Stereoselective Synthesis of Polysubstituted Conjugated Dienes Enabled by Photo-Driven Sequential Sigmatropic Rearrangement

We here reported a highly stereoselective method for the synthesis of polysubstituted conjugated dienes from α-aryl α-diazo alkynyl ketones and pyrazole-substituted unsymmetric aminals under mild conditions, which was promoted by photo-irridation and involved with 1,6-dipolar intermediate and quadruple sigmatropic rearrangements, was successfully developed. In this transformation, the cleavage of four bonds and the recombination of five bonds were implemented in one operational step. This protocol provided a modular tool for constructing dienes from amines, pyrazoles and α-alkynyl-α-diazoketones in one-pot manner. The results of mechanistic investigation indicated that the plausible reaction path underwent the 1,6-sigmatropic rearrangement instead of the 1,5-sigmatropic rearrangement.

Transparent Self-Healing Anti-Freezing Ionogel for Monolayered Triboelectric Nanogenerator and Electromagnetic Energy-Based Touch Panel

The advent of Internet of Things and artificial intelligence era necessitates the advancement of self-powered electronics. However, prevalent multifunctional electronics still face great challenges in rigid electrodes, stacked layers, and external power sources to restrict the development in flexible electronics. Here, a transparent, self-healing, anti-freezing (TSA) ionogel composed of fluorine-rich ionic liquid and fluorocarbon elastomer, which is engineered for monolayered triboelectric nanogenerators (M-TENG) and electromagnetic energy-based touch panels is developed. Notably, the TSA-ionogel exhibits remarkable features including outstanding transparency (90%), anti-freezing robustness (253 K), impressive stretchability (600%), and repetitive self-healing capacity. The resultant M-TENG achieves a significant output power density (200 mW m-2 ) and sustains operational stability beyond 1 year. Leveraging this remarkable performance, the M-TENG is adeptly harnessed for biomechanical energy harvesting, self-powered control interface, electroluminescent devices, and enabling wireless control over electrical appliances. Furthermore, harnessing Faraday's induction law and exploiting human body's intrinsic antenna properties, the TSA-ionogel seamlessly transforms into an autonomous multifunctional epidermal touch panel. This touch panel offers impeccable input capabilities through word inscription and participation in the Chinese game of Go. Consequently, the TSA-ionogel's innovation holds the potential to reshape the trajectory of next-generation electronics and profoundly revolutionize the paradigm of human-machine interaction.

A Digital-Analog Bimodal Memristor Based on CsPbBr3 for Tactile Sensory Neuromorphic Computing

Memristor with digital and analog bipolar bimodal resistive switching offers a promising opportunity for the information-processing component. However, it still remains a huge challenge that the memristor enables bimodal digital and analog types and fabrication of artificial sensory neural network system. Here, a proposed CsPbBr3 -based memristor demonstrates a high ON/OFF ratio (>103 ), long retention (>104 s), stable endurance (100 cycles), and multilevel resistance memory, which acts as an artificial synapse to realize fundamental biological synaptic functions and neuromorphic computing based on controllable resistance modulation. Moreover, a 5 × 5 spinosum-structured piezoresistive sensor array (sensitivity of 22.4 kPa-1 , durability of 1.5 × 104 cycles, and fast response time of 2.43 ms) is constructed as a tactile sensory receptor to transform mechanical stimuli into electrical signals, which can be further processed by the CsPbBr3 -based memristor with synaptic plasticity. More importantly, this artificial sensory neural network system combined the artificial synapse with 5 × 5 tactile sensing array based on piezoresistive sensors can recognize the handwritten patterns of different letters with high accuracy of 94.44% under assistance of supervised learning. Consequently, the digital-analog bimodal memristor would demonstrate potential application in human-machine interaction, prosthetics, and artificial intelligence.

