Molecular dissection of ALS-associated toxicity of SOD1 in transgenic mice using an exon-fusion approach.

Mutations in Cu,Zn superoxide dismutase (SOD1) are associated with amyotrophic lateral sclerosis (ALS). Among more than 100 ALS-associated SOD1 mutations, premature termination codon (PTC) mutations exclusively occur in exon 5, the last exon of SOD1. The molecular basis of ALS-associated toxicity of the mutant SOD1 is not fully understood. Here, we show that nonsense-mediated mRNA decay (NMD) underlies clearance of mutant mRNA with a PTC in the non-terminal exons. To further define the crucial ALS-associated SOD1 fragments, we designed and tested an exon-fusion approach using an artificial transgene SOD1(T116X) that harbors a PTC in exon 4. We found that the SOD1(T116X) transgene with a fused exon could escape NMD in cellular models. We generated a transgenic mouse model that overexpresses SOD1(T116X). This mouse model developed ALS-like phenotype and pathology. Thus, our data have demonstrated that a 'mini-SOD1' of only 115 amino acids is sufficient to cause ALS. This is the smallest ALS-causing SOD1 molecule currently defined. This proof of principle result suggests that the exon-fusion approach may have potential not only to further define a shorter ALS-associated SOD1 fragment, thus providing a molecular target for designing rational therapy, but also to dissect toxicities of other proteins encoded by genes of multiple exons through a 'gain of function' mechanism.

Clinical Features of Infection in Newly Diagnosed Patients with Myelodysplastic Syndrome and Its Correlation with Curative Effect / 中国实验血液学杂志

OBJECTIVE@#To explore the characteristics of infection in patients with myelodysplastic syndromes (MDS), risk factors of serious infection, and their correlation with curative effect.@*METHODS@#The clinical data of 92 newly diagnosed MDS patients with nosocomial infection from January 2016 to June 2020 in our hospital were retrospectively analyzed.@*RESULTS@#A total of 306 courses of treatment were completed in 92 newly diagnosed MDS patients. The infection rate was the highest in the first course of treatment (84.8%, 78/92), and then decreased gradually. The top three infection sites were lung, upper respiratory tract, and gastrointestinal tract. A total of 90 strains of pathogenic bacteria were detected, of which 33.4% (30/90) were gram-negative bacilli, 23.3% (21/90) were gram-positive cocci, 23.3% (21/90) were fungi, and 20.0% (18/90) were viruses. The serious infection rate among 92 patients with MDS was 22.8% (21/92). Multivariate analysis showed that neutrophil deficiency>7 days (OR=10.875, 95%CI: 2.747-43.051, P=0.001) was an independent risk factor for serious infection in MDS patients. Compared with non-severe infection group, the total effective rate of severe infection group was lower (90.9% vs 63.6%, χ2=4.393, P<0.05).@*CONCLUSION@#The infection rate of MDS patients is high in the first course of treatment, and the most common infection site is the lung. Gram-negative bacteria is the most common pathogen. MDS patients with neutrophil deficiency>7 days have a high risk of serious infection and poor efficacy.

Nivolumab-associated pulmonary toxicities： a retrospective study based on FARES database from 2016 to 2019 / 上海预防医学

Objective:Nivolumab is one of the most common programmed death 1 （PD-1） inhibitors used as an immune checkpoint inhibitor （ICI）. It brings significant therapeutic effects but often accompanied by serious drug toxicity. The pulmonary toxicities of nivolumab are not clear. This study aims to systematically explore the nivolumab-associated pulmonary toxicities and provide reference for clinical treatment. Methods:Data were extracted from US Food and Drug Administration （FDA） Adverse Event Reporting System （FAERS） database from January 1， 2016 to September 30， 2019. Two types of disproportionality analysis， information component （IC） and reporting odds ratio （ROR）， were applied in nivolumab-associated pulmonary adverse events （AEs） signal detection. Results:A total of 28 489 309 records were extracted from FAERS database and 8 181 records were associated with nivolumab. Analysis was conducted in 179 AEs and 86 signals were detected. Notably， potent signals were detected in radiation pneumonitis （IC025： 3.99， ROR025： 17.25）， pneumonitis （IC025： 3.34， ROR025： 10.64） and bronchial fistula （IC025： 2.94， ROR025： 8.78）. Nivolumab-associated pulmonary toxicities were more frequently reported in dyspnoea （IC025： 0.50， ROR025： 1.44）， pneumonia （IC025： 0.08， ROR025： 1.07） and pneumonitis （IC025： 3.34， ROR025： 10.64）. Results of IC and ROR methods were similar to each other. Most pulmonary toxicities were observed in patients with non-small cell lung cancer （N=3 711， 32.13%）， malignant melanoma （N=1 658， 14.36%） and renal cell carcinoma （N=731， 6.33%）. Conclusion:Significant pulmonary toxicities were detected in patients treated with nivolumab. Thus， it is highly important for clinicians to be vigilant about nivolumab-associated pulmonary AEs and be prepared to take immediate action for patient safety.

