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Background: Insufficient occlusal support (IOS) frequently causes subchondral bone absorption in temporomandibular joint osteoarthritis, and the underlying mechanism requires further investigation., Methods: An IOS model was established by abrading rat molars. Micro-computed tomography was used to evaluate subchondral bone changes. Osteoclastogenesis of synovium-derived macrophages (SDMs) was confirmed by TRAP staining. Cartilage-specific TNFα depletion was achieved by intra-articular injection of adeno-associated virus carrying shRNA against murine TNFα under control of collagen type II. In vitro, chondrocytes were mechanically compressed and conditioned medium (CM) was collected to detect its ability to induce osteoclastogenesis of SDMs., Results: Synovial osteoclastogenesis and condyle resorption were observed following IOS. TNFα level was elevated in hypertrophic chondrocytes after IOS. Synovial Wnt5a level increased, but Wnt3a level decreased after IOS. Depletion of TNFα in chondrocytes alleviated the synovial osteoclastogenesis and condyle bone resorption. In vitro compression of chondrocytes potentiated TNFα expression and secretion. The CM promoted osteoclastogenesis of SDMs, which were partially prohibited by TNFα neutralizing antibody. Furthermore, inhibition of Wnt3a facilitated osteoclastogenesis, whereas inhibition of Wnt5a partially suppressed osteoclastogenesis, of SDMs cultured in CM., Conclusion: Chondrocyte-secreted TNFα induced by IOS is a critical regulator of synovial osteoclastogenesis and subsequent condylar resorption, partially through non-canonical Wnt5a pathway., (© 2024 Wiley Periodicals LLC.)

The article has been withdrawn at the request of the author of the journal Current HIV Research (CHIVR)., Bentham Science apologizes to the readers of the journal for any inconvenience this may have caused. The Bentham Editorial Policy on Article Withdrawal can be found at https://benthamscience.com/editorial-policies-main.php, Bentham Science Disclaimer: It is a condition of publication that manuscripts submitted to this journal have not been published and will not be simultaneously submitted or published elsewhere. Furthermore, any data, illustration, structure or table that has been published elsewhere must be reported, and copyright permission for reproduction must be obtained. Plagiarism is strictly forbidden, and by submitting the article for publication the authors agree that the publishers have the legal right to take appropriate action against the authors, if plagiarism or fabricated information is discovered. By submitting a manuscript the authors agree that the copyright of their article is transferred to the publishers if and when the article is accepted for publication., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

De novo design of peptides that bind specifically to functional proteins is beneficial for diagnostics and therapeutics. However, complex permutations and combinations of amino acids pose significant challenges to the rational design of peptides with desirable stability and affinity. Herein, we develop a computational-based evolution method, namely, peptidomimetics-driven recognition elements design (PepDRED), to derive hemoglobin-inspired peptidomimetics. PepDRED mimics the natural evolutionism pipeline to generate stable apovariant (AVs) structures for wild-type counterparts via automated point mutations and validates their efficiency through free binding energy analysis and per residue energy decomposition analysis. For application demonstration, we applied PepDRED to design de novo peptides to bind FhuA, a typical TonB-dependent transporter (TBDT). TBDTs are Gram-negative bacterial outer membrane proteins responsible for iron transport and vital for bacterial resistance. PepDRED generated a pool of AVs and proceeded to reach an optimized peptide, AV440, with a remarkable binding affinity of -21 kcal/mol. AV440 is ∼2.5-fold stronger than the existing FhuA inhibitor Microcin J25. Network energy analysis further unveils that incorporating methionine (M42) in the N-terminal region significantly enhances inter-residue contacts and binding affinity. PepDRED offers a prompt and efficient in silico approach to develop potent peptide candidates for target proteins.

To evaluate the effectiveness of orthodontics in combination with porcelain laminate veneers (PLV) in the aesthetic restoration and flora regulation of anterior teeth. A retrospective analysis of 336 patients who underwent aesthetic restoration of anterior teeth in our hospital from April 2019 to September 2022 was performed and divided into a control group (n = 168) and an observation group (n = 168) according to the restorative modality. The restorative modality in the control group was conventional restorative remediation, while the restorative modality in the observation group was orthodontic combined with PLV treatment. To evaluate the excellent rate of aesthetic restoration of anterior teeth in the 2 groups, and compare the color, shape, degree of translucency, edge aesthetic score, complications and satisfaction rate of restoration of anterior teeth in the 2 groups before and after restoration. The observation group had a significantly higher rate of excellent aesthetic restorations (95.23%) compared to the control group (80.95%) (P < .001). The scores of anterior tooth color, morphology, degree of translucency and marginal aesthetics were improved in both groups after restoration compared to before restoration, and the scores were significantly higher in the observation group (P < .05). After restoration, the subgingival Digestive streptococcus, Campylobacter and Propionibacterium increased in both groups, but the number of bacterial strains was significantly less in the observation group (P < .05). Compared with the total complication rate in the control group (16.66%), the total complication rate in the observation group (2.38%) was significantly lower (P < .001). Compared with the control group (85.71%), the observation group had a significantly higher restoration satisfaction rate of 97.61%, with a statistically significant difference (P < .001). The application of orthodontics combined with PLV in the aesthetic restoration of anterior teeth has a significant clinical effect, which is conducive to improving the aesthetic restoration and satisfaction rate of anterior teeth, reducing the subgingival microbial imbalance and decreasing the incidence of complications., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Objective: To explore the differences in type I hypersensitivity-induced inflammatory response among children of different age groups with acute appendicitis., Methods: We selected children diagnosed with "acute appendicitis" who underwent surgery in the Department of General Surgery of Anhui Provincial Children's Hospital from January 2022 to June 2022 and collected their basic data. We divided them into two groups according to age: the infant group (less than 3 years old) and the pediatric group (3-14 years old). The gender, age, onset time, hospital stay, preoperative white blood cells, percentage of neutrophils, C-reactive protein (CRP), and enzyme-linked immunosorbent assay (ELISA) were collected to determine the levels of immunoglobulin E (IgE), interleukin-4 (IL-4), interleukin-5 (IL-5), interleukin-6 (IL-6), and interleukin-9 (IL-9) in appendicular lavage fluid, and the differences between the two groups were compared., Results: There were 15 children in the infant group and 15 in the pediatric group. There was no significant difference between the two groups with respect to onset time and gender. The hospitalization time in the pediatric group was (5.7 ± 2.1) d, the preoperative white blood cells were (14.3 ± 3.7) × 10^9/mL, neutrophil percentage was (84.5 ± 6.3)%, and CRP was (20.0 ± 17.9) mg/mL. The hospitalization time of the infant group was (8.0 ± 3.1) d, the preoperative white blood cells were (19.0 ± 3.8) × 10^9/mL, neutrophil percentage was (77.8 ± 10.4)%, and CRP was (42.5 ± 25.0) mg/mL. The differences between the two groups were significant. There was no significant difference in IL-5 concentration between the two groups in the appendicular lavage fluid. IgE (610.74 ± 72.56) ng/mL, IL-4 (30.80 ± 12.04) ng/mL, IL-6 (118.09 ± 14.29) ng/mL, IL-9 (133.94 ± 16.00) ng/mL were found in the infant group, and IgE (495.61 ± 95.09) ng/mL, IL-4 (22.68 ± 7.05) ng/mL, IL-6 (98.22 ± 22.18) ng/mL and IL-9 (107.86 ± 27.34) ng/mL were found in the pediatric group, and the differences between the two groups were statistically significant., Conclusions: The inflammatory response in children with acute appendicitis was associated with type I hypersensitivity-induced inflammatory responses, and the type I hypersensitivity was more intense in children in the lower age group., Competing Interests: Competing interests The authors declare that they have no competing interests., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

We conducted a two-year (2019-2020) longitudinal study in Jiangsu Province, China to analyze risk factors of pinworm infection and evaluate the effect of behavior change communication-based (BCC-based) interventions in preschool children. The positive rate of pinworm infection was higher in private preschool (2%) than in public preschool (0.24%). Poor sanitation behaviors were risk factors among private preschool children. BCC-based intervention could improve knowledge and practice and reduce pinworm infection. This study may help fill in gaps in pinworm control. ( Am J Public Health. 2022;112(12):1716-1720. https://doi.org/10.2105/AJPH.2022.307067).

