Orientation-dependent oxidation behavior of Cu under In-situ E-Beam irradiation

Herein, we present an atomic in-situ investigation of Cu oxidation along different orientations stimulated by high-energy electron beams (E-Beam) in transmission electron microscopy (TEM). By following the microstructural evolution of the Cu substrate in real time, high-resolution TEM (HRTEM) images reveal an orientation-dependent oxidation mechanism, whereby Cu along [110] zone axis migrates onto the surface and be oxidized while Cu along [100] zone axis is oxidized completely both in bulk and at the surface. The different oxidation mechanisms can be attributed to the differing diffusion rates of oxygen in Cu structures along directions. Moreover, the growth of Cu oxides is found to follow a layer-by-layer mechanism, where Cu mostly migrates onto nanocrystal {110} planes. This behavior would lead to the oxides wider in geometric shape and therefore promote the aggregation of adjacent oxides. These findings have important implications for the practical use of copper-based materials in oxidizing environments.

Effects of neuropeptide Y on the immune-protection and intestinal tract of juvenile Micropterus salmoides

Neuropeptide Y is known to be directly or indirectly involved in immune regulation. The immune effects of NPY include immune cell transport, helper T cell differentiation, cytokine secretion, staining and killer cell activity, phagocytosis and production of reactive oxygen species. In this study, we investigated the immunoprotective effect of synthetic NPY on largemouth bass larvae. For the first time, the dose and time effects of NPY injection on largemouth bass was explored, and then Poly I:C and LPS infection was carried out in juvenile largemouth bass, respectively, after the injection of NPY. The results showed that NPY could reduce the inflammatory response by inhibiting the expression of il-1β, tgf-β, ifn-γ and other immune factors in head kidney, spleen and brain, and alleviate the immune stress caused by strong inflammatory response in the early stage of infection. Meanwhile, NPY injection ameliorated the intestinal tissue damage caused by infection. This study provides a new way to protect juvenile fish and improve its innate immunity.

Nonthermal plasma air disinfection for the inactivation of airborne microorganisms in an experimental chamber and indoor air

AIMS

Airborne transmission of diseases presents a serious threat to human health, so effective air disinfection technology to eliminate microorganisms in indoor air is very important. This study evaluated the effectiveness of a non-thermal plasma (NTP) air disinfector in both laboratory experiments and real environments.

METHODS AND RESULTS

An experimental chamber was artificially polluted with a bioaerosol containing bacteria or viruses. Additionally, classroom environments with and without people present were used in field tests. Airborne microbial and particle concentrations were quantified. A 3.0 log10 reduction in the initial load was achieved when a virus-containing aerosol was disinfected for 60 min and a bacteria-containing aerosol was disinfected for 90 min. In the field test, when no people were present in the room, NTP disinfection decreased the airborne microbial and particle concentrations (P < 0.05). When people were present in the room, their constant activity continuously contaminated the indoor air, but all airborne indicators decreased (P < 0.05) except for planktonic bacteria (P = 0.094).

CONCLUSIONS

NTP effectively inactivated microorganisms and particles in indoor air.

Deep Fusion of Multi-Template Using Spatio-Temporal Weighted Multi-Hypergraph Convolutional Networks for Brain Disease Analysis

Conventional functional connectivity network (FCN) based on resting-state fMRI (rs-fMRI) can only reflect the relationship between pairwise brain regions. Thus, the hyper-connectivity network (HCN) has been widely used to reveal high-order interactions among multiple brain regions. However, existing HCN models are essentially spatial HCN, which reflect the spatial relevance of multiple brain regions, but ignore the temporal correlation among multiple time points. Furthermore, the majority of HCN construction and learning frameworks are limited to using a single template, while the multi-template carries richer information. To address these issues, we first employ multiple templates to parcellate the rs-fMRI into different brain regions. Then, based on the multi-template data, we propose a spatio-temporal weighted HCN (STW-HCN) to capture more comprehensive high-order temporal and spatial properties of brain activity. Next, a novel deep fusion model of multi-template called spatio-temporal weighted multi-hypergraph convolutional network (STW-MHGCN) is proposed to fuse the STW-HCN of multiple templates, which extracts the deep interrelation information between different templates. Finally, we evaluate our method on the ADNI-2 and ABIDE-I datasets for mild cognitive impairment (MCI) and autism spectrum disorder (ASD) analysis. Experimental results demonstrate that the proposed method is superior to the state-of-the-art approaches in MCI and ASD classification, and the abnormal spatio-temporal hyper-edges discovered by our method have significant significance for the brain abnormalities analysis of MCI and ASD.

Response of Neuropeptides to Hunger Signals in Teleost

INTRODUCTION

The perception of hunger is a complex physiological process that requires precise coordination between the central and peripheral tissues.

METHODS

In this study, tilapia fasted for 24 h was chosen to establish a hunger model to study the mechanism of homeostasis recovery under the joint regulation of the central nervous system (CNS) and peripheral tissues.

RESULTS

The gastric and intestinal contents of tilapia were predominantly depleted after a fasting period of 9 h and 24 h, respectively. The serum glucose level significantly decreased at the 9-h and 24-h fasting, respectively, and the glucokinase-dependent glucosensing mechanism in the liver was identified as well as the significant activation of phospho-AMPK. However, fasting for 24 h did not activate glucosensing mechanisms and AMPK signaling pathways in the hypothalamus. On the other hand, significant reductions were observed in the mRNA levels of the lipid synthesis-related genes fas and accα, and the serum triglyceride levels as well. The mRNA levels of npy, agrp, pomc, and cart in the hypothalamus fluctuated during the fasting period without significant differences. With in situ hybridization npy signals upregulated in the ventral zone of posterior periventricular nucleus after 24-h fasting, pomc signals enhanced in the lateral tuberal nucleus. Based on the serum metabolomic analysis, the levels of branched-chain amino acids, butyrate, and short-chain acylcarnitine decreased, while those of medium- and long-chain acylcarnitine increased.

CONCLUSION

Fasting for 24 h resulted in changes in npy and pomc signals within the hypothalamus and triggered the glucosensing mechanism in the liver of tilapia. This study is beneficial for elucidating the response of neuropeptides in the CNS to the changes of nutritional factors when hungry.

Quality Assurance of Protocol Compliance in a Multicenter Randomized Trial Investigating the Role of Hypofractionated Comprehensive Reginal Nodal Irradiation in Node-Positive Breast Cancer (HARVEST)

PURPOSE/OBJECTIVE(S)

The HARVEST trial (NCT03829553) is a phase III, multicenter, randomized clinical trial to explore efficacy and safety of hypofractionated irradiation (HFI) involving regional nodal irradiation (RNI, including internal mammary nodes, IMN) in N+ breast cancer patients treated with mastectomy or breast conserving surgery (BCS). Current study aims to analyze the dosimetric quality assurance so as to evaluate the compliance to the trial protocol.

MATERIALS/METHODS

Eligible patients were randomly assigned (1:1) to receive conventional fractionated irradiation (CFI: 50 Gy/25Fx) or HFI (40.05 Gy/15Fx), which is delivered to ipsilateral chest wall or whole breast (CW/WB) with tumor bed boost (HFI: 10.68 Gy/4Fx; CFI: 10 Gy/5Fx) and comprehensive RNI (supra/infraclavicular nodes and IMN in each patient, lower axilla if indicated) by using IMRT technique. The plan quality was evaluated based on dose distribution, dose volume histogram (DVH) and field parameters. The target coverage, including planning target volume of CW/WB (PTV1) and tumor bed (PTV2) and doses of the organs at risk (OARs) were evaluated. The LQ model was used to convert doses of OARs in HFI group using α/β = 3 Gy (EQD23) for comparison.