The value of myocardial torsion and aneurysm volume for evaluating cardiac function in rabbit with left ventricular aneurysm.

OBJECTIVE: This study aimed to investigate the effect of left ventricular aneurysm (LVA) volume and left ventricular global torsion on cardiac function by real time three-dimensional echocardiography (RT-3DE) and two-dimensional speckle tracking imaging(2D-STI), to determine the accuracy of RT-3DE and 2D-STI in assessing LV function. METHODS: Thirty New Zealand rabbit models of with LVA were prepared by ligation of the middle segment of the left anterior descending and left circumflex arteries. Four weeks post-procedure, RT-3DE was conducted to obtain data on LVEF, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and LVA volume (LVAV), Peak rotation angles at the mitral valve annulus level (MV-ROT), peak rotation angles at the apical level (AP-ROT), and left ventricular global torsion angles (LV-TOR) were measured by 2D-STI. RESULTS: Compared with controls, LVEDV and LVESV were significantly increased in the LVA group, while LVEF, MV-ROT, AP-ROT, and LV-TOR were consistently reduced (p<0.01). Moreover, LVEF correlated with LVA volume and LV torsion angle (r= -0.778 and 0.821, p<0.01). LVA volume/LVEDV had the strongest inverse relationship with LVEF (r= -0.911, p<0.01). CONCLUSION: LVA volume, LVA volume/LVEDV, and LV torsion may be used as an indicator for evaluation of cardiac function after LVA. Moreover, LVA volume/LVEDV may be a more sensitive and reliable marker of cardiac function after LVA formation.

A analysis for the value of ultrasonography and MRI in diagnosis of adrenal pheochromocytoma / 中国医学装备

Objective:To analyze differential diagnosis and imaging feature of ultrasonography and MRI for adrenal pheochromocytoma.Methods: The manifestations of the preoperative ultrasound and MRI of the 37 patient with adrenal pheochromocytoma who once were confirmed by pathology were analyzed by the retrospective analysis. The result of pathology was used as standard to analyze the accuracy rate and clinical feature of the two detection methods in the diagnosis of adrenal pheochromocytoma.Results: The results of pathological diagnosis for the 37 cases showed that 35 cases were benign and 2 cases were malignant. After the results of preoperative ultrasound was tested by using pathology, the tested results of 37 cases showed 32 cases were adrenal pheochromocytoma, 2 cases were adrenocortical adenocarcinoma and 3 cases were adrenal adenoma. As these results, the accuracy rate of preoperative ultrasound was 86.49%. And after the results of preoperative MRI was tested by using pathology, the tested results of 37 cases showed that 34 cases were adrenal pheochromocytoma, 2 cases were adrenocortical adenocarcinoma and 1 case was adrenal adenoma. And its accuracy rate was 91.89%. Therefore, if patients were diagnosed with adrenal pheochromocytoma by using preoperative imaging detection, they should be considered to receive further diagnosis so as to distinguish adrenal pheochromocytoma with adrenal adenoma, adrenocortical adenocarcinoma, metastatic tumor and lipomatous. Conclusion: Both of ultrasound and MRI can accurately achieve location, diagnosis of qualitative identification for adrenal pheochromocytoma, and the clinical feature and imaging feature which combined the two detections can increase the detectable rate and accuracy rate for adrenal pheochromocytoma.