Currently, organic field effect transistors (OFETs) are widely used in the field of biodetection because of their inherent gain amplification function and good biocompatibility. However, the vast majority of OFET biosensors have disadvantages including a long preparation cycle, complicated processing and expensive materials. Thus, this paper proposes a simple and inexpensive preparation method for label-free detection of immunoglobulin G (IgG). In this work an active dielectric bilayer field effect transistor with 3D-printed silver source and drain electrodes was used. The active layer was modified by physically adsorbing an anti-IgG antibody on P3HT as a recognition element and then sealed with bovine serum albumin (BSA) to prevent nonspecific adsorption. The carrier mobility of the bilayer dielectric layer active field effect transistor reached 4.6 × 10 -2 cm 2 /Vs, and the dynamic detection range for IgG spanned 6 orders of magnitude with a detection limit of 2.9 Picomolar (pM). Controlled experiments demonstrated that the developed sensor has high selectivity for IgG. Overall, this easy-to-operate and low-cost OFET biosensor has broad commercialization prospects and lays the foundation for the early clinical detection of disease-causing biomolecules., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Qiang Li reports financial support was provided by Science and Technology Department of Shanxi Province., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: The purpose of this study is to develop an artificial intelligence (AI)-based automated diabetic retinopathy (DR) grading and training system from a real-world diabetic dataset of China, and in particular, to investigate its effectiveness as a learning tool of DR manual grading for medical students., Methods: We developed an automated DR grading and training system equipped with an AI-driven diagnosis algorithm to highlight highly prognostic related regions in the input image. Less experienced prospective physicians received pre- and post-training tests by the AI diagnosis platform. Then, changes in the diagnostic accuracy of the participants were evaluated., Results: We randomly selected 8,063 cases diagnosed with DR and 7,925 with non-DR fundus images from type 2 diabetes patients. The automated DR grading system we developed achieved accuracy, sensitivity/specificity, and AUC values of 0.965, 0.965/0.966, and 0.980 for moderate or worse DR (95 percent CI: 0.976-0.984). When the graders received assistance from the output of the AI system, the metrics were enhanced in varying degrees. The automated DR grading system helped to improve the accuracy of human graders, i.e., junior residents and medical students, from 0.947 and 0.915 to 0.978 and 0.954, respectively., Conclusion: The AI-based systemdemonstrated high diagnostic accuracy for the detection of DR on fundus images from real-world diabetics, and could be utilized as a training aid system for trainees lacking formal instruction on DR management., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Qian, Jingying, Xian, Yuqing, Lili, Baorui, Wei, Yefeng, Qiang, Chunyan, Cheng, Kai and Yi.)

In this study, chitosan-based silicon nanoparticles (Chsi-NPs) are prepared that primarily consists of C (57.9%), O (31.3%), N (5.6%), and Si (3.5%) and are 10-180 nm in size. We then explore the effect on the foliage applied on rice planted on soil contaminated with 104 mg·kg -1 arsenic (As); low (3 mg·L -1 )and high (15 mg·L -1 ) doses of the foliar Chsi-NPs are administered during the rice grain filling stage. The results showed that the higher dose foliar Chsi-NPs treatment reduced the As concentration in the grain by 61.2% but increased As concentration in the leaves by 47.1% compared to the control treatment. The foliar spraying of the Chsi-NPs inhibited As transport to the grain by facilitating the attachment of As to the cell wall, with higher doses of the foliar Chsi-NPs treatment increased by 8.7%. The foliar spraying of Chsi-NPs increased the malondialdehyde levels by 18.4%, the catalase activity by 49.0%, and the glutathione activity by 99.0%. These results indicated that the foliar Chsi-NPs application was effective for alleviating As toxicity and accumulation in rice. This study provides a novel method for effectively alleviating As accumulation in rice., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Objective: This study aims to investigate the expression of neuronal transcription factor SOX11 in small-cell lung cancer (SCLC) and compare it with the expression of CD56 (nerve cell adhesion molecule), synaptophysin (Syn), chromogranin A (CgA), and thyroid transcription factor-1 (TTF-1) to explore the application value of SOX11 in the pathological diagnosis of SCLC., Methods: Immunohistochemical methods were used to detect the expression of SOX11, TTF-1, CD56, Syn, and CgA in 120 lung tumor tissues, and experimental results were analyzed using SPSS23.0 statistical software., Results: Immunohistochemical results showed that in the 120 lung tumor samples, SOX11 was highly expressed in SCLC and localized to the nucleus, with low or no expression in control carcinoid/lung neuroendocrine tumors, lung adenocarcinomas, and lung squamous cell carcinomas. Statistical analysis results revealed the following points. First, the expression of SOX11 was closely related to the tumor histological type. The expression of SOX11 in SCLC (positive rate of 63.33%) was significantly higher than that in carcinoid/neuroendocrine tumors (positive rate of 12.50%), lung adenocarcinoma (positive rate of 0%), and lung squamous cell carcinoma (positive rate of 0%). Second, immunohistochemical investigation of 60 SCLC cases revealed that the highest positive rates of CD56, TTF-1, and Syn, respectively, were 93.33 percent, 95 percent, and 86.67 percent. SOX11 also exhibited high sensitivity (0.633) and specificity (0.875) in SCLC. The positive rates of SOX11 and CgA were 63.33% and 50.00%, respectively. Statistical results revealed that the positive rate of CgA had no significant difference ( P > 0.05). Lastly, the combined use of antibodies SOX11, CgA, CD56, Syn, and TTF-1 was more beneficial to improving the diagnosis rate of SCLC than the single use of one or two antibodies., Conclusion: The expression of SOX11 in different histological types of lung tumors differs considerably. SOX11 is highly expressed in SCLC. SOX11 can be used as a beneficial supplement to the combination of classical neuroendocrine markers and in combination with CgA, CD56, Syn, and TTF-1 to assist in the diagnosis of SCLC., Competing Interests: The authors report no declarations of interest., (Copyright © 2022 Wang Xinli et al.)

With the emergence of the Internet of Things, technology and Internet thinking have entered traditional communities, and combined with traditional technologies, many new and better management methods and solutions have been born. Among them, the concept of intelligent buildings is also known to people. Based on big data technology, cloud computing technology, and Internet of Things technology, smart buildings provide smart and convenient devices and services for smart device users. The Internet of Things technology is entering our lives at an unimaginable speed. It has been applied in many fields. Smart home, smart transportation, smart medical, smart agriculture, and smart grid are widely used in the Internet of Things technology. The application of Internet of Things technology to the construction of folk sports characteristic towns is of great significance. The construction of folk sports characteristic towns and the protection of intangible cultural heritage have the same purpose and interoperability of elements as the development of traditional cities. From the perspective of protecting folk culture and intangible cultural heritage, it is effective to promote the development of small towns with folk custom characteristics. Based on the research on the construction of folk-custom sports towns, this paper proposes a series of data model analysis and analyzes the proportion of sports preferences in the survey of volunteers in the folk-custom sports towns. The final result of the research shows that the ball games sports personnel accounted for the largest proportion, with 156 people accounting for 48.15%. This shows that about half of the people like ball sports, which proves that ball sports should be the mainstay of folk sports towns, and other sports should be supplemented by other sports., Competing Interests: There is no potential conflict of interest in our paper., (Copyright © 2022 Zhou Li-yun et al.)