RESULTS

Between Feb 21, 2019 and Feb 14, 2022, 801 patients were enrolled at 8 centers with 401 and 400 in CFI and HFI group, respectively. There were 182 patients received BCS and 387 patients were with more than three positive lymph nodes. In the CFI group, the D90 and V45 of PTV1 reached the prescribed dose in 70.6% and 96.0% of the patients, respectively. In the HFI group, the D90 and V36 of PTV1 reached the prescribed dose in 87.8% and 95.5% of the patients, respectively. When the tumor bed was irradiated, the D90 of PTV2 reached the prescribed dose in 95.6% in the CFI group and 100% in the HFI group, respectively. The mean D90 of PTV1 and PTV2 were 50.09±0.65 Gy and 60.63±0.91 Gy in CFI group while 40.11±0.56 Gy and 50.79±2.03 Gy in HFI group. For OARs constraints, protocol compliance was all above 95% (heart: 95.3%; ipsilateral lung: 95.5%; contralateral lung: 97.1%; humeral head: 98.2% and spinal cord: 100%) with no significant difference between CFI and HFI groups. For patients with left-sided breast cancer, the Dmean of the heart was 5.10±1.75 Gy vs. 4.59±1.86 Gy (EQD23) in CFI and HFI groups (p = 0.51), respectively. No significant differences in Dmean of the heart (1.45±0.71 Gy vs. 1.33±0.77 Gy (EQD23), p = 0.40) was found either between two groups in right-sided patients. The differences were significant in the Dmean of the ipsilateral lung (13.37±1.99 Gy vs. 11.17±3.50 Gy (EQD23), p<0.01), contralateral lung (0.88±0.73 Gy vs. 0.74±0.61 Gy (EQD23), p<0.01) and the ipsilateral humeral head (15.27±7.62 Gy vs. 13.05±6.19 Gy (EQD23), p<0.01) and the Dmax of spinal cord (21.40±8.82 Gy vs. 19.47±7.99 Gy (EQD23), p = 0.05) between CFI and HFI groups.

CONCLUSION

A high degree of compliance with protocol dose constraints was found for treatment plans in the HARVEST trial and doses to the most of OARs decreased in HFI group.

Toripalimab Combined with Chemoradiotherapy for Locally Advanced Cervical Squamous Cell Carcinoma Patients: Early Results of Safety and Feasibility

PURPOSE/OBJECTIVE(S)

To assess the safety and efficacy of toripalimab combined with chemoradiotherapy for locally advanced cervical squamous cell carcinoma.

MATERIALS/METHODS

Twenty-two locally advanced cervical cancer patients, regardless of programmed death ligand-1 (PD-L1) status, received toripalimab treatment combined with concurrent chemoradiotherapy (CCRT), includes cisplatin (40 mg/m2, once a week for 5 weeks), radiotherapy (45-50.4 Gy/25-28Fx, 5 fractions a week, followed by brachytherapy 24-30 Gy/3-5Fx) and toripalimab (240mg on day 1, 22 and 43). The primary endpoints were safety and 2-year progression-free survival (PFS).

RESULTS

The median age was 55 years old (42 to 72), with 2 patients in FIGO stage Ⅱ, 15 patients in stage ⅢC, and 5 patients in stage ⅣA. All patients completed CCRT successfully. Grade Ⅲ and higher adverse events (AEs) were observed in 11 patients (11/22, 50%), and no patient had a grade Ⅴ AE. The most frequent grade Ⅲ AE was leukopenia (8/22, 36.4%). The most common immunotherapy-related adverse event was hypothyroidism (2/22, 9.1%). The objective response rate (ORR) was 100%. At data cutoff (Sep 30, 2022), the median follow-up was 19.7 months (7.67 to 26.1 months). The LC and the PFS rate were 95.5% and 81.8%, and the OS rate was 90.9%. The patients with baseline absolute lymphocyte count (ALC) ≤1.255 × 10^9/L had significant higher rates of metastasis than those with ALC >1.255 × 10^9/L (42.9% vs 0%, p = 0.023).

CONCLUSION

Toripalimab combined with CCRT achieved good tolerance and demonstrated promising anti-tumor effects in patients with locally advanced cervical cancer. Longer follow-up results and further phase Ⅱ/Ⅲ studies are expected. Chinese Clinical Trial Registry number, ChiCTR2000032879.

Nodal Response to Neo-Adjuvant Systemic Therapy Predicts Prognosis of cN3c Breast Cancer Patients Receiving Multidisciplinary Therapy

PURPOSE/OBJECTIVE(S)

cN3c breast cancer with ipsilateral supraclavicular (SCV) lymph nodal (SCLN) metastasis has a dismal prognosis. We investigated the survival outcomes, patterns and risks of recurrence in those patients after multidisciplinary therapy, as well as the predictors of candidates for SCV area boosting.

MATERIALS/METHODS

Consecutive cN3c breast cancer patients without distant metastases from January 2009 to December 2020 in our institution were retrospectively reviewed. Based on nodal response to neoadjuvant therapy (NAT), patients were categorized into three groups: clinical complete response (cCR) not achieved in SCLN (Group A, n = 66), SCLN cCR but axillary node (ALN) did not achieve pathological complete response (pCR, Group B, n = 34), cCR in SCLN and pCR in ALN (Group C, n = 13).

RESULTS

The median follow-up time was 32.7 months (range, 21.9-53.3months). The 5-year overall survival (OS) and recurrence-free survival (RFS) rates were 64.6% and 43.7% respectively. Multivariate analysis showed cumulative SCV dose and ypT stage, ALN response and SCV response to NAT were significantly associated with OS and RFS respectively. The 3-year for patients receiving the cumulative SCV dose of ≥60 Gy versus <60 Gy was 81.3% versus 69.0% (P = 0.042). Compared with Group A or B, Group C showed significantly improved RFS (3y-RFS: 53.8% vs 73.6% vs 100%, p = 0.003) and a numerically longer OS (3y-OS: 73.4% vs 86.7% vs 100%, p = 0.089). Meanwhile, Group C showed the lowest rate of DM as first failure (37.9 % vs 23.5% vs 0 in group A, B and C, respectively, p = 0.010). In patients of Group A, the 3-year OS rates for patients receiving the cumulative SCV dose of ≥60 Gy versus <60 Gy was 78.0% versus 57.3% (p = 0.029).

CONCLUSION

Nodal response to NAT is an independent prognostic factor for survival and pattern of failure. cN3c breast cancer patients with SCLN cCR and ALN pCR after NAT are potentially curable. A cumulative SCV dose of ≥60 Gy is positively associated with improved OS, especially in patients of SCLN without achieving cCR. Our data supports the perspective of optimizing radiotherapeutic strategy based on nodal response.

