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A novel biodegradable protein-based material (UMSPIE) that consists of natural polymer soy protein isolate (SPI), ultrasonic-modified montmorillonite (UMMT), and ethylene glycol diglycidyl ether (EGDE) was produced by solution casting. Fourier infrared spectroscopy (FTIR), X-ray diffraction (XRD), thermogravimetric analysis (TG), and scanning electron microscopy (SEM) were used to characterize the chemical structure and micro-morphologies of as-synthesized protein-based composite films. The results showed that the interlayer structure of MMT was destroyed by ultrasonic treatment, and the hydrogen bonding between SPI chains and the ultrasound-treated MMT plates was enhanced. The synergistic effect of UMMT and EGDE on SPI molecules made the network structure of the UMSPIE film denser. In addition, the mechanical and barrier properties of the as-synthesized films were explored. Compared with pure soy protein film, the tensile strength of the UMSPIE film has an increase of 266.82% (increasing from 4.4 to 16.14 MPa). From the above, the modified strategy of layered silicates filling combining crosslinking agents is considered as an effective method to improve the functional properties of bio-based polymer composites.

Objective To analyze the relationship between preoperative enhanced MRI manifestation and recurrent time of recurrent glioblastoma, and to explore the predictive value of imaging signs for recurrence time. Methods A total of 36 patients with pathologically confirmed glioblastoma were collected from February 2012 to April 2017. All patients underwent preoperative and postoperative T1WI and enhanced MRI scans, and enhanced cross - sections and sagittal or coronary scans were performed. Manually measure the volume of the lesion-enhanced and non-enhanced necrotic areas on the enhanced MRI image. The totality was divided into 2 groups according to the percentage of necrosis that accounts for the entire tumor volume. Necrosis in group A accounts for > 50% of the total tumor volume, and necrosis in group B accounts for < 50% of the total tumor volume. Analyze the enhanced MRI features before surgery, the time of first recurrence, MRI manifestations and overall survival (OS). Results The recurrence time in group A was significantly shorter than that in group B [(6.00 ± 0.99) months vs. (9.00 ± 1.49) months, P = 0.049]. Necrotic-based glioblastomas recurred faster. When stratifying patients in group A and group B based on clinical characteristics, the recurrence time of patients in group A was still significantly shorter than that in group B in the group of age < 65 years old and receiving radiotherapy and chemotherapy [6 (3, 8) months vs. 9 (6, 13) months, 6 (6, 10) months vs. 12 (3, 24) months; P < 0.05, for all]. Conclusions Preoperative enhanced MRI findings have predictive value for postoperative recurrence in patients with glioblastoma who are younger than 65 years old and receive radiotherapy and chemotherapy. [ABSTRACT FROM AUTHOR]

Objective To summarize the clinical value of molecular pathology in glioma. Methods and Results The clinical course and molecular pathology results of 3 glioma patients were compared. All 3 patients underwent integrated diagnosis according to the WHO 2016 diagnostic criteria. Molecular pathology included whole exome sequencing (WES) and detection of MGMT promoter methylation and TERT promoter mutation. Case 1 had the first surgery 32 years ago, diagnosed with left frontal glioma, only radiotherapy after surgery. The tumor was found recurrent 31 years later. Molecular pathology after reoperation suggested ÍDH mutation, 1p/19q combined deletion, TERT promoter region mutation, MGMT promoter methylation positive, integration diagnosed as anaplastic oligodendroglioma. The patient had overall survival over 32 years, and was still alive. Case 2 underwent two surgeries within 6 months, molecular pathology suggested IDH wild type, 1p/19q without combined deletion, TERT promoter region mutation, MGMT promoter non - methylation, integration diagnosed as glioblastoma. The overall survival was 6 months. Case 3 was suffered from left temporal giant glioma. Molecular pathology after total tumor removal revealed IDH wild type, 1p/19q without combined deletion, and non-mutation in the TERT promoter region, and MGMT promoter non - methylation. The integration diagnosis was glioblastoma. This patient underwent concurrent chemoradiotherapy after surgery. MRI showed signs of recurrence after 2 months. According to the results of WES, this patient had FGFR3 amplification, and Anrotinib the multi - target tyrosinase inhibitor was used, which was gradually relieved after 2 months. Conclusions The molecular pathology of glioma patients can help clinicians to integrate diagnosis, predict the prognosis, and help neurosurgeons to screen drugs. [ABSTRACT FROM AUTHOR]

The complex heterogeneity and therapeutic resistance of malignant glioma may largely account for the poor prognosis of glioma. The incomplete response assessment system of clinical outcomes is an underlying cause for the confounding of true prognostic benefits expected in patients with glioma. The investigation and development of recently introduced agents or radiological measurements caused emergent misunderstandings to the response assessment of glioma. To date, the classical Macdonald's criteria and the Response Assessment of Neuro- Oncology (RANO) criteria have been used successively for the evaluation of glioma outcome. However, the Macdonald's criteria only addresses the contrast - enhancement component of the tumor, which is only a surrogate to true tumor growth and activity. Ongoing efforts on complementary assessments are necessary to combat malignant glioma. In this review, we highlight the shortcomings of the current criteria and introduce the initiative effort of RANO criteria and its offspring. [ABSTRACT FROM AUTHOR]