Objectives: The intraoperative frozen section examination (IFSE) of pulmonary ground-glass density nodules (GGNs) is a great challenge. In the present study, through comparing the correlation between the computed tomography (CT) findings and pathological diagnosis of GGNs, the CT features as independent risk factors affecting the examination were defined, and their value in the rapid intraoperative examination of GGNs was explored., Methods: The relevant clinical data of 90 patients with GGNs on CT were collected, and all CT findings of GGNs, including the maximum transverse diameter, average CT value, spiculation, solid component, vascular sign, air sign, bronchus sign, lobulation, and pleural indentation, were recorded. All the cases received thoracoscopic surgery, and final pathological results were obtained. The cases were divided into three groups on the basis of pathological diagnosis: benign/atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ (AIS)/microinvasive adenocarcinoma (MIA), and invasive adenocarcinoma (IAC). The CT findings were analyzed statistically, the independent risk factors were identified through the intergroup bivariate logistic regression analysis on variables with statistically significant differences, and a receiver operating curve (ROC) was plotted to establish a logistic regression model for diagnosing GGNs. A retrospective analysis was conducted on the coincidence rate of the rapid intraoperative and routine postoperative pathological examinations of the 90 cases with GGNs. The relevant clinical data of 49 cases with GGNs were collected. Conventional rapid intraoperative examination and CT-assisted rapid intraoperative examination were performed, and their coincidence rates with routine postoperative pathological examinations were compared., Results: No statistical differences in the onset age, gender, smoking history, and family history of malignant tumors were found among cases with GGNs in the identification of benign/AAH, AIS/MIA, and IAC ( P = 0.158, P = 0.947, P = 0.746, P = 0.566). No statistically significant difference was found among the three groups in terms of CT findings, such as lobulation, bronchus sign, pleural indentation, spiculation, vascular sign, and solid component ( P > 0.05). The air sign, the maximum transverse diameter of GGNs, and average CT value showed statistically significant differences among the groups ( P < 0.001, P < 0.05, P < 0.001). Bivariate logistic regression analysis was performed on three risk factors, and the predicted probability value was obtained. A ROC curve was plotted by using the maximum transverse diameter as a predictor for analysis between the groups with benign/AAH and AIS/MIA, and the results demonstrated that the area under the curve (AUC) was 0.692. A ROC curve was plotted by using the predicted probability value, maximum transverse diameter, and average CT value as predictors for distinguishing between the groups with AIS/MIA and IAC, and the results showed that the AUC values of the predicted probability value, maximum transverse diameter, and CT value were 0.920, 0.816, and 0.772, respectively. A regression model [Logit ( P ) = 2.304 - 2.689X1 + 0.302X2 + 0.011X3] was established to identify GGNs as IAC, obtaining AUC values of up to 0.920 for the groups with AIS/MIA and IAC, the sensitivity of 0.821, and the specificity of 0.894. The coincidence rate of rapid intraoperative and routine postoperative pathological examinations taken for modeling was 79.3%, that of conventional IFSE and postoperative pathological examination in prospective studies was 83.7%, and that of CT-assisted rapid intraoperative and postoperative pathological examinations was 98.0%. The former two were statistically different from the last one ( P = 0.003 and P = 0.031, respectively)., Conclusion: The air sign, maximum transverse diameter, and average CT value of the CT findings of GGNs had superior capabilities to enhance the pathologic classification of GGNs. The auxiliary function of the comprehensive multifactor analysis of GGNs was better than that of single-factor analysis. CT-assisted diagnosis can improve the accuracy of rapid intraoperative examination, thereby increasing the accuracy of the selection of operative approaches in clinical practice., Competing Interests: The authors report no declarations of interest., (Copyright © 2022 Wang Xinli et al.)

Suppressor of variegation 3-9 homolog 2 (SUV39H2/KMT1B), a member of the SUV39 subfamily of lysine methyltransferases (KMTs), functions as an oncogene in various types of cancers. Here, we demonstrate a novel function of SUV39H2 that drives the cardiomyocyte aging process through BTG2. In our study, cardiomyocyte aging was induced by H2O2 and aging cells exhibited increases in SUV39H2. Knockdown of SUV39H2 accelerated cardiomyocyte senescence, while overexpression of SUV39H2 inhibited the cardiomyocyte senescence phenotype. These effects of SUV39H2 on cardiomyocytes were independent of DNA damage and mitochondrial dysfunction. Interestingly, RNA sequencing and bioinformatics analyses identified a strong correlation between SUV39H2 and BTG2. In addition to this, BTG2 protein levels were significantly increased in SUV39H2-deficient cardiomyocytes, and BTG2 knockdown virtually rescued the cardiomyocyte senescence phenotype induced by SUV39H2 knockdown. Taken together, these results indicate that SUV39H2 protects cardiomyocytes from H2O2 exposure-induced oxidative stress, DNA damage, and mitochondrial dysfunction by regulating the p53-BTG2 pathway. Our findings provide evidence that the activation of SUV39H2 has therapeutic or preventive potential against cardiac aging.

Purpose: This study aims to evaluate the effectiveness of breast magnetic resonance imaging (MRI) in detecting residual breast cancer in patients after vacuum-assisted breast biopsy (VABB)., Methods: Between 2012 and 2019, 26 patients with breast cancer who underwent VABB were enrolled. Breast MRI was conducted after VABB. Imaging findings were then compared with the histopathological results. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated., Results: Residual cancer was confirmed histologically in 8 of the 26 patients after VABB. The overall sensitivity, specificity, PPV, NPV, and accuracy of MRI for diagnosing residual cancer were 79.9%, 73.0%, 87.1%, 61.3%, and 77.8%, respectively. The sensitivity and NPV improved to 100%, when the number of biopsy specimens was larger than five., Conclusion: Breast MRI showed high sensitivity and NPV in detecting residual breast tumor after VABB.

Bletilla striata is a shallow-rooted herbaceous plant, which is highly dependent on the planting environment.In order to improve the quality of B.striata effectively and solve the contradiction between the production of traditional Chinese medicine and the ecological environment, a variety of simulated cultivation patterns have been explored in various producing areas. Through field investigation and literature collation, this paper sorted out 24 sets of simulated cultivation modes of B.striata, including 4 kinds of sub-forest imitative wild planting techniques, 10 kinds of B.striata-economic forest cooperative development mode, 14 kinds of intercropping techniques of B.striata and 1 kind of ecological rotation technique of B.striata-edible fungi under economic forest. Combining economic benefit, social benefit and ecological benefit, the advantages and disadvantages of these planting patterns were compared. The ecological principles of B.striata simulative cultivation are analyzed in detail, as follows:(1) the wild cultivation of B.striata simulative cultivation under forest is to utilize the complementary principle of land resources under forest and spatial light and heat resources, and carry out the compound cultivation of cultivating forest with medicine and growing with short growth;(2) the intercropping of B.striata makes full use of the difference in height and height of the two plants to meet their needs for light, humidity and ventilation, reduce the cost of shading and weeding, improve the risk-resistant ability of Chinese medicinal materials cultivation, and increase the utilization rate of land, and give consideration to the benefits of both length and length;(3) the ecological rotation technology of &quot;B.striata-edible fungi&quot; in economic forests is to realize the effective utilization of waste bacteria and residues according to the mutually beneficial relationship between B.striata and edible fungi. The promotion and optimization of B.striata imitated wild cultivation technology will further promote the sustainable development of B.striata industry.

Terrain-aided navigation (TAN) holds high potential for long-term accurate navigation of autonomous underwater vehicles (AUVs), and path planning algorithms are essential in TAN to decrease positioning errors by avoiding flat areas. This study proposed an AUV localization and path planning algorithm for TAN, which consists of a value function calculation and online path planning. In the value function calculation, the topographic complexity is treated as a factor that influences AUV state transition probabilities to calculate the optimal policy; meanwhile, the online path planning applies a particle filter to localize and command AUVs, and particle weights are calculated according to topographic complexity. Simulation experimental results demonstrate that this algorithm could provide paths with accurate TAN location results and good maneuvering performance., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 ISA. Published by Elsevier Ltd. All rights reserved.)

Two novel fluorescent probes were designed to detect the biothiol in foods using the highly efficient Michael addition reaction between maleimide-derived probes and the biothiol. First, maleimide functionalized GQDs (M-GQDs) were synthesized and used for biothiol identification according to the Michael addition principle. The biothiol can be detected in the range of 5 × 10 -9 to 4 × 10 -7  mol/L and the detection limit was 1.69 × 10 -9  mol/L. Then, a fluorescence resonance energy transfer (FRET) system between M-GQDs and tetrakis (4-aminophenyl) porphyrin (TAPP) for biothiol detection was developed. However, the process of FRET was switched off in the presence of biothiols due to the switch of M-GQDs fluorescence emission to the"ON" mode following the Michael addition mechanism. The system could quickly and accurately detect the biothiol with a detection range of 6.7 × 10 -10 to 2 × 10 -7  mol/L and a detection limit of 2.34 × 10 -10  mol/L. Compared to the single detection system, the FRET system had a wider detection range and lower detection limit, and the related biomolecules did not interfere with the quantitative identification of the biothiol. The proposed method was successfully applied for the determination of the biothiol in foods and human blood samples., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020. Published by Elsevier B.V.)