All Resistive Pressure-Temperature Bimodal Sensing E-Skin for Object Classification

Electronic skin (E-skin) with multimodal sensing ability demonstrates huge prospects in object classification by intelligent robots. However, realizing the object classification capability of E-skin faces severe challenges in multiple types of output signals. Herein, a hierarchical pressure-temperature bimodal sensing E-skin based on all resistive output signals is developed for accurate object classification, which consists of laser-induced graphene/silicone rubber (LIG/SR) pressure sensing layer and NiO temperature sensing layer. The highly conductive LIG is employed as pressure-sensitive material as well as the interdigital electrode. Benefiting from high conductivity of LIG, pressure perception exhibits an excellent sensitivity of -34.15 kPa-1 . Meanwhile, a high temperature coefficient of resistance of -3.84%°C-1 is obtained in the range of 24-40 °C. More importantly, based on only electrical resistance as the output signal, the bimodal sensing E-skin with negligible crosstalk can simultaneously achieve pressure and temperature perception. Furthermore, a smart glove based on this E-skin enables classifying various objects with different shapes, sizes, and surface temperatures, which achieves over 92% accuracy under assistance of deep learning. Consequently, the hierarchical pressure-temperature bimodal sensing E-skin demonstrates potential application in human-machine interfaces, intelligent robots, and smart prosthetics.

Ultrastretchable High-Conductivity MXene-Based Organohydrogels for Human Health Monitoring and Machine-Learning-Assisted Recognition

Conductive hydrogels as promising candidates of wearable electronics have attracted considerable interest in health monitoring, multifunctional electronic skins, and human-machine interfaces. However, to simultaneously achieve excellent electrical properties, superior stretchability, and a low detection threshold of conductive hydrogels remains an extreme challenge. Herein, an ultrastretchable high-conductivity MXene-based organohydrogel (M-OH) is developed for human health monitoring and machine-learning-assisted object recognition, which is fabricated based on a Ti₃C₂T_x MXene/lithium salt (LS)/poly(acrylamide) (PAM)/poly(vinyl alcohol) (PVA) hydrogel through a facile immersion strategy in a glycerol/water binary solvent. The fabricated M-OH demonstrates remarkable stretchability (2000%) and high conductivity (4.5 S/m) due to the strong interaction between MXene and the dual-network PVA/PAM hydrogel matrix and the incorporation between MXene and LS, respectively. Meanwhile, M-OH as a wearable sensor enables human health monitoring with high sensitivity and a low detection limit (12 Pa). Furthermore, based on pressure mapping image recognition technology, an 8 × 8 pixelated M-OH-based sensing array can accurately identify different objects with a high accuracy of 97.54% under the assistance of a deep learning neural network (DNN). This work demonstrates excellent comprehensive performances of the ultrastretchable high-conductive M-OH in health monitoring and object recognition, which would further explore extensive potential application prospects in personal healthcare, human-machine interfaces, and artificial intelligence.

A generalized l 2,p-norm regression based feature selection algorithm

Feature selection is an important data dimension reduction method, and it has been used widely in applications involving high-dimensional data such as genetic data analysis and image processing. In order to achieve robust feature selection, the latest works apply the l 2 , 1 or l 2 , p -norm of matrix to the loss function and regularization terms in regression, and have achieved encouraging results. However, these existing works rigidly set the matrix norms used in the loss function and the regularization terms to the same l 2 , 1 or l 2 , p -norm, which limit their applications. In addition, the algorithms for solutions they present either have high computational complexity and are not suitable for large data sets, or cannot provide satisfying performance due to the approximate calculation. To address these problems, we present a generalized l 2 , p -norm regression based feature selection ( l 2 , p -RFS) method based on a new optimization criterion. The criterion extends the optimization criterion of ( l 2 , p -RFS) when the loss function and the regularization terms in regression use different matrix norms. We cast the new optimization criterion in a regression framework without regularization. In this framework, the new optimization criterion can be solved using an iterative re-weighted least squares (IRLS) procedure in which the least squares problem can be solved efficiently by using the least square QR decomposition (LSQR) algorithm. We have conducted extensive experiments to evaluate the proposed algorithm on various well-known data sets of both gene expression and image data sets, and compare it with other related feature selection methods.

