Skeletal Muscle Change During Neoadjuvant Therapy and Its Impact on Prognosis in Patients With Gastrointestinal Cancers: A Systematic Review and Meta-Analysis.

Background: Gastrointestinal cancers are the most common malignant tumors worldwide. As the improvement of survival by surgical resection alone for cancers is close to the bottleneck, recent neoadjuvant therapy has been emphasized and applied in the treatment. Despite the advantage on improving the prognosis, some studies have reported neoadjuvant therapy could reduce skeletal muscle and therefore affect postoperative outcomes. However, the conclusions are still controversial. Methods: PubMed, CINAHL, Embase, and Cochrane Library were searched from inception to September 2, 2021. The inclusion criteria were observational studies, published in English, of individuals aged ≥18 years who underwent neoadjuvant therapy with gastrointestinal cancers and were assessed skeletal muscle mass before and after neoadjuvant therapy, with sufficient data on skeletal muscle change or the association with clinical outcomes. Meta-analysis was conducted by using the STATA 12.0 package when more than two studies reported the same outcome. Results: A total of 268 articles were identified, and 19 studies (1,954 patients) were included in the review. The fixed effects model showed that the risk of sarcopenia increased 22% after receiving neoadjuvant therapy (HR=1.22, 95% CI 1.14, 1.31, Z=4.286, P<0.001). In the random effects model, neoadjuvant therapy was associated with skeletal muscle loss, with a standardized mean difference of -0.20 (95% CI -0.31, -0.09, Z=3.49, P<0.001) and a significant heterogeneity (I2 = 62.2%, P<0.001). Multiple meta regression indicated that population, neoadjuvant therapy type, and measuring tool were the potential sources of heterogeneity. The funnel plot revealed that there was no high publication bias in these studies (Begg's test, P=0.544) and the sensitivity analysis showed stable results when separately excluding studies. For the postoperative outcomes, the results revealed that muscle loss during neoadjuvant therapy was significantly related to overall survival (HR=2,08, 95% CI =1.47, 2.95, Z=4.12, P<0.001, I2 = 0.0%), but not related to disease-free survival and other short-term outcomes. Conclusions: This systematic review and meta-analysis revealed that skeletal muscle decreased significantly during neoadjuvant therapy in patients with gastrointestinal cancers and skeletal muscle loss was strongly associated with worse overall survival. More high-quality studies are needed to update and valid these conclusions in a more specific or stratified way. Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier PROSPERO (CRD42021292118).

Synergy of N-(3-oxohexanoyl)-L-homoserine lactone and tryptophan-like outer extracellular substances in granular sludge dominated by aerobic ammonia-oxidizing bacteria.

Nitrogen removal via nitrite is an energy-saving method for high-strength ammonia wastewater treatment. A better understanding of the formation of granular sludge dominated by aerobic ammonia-oxidizing bacteria (AerAOB) could facilitate the improved use of rapid sludge granulation for nitritation. In this study, AerAOB-dominated activated sludge (NAS) and granular sludge (NGS) produced different N-scyl-homoserine lactones (AHLs). N-(3-oxohexanoyl)-L-homoserinelactone (OHHL), only released from NGS, was shown to accelerate sludge aggregation by increasing the biomass growth rate, microbial activity, extracellular protein, and AerAOB biomass. For both NAS and NGS, sludge cells were glued together by inner extracellular polymeric substances (EPSs) with similar components to form microcolony. Different from the characterized negative effect of NAS's outer-EPS on cell adhesion, the outer-EPS of NGS played a positive role in the attached growth of AerAOB-dominated sludge and contained more tryptophan-like substances. More interesting, OHHL enhanced the yields of tryptophan-like substances after mixing with the outer-EPS of NGS, enhancing cell adhesion. In a word, OHHL and more tryptophan-like substances were produced in the process of granulation under the selective sludge discharge condition, which was proved to be able to accelerate NAS granulation. Therefore, the sludge granulation process for nitritation can be improved by increasing the levels of OHHL and tryptophan in the initial startup stage. The appropriate engineering strategy should be further studied to facilitate the actual application of granular sludge for nitrogen removal on a large scale.

Selected non-Saccharomyces wine yeasts in controlled multistarter fermentations with Saccharomyces cerevisiae on alcoholic fermentation behaviour and wine aroma of cherry wines.