Isoelectric focusing (IEF) has been used for determination of meat quality with high stability analysis. However, it still suffered from time-consuming, laborious and cost-effective performances, e.g., 3 h protein extraction, more than 10 h rehydration time, 5-12 h focusing time, and imaging of protein band. To overcome these issues, a speedy extraction of colorful proteins was developed by controlling extraction and centrifugation of 0.2g sample within 10 min and 15 min respectively; a rapid analytical method was designed by using a quick array IEF with 25 min rehydration, 7 min focusing, 2 min online scanning and imaging of focused proteins. The total analytical time was well controlled within 1 h, significantly less than the traditional IEF time of 24 h. To demonstrate the proposed method, 18 chickens were classified into three groups, e.g., the normal slaughtering, death treatment underwater, and death with infection via the New castle disease (NDV) virus. The experiments demonstrated that two Mb bands with pI 6.8 and 7.4 were present in slaughtered chickens, while four other bands with pI 6.83, 6.95, 7.09, and 7.13 were observed in abnormal chicken. The additional four proteins bands were identified by western blot (WB) as hemoglobin proteins. Furthermore, array Immobilized pH Gradient (IPG) has high sensitivity (absolute LOD of Mb and Hb were 1.3 ng and 5.5 ng), fair stability (RSD values of 2.32%, 2.27%, and 1.69%) for slaughtered, drowned, NDV-infected chickens for intra-day and (2.94%, 1.66%, and 1.07%) for inter-days, and good recovery (100%, 98.25% and 99.75%). Finally, the developed method could be used for the identification of chicken meat quality with less time and small volume reagents consuming., (Copyright © 2019. Published by Elsevier B.V.)

Purpose: To investigate the effect of 4-phenylbutyric acid (4-PBA) on intermittent hypoxia (IH)-induced liver cell injury and to clarify the underlying mechanisms., Methods: L02 cells (normal human liver cells) were cultured in normoxic condition or subjected to intermittent hypoxia for 4, 8, and 12 h. A part of hypoxia-treated L02 cells was applied with 4-PBA 1 h before exposure to hypoxia. The effect of 4-PBA on liver injury, hepatocyte apoptosis, endoplasmic reticulum stress (ERS), and PERK-eIFa2-ATF4-CHOP apoptotic pathway was investigated., Results: (1) IH caused apoptosis in hepatocyte; (2) IH caused ERS in hepatocyte; (3) IH caused hepatic injury; (4) 4-PBA attenuated IH-induced liver cell injury; (5) 4-PBA protected liver cell from IH-induced apoptosis; (6) 4-PBA suppressed ERS-related apoptotic pathway (PERK-eIFa2-ATF4-CHOP), but did not suppress IH-induced unfold protein reaction (UPR)., Conclusions: 4-PBA could protect liver cells by suppressing IH-induced apoptosis mediated by ERS, but not by reducing the UPR.

The decision-making process, which is regarded as cognitive and ubiquitous, has been exploited in diverse fields, such as psychology, economics, and artificial intelligence. This paper considers the problem of modeling agent cognition in a class of game-theoretic decision-making scenarios called extensive games. We present a novel framework in which artificial neural networks are incorporated to simulate agent cognition regarding the structure of the underlying game and the goodness of the game situations therein. An algorithmic procedure is investigated to describe the process for solving games with cognition, and then, a new equilibrium concept is proposed as a refinement of the classical one-subgame perfect equilibrium-by involving players' cognitive reasoning. Moreover, a series of results concerning the computational complexity, soundness, and completeness of the algorithm, as well as the existence of an equilibrium solution, is obtained. This framework, which is shown to be general enough to model the way in which AlphaGo plays Go, may offer a means for bridging the gap between theoretical models and practical problem-solving.

The study analyzes the strengths, weaknesses, opportunities and threats (SWOT) of the informatization of parasitic disease prevention and control in China, and puts forward the development strategies, in order to provide the reference for accelerating the informatization of parasitic disease prevention and control.

Here, we propose a highly sensitive and stretchable strain sensor based on silver nanoparticles and nanowires (Ag NPs and NWs), advancing the rapid development of electronic skin. To improve the sensitivity of strain sensors based on silver nanowires (Ag NWs), Ag NPs and NWs were added to polydimethylsiloxane (PDMS) as an aid filler. Silver nanoparticles (Ag NPs) increase the conductive paths for electrons, leading to the low resistance of the resulting sensor (14.9 Ω). The strain sensor based on Ag NPs and NWs showed strong piezoresistivity with a tunable gauge factor (GF) at 3766, and a change in resistance as the strain linearly increased from 0% to 28.1%. The high GF demonstrates the irreplaceable role of Ag NPs in the sensor. Moreover, the applicability of our high-performance strain sensor has been demonstrated by its ability to sense movements caused by human talking, finger bending, wrist raising and walking.

Objective: To evaluate the value of the three-dimensional visualization technology for the preoperative assessment of liver autotransplantation for end-stage hepatic alveolar echinococcosis., Methods: A total of 8 patients with end-stage hepatic alveolar echinococcosis undergoing liver autotransplantation in Qinghai Provincial People's Hospital from May 2013 to July 2017 were collected. All cases received preoperative abdominal CT scanning and dynamic three-phase enhanced CT scanning, and the original CT data were transferred to the human 3D visualization virtual surgical planning system. The volumes of Echinococcus multilocularis and pre-resected liver were measured using the 3D visualization reconstruction, and the relationship between the lesion and the neighboring tissues was observed. The value of the 3D visualization technology for the preoperative assessment of liver autotransplantation for end-stage hepatic alveolar echinococcosis was assessed by comparing with the intraoperative findings., Results: The 3D visualization reconstruction model clearly displayed the adjacent relationship between the lesions of end-stage hepatic alveolar echinococcosis and the neighboring tissues, and no significant difference was seen between the pre-resected liver volume in 3D visualization reconstruction model and the actually resected liver volume ( t = 1.083, P > 0.05)., Conclusions: 3D visualization technology is feasible to develop a reasonable scheme for liver resection and vascular anastomosis for end-stage hepatic alveolar echinococcosis prior to liver autotransplantation, which may increase the success of surgery and improve the prognosis.

This paper reports a case of cerebral alveolar echinococcosis misdiagnosed.

The completeness of a medical terminology system consists of two parts: complete content coverage and complete semantics. In this paper, we focus on semantic completeness and present a scalable approach, called Spark-MCA, for evaluating the semantic completeness of SNOMED CT. We formulate the SNOMED CT contents into an FCA-based formal context, in which SNOMED CT concepts are used for extents, while their attributes are used as intents. We applied Spark-MCA to the 201403 US edition of SNOMED CT to exhaustively compute all the formal concepts and sub concept relationships in about 2 hours with 96 processors using an Amazon Web Service cluster. We found a total of 799,868 formal concepts, within which 500,583 are not contained in the 201403 release. We compared these concepts with the cumulative addition of 22,687 concepts from the 5 "delta" files from the 201403 release to the 201609 release. 3,231 matches were found between those suggested by FCA and those from cumulative concept addition by the SNOMED CT Editorial Panel. This result provides encouraging evidence that our approach could be useful for enhancing the semantic completeness of SNOMED CT.

We introduce RGT, Retrospective Ground-Truthing, as a surrogate reference standard for evaluating the performance of automated Ontology Quality Assurance (OQA) methods. The key idea of RGT is to use cumulative SNOMED CT changes derived from its regular longitudinal distributions by the official SNOMED CT editorial board as a partial, surrogate reference standard. The contributions of this paper are twofold: (1) to construct an RGT reference set for SNOMED CT relational changes; and (2) to perform a comparative evaluation of the performances of lattice, non-lattice, and randomized relational error detection methods using the standard precision, recall, and geometric measures. An RGT relational-change reference set of 32,241 IS-A changes were constructed from 5 U.S. editions of SNOMED CT from September 2014 to September 2016, with reversals and changes due to deletion or addition of new concepts excluded. 68,849 independent non-lattice fragments, 118,587 independent lattice fragments, and 446,603 relations were extracted from the SNOMED CT March 2014 distribution. Comparative performance analysis of smaller (less than 15) lattice vs. non-lattice fragments was also given to approach the more realistic setting in which such methods may be applied. Among the 32,241 IS-A changes, independent non-lattice fragments covered 52.8% changes with 26.4% precision with a G-score of 0.373. Even though this G-score is significantly lower in comparison to those in information retrieval, it breaks new ground in that such evaluations have never performed before in the highly discovery-oriented setting of OQA.