[SHOX2 promotes migration, invasion and stemness of bladder cancer cells in vitro]

OBJECTIVE

To explore the role of human short stature homeobox 2 (SHOX2) in regulating the migration, invasion and stemness of human bladder cancer cells.

METHODS

We analyzed SHOX2 gene expression in bladder cancer and adjacent tissues based on TCGA database. Univariate survival analysis of SHOX2 gene expression in TCGA-BLCA data was performed using GEPIA. The probable function of SHOX2 was predicted using GSEA. Human bladder cancer T24 cell models of SHOX2 knockdown or overexpression were assessed for changes in migration and invasion abilities using wound healing assay and Transwell assay, and their cancer stem cell-like characteristics were evaluated using tumorsphere formation assay and colony formation assay. Western blotting was used to detect the expressions of epithelial mesenchymal transition (EMT) markers Ecadherin and vimentin and the TGF-β signaling network component TβR-I in the cells.

RESULTS

SHOX2 expression was significantly higher in bladder cancer tissues than in the adjacent tissues (P < 0.05), especially in paired tissue specimens (P < 0.01), and was negatively correlated with the overall survival of the patients (P < 0.05). SHOX2 gene expression was correlated positively with EMT-related (P < 0.05) and stemness-related gene signatures (P < 0.01). In T24 cells, SHOX2 knockdown significantly suppressed cell migration and invasion, which was significantly enhanced by SHOX2 overexpression (P < 0.01). The cancer stem cell-like characteristics of T24 cells was repressed by SHOX2 knockdown but significantly enhanced by SHOX2 overexpression (P < 0.01). SHOX2 knockdown induced morphological changes of the cells into epithelioid cells, whereas SHOX2 overexpression induced a mesenchymal morphology of the cells. SHOX2 knockdown increased E-cadherin expression and decreased vimentin and TβR-I expression, while SHOX2 overexpression increased the expressions of vimentin and TβR-I in the cells.

CONCLUSION

SHOX2 promotes the migration, invasion and stemness of human bladder cancer cells possibly by regulating EMT via the TGF-β signaling pathway.

Decreased Expression of TIM-3 on Th17 Cells Associated with Ophthalmopathy in Patients with Graves' Disease

Purpose:

Thyroid-associated Ophthalmopathy (TAO) is one of the most common orbital immunological diseases in adults. CD4+ helper T (Th) cells play important roles in the pathogenesis of TAO. But the mechanisms regulating CD4+ T cell activity is unclear. This study examines T cell immunoglobulin domain and mucin domain 3 (TIM-3) expression in helper T cell type 1 (Th1), Th17, and regulatory T cells in sufferers of TAO.

Methods:

Participants were divided into 3 groups: patients with TAO, patients with Graves’ disease but without orbitopathy (GD), and healthy control patients (HC). Peripheral blood samples were collected for each patient in the designated group. Flow cytometry methods assessed the frequency of Th1 (CD4+IFN-γ+), Th17 (CD4+IL-17+), regulatory T cells (CD4+CD25hiCD127lo), and TIM-3 protein expression. Mean fluorescence intensity (MFI) measured the magnitude of TIM-3 expression and the percentage of TIM-3+ cells for each patient.

Results:

Compared to the GD group, TAO patients possessed higher frequencies of Th1 and Th17 cells in peripheral blood samples. The percentage of TIM-3+ Th1 and Th17 cells was significantly lower in the TAO patients than the GD group. Across all patients sampled, TIM-3+ cell percentage negatively correlated with Th1 cell frequency. Th1 and Th17 cells exhibited significantly decreased expression of TIM-3 in TAO patients compared to healthy controls. Regulatory T cells showed little TIM-3 expression and we observed no significant differences in frequency between groups.

Conclusion:

These results suggest a role for TIM-3 in the regulation of Th1 and Th17 cells and the pathogenesis of Graves’ ophthalmopathy.

