Successful treatment of advanced muscle-invasive bladder cancer with the combined therapy of toripalimab and chemotherapy: a case report.

Bladder cancer is the most common malignancy in the urinary system, and muscle-invasive bladder cancer (MIBC) accounts for 25-30% among all types of bladder cancers. Although MIBC can be treated by surgery and chemotherapy, favorable outcomes can still not be obtained. In recent years, the emergence of immunotherapy represented by programmed death-1 (PD-1)/programmed death ligand-1 (PD-L1) inhibitors and other immune checkpoint inhibitors provides attractive prospects for the treatment of advanced bladder cancer. PD-1/PD-L1 inhibitors can block the binding of PD-1/PD-L1, which can block negative immunomodulatory signals, thereby improving anti-tumor immune activity. In this article, we reported a case of advanced MIBC who achieved complete pathological remission after receiving the combined therapy of toripalimab and chemotherapy, which could provide clinical data for the treatment of bladder cancer with triprizumab.

Control the Neural Stem Cell Fate with Biohybrid Piezoelectrical Magnetite Micromotors.

Inducing neural stem cells to differentiate and replace degenerated functional neurons represents the most promising approach for neural degenerative diseases including Parkinson's disease, Alzheimer's disease, etc. While diverse strategies have been proposed in recent years, most of these are hindered due to uncontrollable cell fate and device invasiveness. Here, we report a minimally invasive micromotor platform with biodegradable helical Spirulina plantensis (S. platensis) as the framework and superparamagnetic Fe3O4 nanoparticles/piezoelectric BaTiO3 nanoparticles as the built-in function units. With a low-strength rotational magnetic field, this integrated micromotor system can perform precise navigation in biofluid and achieve single-neural stem cell targeting. Remarkably, by tuning ultrasound intensity, thus the local electrical output by the motor, directed differentiation of the neural stem cell into astrocytes, functional neurons (dopamine neurons, cholinergic neurons), and oligodendrocytes, can be achieved. This micromotor platform can serve as a highly controllable wireless tool for bioelectronics and neuronal regenerative therapy.

Pharmacogenomic study on anti-VEGF medicine in treatment of macular Neovascular diseases: a study protocol for a prospective observational study.

BACKGROUND: Macular neovascular diseases can cause severe vision loss. A newly approved anti-VEGF drug Conbercept has shown good efficacy and safety in rigorous random controlled trials (RCT), however, it cannot fully reflect the clinical application of Conbercept in real world clinical practice. Moreover, anti-VEGF drugs are expensive and often require multiple treatments, and some patients have poor or even no response to the drugs,this resulted enormous waste of medical resources. Therefore, how to find out those patients who have good response, and how to develop individualized therapeutic regimen in real world need to be urgently investigated in the aspect of pharmacogenomics and pharmacometabolomics. METHODS: This study is a multicenter, prospective, observational study of Conbecept treating macular neovascular diseases in China. Patients suffered from age-related macular degeneration, polypoidal choroidal vasculopathy, and pathological myopia who already planned to receive Conbercept treatment will be recruited. We aimed to enroll more than 5000 patients from 43 ophthalmic centers in China. Patients' clinical data and blood samples will be collected during the one-year follow-up period. Finally, the safety and efficacy of Conbercept, and the potential predictors of patients' response to Conbercept will be investigated by pharmacogenomics and pharmacometabolomics analysis. DISCUSSION: This study will provide important data of Conbercept in treating macular neovascular diseases in real world. Besides, finding the predictor of patients' response will help doctor make more precise individualized therapeutic regimens. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03128463 . Registered on 9 March 2017.

Effect of Combined General/Epidural Anesthesia on Postoperative NK Cell Activity and Cytokine Response in Gastric Cancer Patients Undergoing Radical Resection.