Objective: To compare the clinical efficacy of nerve growth factor (NGF) in combination with oxiracetam and single use of oxiracetam in the treatment of hypertensive cerebral hemorrhage., Methods: One hundred and forty patients with hypertensive cerebral hemorrhage who were admitted to the hospital from July 2015 to September 2016 were selected as research subjects and randomly divided into a treatment group which was treated by NGF in combination with oxiracetam and a control group which was treated by oxiracetam only. The clinical efficacy was observed, and the death of both groups was recorded., Results: The National Institutes of Health Stroke Scale (NIHSS) score, Glasgow Coma Scale (GCS) score and limbs muscle force of both groups improved after treatment, and the improvement of the treatment was superior to that of the control group, suggesting a significant difference (P<0.05). The reduction of serum inflammatory factor level of the treatment group was much larger than that of the control group after treatment, and the difference had statistical significance (P<0.05). The survival analysis suggested that the survival rates of the two groups had a statistically significant difference (P<0.05)., Conclusion: NGF in combination with oxiracetam is significantly effective in treating hypertensive cerebral hemorrhage as it can apparently recover neurologic impairment and limbs muscle force. The therapy has important clinical application values.

Purpose Treatment of oropharyngeal squamous cell carcinoma (OPSCC) is evolving toward risk-based modification of therapeutic intensity, which requires patient-specific estimates of overall survival (OS) and progression-free survival (PFS). Methods To develop and validate nomograms for OS and PFS, we used a derivation cohort of 493 patients with OPSCC with known p16 tumor status (surrogate of human papillomavirus) and cigarette smoking history (pack-years) randomly assigned to clinical trials using platinum-based chemoradiotherapy (NRG Oncology Radiation Therapy Oncology Group [RTOG] 0129 and 0522). Nomograms were created from Cox models and internally validated by use of bootstrap and cross-validation. Model discrimination was measured by calibration plots and the concordance index. Nomograms were externally validated in a cohort of 153 patients with OPSCC randomly assigned to a third trial, NRG Oncology RTOG 9003. Results Both models included age, Zubrod performance status, pack-years, education, p16 status, and T and N stage; the OS model also included anemia and age × pack-years interaction; and the PFS model also included marital status, weight loss, and p16 × Zubrod interaction. Predictions correlated well with observed 2-year and 5-year outcomes. The uncorrected concordance index was 0.76 (95% CI, 0.72 to 0.80) for OS and 0.70 (95% CI, 0.66 to 0.74) for PFS, and bias-corrected indices were similar. In the validation set, OS and PFS models were well calibrated, and OS and PFS were significantly different across tertiles of nomogram scores (log-rank P = .003;< .001). Conclusion The validated nomograms provided useful prediction of OS and PFS for patients with OPSCC treated with primary radiation-based therapy.

Aim: To compare the outcomes of preoperative endoscopic nasobiliary drainage (ENBD) and endoscopic retrograde biliary drainage (ERBD) in patients with malignant distal biliary obstruction prior to pancreaticoduodenectomy (PD)., Methods: Data from 153 consecutive patients who underwent preoperative endoscopic biliary drainage prior to PD between January 2009 and July 2016 were analyzed. We compared the clinical data, procedure-related complications of endoscopic biliary drainage (EBD) and postoperative complications of PD between the ENBD and ERBD groups. Univariate and multivariate analyses with odds ratios (ORs) and 95% confidence intervals (95%CIs) were used to identify the risk factors for deep abdominal infection after PD., Results: One hundred and two (66.7%) patients underwent ENBD, and 51 (33.3%) patients underwent ERBD. Endoscopic sphincterotomy was less frequently performed in the ENBD group than in the ERBD group ( P = 0.039); the EBD duration in the ENBD group was shorter than that in the ERBD group ( P = 0.036). After EBD, the levels of total bilirubin (TB) and alanine aminotransferase (ALT) were obviously decreased in both groups, and the decreases of TB and ALT in the ERBD group were greater than those in the ENBD group ( P = 0.004 and P = 0.000, respectively). However, the rate of EBD procedure-related cholangitis was significantly higher in the ERBD group than in the ENBD group ( P = 0.007). The postoperative complications of PD as graded by the Clavien-Dindo classification system were not significantly different between the two groups ( P = 0.864). However, the incidence of deep abdominal infection after PD was significantly lower in the ENBD group than in the ERBD group ( P = 0.019). Male gender (OR = 3.92; 95%CI: 1.63-9.47; P = 0.002), soft pancreas texture (OR = 3.60; 95%CI: 1.37-9.49; P = 0.009), length of biliary stricture (≥ 1.5 cm) (OR = 5.20; 95%CI: 2.23-12.16; P = 0.000) and ERBD method (OR = 4.08; 95%CI: 1.69-9.87; P = 0.002) were independent risk factors for deep abdominal infection after PD., Conclusion: ENBD is an optimal method for patients with malignant distal biliary obstruction prior to PD. ERBD is superior to ENBD in terms of patient tolerance and the effect of biliary drainage but is associated with an increased risk of EBD procedure-related cholangitis and deep abdominal infection after PD., Competing Interests: Conflict-of-interest statement: The authors declare that there is no conflict of interest related to this report.

This paper reviews the computer vision and image analysis studies aiming at automated diagnosis or screening of malaria in microscope images of thin blood film smears. On the basis of introducing the background and significance of automatic detection technology, the existing detection technologies are summarized and divided into several steps, including image acquisition, pre-processing, morphological analysis, segmentation, count, and pattern classification components. Then, the principles and implementation methods of each step are given in detail. In addition, the promotion and application in automatic detection technology of thick blood film smears are put forwarded as questions worthy of study, and a perspective of the future work for realization of automated microscopy diagnosis of malaria is provided.

Objective: To understand the epidemic status of alveolar echinococcosis in Tibetan children in south Qinghai Province., Methods: The imageology and serology methods were applied to investigate the epidemic status of alveolar echinococcosis of elementary school students in Yushu and Guoluo prefectures., Results: Totally 19 629 children were investigated by the portable B ultrasound and 221 children were diagnosed as alveolar echinococcosis with the morbidity of 1.13%. Totally 9 888 were investigated by the indirect ELISA, and the positive rate of serum tests was 12.59% (190/9 888). The total morbidity of alveolar echinococcosis of children in Yushu Prefecture was 0.42% (31/7 454) and it was 1.57% (190/12 175) in Guoluo Prefecture and there was a significant difference between them ( χ 2 = 53.42, P ＜0.005). The sero-positive rates of children in Yushu and Guoluo were 4.26% (302/7 081) and 18.56% (1 835/9 888), respectively ( χ 2 = 765.77, P ＜0.005). The counties with the highest prevalence of alveolar echinococcosis in children were Dari County (4.31%, 106/2 461) and Banma County (1.92%, 26/1 351) of Guoluo Prefecture, and Chengduo County (1.11%, 18/1 612) of Yushu Prefecture. The total morbidity rates of alveolar echinococcosis of male and female children were 0.91% (91/9 954) and 1.34% (130/12 175) respectively ( χ 2 = 7.35, P ＜0.005). The total sero-positive rates of alveolar echinococcosis of male and female children were 12.10% (1 037/8 568) and 13.09% (1 100/8 406) respectively ( χ 2 = 3.63, P ＞0.05). The total morbidity of alveolar echinococcosis of children in different age groups was from 1.00% to 1.13%, and there was no significant difference among the age groups ( χ 2 = 2.73, P ＞0.05). The P1a type, P1b type and P2 type accounted for 67.76% (145/214), 10.75% (23/214) and 16.36% (35/ 214) respectively among the alveolar echinococcosis patients. The diameters of nidus of 87.38% (187/214) patients were less than 5 cm, and 2.80% (6/214) were more than 10 cm., Conclusions: The epidemic status of alveolar echinococcosis of Tibetan children in south Qinghai Province is serious, but most of the patients were at early stage of the disease. The screening work of alveolar echinococcosis should be strengthened in Tibetan children, so as to perform the early diagnosis and treatment.