Modelling invasive group A streptococcal disease using bioluminescence

BACKGROUND

The development of vaccines and evaluation of novel treatment strategies for invasive group A streptococcal (iGAS) disease requires suitable models of human infection that can be monitored longitudinally and are preferably non-invasive. Bio-photonic imaging provides an opportunity to reduce use of animals in infection modelling and refine the information that can be obtained, however the range of bioluminescent GAS strains available is limited. In this study we set out to develop bioluminescent iGAS strains for use in in vivo pneumonia and soft tissue disease models.

RESULTS

Using clinical emm1, emm3, and emm89 GAS strains that were transformed with constructs carrying the luxABCDE operon, growth and bioluminescence of transformed strains were characterised in vitro and in vivo. Emm3 and emm89 strains expressed detectable bioluminescence when transformed with a replicating plasmid and light production correlated with viable bacterial counts in vitro, however plasmid instability precluded use in the absence of antimicrobial pressure. Emm89 GAS transformed with an integrating construct demonstrated stable bioluminescence that was maintained in the absence of antibiotics. Bioluminescence of the emm89 strain correlated with viable bacterial counts both in vitro and immediately following infection in vivo. Although bioluminescence conferred a detectable fitness burden to the emm89 strain during soft tissue infection in vivo, it did not prevent dissemination to distant tissues.

CONCLUSION

Development of stably bioluminescent GAS for use in vitro and in vivo models of infection should facilitate development of novel therapeutics and vaccines while also increasing our understanding of infection progression and transmission routes.

Quality of meta-analyses in major leading orthopedics journals: A systematic review

BACKGROUND

Meta-Analyses are the basis of professional and healthcare agencies recommendations and have a growing importance. Quality of meta-analyses has been investigated in some medical fields but to our best knowledge this issue remains under investigated in orthopedics. Therefore, we performed a systematic analysis to: 1) after the introduction of PRISMA statement as a comprehensive guideline and the use of the AMSTAR tool as the standard for sufficient review methodology, has the quality of MAs improved because of that? 2) have some general characteristics influenced the quality of MAs (country, funding source, number of authors)?

MATERIAL AND METHODS

We systematically searched the meta-analyses in the top four journals with the impact factor (2015) as following: JBJS, Osteoarthritis Cartilage Arthroscopy and Clin Orthop Relat Res from 2005 to 2008 and from 2012 to 2015. Likewise from 2012-2015, we also analyzed the meta-analyses from OTSR. Characteristics were extracted based on the PRISMA statement and the AMSTAR tool. Country, number of authors, funding source were also extracted.

RESULTS

A total of 154 meta-analyses were included in the present study. Score with PRISMA statement and the AMSTAR checklist were 20.86±3.04 out of a maximum of 27 and 7.86±1.55 out of a maximum of 11. The best journal was OTSR according to the PRISMA (23.06±1.92) and AMSTAR (9.13±0.87) scores. And the worst journal was Clin Orthop Relat Res according to the PRISMA score (19.4±2.70) and JBJS according to the AMSTAR score (6.78±1.65). Twelve items showed significant difference in the PRISMA statement, and five items in the AMSTAR checklist. Integral score of PRISMA statement and AMSTAR checklist has a significant difference between 2005-2008 and 2012-2015. The MAs reported from U.S. (56, 36.4%) were more than any other region in the world. And the MAs published by Asia/Oceania increased remarkably between these two period times [from (4, 10.8%) to (45, 38.5%)].

CONCLUSION

This study showed that methodological reporting quality of meta-analyses in the major orthopedics journals has improved after the publication of the PRISMA statement.

LEVEL OF EVIDENCE

Level III.