In Situ Atomic-Scale Deciphering of Multiple Dynamic Phase Transformations and Reversible Sodium Storage in Ternary Metal Sulfide Anode

Ternary metal sulfides (TMSs), endowed with the synergistic effect of their respective binary counterparts, hold great promise as anode candidates for boosting sodium storage performance. Their fundamental sodium storage mechanisms associated with dynamic structural evolution and reaction kinetics, however, have not been fully comprehended. To enhance the electrochemical performance of TMS anodes in sodium-ion batteries (SIBs), it is of critical importance to gain a better mechanistic understanding of their dynamic electrochemical processes during live (de)sodiation cycling. Herein, taking BiSbS₃ anode as a representative paradigm, its real-time sodium storage mechanisms down to the atomic scale during the (de)sodiation cycling are systematically elucidated through in situ transmission electron microscopy. Previously unexplored multiple phase transformations involving intercalation, two-step conversion, and two-step alloying reactions are explicitly revealed during sodiation, in which newly formed Na₂BiSbS₄ and Na₂BiSb are respectively identified as intermediate phases of the conversion and alloying reactions. Impressively, the final sodiation products of Na₆BiSb and Na₂S can recover to the original BiSbS₃ phase upon desodiation, and afterward, a reversible phase transformation can be established between BiSbS₃ and Na₆BiSb, where the BiSb as an individual phase (rather than respective Bi and Sb phases) participates in reactions. These findings are further verified by operando X-ray diffraction, density functional theory calculations, and electrochemical tests. Our work provides valuable insights into the mechanistic understanding of sodium storage mechanisms in TMS anodes and important implications for their performance optimization toward high-performance SIBs.

Metal(loid)s in organic-matter-polluted urban rivers in China: Spatial pattern, ecological risk and reciprocal interactions with aquatic microbiome

Black-odorous urban rivers can serve as reservoirs for heavy metals and other pollutants, in which sewage-derived labile organic matter triggering the water blackening and odorization largely determine the fate and ecological impact of the heavy metals. Nonetheless, information on the pollution and ecological risk of heavy metals and their reciprocal impact on microbiome in organic matter-polluted urban rivers remain unknown. In this study, sediment samples were collected and analyzed from 173 typical black-odorous urban rivers in 74 cities across China, providing a comprehensive nationwide assessment of heavy metal contamination. The results revealed substantial contamination levels of 6 heavy metals (i.e., Cu, Zn, Pb, Cr, Cd, and Li), with average concentrations ranging from 1.85 to 6.90 times higher than their respective background values in soil. Notably, the southern, eastern, and central regions of China exhibited particularly elevated contamination levels. In comparison to oligotrophic and eutrophic waters, the black-odorous urban rivers triggered by organic matter exhibited significantly higher proportions of the unstable form of these heavy metals, indicating elevated ecological risks. Further analyses suggested the critical roles of organic matter in shaping the form and bioavailability of heavy metals through fueling microbial processes. In addition, most heavy metals had significantly higher but varied impact on the prokaryotic populations relative to eukaryotes.

An Integrated Liver Function, Systemic Inflammation, and Tumor Characteristic Score Predicts Prognosis in Hepatocellular Carcinoma After Curative Resection

BACKGROUND

Several scoring systems are currently used to predict prognosis of hepatocellular carcinoma (HCC), but none of them integrates liver function, systemic inflammation, and tumor characteristics in a unified model. The current study aimed to develop and validate a novel prognostic score that integrates liver function, systemic inflammation, and tumor characteristics in a unified model to predict the prognosis of HCC after curative resection.

METHODS

Patients with HCC who underwent curative liver resection were included in a training set (n = 1027). Multivariate Cox regression was performed to determine the risk factors for a poor prognosis. A prognostic score was developed by assigning points for risk factors in proportion to beta coefficients in a Cox multivariable model. Predictive performance and distinction ability of the prognostic score were further evaluated in two independent validation cohorts treated with either curative resection (n = 281) or transarterial chemoembolization (TACE) (n = 404) and compared with 16 other models.

RESULTS

The prognostic predictive system, named the function-inflammation-burden-alpha-fetoprotein (FIBA) score, was derived by assigning points for six independent predictors including albumin, total bilirubin, lymphocyte count, diameter of the largest tumor, number of tumors, and alpha-fetoprotein (AFP). The FIBA score showed an outperformed predictive value compared with other systems in both training and validation cohorts by giving the highest C-index, likelihood ratio chi-square values, and Wald test values as well as the lowest Akaike information criterion.

CONCLUSION

The FIBA score can be used to stratify HCC patients treated with curative resection. Meanwhile, the FIBA score performs well against other prognostic scoring systems and is potentially broadly applicable to a TACE-treated patient cohort.

[Genomic epidemiology of Vibrio parahaemolyticus from acute diarrheal patients in Shenzhen City from 2013 to 2021]

Objective: To characterize the prevalence and genomic epidemiology of Vibrio parahaemolyticus from acute diarrheal patients in Shenzhen City from 2013 to 2021. Methods: Based on the Shenzhen Infectious Diarrhea Surveillance System, acute diarrheal patients were actively monitored in sentinel hospitals from 2013 to 2021. Whole-genome sequencing (WGS) of Vibrio parahaemolyticus isolates was performed, and the genomic population structure, serotypes, virulence genes and multilocus sequence typing were analyzed. Outbreak clusters from 2019 to 2021 were explored based on single-nucleotide polymorphism analysis. Results: A total of 48 623 acute diarrhea cases were monitored in 15 sentinel hospitals from 2013 to 2021, and 1 135 Vibrio parahaemolyticus strains were isolated, with a positive isolation rate of 2.3%. Qualified whole-genome sequencing data of 852 isolates were obtained. Eighty-nine serotypes, 21 known ST types and 5 new ST types were identified by sequence analysis, and 93.2% of strains were detected with toxin profile of tdh+trh-. 8 clonal groups (CGs) were captured, with CG3 as the absolute predominance, followed by CG189. The CG3 group was dominated by O3:K6 serotype and ST3 sequence type, while CG189 group was mainly O4:KUT, O4:K8 serotypes and ST189a and ST189 type. A total of 13 clusters were identified, containing 154 cases. About 30 outbreak clusters with 29 outbreak clusters caused by CG3 strains from 2019 to 2021. Conclusion: Vibrio parahaemolyticus is a major pathogen of acute infectious diarrhea in Shenzhen City, with diverse population structures. CG3 and CG189 have been prevalent and predominant in Shenzhen City for a long time. Scattered outbreaks and persistent sources of contamination ignored by traditional methods could be captured by WGS analysis. Tracing the source of epidemic clone groups and taking precise prevention and control measures are expected to significantly reduce the burden of diarrhea diseases caused by Vibrio parahaemolyticus infection in Shenzhen City.

Liver resection versus microwave ablation for hepatocellular carcinoma in ideal candidates for ablation per Barcelona Clinic Liver Cancer staging: a propensity score matching and inverse probability of treatment weighting analysis

BACKGROUND

Liver resection (LRE) and microwave ablation (MWA) for hepatocellular carcinoma (HCC) have been widely compared.

AIMS

To compare the therapeutic outcomes of percutaneous MWA and LRE for HCC in ideal candidates for ablation according to Barcelona Clinic Liver Cancer (BCLC) staging METHODS: Between August 2013 and November 2020, 483 consecutive patients meeting criteria for "ideal candidates for ablation" per the BCLC staging initially treated with MWA (n = 168) or LRE (n = 315) were included. Patients were further divided into BCLC-0 (n = 116) and BCLC-A (n = 367) groups. Overall survival (OS), recurrence-free survival (RFS) and post-procedure-related complication rates were compared before and after propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) in the overall population and subgroups. Multivariate Cox regression analysis was performed to determine whether the treatment modality was an independent prognostic factor.

RESULTS

LRE had a better RFS and similar OS and post-procedure-related complication rates compared to MWA in the overall population and in the BCLC-A subgroup both before and after PSM and IPTW. However, the OS, RFS and post-procedure-related complication rates were equivalent between the two groups before and after PSM and IPTW in patients with BCLC-0 disease. The multivariate Cox regression analysis showed that LRE was associated with better RFS over MWA in overall population (p = 0.003; HR = 0.67; 95% CI: 0.51-0.87) and BCLC-A disease (p = 0.046; HR = 0.74; 95% CI: 0.56-0.99), while it did not differ in OS.