The expression and clinical significance of miR-98 in peripheral blood mononuclear cells in asthmatic children / 中国小儿急救医学

Objective To explore the role of miR-98 in peripheral blood mononuclear cells (PBMC) in the pathogenesis and development of childhood asthma.Methods A total of 43 cases of asthmatic children and 30 cases of healthy controls were enrolled in the study.Peripheral blood mononuclear cells were isolated in both healthy subjects and asthmatic children in acute attack and remission stages.The expressions of miR-98 and interleukin-4(IL-4) and IL-13 mRNA were detected by real-time quantitative PCR.Results The miR-98 levels of asthmatic children in attack stage were significantly lower than those in remission stage and control group (P0.05).Furthermore,a negative correlation was found between the expression of miR-98 and IL-5(r=-0.794,P<0.01) and between the expression of miR-98 and IL-13 mRNA (r=-0.804,P<0.01) in asthmatic children in attack stage.A positive correlation was also found between IL-4 and IL-13 mRNA in asthmatic children in attack stage (r=0.853,P<0.01).Conclusion The expression of miR-98 decreased in asthmatic children,and miR-98 might be involved in the pathogenesis and development of asthma.

The correlation between matrix metalloproteinase-9 and cardiac function,aneurysm volume in the process of ventricular aneurysm formation / 重庆医学

Objective To explore the correlation between matrix metalloproteinase‐9(MMP‐9) and cardiac function ,aneu‐rysm volume in the process of left ventricular aneurysm (LVA) formation .Methods Rabbit models of LVA were established in 20 New Zealand rabbits by lighting left anterior descending artery and left circumflex artery .Two‐dimensional echocardiography were performed at preoperative and postoperative 1 d ,2 d ,3 d ,1 w ,2 w ,3 w ,4 w .The survived animals which had LVA formed were en‐rolled .Real time three‐dimensional echocardiography was performed to obtain left ventricular volume ,LVEF and LVA volume ,The MMP‐9 serum concentration was measured by ELISA .Results (1)There were a significant increase in the serum concentration of MMP‐9 from postoperative 1 d and arrived at the peak at postoperative 3 d ,there were higher than preoperative at postoperative 4 w (P<0 .05) .(2)Compared with preoperative ,the LVEDV ,LVESV and LVAV volume at postoperative showed an increase trend (P<0 .05) ,while there was a decreasing trend in LVEF(P<0 .05) .(3)The MMP‐9 had the better relationship with LVEF at post‐operative 1 d ,2 d ,3 d ,1 w ,2 w ,3 w ,4 w ,in which MMP‐9 had the tightest relationship with LVEF at postoperative 3 d (r=0 .731 , P<0 .05) .MMP‐9 had the better relationship with LVA volume at postoperative 2 d ,3 d ,1 w ,2 w ,3 w ,4 w ,in which MMP‐9 had the tightest relationship with LVA volume at postoperative 3 d (r=0 .636 ,P<0 .05) .Conclusion The MMP‐9 had an effect on cardiac function and LVA volume in the process of LVA formation .

The thinking of improving the management level of scientific research via information management system / 中华医学科研管理杂志

This study is to explore that how to use the information management system to research composed of the management and sharing of research projects,study exchanging and technical guidance.The purpose is to improve the management efficiency and level of scientific research projects.Current study aimed to explore establish a digital management system