Geographical and ethnic distribution of MTHFR gene polymorphisms and their associations with diseases among Chinese population

Numerous studies have investigated the distribution of methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C polymorphisms and their associations with diseases in China. In this study we conducted a systematic review and meta-analysis of these studies (715 eligible studies in total).Results revealed that the frequencies of the MTHFR C677T and A1298C polymorphisms varied markedly in different areas and ethnicities, and even showed geographical gradients. The MTHFR C677T polymorphism was significantly associated with 42 clinical disorders (p < 0.05), mostly relating to the diseases of circulatory system, birth defects and cancers. The association of the A1298C polymorphism with three diseases (coronary heart disease, breast cancer and neural tube defects fathers) was statistically significant (p < 0.05). However, according to the Venice criteria, only the associations of the C677T polymorphism with breast and ovarian cancers were assessed as having strong epidemiological credibility. This is the first study to provide a comprehensive assessment of the current status and gaps in genetic epidemiological study of the two polymorphisms in China, and its findings may be useful for medical and public health practices. Future studies are warranted to focus on the interactions of MTHFR genes with environmental exposure and with other genes, and to improve their methodological quality and reporting of findings.

Orthopedics research output from China, USA, UK, Japan, Germany and France: A 10-year survey of the literature

BACKGROUND

In the past decade, researchers have made great progress in the field of Orthopedics. However, the research status of different countries is unclear. To summarize the number of published articles, we assessed the cumulative impact factors in top orthopedic journals. The aims of the study were to measure: 1) the quality and quantity of publications in orthopedics-related journals from China and other five counties, 2) the trend of the number of publications in orthopedics-related journals.

METHODS

The related journals were selected based on the 2014 scientific citation index (SCI) and articles were searched based on the PubMed database. To assess the quantity and quality of research output, the number of publications including clinical trials, randomized controlled trials, meta-analyses, case reports, reviews, citations, impact factors, number of articles in the top 10 journals and most popular journals were recorded.

RESULTS

A total of 143,138 orthopedics articles were published from 2005 to 2014. The USA accounts for 24.9% (35,763/143,138) of the publications, followed by UK (7878/143,138 (5.5%)), Japan (7133/143,138 (5.0%)), Germany (5942/143,138 (4.2%)), China (4143/143,138 (2.9%)) and France (2748/143,138 (1.9%)). The ranking for accumulated impact factors as follows: USA, UK, Japan, Germany, France and China. The mean impact factor's order is USA, China, Germany, Japan, France, UK, and interestingly the mean impact factors in Japan is similar to the Germany in 2005-2014. The USA had the highest percentage of articles in the top 10 journals, while China owns the least. The USA had the highest number of average citations, while Japan had lowest number of average citations.

CONCLUSIONS

According to this study, we can conclude that the USA has had been leading the orthopedics research in the past 10 years. Although China still falls behind, it has made considerable progress in the orthopedics research, not only in quantity but also quality.

LEVEL OF EVIDENCE

IV.

Final overall survival results from a randomised, phase III study of erlotinib versus chemotherapy as first-line treatment of EGFR mutation-positive advanced non-small-cell lung cancer (OPTIMAL, CTONG-0802)

BACKGROUND

The OPTIMAL study was the first study to compare efficacy and tolerability of the epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) erlotinib, versus standard chemotherapy in first-line treatment of patients with EGFR mutation-positive advanced non-small-cell lung cancer (NSCLC). Findings from final overall survival (OS) analysis and assessment of post-study treatment impact are presented.

PATIENTS AND METHODS

Of 165 randomised patients, 82 received erlotinib and 72 gemcitabine plus carboplatin. Final OS analyses were conducted when 70% of deaths had occurred in the intent-to-treat population. Subgroup OS was analysed by Cox proportional hazards model and included randomisation stratification factors and post-study treatments.

RESULTS

Median OS was similar between the erlotinib (22.8 months) and chemotherapy (27.2 months) arms with no significant between-group differences in the overall population [hazard ratio (HR), 1.19; 95% confidence interval (CI) 0.83-1.71; P = 0.2663], the exon 19 deletion subpopulation (HR, 1.52; 95% CI 0.91-2.52; P = 0.1037) or the exon 21 L858 mutation subpopulation (HR, 0.92; 95% CI 0.55-1.54; P = 0.7392). More patients in the erlotinib arm versus the chemotherapy arm did not receive any post-study treatment (36.6% versus 22.2%). Patients who received sequential combination of EGFR-TKI and chemotherapy had significantly improved OS compared with those who received EGFR-TKI or chemotherapy only (29.7 versus 20.7 or 11.2 months, respectively; P < 0.0001). OS was significantly shorter in patients who did not receive post-study treatments compared with those who received subsequent treatments in both arms.