CONCLUSION

An 'ideal candidate for ablation' according to the BCLC staging system may not be an ideal candidate for MWA. However, patients with BCLC-0 may be the optimal population for MWA.

Cone-beam computed tomography is not a mandatory procedure in adrenal venous sampling for primary hyperaldosteronism

Objectives

To investigate the necessity of cone-beam computed tomography (CBCT) in adrenal venous sampling (AVS).

Methods

This retrospective study included 120 consecutive patients with primary hyperaldosteronism who underwent AVS. Based on the learning curve of the interventional radiologists, the patients were divided into the learning (n = 36) and proficiency (n = 84) groups chronologically. Based on the imaging pattern of the right adrenal vein (RAV), the patients were divided into the typical (n = 36) and atypical (n = 84) groups. The success rate, radiation dose, and sampling time were compared among the entire study population and each subgroup.

Results

A total of 69 patients underwent CBCT, whereas 51 patients did not. The overall success rate was 85.8%, and no difference was noted between patients with and without CBCT (P = 0.347). However, radiation dose (P = 0.018) and sampling time (P = 0.001) were significantly higher in patients who underwent CBCT than in patients who did not. In learning group, CBCT improved success rate from 62.5 to 96.4% (P = 0.028), whereas it was not found in the proficiency group (P = 0.693). Additionally, success rate in patients with an atypical RAV imaging pattern was significantly higher when CBCT was used than when it was not used (P = 0.041), whereas no difference was noted in patients with typical RAV imaging pattern (P = 0.511).

Conclusion

For physicians not very experienced doing AVS, there is a clear significant improvement in success rate when CBCT is used. However, CBCT only has minimal benefit for experienced operators, meanwhile CBCT may take an extra time and increase the radiation dose during AVS.

Unraveling Atomic-Scale Origins of Selective Ionic Transport Pathways and Sodium-Ion Storage Mechanism in Bi2 S3 Anodes

It is a major challenge to achieve a high-performance anode for sodium-ion batteries (SIBs) with high specific capacity, high rate capability, and cycling stability. Bismuth sulfide, which features a high theoretical specific capacity, tailorable morphology, and low cost, has been considered as a promising anode for SIBs. Nevertheless, due to a lack of direct atomistic observation, the detailed understanding of fundamental intercalation behavior and Bi₂ S₃ 's (de)sodiation mechanisms remains unclear. Here, by employing in situ high-resolution transmission electron microscopy, consecutive electron diffraction coupled with theoretical calculations, it is not only for the first time identified that Bi₂ S₃ exhibits specific ionic transport pathways preferred to diffuse along the (110) direction instead of the (200) plane, but also tracks their real-time phase transformations (de)sodiation involving multi-step crystallographic tuning. The finite-element analysis further disclosed multi-reaction induced deformation and the relevant stress evolution originating from the combined effect of the mechanical and electrochemical interaction. These discoveries not only deepen the understanding of fundamental science about the microscopic reaction mechanism of metal chalcogenide anodes but also provide important implications for performance optimization.

Atomic-Scale Tracking of Dynamic Nucleation and Growth of an Interfacial Lead Nanodroplet

Revealing the evolutional pathway of the nucleation and crystallization of nanostructures at the atomic scale is crucial for understanding the complex growth mechanisms at the early stage of new substances and spices. Real-time discrimination of the atomic mechanism of a nanodroplet transition is still a formidable challenge. Here, taking advantage of the high temporal and spatial resolution of transmission electron microscopy, the detailed growth pathway of Pb nanodroplets at the early stage of nucleation was directly observed by employing electron beams to induce the nucleation, growth, and fusion process of Pb nanodroplets based on PbTiO3 nanowires. Before the nucleation of Pb nanoparticles, the atoms began to precipitate when they were irradiated by electrons, forming a local crystal structure, and then rapidly and completely crystallized. Small nanodroplets maintain high activity and high density and gradually grow and merge into stable crystals. The whole process was recorded and imaged by HRTEM in real time. The growth of Pb nanodroplets advanced through the classical path and instantaneous droplet coalescence. These results provide an atomic-scale insight on the dynamic process of solid/solid interface, which has implications in thin-film growth and advanced nanomanufacturing.

Electron Tomography Reveals Porosity Degradation Spatially on Individual Pt-Based Nanocatalysts

Probing porosity evolution is essential to understand the degradation mechanism of electrocatalytic activity. However, spatially dependent degradation pathways for porous catalysts remain elusive. Here, we reveal the multiple degradation behaviors of individual PtCu₃ nanocatalysts spatially by three-dimensional (3D) electron tomography. We demonstrate that the surface area-volume ratio (SVR) of cycled porous particles decreases linearly rather than reciprocally with particle size. Additionally, an improved SVR (about 3-fold enhancement) results in increased oxygen reduction reaction (ORR) efficiency at the early stage. However, in the subsequent cycles, the degradation of catalytic activity is due to the excessive growth of pores, the reduction of reaction sites, and the chemical segregation of Cu atoms. The spatial porosity evolution model of nanocatalysts is applicable for a wide range of catalytic reactions, providing a critical insight into the degradation of catalyst activity.

Enhancement of denitrification in biofilters by immobilized biochar under low-temperature stress

Efficient removal of nitrate under low temperature is challenging because of the reduction of the microbial activity. This study successfully explored the promotion on the performance of denitrification utilizing the immobilized biochar in biofilters under low temperature (6 ± 2 °C). The results showed that the immobilized biochar increased the denitrification rate by 76.8% and decreased the nitrous oxide emissions by 82.5%. Mechanistic studies revealed that the immobilized biochar increased the activities of the denitrifying enzymes and three enzymes involved in glycolysis. Furthermore, the immobilized biochar elevated the activity of the electron transport system by 31.8%. Finally, structural equation model explained that the increase of nitrate reductase activity was a crucial factor to enhance the total nitrogen removal efficiency in biofilters with immobilized biochar. Overall, the use of immobilized biochar can be a novel strategy to enhance nitrogen removal and reduce greenhouse gas emissions in biofilters under low temperature.

Ultraviolet-Light-emitting-diode activated monochloramine for the degradation of carbamazepine: Kinetics, mechanisms, by-product formation, and toxicity

Monochloramine (NH₂Cl) oxidant combined with a Ultraviolet (UV)-Light-emitting-diode (LED) light source forms a new advanced oxidation process (AOP), which can achieve high-efficiency degradation of carbamazepine (CBZ). The degradation of CBZ displayed pseudo-first-order reaction kinetics (R² > 0.98, k_CBZ = 0.0043 cm² mJ^-1 at pH 7). The degradation of CBZ was dependent on UV-LED wavelength, with maximum degradation efficiency observed at 265 nm since it was the lowest wavelength studied among UV-LEDs. Variation in pH across the range, which might be expected under normal environmental conditions (pH 6-8), and the presence of Cl^- had no significant effect on the degradation efficiency of CBZ, while the presence of HCO₃^- and natural organic matter (NOM) inhibited degradation. Electron paramagnetic resonance (EPR) experiments detected OH in the system. Probe compounds were used to distinguish the contribution of reactive chlorine species (RCS). It was proved that OH and Cl played major roles and OH was responsible for around 50% of the observed degradation of CBZ. Eight transformative products (TPs) in the degradation process of CBZ were identified, with a generally decreasing toxicity. The concentration of disinfection by-products (DBPs) formed during CBZ degradation was all within limits of WHO and China standard for drinking water. Although the concentration of nitrogen-containing DBPs (N-DBPs) was the lowest, N-DBPs were the main contributors to toxicity, and these would require more attention in practical applications. UV-LED/NH₂Cl AOP was identified as an effective way to degrade pharmaceutically active compounds.