BACKGROUND/AIMS: Emerging evidence has shown that epidural anesthesia could reduce the excessive stress response after surgery, and may help to preserve the body's defenses against tumor progression in comparison with general anesthesia in malignant patients receiving operation. This study aims to evaluate the effect of epidural anesthesia on postoperative immune suppression in gastric cancer patients undergoing radical resection. METHODOLOGY: Seventy one gastric cancer patients receiving radical resection were randomized to combined general/epidural anesthesia (study group) or general anesthesia alone (control group). Natural killer cell activity and serum concentrations of protumorigenic cytokines IL-1ß and IL-6, and antitumorigenic cytokines IL-2 and IL-10 were measured before anesthesia (T1), 4h after skin incision (T2), and 24h after skin incision (T3) in both groups. RESULTS: In both groups, the concentrations of IL-10, IL-6, and IL-10 increased at T2 and T3 when compared with T1, whereas IL-2 concentration and NK cell activity decreased at T2 and T3. Furthermore, the study group exhibited less suppression of NK cell activity, higher levels of IL-2 and IL-10, and lower levels of IL-1ß and IL-6 in the early stage after operation, compared with the control group. CONCLUSIOns: Combined general/epidural anesthesia seems to helpful to maintain the body's perioperative immune function compared to general anesthesia alone in patients with gastric cancer operation.

A novel detection method for wheat aging based on the delayed luminescence.

Wheat aging plays an important role in assessing storage wheat quality and its subsequent processing purposes. The conventional detection methods for wheat aging are mainly involved in chemical techniques, which are time-consuming as well as waste part of wheat samples for each detection. Although some physical detection methods have obtained gratifying results, it is extremely hard to expand their application fields but to stay in the theory stage. For this reason, a novel nondestructive detection model for wheat aging based on the delayed luminescence (DL) has been proposed in this paper. Specifically, after collecting enough sample data, we first took advantage of certain hyperbolic function to fit DL signal, and then used four parameters of the hyperbolic function to feature the decay trend of the DL signal. Secondly, in order to better feature the DL signal, we extracted other six features together with above four features to form the input feature vector. Finally, as the bidirectional long short-term memory (Bi-LSTM) network lacked error-correcting performance, the Bi-LSTM network based on Walsh coding (Walsh-Bi-LSTM) mechanism was proposed to establish the detection model, which made the detection model have the error-correcting performance by reasonably splitting the multi-classification target task. Shown by experimental results, the newly proposed wheat aging detection model is able to achieve 94.00% accuracy in the testing dataset, which can be used as a green and nondestructive method to timely reflect wheat aging states.

Management of penile defects: a review.

Penile amputation is a rare injury. Although, in principle, penile replantation can be performed using a variety of methods, few, if any, standardized procedures exist to deal with this medical emergency. The value of the various microsurgical techniques for replantation of the penis remains uncertain. This article provides a review of the management of penile defects and complications.

Study of silver aerosol source term at different specific internal energy input from HE detonation devices.

Radioactive aerosols harmful to humans are often produced in nuclear accidents, and their source term characteristics (total volume and particle size distribution) and dispersion patterns have important implications for accident response and hazard assessment. However, experimental studies of radioactive aerosols cannot be directly conducted in open space due to the hazardous nature of radioactive aerosols. In this study, silver was used instead of plutonium to study the aerosol source term under different specific internal energy inputs (SIEI) to simulate a low order explosion in an accident. Results show that aerosol release fraction (ARF) and respirable release fraction (RRF) of silver increase linearly with SIEI first, then varies in a range of 8% ~ 19%, with a turning point at SIEI of 1.4 MJ/kg. Analysis suggests an increase of difference between ARF and RRF with respect to SIEI. The size distribution of silver aerosol around 10 µm is influenced by SIEI significantly, which could be possibly attributed to the interactions between silver aerosol and ambient aerosol (solid HE products or rust). Comparison between the source term of silver and plutonium suggests that silver is a good surrogate of plutonium in studying aerosol for SIEI of MJ/kg level.

The Significant Role of the Microfilament System in Tumors.