CONCLUSION

The significant OS benefit observed in patients treated with EGFR-TKI emphasises its contribution to improving survival of EGFR mutant NSCLC patients, suggesting that erlotinib should be considered standard first-line treatment of EGFR mutant patients and EGFR-TKI treatment following first-line therapy also brings significant benefits to those patients.

CLINICALTRIALSGOV IDENTIFIER

NCT00874419.

Knee osteoarthritis and all-cause mortality: the Wuchuan Osteoarthritis Study

BACKGROUND

Previous studies showed that knee osteoarthritis (OA) is associated with increased mortality in Caucasians. While prevalence of knee OA is higher in Chinese than in Caucasians, no study has examined whether knee OA increases mortality in Chinese population.

METHODS

Between 8/2005-10/2005 1025 residents aged ≥50 years were recruited in randomly selected rural communities in Wuchuan, China. Subjects completed a home interview and had weight-bearing posteroanterior semiflexed view of radiographs at tibiofemoral joints and skyline view of radiographs at patellofemoral joints, and were followed until end of 2013. A knee was defined as having radiographic osteoarthritis (ROA) if either Kellgren/Lawrence (KL) score at tibiofemoral joint ≥2 or presence of OA at patellofemoral joint based on OARSI criteria. Symptomatic knee osteoarthritis (SxOA) was defined if both pain (i.e., knee pain occurred on most days in past month) and ROA were present at the same knee. We examined the relation of knee SxOA and knee ROA to the all-cause mortality, respectively, using Cox-proportional hazard models adjusting for potential confounders.

RESULTS

Over the follow-up period 99 subjects died. The mortality rates were 32.6 (95% confidence interval (CI): 19.6-54.0) and 10.9 (95% CI: 8.8-13.5) per 1000 person-years among subjects with and without SxOA, respectively. Multivariable adjusted hazard ratio of all-cause mortality for knee SxOA was 1.9 (95% CI: 1.0-3.5). However, no such association was observed for knee ROA (hazard ratio = 1.2, 95% CI: 0.7-1.9).

CONCLUSIONS

Knee SxOA was associated with an increased risk of all-cause mortality among the residents in the rural areas of China.

Basic fibroblast growth factor promotes macaque follicle development in vitro

Fertility preservation is an important type of frontier scientific research in the field of reproductive health. The culture of ovarian cortices to i) initiate primordial follicle growth and ii) procure developing follicles for later oocyte maturation is a promising fertility preservation strategy, especially for older women or cancer patients. At present, this goal remains largely unsubstantiated in primates because of the difficulty in attaining relatively large follicles via ovarian cortex culture. To overcome this hurdle, we cultured macaque monkey ovarian cortices with FSH, kit ligand (KL), basic fibroblast growth factor (bFGF), and/or epidermal growth factor (EGF). The various factors and factor combinations promoted primordial follicle development to different extents. Notably, both bFF (bFGF, 100 ng/ml and FSH, 50 ng/ml) and KF (KL, 100 ng/ml and FSH, 50 ng/ml) contributed to the activation of primordial follicles at day 12 (D12) of culture, whereas at D18, the proportions of developing follicles were significantly higher in the bFF and KF groups relative to the other treatment groups, particularly in the bFF group. Estradiol and progesterone production were also highest in the bFF group, and primary follicle diameters were the largest. Up until D24, the bFF group still exhibited the highest proportion of developing follicles. In conclusion, the bFGF–FSH combination promotes nonhuman primate primordial follicle developmentin vitro, with the optimal experimental window within 18 days. These results provide evidence for the future success of human ovarian cortex culture and the eventual acquisition of mature human follicles or oocytes for fertility restoration.