Monitoring the cleanliness of reusable surgical instruments in central sterile supply department by adenosine triphosphate method

BACKGROUND

Cleaning is very important in reusable surgical instruments (RSI) reprocessing. Adenosine triphosphate (ATP) method is widely used for cleanliness assessing while few studies focused on using this method on RSIs.

OBJECTIVE

To assess the effectiveness of ATP Bioluminescence Assay for monitoring the cleanliness of RSIs.

METHODS

The study conducted in three central sterile supply departments (CSSD) from 2015 to 2020, surgical scissors, haemostatic forceps, and other non-lumen instruments after cleaning were sampled. Each instrument was swabbed in a uniform manner on the surface including hinged joints and teeth, the amount of ATP (amol) was calculated.

RESULTS

A total of 871 RSIs after cleaning were tested, the mean ATP lg (amol) was 2.829 ± 0.539 and the qualified rate was 80.57%. Washer-disinfector cleaning was more efficiency than manual cleaning, the mean ATP lg (amol) were 2.776 ± 0.513 and 2.948 ± 0.575, respectively; the qualified rates were 84.97% and 70.59%, respectively. The qualified rate was decreased with the time of instruments after cleaning exploring to environment increased (P  trend = 0.044).

CONCLUSION

ATP level are stable and repeatable for continuous monitoring the cleanliness of RSIs, it is a rapid and viable method for assessing the cleanliness of RSIs. Washer-disinfector cleaning is recommended and cleaned instruments should go on packing for sterilization in time.

HIGHLIGHTS

- ATP method is viable for assessing the cleanliness of reusable surgical instruments in CSSDs.- Reusable surgical instruments suggested washer-disinfector cleaning and should go on packing for sterilization in time.

Innate Immune Response to Fasting and Refeeding in the Zebrafish Kidney

Animals acquire nutrients and energy through feeding to achieve a balance between growth and organismal health. When there is a change in nutrient acquisition, the state of growth changes and may also cause changes in the intrinsic immune system. Compensatory growth (CG), a specific growth phenomenon, involves the question of whether changes in growth can be accompanied by changes in innate immunity. The zebrafish (Danio rerio), a well-known fish model organism, can serve as a suitable model. In this study, the zebrafish underwent 3 weeks of fasting and refeeding for 3 to 7 day periods. It was found that CG could be achieved in zebrafish. Zebrafish susceptibility to Streptococcus agalactiae increased after starvation. In addition, the amount of melano-macrophage centers increased after fasting and the proportion of injured tubules increased after refeeding for 3 and 5 days, respectively. Furthermore, the kidneys of zebrafish suffering from starvation were under oxidative stress, and the activity of several antioxidant enzymes increased after starvation, including catalase, glutathione peroxidases and superoxide dismutase. Innate immune parameters were influenced by starvation. Additionally, the activity of alkaline phosphatase and lysozyme increased after starvation. The mRNA expression of immune-related genes like il-1β was elevated to a different extent after fasting with or without lipopolysaccharides (LPS) challenge. This study showed that the function of the innate immune system in zebrafish could be influenced by nutrition status.

The transcriptional regulator Zur regulates the expression of ZnuABC and T6SS4 in response to stresses in Yersinia pseudotuberculosis

Zinc homeostasis is crucial for the development and stress resistance of bacteria in the environment. Serial zinc sensing transcriptional regulators, zinc transporters and zinc binding proteins were found to maintain the zinc homeostasis in bacteria. Zur is a zinc uptake regulator that is widely distributed in species, and ZnuABC, as well as the Type VI Secretion System (T6SS4) function in zinc acquisition. Here, we report that the regulator Zur inhibits the expression of the ZnuABC which inhibition could be eliminated at low zinc level, and upregulates the T6SS4 operon in Yersinia pseudotuberculosis to facilitate Zn²⁺ uptake and oxidative stress resistance. Zur regulates the expression of ZnuABC and T6SS4 by directly binding to their promoter regions. Zur senses the Zn²⁺ concentration and represses ZnuABC in a Zn²⁺-containing environment. Zur works as an auxiliary regular activator of T6SS4, facilitating oxidative stress resistance. This study revealed the dual function of regulator Zur on ZnuABC and T6SS4, and enriched the knowledge of Zn²⁺ homeostasis maintenance in Y. pseudotuberculosis.

Assessment of risk factors of treatment discontinuation among patients on paliperidone palmitate and risperidone microspheres in france, germany and belgium – a retrospective database study

Introduction

Long-acting antipsychotics (e.g. 1-monthly (PP1M) / 3-monthly (PP3M) injection forms of paliperidone palmitate) have been developed to improve treatment continuation in schizophrenia patients.

Objectives

To assess risk factors of treatment discontinuation in patients on paliperidone palmitate and risperidone microsphere. Additionally, treatment continuation between patients with PP1M and PP3M was compared.

Methods

The IQVIA Longitudinal Prescription databases were used. Risk factors of treatment discontinuation were identified by a multilevel survival regression using Cox proportional hazards model. Kaplan Meier analyses were performed by identified significant risk factors.

Results

25,361 patients (France: 9,720; Germany: 14,461; Belgium: 1,180) were included. Over a one-year follow-up period, a significant higher treatment continuation was observed for patients newly initiated on paliperidone palmitate (46.2%) than those initiated on risperidone microspheres (14.6%). Additionally, a significantly higher treatment continuation was found for ‘stable’ PP3M patients (81.8%) than ‘stable’ PP1M patients (62.9%). Patients were more likely to discontinue when drugs prescribed by GP only (HR = 1.68, p < 0.001 vs. psychiatrist only) or being females (HR = 1.07, p < 0.001), whereas discontinuation rate decreased with age (31-50 years: HR = 0.95, p = 0.006 and > 50 years: HR = 0.91, p < 0.001 vs. 18-30 years).

Conclusions

Paliperidone palmitate was associated with a significantly higher treatment continuation than risperidone microspheres. Treatment continuation is likely to be improved by targeting young patients (18-30 years), empowering GPs with mental health knowledge and managing patients by a collaborative primary care-mental health model. Further research is needed to understand why females have more treatment discontinuation.

Disclosure

Rui Cai, Flore Decuypere and Pierre Chevalier are IQVIA employees and served as paid consultants to Janssen during the conduct of this study. Antonie Wimmer, Pascal Guillon, Stefan Pype, Annabelle Godet, Valeria Timtschenko are Janssen employees.

Treatment persistence in paediatric and adolescent patients with psoriasis followed into young adulthood. From topical to systemic treatment: a prospective, longitudinal, observational cohort study of 448 patients

Background

Although solely topical treatment often suffices, patients with psoriasis may require more intensive treatment (phototherapy and/or systemic treatments) to control their disease. However, in paediatric, adolescent and young adult patients, little is known about persistence of topical treatment and time until switch to systemic treatment.

Objectives

To determine the median time from psoriasis onset until (i) discontinuation of solely topical agents and (ii) switch to systemic treatment, and to identify patient characteristics associated with switching to systemic treatments.