Recurrence and progression to higher grade lesions are characteristic behaviorsof gliomas. Though IDH1 mutation frequently occurs and is considered as an early event in gliomagenesis, little is known about its role in the recurrence and progression of gliomas. We therefore analysed IDH1 and IDH2 statusat codon 132 of IDH1 and codon 172 of IDH2 by direct sequencing and anti-IDH1-R132H immunohistochemistry in 53 paired samples and their recurrences, including 29 low- grade gliomas, 16 anaplastic gliomas and 8 Glioblastomas. IDH1/IDH2 mutation was detected in 32 primarytumors, with 25 low- grade gliomas and 6 anaplastic gliomas harboring IDH1 mutation and 1 low- grade glioma harboring IDH2 mutation. All of the paired tumors showed consistent IDH1 and IDH2 status. Patients were analyzed according to IDH1 status and tumor-related factors. Malignant progression at recurrence was noted in 22 gliomas and was not associated with IDH1 mutation. Survival analysis revealed patients with IDH1 mutated gliomas had a significantly longer progression-free survival (PFS) and overall survival (OS). In conclusion, this study demonstrated a strong tendency of IDH1/IDH2 status being consistent during progression of glioma. IDH1 mutation was not a predictive marker for malignant progression and it was a potential prognostic marker for gliomas of Chinese patients. [ABSTRACT FROM AUTHOR]

IDH mutations frequently occur in WHO grade II and III diffuse gliomas and have favorable prognosis compared to wild-type tumors. However, whether IDH mutations in WHO grade II and II diffuse gliomas predict enhanced sensitivity to adjuvant radiation (RT) or chemotherapy (CHT) is still being debated. Recent studies have identified recurrent mutations in the promoter region of telomerase reverse transcriptase (TERT) in gliomas. We previously demonstrated that TERT promoter mutations may be promising biomarkers in glioma survival prognostication when combined with IDH mutations. This study analyzed IDH and TERT promoter mutations in 295 WHO grade II and III diffuse gliomas treated with or without adjuvant therapies to explore their impact on the sensitivity of tumors to genotoxic therapies. IDH mutations were found in 216 (73.2%) patients and TERT promoter mutations were found in 112 (38%) patients. In multivariate analysis, IDH mutations (p < 0.001) were independent prognostic factors for PFS and OS in patients receiving genotoxic therapies while TERT promoter mutations were not. In univariate analysis, IDH and TERT promoter mutations were not significant prognostic factors in patients who did not receive genotoxic therapies. Adjuvant RT and CHT were factors independently impacting PFS (RT p = 0.001, CHT p = 0.026) in IDH mutated WHO grade II and III diffuse gliomas but not in IDH wild-type group. Univariate and multivariate analyses demonstrated TERT promoter mutations further stratified IDH wild-type WHO grade II and III diffuse gliomas into two subgroups with different responses to genotoxic therapies. Adjuvant RT and CHT were significant parameters influencing PFS in the IDH wt/TERT mut subgroup (RT p = 0.015, CHT p = 0.015) but not in the IDH wt/TERT wt subgroup. Our data demonstrated that IDH mutated WHO grade II and III diffuse gliomas had better PFS and OS than their IDH wild-type counterparts when genotoxic therapies were administered after surgery. Importantly, we also found that TERT promoter mutations further stratify IDH wild-type WHO grade II and III diffuse gliomas into two subgroups with different responses to adjuvant therapies. Taken together, TERT promoter mutations may predict enhanced sensitivity to genotoxic therapies in IDH wild-type WHO grade II and III diffuse gliomas and may justify intensified treatment in this subgroup.

Objective: To evaluate the prognosis and efficacies of comprehensive treatment for recurrent gliomas., Methods: A total of 62 patients diagnosed as recurrent gliomas at our hospital between May 2007 and January 2012 were reviewed and analyzed. The investigators compared the prognosis of different grades of gliomas and evaluated the efficacies of combined modality therapy of surgery, radiotherapy, chemotherapy and immunotherapy., Results: Their median periods of time-to-progression (TTP) and overall survival (OS) were 6.0 and 13.0 months respectively. The median TTP of WHO grade II (n = 21), III (n = 13) and IV (n = 28) recurrent gliomas were 9.0, 9.0 and 5.0 months respectively. And the average OS of WHO grade II, III and IV recurrent gliomas were 26.6, 21.4 and 13.8 months respectively. The efficacious rate of chemotherapy was 26.7%., Conclusion: Combined modality therapy based on chemotherapy may moderately improve the prognosis of recurrent gliomas. And the pathological grades of primary tumors are correlated with the prognosis of recurrent gliomas.