cases of multiple pregnancy belong to group B, and 100 cases without maternal at the same age belong to the control group, ultrasound measurement of the bladder neck mobility, bladder and urethral posterior angle and pelvic diaphragmatic hiatus area were measured.t test were proformed respectively between the three groups, P<0.05 was considered statistically significant difference. Results: In the control group, the bladder neck mobility is (2.59±0.51) cm , the bladder neck mobility in A group is (2.99±0.69) cm, the bladder neck mobility in B group is (3.36±0.71) cm; the bladder and urethral posterior angle in the control group is (112.56±13.61)°, the bladder and urethral posterior angle in the control group after Valsalva action angle is(135.37±12.17)°, the bladder and urethral posterior angle in A group is(119.26±15.80)°, the bladder and urethral posterior angle in group A after Valsalva action is(141.79±12.08)°, the bladder and urethral posterior angle in B group is(123.62±16.20)°, the bladder and urethral posterior angle in group B after Valsalva action is (148.92±13.60)°; the pelvic diaphragmatic hiatus area in the control group is (13.35±2.86) cm(2,) the pelvic diaphragmatic hiatus area in the control group after Valsalva action is(15.28±3.15) cm(2,) the pelvic diaphragmatic hiatus area in A group is(17.52±3.19) cm(2,) the pelvic diaphragmatic hiatus area in A group ater Valsalva action is (18.06±5.13_the pelvic diaphragmatic hiatus area) cm(2,) the pelvic diaphragmatic hiatus area in B group is (18.26±4.18) cm(2,) the pelvic diaphragmatic hiatus area in B group after Valsalva action is (20.3±3.53) cm(2).In group A, group B and the control group, the measured value of the bladder neck mobility, bladder and urethral posterior angle and pelvic diaphragmatic hiatus area were examined by t test, and P<0.05, which means the difference was statistically significant. Conclusion: Pregnancy can affect the function of female pelvic floor, and the effect of parturient is more significant than that of the primipara.

Critically dysregulated signaling pathways and clinical utility of the pathway biomarkers in lymphoid malignancies

Accumulating evidence confirmed that many dysregulated signaling pathways and aberrant genetic alterations contribute to the oncogenesis and heterogeneity of lymphoid malignancies. Therapeutically targeting dysregulating signaling pathways and their hidden oncogenic biomarkers are becoming available, but did not show desired therapeutic effect in current clinical practice. It is meaningful to further understand the underlying mechanisms of the dysregulated signaling pathways and to address the potential utility of pathway-related biomarkers. To precisely identify the dysregulation of signaling pathways and the “driver” oncogenic biomarkers, as well as to develop reliable and reproducible risk-stratification based on biomarkers will be challenging. Nevertheless, pathway-based targeted therapy will raise the hope to improve the outcomes of the patients with lymphoid malignancies, especially with aggressive types, and the efficient utility of pathway-related biomarkers in diagnosis, prognosis, prediction of lymphoid malignancies may also be able to power precision medicine.

Genetic variants in CHEK1 gene are associated with the prognosis of thoracic esophageal squamous cell carcinoma patients treated with radical resection

CHEK1 gene is known to play an important role in tumor progression by cell cycle control. However, the association between CHEK1 and the prognosis of esophageal squamous cell carcinoma (ESCC) is unclear. In this study, we explored the association between genetic variants in CHEK1 gene and prognosis of ESCC patients treated with radical resection. A total of 131 thoracic ESCC patients who underwent radical resection were included in this retrospective study and genotyped using the MassArray method. According to the univariate Cox hazard analysis, the GT/TT genotype of CHEK1 rs555752 was shown to be strongly related to a decreased overall survival (OS) (HR=2.560, 95% CI: 1.415-4.631, P=0.002) and disease-free survival (DFS) (HR=2.160, 95% CI: 1.258-3.710, P=0.005). Furthermore, according to the multivariate Cox hazard analysis and multiple testing, patients with the GT/TT genotype of CHEK1 rs555752 had a notably decreased OS (HR=2.735, 95% CI: 1.468-5.096, P=0.002, Pc=0.006) and DFS (HR=2.282, 95% CI: 1.292-4.023, P=0.004, Pc=0.012). In conclusion, genetic variants of the CHEK1 gene are significantly related to OS and DFS of ESCC patients, and may therefore be predictors of the prognosis of thoracic ESCC after surgery.

Predictive effects of bilirubin on response of colorectal cancer to irinotecan-based chemotherapy

AIM: To examine the predictive effects of baseline serum bilirubin levels and UDP-glucuronosyltransferase (UGT) 1A1*28 polymorphism on response of colorectal cancer to irinotecan-based chemotherapy.