Methods

Data were extracted from the Child‐CAPTURE registry, a prospective, observational cohort of patients with paediatric‐onset psoriasis followed into young adulthood from 2008 to 2018. Data prior to inclusion in the registry were collected retrospectively. Median times were determined through Kaplan–Meier survival analyses. Cox regression analysis was used to identify patient characteristics associated with switch to systemic treatment.

Results

Of 448 patients, 62·3% stayed on solely topical treatment until data lock; 14·3% switched from topicals to phototherapy, but not to systemic treatment; and 23·4% switched to systemic treatment. The median time from psoriasis onset until discontinuation of solely topical treatment was 7·3 years, and until switch to systemics was 10·8 years. Higher Psoriasis Area and Severity Index and (Children’s) Dermatology Life Quality Index > 5 were independently associated with switching to systemic treatment.

Conclusions

In a population of paediatric and adolescent patients with mild‐to‐severe psoriasis, one‐third needed more intensive treatment than solely topical therapy to control their disease. We consider the median time until switching to systemics to be long.

What is already known about this topic?

Psoriasis in the majority of paediatric and adolescent patients can be adequately managed with solely topical treatment. However, some patients require a switch to more intensive treatment in order to control their disease.

Little is known about persistence of topical treatment and time until switch to systemic treatment.

What does this study add?

In 448 paediatric patients with mild‐to‐severe psoriasis, 62·3% persisted on solely topical treatment, 14·3% switched to phototherapy, but not to systemics, and 23·4% switched to systemic treatment at data lock (total median follow‐up 4·2 years, interquartile range 1·8–7·5).

The median time from psoriasis onset until discontinuation of solely topical treatment was 7·3 years, and until switch to systemic treatment 10·8 years.

Higher Psoriasis Area and Severity Index and (Children’s) Dermatology Life Quality Index > 5 at switch were independent characteristics associated with switching to systemic treatment.

Linked Comment: Salman. Br J Dermatol 2021; 184:387–388.

Plain language summary available online

Confining TiO2 Nanotubes in PECVD-Enabled Graphene Capsules Toward Ultrafast K-Ion Storage: In Situ TEM/XRD Study and DFT Analysis

Titanium dioxide (TiO₂) has gained burgeoning attention for potassium-ion storage because of its large theoretical capacity, wide availability, and environmental benignity. Nevertheless, the inherently poor conductivity gives rise to its sluggish reaction kinetics and inferior rate capability. Here, we report the direct graphene growth over TiO₂ nanotubes by virtue of chemical vapor deposition. Such conformal graphene coatings effectively enhance the conductive environment and well accommodate the volume change of TiO₂ upon potassiation/depotassiation. When paired with an activated carbon cathode, the graphene-armored TiO₂ nanotubes allow the potassium-ion hybrid capacitor full cells to harvest an energy/power density of 81.2 Wh kg^-1/3746.6 W kg^-1. We further employ in situ transmission electron microscopy and operando X-ray diffraction to probe the potassium-ion storage behavior. This work offers a viable and versatile solution to the anode design and in situ probing of potassium storage technologies that is readily promising for practical applications.

High-Performance Natural Rubber/Graphene Composites from a Uniquely Designed Physical and Chemical Hybrid-Network

It is well-known that strength and stiffness are commonly inversely related with toughness and ductility for organic filler filled elastomer nanocomposites. These performances are governed by the dispersion of organic fillers and interface of elastomer nanocomposites. Herein, the designed physical and chemical hybrid-network based on tannic acid (TA) as interface regulator and cross-link agent can endow graphene/elastomer nanocomposites with reinforcement as well as toughness simultaneously. The results indicate the formation of a strong and stable network structure composed of elastomer chains and graphene, contrary to traditional graphene/elastomer nanocomposites. The present composites with a physical and chemical hybrid-network effectively improve the load transfer and show excellent mechanical properties.

Applications of Ultrafine Limestone Sorbents for the Desulfurization Process in CFB Boilers

With the stringent emission regulation taking effect, it is difficult for the conventional desulfurization technology in circulating fluidized bed (CFB) boilers to meet the requirements of ultralow SO₂ emission. Therefore, in this paper, the application of natural ultrafine limestone, with a Sauter mean diameter of less than 20 μm, was tested by conducting bench-scale, pilot-scale, and commercial-scale experiments to realize highly efficient desulfurization in CFB furnaces. In the past, such small-size limestone was considered unsuitable for CFB boilers. However, as demonstrated by bench-scale results, the desulfurization performance was clearly superior to that of coarse limestone, especially at low SO₂ concentrations. In a 3 MW_th pilot-scale CFB boiler, the ultrafine limestone exhibited competent desulfurization efficiency to that of the coarse limestone but clearly less significant catalytic effects on NOx formation. As revealed by field tests in four commercial-scale CFB boilers, when high-efficiency cyclones were applied to CFB boilers, the mass inventory of ultrafine particles was significantly increased and the residence time would be extended accordingly; thus, the ultrafine limestone can be used to achieve high desulfurization efficiency and even ultralow SO₂ emission with a favorable Ca/S ratio. Furthermore, a technical roadmap was drawn for the cost-effective control of SO₂ emission.

Pretransplant Homeostasis Model Assessment of Insulin Resistance and Fasting Plasma Glucose Predict New-Onset Diabetes After Renal Transplant in Chinese Patients

BACKGROUND AND AIM

The present study aims to determine if homeostasis model assessment of insulin resistance (HOMA-IR) index, fasting plasma glucose (FPG), and plasma insulin (Ins) are able to predict development of new onset diabetes after transplant (NODAT) for kidney recipients.

METHODS

We performed a single-center retrospective study of 123 nondiabetic patients receiving a first renal transplant. The NODAT was diagnosed between 1 month and 1 year post transplant. Both univariate and multivariable analyses, including logistic regression analysis and Cox proportional hazards model, were applied to dissect potential pretransplant risk factors of NODAT.

RESULTS

A total of 26.8% (33/123) of recipients developed NODAT in the first year post transplant. The NODAT patients showed higher HOMA-IR index and increased levels of FPG and Ins than non-NODAT. Interestingly, we consistently revealed that both FPG (logistic: odds ratio [OR], 3.17 [1.41-6.45]; P = .01; Cox: OR, 2.75 [1.26-4.56]; P = .02) and HOMA-IR index (logistic: OR, 1.73 [1.21-2.87]; P = .02; Cox: OR, 1.72 [1.21-2.46]; P = .002) robustly predicted the development of NODAT. However, these analyses showed that neither plasma Ins nor hemoglobin A_1c was associated with NODAT.

CONCLUSION

Our findings suggest that pretransplant HOMA-IR and FPG are independent predictors for the development of NODAT in Chinese nondiabetic patients receiving a first renal transplant.