Background: Recurrent aphthous stomatitis (RAS) is one of the most common chronic oral diseases with morbidity ranging from 5% to 20%. The pathogenesis is still not fully understood though immune dysregulation and local trauma have been implicated and the curative effect that can be achieved through current therapy is mainly to alleviate the pain. So, the understanding of its molecular mechanisms can allow the prevention and treatment of RAS at the molecular level., Methods: 14 normal tissues and 14 ulcerated tissues were subjected to Affymetrix Human Genome U133 Plus 2.0 Array transcriptome analysis. Then, Gene Set Expression Analysis and Gene Pattern tools were carried out to determine the gene expression differences between normal and ulcerated tissues. qRT-PCR was used to validate the expression level of identified genes in 10 normal and 10 ulcerated tissues., Results: We obtained a total of 1379 DEGs with adjPval < 0.05 and |logFC| > 1 including 1052 up-regulated genes and 327 down-regulated genes. 4 GO terms and 4 KEGG pathways were screened out by comparing the genomewide gene set expression patterns of normal and ulcerated tissues. 7 genes involved in RAS were identified from the VEGF signaling pathway., Conclusions: Present findings demonstrated that several immune processes have a deep impact on RAS and a number of genes involved in the VEGF signaling pathway may be critical mediators or participators in the pathogenesis of RAS.

Objective: To study the cyfluthrin resistance and potential mechanisms of Anopheles sinensis in Nanchang Chang-bei International Airport, Nanchang City, Jiangxi Province., Methods: The resistance levels of the local An. sinensis were detected by WHO drug resistance bioassay. During the bioassay, the dying mosquitos were classed as sensitive mosquitos, and the survival ones were classed as resistant mosquitos. The P450 monooxygenase activity and glutathione S-transferase activity were detected and compared between the two groups. At the same time, the death time of each sensitive mosquito was recorded, and the correlations between the death time and the P450 monooxygenase activity and glutathione S-transferase activity were analyzed, respectively., Results: The bioassay mortality of the local An. sinensis was 59.5%. The differences of the P450 monooxygenase activities among the resistant mosquitos, sensitive mosquitos and laboratory sensitive mosquitos had statistical significances ( F =151.89, P < 0.01), the resistant mosquitos > sensitive mosquitos > laboratory sensitive mosquitos. The differences of glutathione s-transferase activities among the three groups had no statistical significance ( F = 0.72, P = 0.49). There existed positive correlation between the mosquito death time and the P450 monooxygenase activity, and the regression equation was y = 79.479 +1.512 x with the correlation coefficient of 0.88, while there was no correlation between the mosquito death time and the glutathione S-transferaseactivity., Conclusions: The An. sinensis in Nanchang Changbei International Airport has been resistant to cyfluthrin, and the promotion of P450 monooxygenase activity maybe one of the reasons for the resistance.

Gastrointestinal perforations, which need to be managed quickly, are associated with high morbidity and mortality. Treatments used to close these perforations range from surgery to endoscopic therapy. Nowadays, with the development of new devices and techniques, endoscopic therapy is becoming more popular. However, there are different indications and clinical efficacies between different methods, because of the diverse properties of endoscopic devices and techniques. Successful management also depends on other factors, such as the precise location of the perforation, its size and the length of time between the occurrence and diagnosis. In this study, we performed a comprehensive review of various devices and introduced the different techniques that are considered effective to treat gastrointestinal perforations. In addition, we focused on the different methods used to achieve successful closure, based on the literature and our clinical experiences., Competing Interests: Conflict-of-interest statement: The authors have no conflict of interest to report.

Objectives: To explore the effects and feasibility of single-port video-assisted thoracic surgery (VATS) on lobectomy for pulmonary carcinoma., Methods: A total of 67 patients were enrolled in this study, in which 21 patients were treated by single-port VATS (Sing-port Group) and 46 patients by double-port VATS (Double-port Group). Blood loss, duration of thoracic drainage, length of post-operative hospital stay and post-operative pain ratings were compared between the two groups., Results: No significant difference existed in blood loss, duration of thoracic drainage and length of postoperative hospital stay between the two groups. However, Post-operative pain was significantly reduced in Single-port Group compared to Double-port Group., Conclusion: Single-port VATS was totally feasible with reduced post-operative pain and good looking appearance., Competing Interests: Declaration of interest: None.

Objective: To develop a resin composite incorporated with nano-antibacterial inorganic filler containing long-chain alkyl quaternary ammonium salt, and to measure its effect on human dental plaque microcosm biofilm., Methods: A novel nano-antibacterial inorganic filler containing long-chain alkyl quaternary ammonium salt was synthesized according to methods introduced in previous research. Samples of the novel nano-antibacterial inorganic fillers were modified by a coupling agent and then added into resin composite at 0%, 5%, 10%, 15% or 20% mass fractions; 0% composite was used as control. A flexural test was used to measure resin composite mechanical properties. Results showed that a dental plaque microcosm biofilm model with human saliva as inoculum was formed. Colony-forming unit (CFU) counts, lactic acid production, and live/dead assay of biofilm on the resin composite were calculated to test the effect of the resin composite on human dental plaque microcosm biofilm., Results: The incorporation of nano-antibacterial inorganic fillers with as much as 15% concentration into the resin composite showed no adverse effect on the mechanical properties of the resin composite (P > 0.05). Resin composite containing 5% or more nano-antibacterial inorganic fillers significantly inhibited the metabolic activity of dental plaque microcosm biofilm, suggesting its strong antibacterial potency (P < 0.05)., Conclusion: This novel resin composite exhibited a strong antibacterial property upon the addition of up to 5% nano-antibacterial inorganic fillers, thereby leading to effective caries inhibition in dental application.

Objectives: Cerebral blood volume (CBV) acquired with the use of flat-detector computed tomography with contrast media (CM) injected at the ascending aorta provides real-time brain functional information with minimized CM usage; however, unexpected asymmetric perfusion is observed for certain patients without cerebral circulatory disorders. This work tested the feasibility of left ventricle (LV) CM injection to achieve symmetric perfusion., Methods: CBV maps were acquired for 10 patients without perfusion-related cerebral abnormities. Perfusion symmetry was predicted with the use of color-coded quantitative digital subtracted angiography with CM injected at ascending aorta. Time density curves were extracted at bilateral common carotid arteries with area under curves calculated. Planes were selected on CBV maps with regions of interest defined covering characteristic regions, where asymmetric perfusion most likely to appear., Results: No adverse physiological changes were detected for any patient. Non-uniform CM distributions were detected for 4 patients with relative area under curves 0.66 ± 0.03, indicating asymmetric perfusion using ascending aorta injection. With LV injection, all the patients demonstrated good perfusion symmetry with relative CBV 1.03 ± 0.07., Conclusion: CBV maps acquisition with LV injection offered an approach to acquire immediate brain functional information for patients who are limited by asymmetric perfusion using ascending aorta injection and are sensitive to CM dose., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Purpose: We performed a multi-institutional prospective phase II trial to assess late toxicities in patients with extremity soft tissue sarcoma (STS) treated with preoperative image-guided radiation therapy (IGRT) to a reduced target volume., Patients and Methods: Patients with extremity STS received IGRT with (cohort A) or without (cohort B) chemotherapy followed by limb-sparing resection. Daily pretreatment images were coregistered with digitally reconstructed radiographs so that the patient position could be adjusted before each treatment. All patients received IGRT to reduced tumor volumes according to strict protocol guidelines. Late toxicities were assessed at 2 years., Results: In all, 98 patients were accrued (cohort A, 12; cohort B, 86). Cohort A was closed prematurely because of poor accrual and is not reported. Seventy-nine eligible patients from cohort B form the basis of this report. At a median follow-up of 3.6 years, five patients did not have surgery because of disease progression. There were five local treatment failures, all of which were in field. Of the 57 patients assessed for late toxicities at 2 years, 10.5% experienced at least one grade ≥ 2 toxicity as compared with 37% of patients in the National Cancer Institute of Canada SR2 (CAN-NCIC-SR2: Phase III Randomized Study of Pre- vs Postoperative Radiotherapy in Curable Extremity Soft Tissue Sarcoma) trial receiving preoperative radiation therapy without IGRT (P < .001)., Conclusion: The significant reduction of late toxicities in patients with extremity STS who were treated with preoperative IGRT and absence of marginal-field recurrences suggest that the target volumes used in the Radiation Therapy Oncology Group RTOG-0630 (A Phase II Trial of Image-Guided Preoperative Radiotherapy for Primary Soft Tissue Sarcomas of the Extremity) study are appropriate for preoperative IGRT for extremity STS., (© 2015 by American Society of Clinical Oncology.)