The protective mechanism study of fengshiqing recipe against bone destruction in CIA rats / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the protective mechanism of Fengshiqing Recipe (FR) against bone destruction in collagen-induced arthritis (CIA) rats.</p><p><b>METHODS</b>Rats were divided into four groups in the experiment,i.e., the blank control group, the model group, the MTX group (MTX, 1 mg/1 000 g), and the FR group (24 g crude FR/kg). The CIA model was prepared except the blank control group. Medication was started in the MTX group and the FR group from the 14th day after modeling to the 56th day. The toe volume was measured on every Tuesday and Friday. Expression levels of serum IL-17, RANKL, MIP-1alpha were detected after 3-and 6-week intervention. The bone scintigraphy with nuclide (SPECT), bone mineral density (BMD), and the pathological section were observed to assess the intervention of drugs of heat clearing blood activating actions in the bone destruction of CIA rats.</p><p><b>RESULTS</b>From the 10th day of modeling, the volume of both toes started to swell and reached the peak at about 21 days. It was obviously shrunk at about 30 days. Of them, the swelling degree was milder in the MTX group and the FR group than in the model group. Compared with the model group at the same phase, the levels of IL-17 and RANKL decreased in the MTX group after 3 weeks of intervention (P < 0.01, P < 0.05). The IL-17 level decreased in the FR group after three weeks of intervention (P < 0.05). The RANKL level decreased in the MTX group and the FR group after 6 weeks of intervention (P < 0.01, P < 0.05). Compared with the model group and the MTX group, the overall BMD and ankle BMD increased in the FR group after 6 weeks of intervention (P < 0.01, P < 0.05). The ankle ROI/mandible and the toe ROI/mandible were elevated in the FR group after 3 weeks of intervention (P < 0.05). Pathological results suggested that the joint lacunae was significantly widened, the hyperplasia of the synovial tissue was so severe, and the bone tissue was destroyed in the model group. Compared with the model group, the aforesaid conditions were significantly improved in the MTX group and the FR group. The cartilage structure was complete.</p><p><b>CONCLUSION</b>QR could inhibit decreased BMD, prevent bone destruction, which might be achieved by down-regulating expression levels of IL-17, RANKL, and MIP-1alpha through the osteo immunological Th/RANKL system,inhibiting maturation and differentiation of osteoclasts, thereby, inhibiting bone destruction.</p>

Assessment of the difference of myocardium strain between myocadial infarction and ventricular aneurysm by two-dimensional speckle-tracking imaging in rabbits / 中华超声影像学杂志

Objective To evaluate the difference of myocardium strain between myocadial infarction and ventricular aneurysm (VA) by two-dimensional speckle-tracking imaging in rabbits.Methods 26 healthy New Zealand white rabbits were enrolled in this study,6 were put into the control group and 20 in the experimental group.models of myocardial infarction concomitant with VA were prepared by the ligation of the middle segment of left anterior descending artery and left circumflex artery.At 4 weeks after the procedure,according to the pathological inspect and echocardiography for whether VA formed,the experimental animals were divided into the VA group and the myocadial infarction group.Echocardiography was performed to measure the LV cavity size and cardiac function.Radial strain rate (SrR) and circumferential strain rate(SrC) indexes were measured by 2D-STI software for each animal at the level of apex in left ventricular short-axis view,and then calculated the strain rate decrease percentage in each segment.Results 1)Compared with the control group,SrR-S,SrR-E,SrR A,SrC-S,SrC-E,SrC-A in all segments were reduced significantly in the VA group and the myocadial infarction group (P ＜ 0.05),the VA group was the most significant.2)Compared with the myocadial infarction group,the strain rate decrease percentage of SrR-S,SrR-E,SrR-A,SrC-S,SrC-E,SrC-A in all segment had significant in the VA group.Comparison between the each section,the strain rate decrease percentage of SrR-Santerior wall,SrR-Sateral wall,SrC-Santerior wall,SrC-Slateral wall were the most significant.3)There were the tighter relationship between the strain rate decrease percentage of SrR-Santerior wall,SrC-Santerior wall,SrR-Slateral wall,SrC-Slateral wall and left ventricular ejection fraction (r =0.82,0.72,0.75,0.71,repectively,all P ＜ 0.05).4) The ROC curve analysis showed that when the strain rate decrease percentage was 60％ as the critical point,the strain rate decrease percentage of SrC-Santerior wall,SrC-Slateral wall,SrR-Santerior wall,SrR-Slateral wall had a sensitivity of 83.30 ％,84.40％,83.30％,67.70％％ and a specificity was 73.60％,78.20％％,69.70％,83.30％ for prognosis ventricular aneurysm,repectively.Conclusions After ventricular aneurysm formation,anterior and lateral wall myocardial strain were give priority to the myocardial mechanics reconstruction,thus systolic myocardial strain rate decrease percentage can be important indicator of infarction myocardial developing into ventricular aneurysm.