Abstract P2-10-01: Phase II study of antiangiogenic tyrosine kinase inhibitor apatinib in combination with oral vinorelbine in heavily pretreated HER2-negative advanced breast cancer

Background: Metastatic breast cancer remains an incurable disease, and clinical benefit and progression-free survival are the main end points in advanced setting. Targeted therapies have shown promising potentials in HER2-positive breast cancer, but with uncertain effects in HER2-negative breast cancer, especially when the disease is progressing rapidly. The regimen of antiangiogenic therapy in combination with chemotherapy had been studied for years and gained improved efficacy. Apatinib is an oral, highly potent tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor 2. PhaseIIclinical trials of Apatinib single agent had presented objective response and manageable toxicity in heavily pretreated, metastatic breast cancer. Oral vinorelbine represents a good choice for its toxicity and activity in anthracycline and taxane-pretreated breast cancer patients. This all-oral study aims to investigate the efficacy and safety of the oral vinorelbine-apatinib combination in pre-treated metastatic breast cancer. Methods: This study enrolled patients with HER2-negative advanced breast cancer, pretreated with anthracycline/taxanes, and who failed in the metastatic setting at least one prior chemotherapy or endocrine therapy when hormone receptor is positive. Patients were treated with apatinib 500mg/425mg daily plus oral vinorelbine 60mg/m2 day1,8,15 every 3 weeks/cycle. Patients eligible were evaluated by CT or MRI scan at baseline and every 2 cycles (6 weeks) there after until disease progressed. The primary endpoint wasPFS. The secondary endpoints were objective response rate, clinical benefit rate, OS, and safety. Results: 40 patients were enrolled with a median age of 55 (30-70) years. First 17 patients started apatinib at the dose of 500mg/day. Considering safety issues, a lower dose of apatinib 425mg/day was subsequently started as the initial dose after these 17 patients recruited. 26(65.0%) patients experienced treatment delay and 20(50.0%) patients experienced dose modification during treatment. Median follow-up time was 10.3 months. Of all 40 patients, median PFS was 5.4 months (95% CI, 3.4m–7.3m). Median OS was not reached. 32 patients were eligible for efficacy analysis. ORR was 15.6% (5/32). CBR was 46.9% (15/32). Patients with triple-negative breast cancer or who received combined therapy as second line treatment gained better ORR and longer median PFS. The most common adverse events of all grades included gastrointestinal reaction (70.0%), myelosuppression (67.5%), hypertension(62.5%), pain(60.0%), malaise(52.5%), anorexia(50.0%), elevated transaminase(47.5%), hand-foot reaction (47.5%), proteinuria (37.5%), and elevated bilirubin(32.5%). Proteinuria, treatment delay, and ECOG performance status were independent predictive factors for PFS.Conclusions: The all-oral therapy of antiangiogenic tyrosine kinase inhibitor apatinib plus vinorelbine presented objective efficacy in advanced HER2-negative breast cancer who failed from first-line therapy, with acceptable and manageable toxicity.

Citation Format: Zhu A, Yuan P, Wang J, Fan Y, Luo Y, Cai R, Zhang P, Li Q, Ma F, Xu B. Phase II study of antiangiogenic tyrosine kinase inhibitor apatinib in combination with oral vinorelbine in heavily pretreated HER2-negative advanced breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-10-01.

Correction to: Air quality and acute myocardial infarction in adults during the 2016 Hangzhou G20 summit

Unfortunately, the original publication of this paper contains a mistake. The correct name of the 1st Author is Ming-Wei Wang.

Air quality and acute myocardial infarction in adults during the 2016 Hangzhou G20 summit

To fulfill its commitment to a successful Hangzhou G20 summit (4 to 5 September 2016), the Chinese government implemented a series of measures to improve the air quality in Hangzhou. We report findings on air quality and acute myocardial infarction (AMI) hospital admissions in adults during the Hangzhou G20 summit. Three study periods were defined. The first period was pre-G20 (28 July to 27 August: limited restrictions on industrial emissions). The second period was G20 (28 August to 6 September) when there were further restrictions on industrial emissions and increased transportation restrictions. The third period was post-G20 (7 September to 6 October) when restrictions were relaxed again. The mean number of AMI admissions per day was, respectively, 8.2 during G20, 13.3 during pre-G20, and 15.1 during post-G20. We used time-series Poisson regression models to estimate the relative risk (RR) for AMI associated with pollution levels. Our results suggest that the air quality improvement can reduce the number of hospital admissions for AMI.

Abstract P1-13-13: The treatment patterns and clinical outcomes of trastuzumab in early human epidermal growth factor receptor 2 (HER2) positive breast cancer in the real-world setting in China

Background:Several prospective interventional studies have proved the efficacy and safety of trastuzumab in adjuvant treatment in HER2positive breast cancer,while limited data existed to address the treatment patterns and real-world performance of trastuzumab in early HER2 positive breast cancer in China.

Methods:We retrospectively analyzed all the pts who were diagnosed with HER2-positive breast cancer,underwent surgery and received adjuvant treatment in National Cancer Center from 2000 to 2012.The treatment patterns and disease free survival (DFS),overall survival (OS) were analyzed respectively.

Results:A total of 1398 HER2 positive breast cancer pts were identified.The median follow-up time was 79.1 months.68.5% pts received chemotherapy alone,3.4% pts only received mono trastuzumab,28.2% pts received trastuzumab plus chemotherapy.Among 433 trastuzumab treated pts,64.7% received concurrent trastuzumab with chemotherpy,and 35.3% pts received sequential trastuzumab with chemotherapy

Baseline characteristics by Chemotherapy alone and Chemotherapy + Trastuzumab.No(%) of patients   characteristicTrastuzumab- (N=957)Trastuzumab+ (N=441)Total (N=1398)Age (years)   &lt;=3596 ( 10.0)44 ( 10.0)140 ( 10.0)36 - 50434 ( 45.4)244 ( 55.3)678 ( 48.5)&gt;50427 ( 44.6)153 ( 34.7)580 ( 41.5)Histologic grade   I15 ( 1.6)7 ( 1.6)22 ( 1.6)I-II,II480 ( 50.2)224 ( 50.8)704 ( 50.4)II-III,III285 ( 29.8)166 ( 37.6)451 ( 32.3)IDC148 ( 15.5)29 ( 6.6)177 ( 12.7)Other29 ( 3.0)15 ( 3.4)44 ( 3.1)Clinical stage   026 ( 2.7)16 ( 3.6)42 ( 3.0)I259 ( 27.1)108 ( 24.5)367 ( 26.3)II434 ( 45.4)196 ( 44.4)630 ( 45.1)III238 ( 24.9)121 ( 27.4)359 ( 25.7)Hormone receptor status   Positive635 ( 66.4)256 ( 58.0)891 ( 63.7)Negative322 ( 33.6)185 ( 42.0)507 ( 36.3)

.Trastuzumab plus chemo had significantly longer DFS compared with chemo alone.(85.03%vs72.15%,hazard ratios,HR=0.531,95% confidence interval,95%CI:0.406-0.696, p&lt;0.001).In addition,the concurrent trasuzumab showed the trend with longer DFS compared to the sequential regimen(86.07%vs82.35%,HR=0.843,95%CI:0.515-1.378, p=0.495).Age,tumor size, lymph node status,clinical stage were associated with DFS

Results of Cox regression hazard model with treatment groups and patient characteristics on DFSGroupHR95% CIP valueTreatment group   Concurrent Trastuzumab0.8430.515-1.3780.495Sequential Trastuzumab   Chemotherapy+Trastuzumab0.5310.406-0.696&lt;0.001Chemotherapy alone   Age group (years)  0.001&lt;=351.6501.198-2.2730.00236 - 500.8880.702-1.1220.319&gt;50   Histologic grade  &lt;0.001I0.5200.210-1.2880.158I-II,II0.5040.379-0.671&lt;0.001II-III,III0.5320.390-0.725&lt;0.001Other0.5140.264-0.9970.049IDC   Clinical stage  &lt;0.00100.2610.107-0.6370.003I0.2860.207-0.395&lt;0.001II0.4800.379-0.607&lt;0.001III   Hormone receptor status  0.022Positive0.7730.621-0.9620.021Negative   

.OS was also prolonged in trastuzumab plus chemotherapy compared with chemotherapy alone.(93.20%vs85.45%,HR=0.561,95%CI:0.377-0.835, p=0.004).