Aim: To investigate the value of magnetic resonance elastography (MRE) with regard to assessing liver functional reserve., Methods: Data from inpatients diagnosed with a liver tumor at an interventional radiology department from July 2013 to June 2014 were analyzed. A 3.0 Tesla magnetic resonance unit was used to scan 32 patients with confirmed diagnoses of hepatocellular carcinoma (HCC); an MRE sequence was added to the protocol, and the data were reconstructed and analyzed by two attending radiologists. Regions of interest were identified in different slices of the non-tumor liver parenchyma to measure average stiffness. In addition, the indocyanine green (ICG) test was performed no more than 1 wk before or after the magnetic resonance examination for all 32 patients; the ICG retention rate at 15 min (ICGR-15) and the ICG plasma clearance rate (ICG-K) were recorded. Correlational analyses were performed between the liver stiffness values and the ICGR-15 as well as between the liver stiffness values and the ICG-K., Results: Magnetic resonance imaging, including an MRE sequence and the ICG test, was performed successfully in all 32 enrolled patients. None of the patients developed complications. The mean ± SD of the elasticity values measured by the two attending radiologists were 4.7 ± 2.2 kPa and 4.7 ± 2.1 kPa, respectively. The average liver stiffness value of the non-tumor parenchyma measured using MRE in HCC patients was 4.7 ± 2.2 kPa. The average ICGR-15 was 0.089 ± 0.077, and the average ICG-K was 0.19 ± 0.07. We found that the liver stiffness value of the non-tumor parenchyma was significantly and positively related to the ICGR-15 (r = 0.746, P < 0.01) as well as significantly and negatively related to the ICG-K (r = -0.599, P < 0.01). The ICGR-15 was significantly and negatively related to the ICG-K (r = -0.852, P < 0.01)., Conclusion: MRE is accurate and non-invasive; furthermore, it can be used to effectively assess the liver functional reserve of HCC patients.

Aim: To preliminarily investigate the prognostic significance of the platelet to lymphocyte ratio (PLR) in patients with gallbladder carcinoma (GBC)., Methods: Clinical data of 316 surgical GBC patients were analyzed retrospectively, and preoperative serum platelet and lymphocyte counts were used to calculate the PLR. The optimal cut-off value of the PLR for detecting death was determined by the receiver operating characteristic (ROC) curve. The primary outcome was overall survival, which was estimated by the Kaplan-Meier method. The log-rank test was used to compare the differences in survival. Then, we conducted multivariate Cox analysis to assess the independent effect of the PLR on the survival of GBC patients., Results: For the PLR, the area under the ROC curve was 0.620 (95%CI: 0.542-0.698, P = 0.040) in detecting death. The cut-off value for the PLR was determined to be 117.7, with 73.6% sensitivity and 53.2% specificity. The PLR was found to be significantly positively correlated with CA125 serum level, tumor-node-metastasis (TNM) stage, and tumor differentiation. Univariate analysis identified carcinoembryonic antigen (CEA), CA125 and CA199 levels, PLR, TNM stage, and the degree of differentiation as significant prognostic factors for GBC when they were expressed as binary data. Multivariate analysis showed that CA125 > 35 U/mL, CA199 > 39 U/mL, PLR ≥ 117.7, and TNM stage IV were independently associated with poor survival in GBC. When expressed as a continuous variable, the PLR was still an independent predictor for survival, with a hazard ratio of 1.018 (95%CI: 1.001-1.037 per 10-unit increase, P = 0.043)., Conclusion: The PLR could be used as a simple, inexpensive, and valuable tool for predicting the prognosis of GBC patients.

Aim: To investigate the prognostic value of preoperative platelet count (PLT) in patients with primary gallbladder cancer (GBC)., Methods: The clinical data of 223 GBC patients after surgery was retrospectively reviewed. A receiver operating characteristic (ROC) curve was plotted to verify the optimum cutoff point for PLT. Univariate and multivariate survival analyses were performed to identify the factors associated with the prognosis., Results: The ROC curve showed that the optimum cutoff point for PLT was 178 × 10(9)/L, and the entire cohort was stratified into group A with PLT > 178 × 10(9)/L and group B with PLT ≤ 178 × 10(9)/L. Group A had a better survival than group B (P < 0.001). There was an obvious difference between the two groups in terms of the differentiation degree, advanced tumor stage, lymph node metastasis (P < 0.001) and pathological type (P < 0.05). The univariate analysis demonstrated that tumor location, differentiation degree, TNM stage, Nevin stage, lymph node metastasis and PLT were associated with overall survival (P < 0.001). In the multivariate analysis, PLT (P = 0.032), lymph node metastasis (P = 0.007), tumor location (P < 0.001) and TNM stage (P = 0.005) were independent prognostic factors., Conclusion: PLT is closely correlated with GBC prognosis and could be used to identify the population with a poorer prognosis after surgery.

Aim: To investigate its effect on the proliferation and invasion of laryngeal carcinoma and understand the potential underlying mechanisms to provide new targets for the diagnosis and treatment of recurrent laryngeal cancer metastasis., Methods: We constructed a lentiviral vector expressing EGFL7 specific shRNA, and introduced it in EGFL7 functions were attenuated by a lentiviral vector harboring shRNA targeting at EGFL7 in laryngeal carcinoma cell line Hep-2. Prolifereation and invasion assays were carried out in vitro. And in vivo tumor burden assay was done in nude mice., Results: The expression of EGFL7 was knocked-down by 80% in hep-2 cells transfected by the lentiviral EGFL7 shRNA vector and EGFL7 gene expression was detected by realtime PCR and Western blotting analysis respectively. The flow cytometric analysis showed that arrested the cell cycle in G1 phase, In tumor burden assay, to parental And vector control cells, the survival rates Of nude mice in EGFL7 shRNA group dropped down from the first day after implantation as indicated by MTT assay (P < 0.05). The formation and growth rate of xenograft tumor in mice transfected with siRNA against Bmi-1 slowed down significantly., Conclusion: Attenuation of EGFL7 function significantly suppresses tumor growth and induces apoptosis, both in vitro and in vivo. EGFL7 may be play a key role in invasion and metastasis of Laryngeal squamous cell carcinoma (LSCC), thus would to be a new target for gene therapy in LSCC.

Aim: To investigate the prognostic significance of estrogen receptor 1 (ER1) and vascular endothelial growth factor A (VEGF-A) expression in primary gallbladder carcinoma (GBC) to identify new prognostic markers for this malignancy., Methods: Using immunohistochemistry, we investigated ER1 and VEGF-A expression in 78 GBC and 78 cholelithiasis (CS) tissues. The results were correlated with clinicopathological features. Univariate and multivariate analyses were performed to evaluate the relationship between ER1 and VEGF-A expression and patients' prognosis. Further Kaplan-Meier survival analysis was also performed., Results: ER1 and VEGF-A expression was significantly higher in GBC compared with CS (47/78 vs 28/78, P<0.05; 51/78 vs 33/78, P<0.05). ER1 expression was correlated with gender (P<0.05) and VEGF-A expression was correlated with tumor differentiation in GBC patients (P<0.05). In univariate analysis, age and tumor node metastasis (TNM) stage were factors associated with GBC prognosis (P<0.05). Although there was no statistical difference between the expression of ER1 or VEGF-A and overall survival, the high expression of ER1 combined with VEGF-A predicted a poor prognosis for GBC patients (16.30±1.87 vs 24.97±2.09, log-rank P<0.05). In multivariate analysis, combined expression of ER1 and VEGF-A and TNM stage were independent prognostic factors for GBC patients (P<0.05)., Conclusion: Combined expression of ER1 and VEGF-A is a potential prognostic marker for GBC patients. Clinical detection of ER1 and VEGF-A in surgically resected GBC tissues would provide an important reference for decision-making of postoperative treatment programs.