METHODS: The present study was based on a prospective multicenter longitudinal trial of Chinese metastatic colorectal cancer (mCRC) patients treated with irinotecan-based chemotherapy (NCT01282658). Baseline serum bilirubin levels, including total bilirubin (TBil) and unconjugated bilirubin (UBil), were measured, and genotyping of UGT1A1*28 polymorphism was performed. Receiver operating characteristic curve (ROC) analysis was used to determine cutoff values of TBil and UBil. The TBil values were categorized into > 13.0 or ≤ 13.0 groups; the UBil values were categorized into > 4.1 or ≤ 4.1 groups. Combining the cutoff values of TBil and UBil, which was recorded as CoBil, patients were classified into three groups. The classifier’s performance of UGT1A1*28 and CoBil for predicting treatment response was evaluated by ROC analysis. Associations between response and CoBil or UGT1A1*28 polymorphism were estimated using simple and multiple logistic regression models.

RESULTS: Among the 120 mCRC patients, the serum bilirubin level was significantly different between the UGT1A1*28 wild-type and mutant genotypes. Patients with the mutant genotype had an increased likelihood of a higher TBil (P = 0.018) and a higher UBil (P = 0.014) level compared with the wild-type genotype. Patients were stratified into three groups based on CoBil. Group 1 was patients with TBil > 13.0 and UBil > 4.1; Group 2 was patients with TBil ≤ 13.0 and UBil > 4.1; and Group 3 was patients with TBil ≤ 13.0 and UBil ≤ 4.1. Patients in Group 3 had more than a 10-fold higher likelihood of having a response in the simple (OR = 11.250; 95%CI: 2.286-55.367; P = 0.003) and multiple (OR = 16.001; 95%CI: 2.802 -91.371; P = 0.002) analyses compared with the Group 1 individuals. Patients carrying the UGT1A1*28 (TA)7 allele were 4-fold less likely to present with a response compared with the individuals harboring a homozygous (TA)6 genotype in the simple (OR = 0.267; 95%CI: 0.100-0.709; P = 0.008) and multiple (OR = 0.244; 95%CI: 0.088-0.678; P = 0.007) analyses. Classifier’s performance of CoBil and UGT1A1*28 were comparable.

CONCLUSION: CoBil and UGT1A1*28 are both independent biomarkers for predicting the treatment response of mCRC patients to irinotecan-based chemotherapy. After validation, CoBil, an easily determinable index in the clinic, might be helpful in facilitating stratification of mCRC patients for individualized treatment options.

Isolated gastric recurrence from ovarian carcinoma: A case report

Although ovarian metastasis secondary to gastric cancer (Krukenberg tumor) has been extensively described in the literature, gastric metastasis from ovarian carcinoma is rare. The present case report describes a patient with gastric metastasis from ovarian carcinoma. A 51-year-old female with previously treated ovarian carcinoma of stage III according to the International Federation of Gynecology and Obstetrics was admitted to the Department of Oncology, First Affiliated Hospital of Nanjing Medical University (Nanjing, China) with high serum carbohydrate antigen-125 levels. Endoscopic ultrasound and ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography scanning revealed a lesion in the stomach with the typical appearance of a gastrointestinal stromal tumor. The histopathological examination revealed infiltration of the resected specimens by metastatic serous adenocarcinoma and a comparison with the previously resected ovarian specimen confirmed disease recurrence. Although isolated gastric recurrence from ovarian carcinoma is rare, when a patient has a history of ovarian carcinoma (particularly with a high CA-125 level) and when the imaging results show a mass in the stomach wall, metastasis from ovarian carcinoma should be considered.

Mixed-ligand mononuclear copper(II) complex: crystal structure and anticancer activity

A novel copper(II) complex with mixed ligands including β-[(3-formyl-5-methyl-2-hydroxy-benzylidene)amino]propionic acid anion and 1,10'-phenanthroline was synthesized, and its crystal structure was thoroughly characterized. It exerted excellent inducing apoptosis, anti-angiogenesis and antiproliferative properties in vitro. The complex can bind human serum albumin (HSA) at physiological pH conditions. Remarkably, it can induce formation of the mixed parallel/antiparallel G-quadruplex structures in the G-rich sequence of the proximal vascular endothelial growth factor (VEGF) promoter, and stabilize these G-quadruplex structures, which provide an opportunity for anti-angiogenesis chemotherapeutics. Furthermore, the complex showed a strong uptake, and exhibited multiple anticancer functions by inhibiting the expression of p-Akt and p-Erk1/2 proteins and by upregulating the levels of reactive oxygen species (ROS). Because of the reported results, this new copper(II) complex qualifies itself as a potential anticancer drug candidate.