Conclusions:Our study revealed that,there were still more than half of HER2-positive breast cancer pts couldn't reach anti-HER2 therapy in China,the early stage HER2-positive breast cancer pts could significantly benefit from trastuzumab adjuvant therapy in real-world setting.

Citation Format: Guo J, Xu B, Li Q, Zhang P, Yuan P, Wang J, Ma F, Fan Y, Cai R, Luo Y, Li Q. The treatment patterns and clinical outcomes of trastuzumab in early human epidermal growth factor receptor 2 (HER2) positive breast cancer in the real-world setting in China [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-13-13.

Outcome of postmastectomy radiotherapy after primary systemic treatment in patients with clinical T1-2N1 breast cancer

PURPOSE

The role of postmastectomy radiotherapy following primary systemic treatment in patients with clinical T1-2N1 breast cancer remains a controversial issue. The purpose of this study was to evaluate the benefit of postmastectomy radiotherapy following primary systemic treatment.

PATIENTS AND METHODS

Between 2005 and 2012, in two independent institutions, female patients with T1-2N1 breast cancer receiving primary systemic treatment followed by mastectomy and lymph node dissection because bad response, then treated with or without chest wall and regional lymph node irradiation have been studied retrospectively. The patients received normofractionated radiotherapy using 3D conformal photons or electron techniques. Locoregional recurrence-free survival, distant metastasis-free survival and disease-free survival were calculated using Kaplan-Meier method. Univariate analysis of potential prognostic factors was performed using log-rank test.

RESULTS

Eighty-eight patients have been studied. Of them, 75 patients received postmastectomy radiotherapy. At surgery, 53 patients achieved ypN0. Median follow-up was 67 months. Postmastectomy radiotherapy significantly improved locoregional recurrence-free survival, with a 5-year rate of 96.9% versus 78.6% in the group that did not have postmastectomy radiotherapy. In the subgroup of 53 patients achieving ypN0, postmastectomy radiotherapy improved locoregional recurrence-free survival (a 5-year rate of 94.7% vs. 72.9%), distant metastasis-free survival (a 5-year rate of 92.8% vs. 75%) and disease-free survival (a 5-year rate of 92.9% vs. 62.5%). By univariate analysis, postmastectomy radiotherapy was the only significant prognostic factor affecting locoregional recurrence-free survival.

CONCLUSIONS

For patients with clinical T1-2N1 disease, postmastectomy radiotherapy could significantly improve locoregional recurrence-free survival after primary systemic treatment and be even more therapeutic in the subgroup of patients with good response for primary systemic treatment by improving locoregional recurrence-free, distant metastasis-free and disease-free survival. Larger prospective studies are needed to confirm our findings.

Cord blood NK cells engineered to express IL-15 and a CD19-targeted CAR show long-term persistence and potent antitumor activity

Chimeric antigen receptors (CARs) have been used to redirect the specificity of autologous T cells against leukemia and lymphoma with promising clinical results. Extending this approach to allogeneic T cells is problematic as they carry a significant risk of graft-versus-host disease (GVHD). Natural killer (NK) cells are highly cytotoxic effectors, killing their targets in a non-antigen-specific manner without causing GVHD. Cord blood (CB) offers an attractive, allogeneic, off-the-self source of NK cells for immunotherapy. We transduced CB-derived NK cells with a retroviral vector incorporating the genes for CAR-CD19, IL-15 and inducible caspase-9-based suicide gene (iC9), and demonstrated efficient killing of CD19-expressing cell lines and primary leukemia cells in vitro, with marked prolongation of survival in a xenograft Raji lymphoma murine model. Interleukin-15 (IL-15) production by the transduced CB-NK cells critically improved their function. Moreover, iC9/CAR.19/IL-15 CB-NK cells were readily eliminated upon pharmacologic activation of the iC9 suicide gene. In conclusion, we have developed a novel approach to immunotherapy using engineered CB-derived NK cells, which are easy to produce, exhibit striking efficacy and incorporate safety measures to limit toxicity. This approach should greatly improve the logistics of delivering this therapy to large numbers of patients, a major limitation to current CAR-T-cell therapies.

Effects of blood lead and cadmium levels on homocysteine level in plasma

OBJECTIVE

We studied the effect of non-occupational exposure to lead and cadmium on homocysteine level in plasma. Homocysteine is a marker for plasma folate folic acid metabolism in urban populations.

PATIENTS AND METHODS

159 individuals from Beijing, Guangzhou, Shenzhen and Shanghai with no history of close exposure to heavy metals and no history of metabolic diseases were enrolled to participate in this study. Blood lead and cadmium levels were detected using ICP-MS method and the level of homocysteine was also measured using enzyme method. Our results showed that blood lead and cadmium levels in males were significantly higher than those in females. Also, blood lead and cadmium levels in smokers were higher than those in non-smokers; homocysteine level was significantly higher in smokers as well. According to blood lead and cadmium levels, cases were divided into four groups.

RESULTS

Our results showed that a surge in blood lead and cadmium levels could result in an increase in homocysteine level. We concluded that in the Chinese population, smoking and gender might be the risk factors for elevated levels of lead and cadmium. Meanwhile, blood lead and cadmium levels may influence the homocysteine levels in the body.

CONCLUSIONS

It is possible to speculate that non-occupational exposure to lead and cadmium, by increasing the homocysteine levels, negatively affect the cardiovascular and nervous system.

Etiology and clinical features of 229 cases of bloodstream infection among Chinese HIV/AIDS patients: a retrospective cross-sectional study

Bloodstream infections (BSIs) are prevalent among people living with HIV/AIDS. The etiology varies in different regions and different periods. We aimed to survey the etiological and clinical features of BSIs in HIV patients in mainland China. We assessed all HIV patients with a positive blood culture in a Chinese teaching hospital from September 2009 through December 2014. We excluded those with specimens likely to have been contaminated. We used Pearson's chi-squared test to measure the differences in characteristics among subgroups of different pathogens. Among 2442 Chinese HIV-seropositive inpatients, 229 (9.38 %) experienced BSIs. The most common pathogens detected included Cryptococcus neoformans (22.7 %), Penicillium marneffei (18.8 %), Mycobacterium tuberculosis (15.3 %), and non-tuberculous mycobacterium (14.8 %). 30/229 (13.1 %) HIV patients with BSIs had a poor prognosis. BSIs are prevalent in hospitalized patients with HIV/AIDS in China. Fungi and mycobacteria are the predominant pathogens.

Predictive value of plasma β2-microglobulin on human body function and senescence

OBJECTIVE

To explore the correlation between plasma β2-microglobulin (β2-MG) as senescence factor with age, heart, liver and kidney function as well as the predictive value of β2-MG in human metabolism function and senescence.

PATIENTS AND METHODS

387 cases of healthy people of different ages were selected and the automatic biochemical analyzer was used to test β2-MG in plasma based on immunoturbidimetry and also all biochemical indexes. The correlation between β2-MG and age, gender and all biochemical indexes was analyzed.

RESULTS

β2-MG was positively correlated to age, r = 0.373; and the difference was of statistical significance (p < 0.010). It was significantly negative correlated to HDL-C but positively correlated to LP (a), BUN, CREA, UA, CYS-C, LDH, CK-MB, HBDH, AST, GLB and HCY.

CONCLUSIONS

β2-MG was closely correlated to age, heart, kidney and liver biochemical indexes, which can be taken as an important biomarker for human body function and anti-senescence and have significant basic research and clinical guidance values.