Quality of life (QoL) analyses from OPTIMAL (CTONG-0802), a phase III, randomised, open-label study of first-line erlotinib versus chemotherapy in patients with advanced EGFR mutation-positive non-small-cell lung cancer (NSCLC)

BACKGROUND

The OPTIMAL study found that erlotinib improved progression-free survival (PFS) versus standard chemotherapy in Chinese patients with advanced EGFR mutation-positive non-small-cell lung cancer (NSCLC). This report describes the quality of life (QoL) and updated PFS analyses from this study.

PATIENTS AND METHODS

Chinese patients ≥ 18 years with histologically confirmed stage IIIB or IV NSCLC and a confirmed activating mutation of EGFR (exon 19 deletion or exon 21 L858R point mutation) received erlotinib (150 mg/day; n = 82) or gemcitabine-carboplatin (n = 72). The primary efficacy end point was PFS; QoL was assessed using the Functional Assessment of Cancer Therapy-Lung (FACT-L) questionnaire, Trial Outcome Index (TOI) and Lung Cancer Subscale (LCS).

RESULTS

Patients receiving erlotinib experienced clinically relevant improvements in QoL compared with the chemotherapy group in total FACT-L, TOI and LCS (P < 0.0001 for all scales). Erlotinib scored better than chemotherapy for all FACT-L subscales from baseline to cycles 2 and 4 (non-significant). In the updated analysis, PFS was significantly longer for erlotinib than chemotherapy (median PFS 13.7 versus 4.6 months; HR = 0.164, 95% CI = 0.105-0.256; P < 0.0001), which was similar to the previously reported primary analysis.

CONCLUSION

Erlotinib improves QoL compared with standard chemotherapy in the first-line treatment of patients with EGFR mutation-positive advanced NSCLC.

Sustained moderate visual loss as a predictive end point for visual loss in non-proliferative diabetic retinopathy

PURPOSE

In PKC-DRS2, the efficacy of the oral PKC-beta inhibitor, ruboxistaurin 32 mg/day, was measured by the primary end point of sustained moderate visual loss (SMVL: a > or = 15 letter decrease from baseline on the ETDRS (Early Treatment Diabetic Retinopathy Study) chart sustained at least for the last 6 months of study participation). We now evaluate whether SMVL is more accurate than moderate visual loss (MVL: a single occurrence of a decrease from baseline of > or = 15 ETDRS letters) for predicting future visual loss.

METHODS

Study eyes with moderately severe to very-severe non-proliferative diabetic retinopathy, best-corrected visual acuity of at least 45 letters on the ETDRS chart (approximately Snellen 20/125), and no prior pan retinal photocoagulation were evaluated in 506 patients (869 eyes) who completed 36 months of treatment.

RESULTS

Sixty-five percentage (26/40) of study eyes with the onset of SMVL within 24 months of enrolment still had SMVL at study completion (36 months). In comparison, only 24% (30/126) with MVL within 24 months had SMVL at study completion. Analyses based on data from 6, 12, and 18 months of treatment were similar.

CONCLUSIONS

SMVL is a more predictable measure of subsequent visual loss than is a single time point measure of MVL.

Overexpression of von Hippel-Lindau tumor suppressor protein and antisense HIF-1alpha eradicates gliomas

The von Hippel-Lindau tumor suppressor protein (pVHL) suppresses tumor formation by binding the alpha subunits of hypoxia-inducible-factors responsible for stimulating tumor angiogenesis and glycolysis, and targeting them for ubiquitination and proteasomal destruction. Loss of pVHL leads to tumorigenesis and development of sporadic renal cell carcinomas and central nervous system hemangioblastomas. In the present study, we investigated whether engineered overexpression of pVHL in C6 glioma cells, which already express endogenous pVHL, would suppress the tumorigenicity of this particular tumor cell type. C6 cells overexpressing VHL displayed a reduced growth rate (70% inhibition) compared to the parental cell line when subcutaneously implanted in athymic (nu/nu) mice. Growth inhibition was associated with a 50% reduction in the number of tumor vessels and a 60% increase in tumor cell apoptosis, due in part to downregulation of HIF-1, VEGF, and the antiapoptotic factor Bcl-2, respectively. Gene transfer of VHL suppressed the growth of established C6 gliomas, and synergized with antisense HIF-1 to completely eradicate tumors. The data suggest that VHL gene therapy and/or agents that increase VHL expression could have utility in the treatment of gliomas, particularly when combined with agents that inhibit the expression or function of HIF-1.