MiR-1 targets PIK3CA and inhibits tumorigenic properties of A549 cells

MicroRNAs are small endogenous RNAs that play important roles in the pathogenesis of human diseases, including malignancy. MicroRNA-1 (miR-1) is downregulated in non-small cell lung cancer (NSCLC); however, the underlying mechanisms by which it suppresses tumorigenesis in NSCLC are largely unknown. We investigated whether phosphoinositide-3-kinase catalytic subunit alpha (PIK3CA) was a novel target of miR-1 in the NSCLC cell line A549, and the mechanism of miR-1 inhibition of the tumorigenic properties of A549 cells is discussed. The influence of miR-1 on A549 cells was studied by transfection with miR-1 mimics or inhibitor. MiR-1 overexpression led to downregulation of PIK3CA protein, but not mRNA by western blot and quantitative real-time PCR, respectively. The dual-luciferase reporter assay confirmed that miR-1 targeted PIK3CA directly. PIK3CA downregulation by miR-1 mimics led to a significant reduction of phosphorylated Akt and survivin protein, the downstream targets of the PI3K/Akt pathway. Cell proliferation was studied using a cell counting kit. Migration and invasion were evaluated by Transwell and Matrigel assays, respectively. Cell cycle and apoptosis were detected by flow cytometry. The results were that miR-1 upregulation inhibited A549 cell proliferation, migration, and invasion. These findings indicate that miR-1 may play an important role in the pathogenesis of NSCLC by regulating PIK3CA through the PI3K/Akt pathway. Increasing miR-1 expression may provide a novel approach for NSCLC treatment.

A detailed meta-analysis shows no association between TNF-α -308G/A polymorphism and different forms of glaucoma

OBJECTIVE

Glaucoma is the second leading cause of blindness worldwide. To date, several publications have evaluated the association between the tumor necrosis factor α (TNF-α) -308G/A polymorphism and glaucoma risk. However, the results remain inconclusive. The aim of our study was to clarify the effect of the TNF-α -308G/A polymorphism on glaucoma risk.

METHOD

We conducted searches of the published literature in the PubMed database updated to May 2010. A meta-analysis was performed by critically reviewing 7 publications with a total of 1,199 glaucoma cases and 1,189 controls on the -308G/A polymorphism. Odds ratio (OR) and 95% confidence intervals (CIs) were used to assess the strength of this relationship.

RESULTS

Overall, no association between the TNF-α -308G/A polymorphism and primary open-angle glaucoma or pseudoexfoliation glaucoma risk was found in the A allele versus G allele genetic model (OR = 1.68, 95% CI = 0.78-3.59 or OR = 2.44, 95% CI = 0.40-15.04, respectively), the same as genetic models in AG versus GG and AA + AG versus GG. In the stratified analysis by ethnicity and source of control subgroups, a significant association was still not observed in all genetic models.

CONCLUSION

Our meta-analysis provides strong evidence that the TNF-α -308G/A polymorphism is not associated with different forms of glaucoma risk.

Malignant biliary obstructive jaundice: a clinical analysis of 153 cases

AIM: To evaluate the clinical application value of ultrasound-guided percutaneous transhepatic biliary drainages (PTCD) in 153 patients with malignant biliary obstructive jaundice (MBOJ).

METHODS: The 153 MBOJ cases were divided into four groups at our hospital from March 1995 to March 2008. Twenty seven MBOJ cases in group A were successfully placed expandable metal biliary stents (EMS) using PTCD by X-rays positioning (xPTCD). PTCD by ultrasound-guided (uPTCD) were operated in 75 MBOJ patients in group B. The 16 MBOJ cases in group C received xPTCD or uPTCD , and underwent endoscopic retrograde biliary drainage (ERBD) or endoscopic metal biliary endoprosthesis (EMBE).The 35 MBOJ patients in group D received exploratory laparotomy surgery by uPTCD or xPTCD from 1 wk to 4 mo.

RESULTS: The survival rates of half year, 1-year and 3-year were 52.6%, 10.5% and 0% in group A. The success ratios 1st, 2nd placed the tube were enhanced more obviously in group B than in group A (88.7% vs 66.7%, 100% vs 76.7%, P < 0.01). Survival rates of half year, 1-year and 3-year were 47.7%, 13.8% and 0%. Higher incidence of postoperative complications was observed in group C (68.8%) than in group A or group B (P < 0.01). The survival rates of halsf year, 1-year and 3-year were 53.8%, 23.1% and 0%. The postoperative survival time in group D was more significantly prolonged (P < 0.01). The survival rates of half year, 1-year, 3-year and 5-year were 77.8%, 66.7%, 18.5% and 14.8%.

CONCLUSION: uPTCD or xPTCD and/or ERBD or EMBE is a more effective treatment method of palliative treatment. The uPTCD for advanced MBOJ patients, in preoperative localization at diagnosis, preoperative degrading jaundice to improve liver function, are of important clinical values in the palliative treatment.