Assessment of left ventricular twist in rabbits with ventricular aneurysm formed by two-dimensional speckle tracking echocardiography / 中华超声影像学杂志

ObjectiveTo evaluate the influence on left ventricular(LV) twist,and the relationship between LV twist and function in the rabbits with ventricular aneurysm formed after myocardial infarction by two-dimensional ultrasound speckle tracking imaging.MethodsTwenty-six healthy rabbits were divided into two groups,six as control group,twenty as experimental group.The model of myocardial infarction and ventricular aneurysm were established by ligaturing left anterior descending coronary artery and left circumflex artery.After four weeks,according to the pathological examination of whether ventricular aneurysm formed or not,the experimental group was divided into myocardial infarct group and ventricular aneurysm group.Echocardiography was performed to measure rotations (at the levels of mitral annulus and apex in LV short-axis view),LV twist,left ventricular cavity size and function.ResultsCompared with the myocardial infarct group,LV end-diastolic diameter(LVEDD) and LV end-diastolic volume(LVEDV) were larger in the ventricular aneurysm group,but LV ejection fraction (LVEF),LV fractional shortening (LVFS),apical rotation and LV twist were lower in the ventricular aneurysm group than the myocardial infarct group.Both apical rotation and LV twist had shown a great correlation with LVEF.The conclusion was also shown in the ROC curve that sensitivity and specificity of diagnosis cardiac dysfunction were 76.9％ and 80.0％ respectively when the apical rotation was 1.21°.Conclusions There was a closely relationship between the change of apical rotation and the LV systolic function.When the apical rotation dropped to 1.21°,an apparent decline of LV systolic function was implied.

Investigation on west Nile virus infection in equine of Yili, Xinjiang uygur autonomous region / 重庆医科大学学报

Objective:To investigate the epidemic of west Nile virus(WNV) infection in Yili, Xinjiang uygur autonomous region. Methods:One step real-time RT-PCR was performed to detect the west nile virus envelope(WNV E) in peripheral blood mononuclear cells(PBMCs) of 120 equines. Gene sequence and amino acid sequence were analyzed for positive products. Results:No positive product was found in all the samples. Conclusion:No evidence was found to support WNV infection in Yili, Xinjiang uygur autonomous region.

Dual index grade sequence pattern recognition of extracts with ethanol of Mingmu Dihuang pills and Zhibai Dihuang pills / 中国中药杂志

<p><b>OBJECTIVE</b>A new pattern recognition method suitable for traditional Chinese patent medicine was established in this paper, which is named as the Dual index grade sequence pattern recognition.</p><p><b>METHOD</b>In this method the quality gradation was defined mathematically relying on normal distribution. By this way samples can be clustered and classified depending on which quality gradation is wanted, and the grading samples quantitatively relative to quality can be performed simultaneously. Especially, the redundant information with respect to pattern recognition hiding in dual index sequences of samples can be removed effectively by applying the good grade sequences, which make the pattern recognition results accurate excellently. This approach possesses the advantages of both supervised classification and unsupervised cluster methods. Samples can be clustered and classified at the same time without any standard samples, and the operation is accomplished based on the good grade similar sequences themselves being as the classifying marks. Moreover, the subclasses in each class can be identified more subtly.</p><p><b>RESULT</b>The infrared fingerprint spectra of extracts of 27 kinds of Mingmu Dihuangwan pills and Zhibo Dihuangwan pills samples extracted with ethanol were analyzed with the method proposed in this paper. The results showed that these pills can be classified in their subclasses clearly, respectively.</p><p><b>CONCLUSION</b>The Dual index grade sequence pattern recognition is a new and effective one for identifying complex biological products made from complex herbal medicines.</p>

Applications of the hospital statistics management system / 中国医疗器械杂志

The Hospital Statistics Management System is built on an Office Automation Platform of Shandong provincial hospital system. Its workflow, role and popedom technologies are used to standardize and optimize the management program of statistics in the total quality control of hospital statistics. The system's applications have combined the office automation platform with the statistics management in a hospital and this provides a practical example of a modern hospital statistics management model.

DNA polymorphism detection of Cannabis using amplified fragment length polymorphism / 法医学杂志

OBJECTIVE@#To screen the AFLP primers with good diversity to distinguish various species of Cannabis.@*METHODS@#The AFLP was used to analyze the genetic diversity of 12 species of Cannabis using 55 primer combinations.@*RESULTS@#A total of 285 AFLP bands were obtained using five primer combinations with better diversity, among which 99 bands were polymorphic and 10 bands were special, with 47-76 bands amplified in each pair of primers.@*CONCLUSION@#AFLP may has good resolution in the diversity study of Cannabis. It may provide an essential basis for further study of the genetic diversity of Cannabis.