Tissue-specific regulatory elements in the human alcohol dehydrogenase 6 gene

The human alcohol dehydrogenase gene ADH6 is expressed at the highest levels in fetal and adult liver. We have mapped cis-acting elements that affect its expression. The sequence from bp -34 to -62 (site C) that includes the TATA box was strongly bound by nuclear proteins from liver, hepatoma cells, and fibroblasts. A truncation that removed the upstream part of site C but left the TATA homology intact dramatically reduced transcription; altering 5 bp in this region had much less effect. Part of site C can be bound by C/EBPalpha, but cotransfection with C/EBPalpha or C/EBPbeta did not stimulate transcription. The proximal region did not display tissue specificity, so we cloned the upstream region to search for additional regulatory sequences. The region between -1.6 and -2.3 kb stimulated transcription in hepatoma cells and inhibited it in fibroblasts. We identified two sites in this region that affect transcription independently of their orientation. Site 1 was a negative regulatory element in fibroblasts but had no effect in hepatoma cells. Site 2 was a positive regulatory element in hepatoma cells but had no effect in fibroblasts. This combination of positive and negative regulatory elements can play a significant role in the tissue-specific expression of ADH6.

[Inhibitory effect of paeonol on experimental atherosclerosis in quails]

OBJECTIVE

To study the effect of paeonol on experimental atherosclerosis in quails caused by high lipid feeding.

METHOD

The effects of oral administration of 300 and 600 mg/kg of paeonol on lipid levels in serum, hemorrheology and aortic intimal abnormalities were investigated.

RESULT

Paeonol decreased TC, TG, LDL, vLDL, APOB100 levels in serum and TC levels in aorta and liver. The ratios of HDL/TC, HDL2/HDL3, apoA1/apoB100 were elevated. In addition, the drug reduced the whole blood viscosity, Plasma viscosity and plasma fibrinogen, and inhibited erythrocyte aggregation.

CONCLUSION

Oral administration of paeonol can reduce the development of atherosclerosis.

[Surgical treatment of spinal dural arteriovenous fistulas]

OBJECTIVE

To discuss the operation modalities of spinal dural arteriovenous fistulae (SDAVFs) and treatment with anticoagulant agents after surgery.

METHOD

The medical records, radiographic studies and operations of 23 patients with SDAVFs were reviewed. Laminectomy was performed at the level of the arterialized venous entry into the subarachnoid space in 18 patients with thoracic and lumbar lever AVFs, followed by coagulation, clipping and division of the vein. In 14 of 18 patients, the arteriovenous nidus in the dura was identified and obliterated by coagulation. The draining veins were interrupted at L(5) - S(1) level in 5 patients with sacral AVFs. Anticoagulant treatment was given in 13 patients.

RESULT

Outcome was good in 20 patients and 2 of the 20 had transient postoperative neurological deterioration that reversed by anticoagulant agents. No changes were seen in 2 patients except one deteriorated.

CONCLUSION

Surgical interruption of arterialized radicular-medullary draining vein of SDAVFs provides lasting occlusion of the fistula, and postoperative anticoagulant therapy can prevent thrombosis of the coronal venous plexus.

[Pharmacological studies on Chinese bone extract granules]

The Chinese Bone Extract Granules could enhance the immunity of mice with spleen-deficiency, increase the serum calcium content of rats with bone loose, inhibit the gastrointestinal movement of mice with spleen-deficiency and improve the absorption of D-xylose in small intestine of rats with spleen-deficiency. The maximal tolerance dose for mice to take orally twice a day was greater than 50 g/kg. The subacute toxicologic test for 6 weeks of continuous feeding to rats did not show any obvious toxicity.