Purpose: National Comprehensive Cancer Network guidelines recommend patients with head and neck cancer (HNC) receive treatment at centers with expertise, but whether provider experience affects survival is unknown., Patients and Methods: The effect of institutional experience on overall survival (OS) in patients with stage III or IV HNC was investigated within a randomized trial of the Radiation Therapy Oncology Group (RTOG 0129), which compared cisplatin concurrent with standard versus accelerated fractionation radiotherapy. As a surrogate for experience, institutions were classified as historically low- (HLACs) or high-accruing centers (HHACs) based on accrual to 21 RTOG HNC trials (1997 to 2002). The effect of accrual volume on OS was estimated by Cox proportional hazards models., Results: Median RTOG accrual (1997 to 2002) at HLACs was four versus 65 patients at HHACs. Analysis included 471 patients in RTOG 0129 (2002 to 2005) with known human papillomavirus and smoking status. Patients at HLACs versus HHACs had better performance status (0: 62% v 52%; P = .04) and lower T stage (T4: 26.5% v 35.3%; P = .002) but were otherwise similar. Radiotherapy protocol deviations were higher at HLACs versus HHACs (18% v 6%; P < .001). When compared with HHACs, patients at HLACs had worse OS (5 years: 51.0% v 69.1%; P = .002). Treatment at HLACs was associated with increased death risk of 91% (hazard ratio [HR], 1.91; 95% CI, 1.37 to 2.65) after adjustment for prognostic factors and 72% (HR, 1.72; 95% CI, 1.23 to 2.40) after radiotherapy compliance adjustment., Conclusion: OS is worse for patients with HNC treated at HLACs versus HHACs to cooperative group trials after accounting for radiotherapy protocol deviations. Institutional experience substantially influences survival in locally advanced HNC., (© 2014 by American Society of Clinical Oncology.)

Purpose: Although p16 protein expression, a surrogate marker of oncogenic human papillomavirus (HPV) infection, is recognized as a prognostic marker in oropharyngeal squamous cell carcinoma (OPSCC), its prevalence and significance have not been well established in cancer of the oral cavity, hypopharynx, or larynx, collectively referred as non-OPSCC, where HPV infection is less common than in the oropharynx., Patients and Methods: p16 expression and high-risk HPV status in non-OPSCCs from RTOG 0129, 0234, and 0522 studies were determined by immunohistochemistry (IHC) and in situ hybridization (ISH). Hazard ratios from Cox models were expressed as positive or negative, stratified by trial, and adjusted for clinical characteristics., Results: p16 expression was positive in 14.1% (12 of 85), 24.2% (23 of 95), and 19.0% (27 of 142) and HPV ISH was positive in 6.5% (six of 93), 14.6% (15 of 103), and 6.9% (seven of 101) of non-OPSCCs from RTOG 0129, 0234, and 0522 studies, respectively. Hazard ratios for p16 expression were 0.63 (95% CI, 0.42 to 0.95; P = .03) and 0.56 (95% CI, 0.35 to 0.89; P = .01) for progression-free (PFS) and overall survival (OS), respectively. Comparing OPSCC and non-OPSCC, patients with p16-positive OPSCC have better PFS and OS than patients with p16-positive non-OPSCC, but patients with p16-negative OPSCC and non-OPSCC have similar outcomes., Conclusion: Similar to results in patients with OPSCC, patients with p16-negative non-OPSCC have worse outcomes than patients with p16-positive non-OPSCC, and HPV may also have a role in outcome in a subset of non-OPSCC. However, further development of a p16 IHC scoring system in non-OPSCC and improvement of HPV detection methods are warranted before broad application in the clinical setting., (© 2014 by American Society of Clinical Oncology.)

Purpose: We tested the efficacy and toxicity of cisplatin plus accelerated fractionation with a concomitant boost (AFX-C) versus standard fractionation (SFX) in locally advanced head and neck carcinoma (LA-HNC)., Patients and Methods: Patients had stage III to IV carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx. Radiation therapy schedules were 70 Gy in 35 fractions over 7 weeks (SFX) or 72 Gy in 42 fractions over 6 weeks (AFX-C). Cisplatin doses were 100 mg/m(2) once every 3 weeks for two (AFX-C) or three (SFX) cycles. Toxicities were scored by using National Cancer Institute Common Toxicity Criteria 2.0 and the Radiation Therapy Oncology Group/European Organisation for Research and Treatment of Cancer criteria. Overall survival (OS) and progression-free survival (PFS) rates were estimated by using the Kaplan-Meier method and were compared by using the one-sided log-rank test. Locoregional failure (LRF) and distant metastasis (DM) rates were estimated by using the cumulative incidence method and Gray's test., Results: In all, 721 of 743 patients were analyzable (361, SFX; 360, AFX-C). At a median follow-up of 7.9 years (range, 0.3 to 10.1 years) for 355 surviving patients, no differences were observed in OS (hazard ratio [HR], 0.96; 95% CI, 0.79 to 1.18; P = .37; 8-year survival, 48% v 48%), PFS (HR, 1.02; 95% CI, 0.84 to 1.24; P = .52; 8-year estimate, 42% v 41%), LRF (HR, 1.08; 95% CI, 0.84 to 1.38; P = .78; 8-year estimate, 37% v 39%), or DM (HR, 0.83; 95% CI, 0.56 to 1.24; P = .16; 8-year estimate, 15% v 13%). For oropharyngeal cancer, p16-positive patients had better OS than p16-negative patients (HR, 0.30; 95% CI, 0.21 to 0.42; P < .001; 8-year survival, 70.9% v 30.2%). There were no statistically significant differences in the grade 3 to 5 acute or late toxicities between the two arms and p-16 status., Conclusion: When combined with cisplatin, AFX-C neither improved outcome nor increased late toxicity in patients with LA-HNC. Long-term high survival rates in p16-positive patients with oropharyngeal cancer support the ongoing efforts to explore deintensification., (© 2014 by American Society of Clinical Oncology.)

Purpose: Risk of cancer progression is reduced for patients with human papillomavirus (HPV) -positive oropharynx cancer (OPC) relative to HPV-negative OPC, but it is unknown whether risk of death after progression is similarly reduced., Patients and Methods: Patients with stage III-IV OPC enrolled onto Radiation Therapy Oncology Group trials 0129 or RTOG 0522 who had known tumor p16 status plus local, regional, and/or distant progression after receiving platinum-based chemoradiotherapy were eligible for a retrospective analysis of the association between tumor p16 status and overall survival (OS) after disease progression. Rates were estimated by Kaplan-Meier method and compared by log-rank; hazard ratios (HRs) were estimated by Cox models. Tests and models were stratified by treatment protocol., Results: A total of 181 patients with p16-positive (n = 105) or p16-negative (n = 76) OPC were included in the analysis. Patterns of failure and median time to progression (8.2 v 7.3 months; P = .67) were similar for patients with p16-positive and p16-negative tumors. After a median follow-up period of 4.0 years after disease progression, patients with p16-positive OPC had significantly improved survival rates compared with p16-negative patients (2-year OS, 54.6% v 27.6%; median, 2.6 v 0.8 years; P < .001). p16-positive tumor status (HR, 0.48; 95% CI, 0.31 to 0.74) and receipt of salvage surgery (HR, 0.48; 95% CI; 0.27 to 0.84) reduced risk of death after disease progression whereas distant versus locoregional progression (HR, 1.99; 95% CI, 1.28 to 3.09) increased risk, after adjustment for tumor stage and cigarette pack-years at enrollment., Conclusion: Tumor HPV status is a strong and independent predictor of OS after disease progression and should be a stratification factor for clinical trials for patients with recurrent or metastatic OPC., (© 2014 by American Society of Clinical Oncology.)