Epidemiological surveillance of Henipavirus in Chongqing / 中华微生物学和免疫学杂志

Objective To establish nucleic acid testing techniques for detecting Nipah virus (NiV) and Hendra virus (HeV), and to test the NiV and HeV in peripheral blood collected from domestic pigs, cows and goats in Chongqing. Methods Peripheral blood samples of 580 domestic pigs, 250 cows, 180 goats were collected from Chongqing since June 2007 to June 2008. The lymphocytes were separated by density gradient centrifugation and total RNA was extracted using Trizol method for detection of NiV and HeV with one-step real-time RT-PCR. Sequence identification and analysis were performed for positive PCR prod-ucts. Virus isolation and culture were adopted for positive samples, and epidemiologic reports were submit-ted. Results Nucleic acid detections searching for NiV and HeV were successfully performed in animal blood samples collected from Chongqing. "Takeoff points" were not found in fluorescence amplification curves of all samples. Curves kept the same slope, and assays were judged as negative. Conclusion Until now, Neither NiV or HeV infection has been found in domestic animals blood samples collected from Chongqing, which suggest a lower possibility of outbreaks of Nipah disease and Hendra disease in Chongqing in the near future.

Study on corresponding areas the liver and lung channels in brain with fMRI / 中国针灸

<p><b>OBJECTIVE</b>To explore distribution of the Liver and Lung Channels in the brain so as to provide imaging basis for construction of channel theory in the brain.</p><p><b>METHODS</b>Sixty healthy student volunteers were randomly divided into a Liver Channel group (I) and a Lung Channel group (II), and the each group was further divided into five subgroups with 6 volunteers in each subgroup, based on five-shu-point principles which, were Dadun (LR 1, I 1), Xingjian (LR 2, I 2), Taichong (LR 3, I 3), Zhongfeng (LR 4, I 4), Ququan (LR 8, I 5), Shaoshang (LU 11, II 1), Yuji (LU 10, II 2), Taiyuan (LU 9, II 3), Jingqu (LU 8, II 4), and Chize (LU 5, II 5), respectively. In order to observe the brain activating patterns during acupuncture at the different acupoints, functional magnetic resonance imaging (fMRI) technique was adopted. All image data were then analyzed with SPM 2 software. The statistical parameter gram was composed of the pixel P < 0.01, and anatomic location was made according to Talairach coordinate, attaining experimentally activated areas, and the commonly activated area of five-shu-point of each channel was considered as the brain distribution of the Liver and Lung Channels.</p><p><b>RESULTS</b>The common areas activated by the five-shu-points of the Liver Channel were homolateral Brodmann area (BA) 34, BA 47, red nucleus, contralateral BA 19, BA 30, BA 39, the superior parietal lobule, cerebellum decline, and bilateral BA 3 and culmen. The common areas activated by the five-shu-points of the Lung Channels included homolateral BA 2, BA 18, BA 35, and contralateral BA 9 and substania nigra.</p><p><b>CONCLUSION</b>There are relatively specific corresponding brain areas for the Liver and Lung Channels, indicating that there is possible relatively specific connection between channels and the brain.</p>

Screening and identification of phage-displayed polypeptides specifically binding to human gastric cancer with high metastatic potential to peritoneum / 中华肿瘤杂志

<p><b>OBJECTIVE</b>By means of phage-display technique, to screen polypeptides that specifically bind to human gastric cancer with high metastatic potential to peritoneum.</p><p><b>METHODS</b>Two human gastric cancer cell lines were used: GC9811-P with high metastatic potential to peritoneum and its wild type parental GC9811, to carry out subtractive screening with a phage display-12 peptide library.</p><p><b>RESULTS</b>After three rounds of screening, 40 phage clones bond to GC9811-P cells were randomly selected. When injected into the peritoneal cavity of nude mice, 6 of the 40 clones did not bind to mouse peritoneum as examined by immunohistochemical staining. They were considered to be capable of binding specifically to GC9811-P cells. Sequence analysis revealed two different exogenous peptides: TLNINRLILPRT and SMSI(X)SPYI(XXX).</p><p><b>CONCLUSION</b>Two peptides have been obtained that specifically bind to a gastric cancer cell variant GC9811-P, which easily disseminates to the peritoneum. Whether or not they could block GC9811-P metastasis to peritoneum in vivo remains to be determined.</p>