This study examined the effect of mixed fermentation of non-Saccharomyces (Torulaspora delbrueckii ZYMAFLORE Alpha(TD n. Sacch) and Metschnikowia pulcherrima JS22) and Saccharomyces cerevisiae yeasts (D254 and EC1118) on the production of cherry wines, in comparison with commonly used mono-culture. Results obtained during AF demonstrated that negligible inhibitory effect was observed in S. cerevisiae/Alpha pair, whereas a strong antagonistic effect was detected between MJS22 and S. cerevisiae strain, resulting in an early death of MJS22. For volatile components determined, S. cerevisiae/MJS22 couple was found to significantly boost the production of most detected compounds, more particularly in higher alcohols, esters, acids and terpenes; while the characteristic of S. cerevisiae/Alpha pair is an increase in fruity esters, higher alcohols and decrease in acid production. Sensory evaluation revealed that S. cerevisiae/MJS22 pair reinforced sweet, green and fatty notes to the cherry wines, and S. cerevisiae/Alpha trial enhanced the fruity odour and reduced green note.

[Adsorption of Cu2+ by xanthate-functionalized waste sludge].

Waste sludge from waste water treatment plants was treated with the carbon disulfide in alkaline medium to prepare xanth, aiming to explore an efficient way to recycle waste sludge. Fourier transform infrared spectroscopy (FTIR) was applied to characterize the sludge. Batch experiments were conducted to investigate the adsorption property of Cu2+ as well as effecting factors including pH and initial concentration of Cu2+ . Results show that the chemical modification introduces sulfur groups successfully and the adsorption capacity of xanthate-functionalized sludge increases by 20.6%- 46. 9% comparing to the pristine waste sludge. The Cu2+ removal efficiency of xanthate-functionalized sludge reaches 96.7% when the initial concentration of Cu2+ is 25 mgL-1. The adsorption process can attain equilibrium within 3 hours and kinetics is found to be best-fit the Pseudo-second-order equation. The process is jointly controlled by film diffusion and intraparticle diffusion. Both Langmuir model and Freundlich model can describe the adsorption, process well. The maximum adsorption capacity given by the Langmuir model is 142.92 mgg-1 at 25 degree C (pH = 5). Adsorption capacity increases with pH value (1-5) and initial Cu2+ concentration. The xanthate-functionalized sludge can be used as high performance adsorbents to recycle waste resources.

Comparative investigation on microbial community and electricity generation in aerobic and anaerobic enriched MFCs.

This study compared the difference in microbial community and power generation capacity of air-cathode MFCs enriched under anode aerobic and anaerobic conditions. Results showed that MFCs successfully started with continuous air inputting to anode chamber. The aerobic enriched MFC produced comparable and even more electricity with the fuels of acetate, glucose and ethanol compared to the anaerobic MFC when returning to anaerobic condition. The two MFCs showed a slightly different microbial community for anode biofilms (a similarity of 77%), but a highly similar microbial community (a similarity of 97%) for anolyte microbes. The anode biofilm of aerobic enriched MFC showed the presence of some specific bacteria closely related to Clostridium sticklandii, Leucobacter komagatae and Microbacterium laevaniformans. The anaerobic enriched MFC found the presence of a large number of yeast Trichosporon sp. This research demonstrates that it is possible to enrich oxygen-tolerant anode respiring bacteria through purposely aeration in anode chamber.

The study of the combination detection of HPV-DNA and p16INK4a in cervical lesions.

The objective of this study is to detect the infection of human papillomavirus (HPV) and the expression of p16(INK4a) in cervical lesions and to investigate the interaction between hrHPV and p16(INK4a) for cervical lesions and its diagnostic efficiency. hrHPV-DNA was detected by the hybrid capture II (HC-II) system. Immunochemical method was used to detect the expression of p16(INK4a), and histopathologic test was performed to identify cervical lesions. χ(2) test and Spearman's rank correlation were used for statistical analysis. Additive effects model was used to analyze the interaction. The diagnostic sensitivity, specificity, positive predictive values, negative predictive values, accuracy, and the area under the receiver operating characteristic curve were calculated with SPSS 13.0. hrHPV and p16(INK4a) positive rate increased (P < 0.05) with histopathologic diagnosis increasing. The positive rates of hrHPV and p16(INK4a) in negative or chronic inflammation were statistically lower than that in cervical intraepithelial neoplasia (CIN)1, CIN2, CIN3, and squamous-cell carcinoma (SCC) (P < 0.05), respectively. There was a positive interaction between hrHPV and p16(INK4a), relative excess risk of interaction (RERI) was 52.49, attributable proportions of interaction (API) were 72.34%, and the synergy index (S) was 3.75. The specificity and AUC of combining hrHPV with p16(INK4a) were statistically higher than hrHPV or p16(INK4a) alone (P < 0.05). hrHPV and p16(INK4a) are useful markers for the early diagnosis of cervical lesions. A positive interaction between hrHPV and p16(INK4a) is seen. The combination of hrHPV and p16(INK4a) has a higher diagnostic accuracy than hrHPV or p16(INK4a) alone in diagnosis of cervical lesions.

An analysis on the combination expression of HPV L1 capsid protein and p16INK4a in cervical lesions.

Human papillomavirus (HPV) infection in cervix is the most important reason for cervical cancer, but only 2% cervical HPV infection will develop into cervical cancer. So how to identify patients at risk of progressive cervical lesions from those infected with HPV to avoid over treatment is a big issue in clinic. The aims of this study were to detect the expression of HPV L1 capsid protein and p16(INK4a) in cervical lesions and to investigate the combination expression of HPV L1 capsid protein and p16(INK4a) in cervical lesions and its diagnostic efficiency in clinic. Immunochemical method was used to detect the expression of HPV L1 capsid protein and p16(INK4a) in 169 cases of abnormal cytology. Histopathologic test was performed to identify cervical lesions of all the cases. chi(2) test and spearman's rank correlation were used for statistical analysis. The diagnostic sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), accuracy, and the area under the receive operating characteristic (ROC) curve (denoted by A(Z)) were calculated with SPSS 13.0. All the statistical tests were two sided at the 5% level of significance. L1 expression decreased (P < 0.001), but p16(INK4a) expression increased (P < 0.001) with histopathologic diagnosis increasing. The expression rates of HPV L1 capsid protein, p16(INK4a), and L1(-)/p16(+) in cervical intraepithelial neoplasia (CIN)2, CIN3, and squamous-cell carcinoma were statistically different from those in CIN1 (P < 0.001). The expressions of HPV L1 capsid protein, L1(+)/p16(+), L1(+)/p16(-), and L1(-)/p16(-) were negatively correlated with the severity of cervical lesions (P < 0.001), whereas the expressions of p16(INK4a) and L1(-)/p16(+) were positively correlated with the severity of cervical lesions (P < 0.001). The specificity and A(Z) of combining L1 with p16 (INK4a) were statistically higher than L1 or p16 (INK4a) alone (P < 0.05). L1 and p16(INK4a) are useful biomarkers for the early diagnosis of cervical lesions. The combination of L1 and p16(INK4a) has a higher diagnostic accuracy than L1 or p16(INK4a) alone in diagnosis of cervical lesions.

Analysis of the dose-response relationship between high-risk human papillomavirus viral load and cervical lesions.

The aims of this study were to explore the dose-response relationship between high-risk human papillomavirus (hrHPV) load and cervical lesions; the relationship between hrHPV viral load and the severity of cervical lesions; and the clinical application of the hybrid capture II (HC-II) system in the secondary prevention of cervical cancer. HrHPV viral load was detected by the HC-II system and cervical lesions were diagnosed from biopsied tissue. Curve estimation and Mantel trend analysis were used to explore the dose-response relationship between hrHPV viral load and cervical lesions. Spearman's rank correlation analysis and ordinal regression model were used for the analysis of hrHPV viral load and the severity of cervical lesions. Curve estimation showed good correlation between cervical lesion rates and hrHPV viral load (r=0.775, P=0.008); the rate of cervical lesions increased with hrHPV viral load (chi(trend)=8.000, P<0.001). Medium intensity rank correlation was found between hrHPV viral load grades and the severity of cervical lesions (r(s)=0.321, P<0.001); a correlation appeared between hrHPV viral load and the severity of cervical lesions (P<0.001). These results suggest a dose-response relationship between hrHPV viral load and the severity of cervical lesions. This dependence has important clinical applications and shows the potential value of the HC-II system in cervical cancer prevention.