Actin is the structural protein of microfilaments, and it usually exists in two forms: monomer and polymer. Among them, monomer actin is a spherical molecule composed of a polypeptide chain, also known as spherical actin. The function of actin polymers is to produce actin filaments, so it is also called fibroactin. The actin cytoskeleton is considered to be an important subcellular filament system. It interacts with numerous relevant proteins and regulatory cells, regulating basic functions, from cell division and muscle contraction to cell movement and ensuring tissue integrity. The dynamic reorganization of the actin cytoskeleton has immense influence on the progression and metastasis of cancer as well. This paper explores the significance of the microfilament network, the dynamic changes of its structure and function in the presence of a tumor, the formation process around the actin system, and the relevant proteins that may be target molecules for anticancer drugs so as to provide support and reference for interlinked cancer treatment research in the future.

Effects of CT images at different reconstruction energies on radiotherapy planning of patients diagnosed with nonsmall cell lung cancer.

OBJECTIVE AND AIMS: We conducted this study to explore the influence of spectral computer tomography (CT) images at different reconstruction energies on the radiotherapy plan of patients with nonsmall-cell lung cancer (NSCLC). SUBJECT AND METHODS: Here, 38 NSCLC patients were selected to undergo energy spectral scanning. All energy spectral images obtained were then transferred to the Discover™ CT postprocessing workstation to generate 40k eV, 60 keV, 80keV, 100keV, 120keV, and different 140keV single-energy images. Subsequently, the images were imported to the Eclipse planning system, after which an oncologist contoured the target area and organs at risk (OARs) on these single-energy images described above. Furthermore, a physicist then designed radiotherapy plans to conduct statistical analysis on the tissue CT value and target volume of each single-energy image, to compare the dosimetry of different plans about the OARs and the target area. RESULTS: The CT values of gross tumor volumes (GTV), heart, lung, and spinal cord samples subjected to different energy CT images were statistically different (P < 0.05). Among them, the CT value of each tissue obtained in the 40 keV group was the largest and decreased with the increase in energy. As shown, no statistically significant differences were observed in the homogeneity index and conformity index, including the maximum, minimum, and average doses of GTV delineated on the CT images of different energies (P > 0.05), as well as the OARs. CONCLUSIONS: When CT images of different energies obtained from the energy spectral CT scans were used in the design of radiotherapy planning, no significant differences were observed in the target area outlines and in the doses caused by energy factors. However, the differences in tissue CT values had statistical significance.

Drug-coated balloon treatment for nonsmall de-novo coronary artery disease: angiographic and clinical outcomes.

OBJECTIVES: Although drug-coated balloons (DCBs) are established for de-novo lesions in small coronary arteries, the impact of DCB treatment according to the reference vessel diameter (RVD) remains poorly defined. This study aimed to evaluate the angiographic and long-term clinical outcomes of DCB treatment for de-novo coronary lesions according to RVD. METHODS AND RESULTS: A total of 227 patients were retrospectively enrolled and stratified according to an RVD >2.5 mm [nonsmall vessel disease (NSVD) group, n = 100] and ≤2.5 mm [small vessel disease (SVD) group, n = 127]. The primary endpoint was late lumen loss (LLL) at a 6-month follow-up, and the secondary endpoint was target vessel failure (TVF, a composite of cardiac death, target vessel myocardial infarction, target vessel revascularization and target vessel thrombosis). The LLL among the 206 patients (90.8%) returning for scheduled angiography at 6 month was similar (NSVD, 0.03 ± 0.22 mm vs. SVD, 0.06 ± 0.25 mm; P = 0.384). TVF was also comparable in both groups at a median follow-up of 3.4 years (NSVD, 7.0 vs. SVD, 7.9 %; P = 0.596). At baseline, there were numerically more dissections in the SVD group compared to the NSVD group (47.2 vs. 35.0 %; P = 0.064); however, most of these had disappeared in both groups at a 6-month follow-up. In a multivariable analysis, the presence of dissection was not associated with LLL or TVF in either group. CONCLUSIONS: The safety and efficacy of DCB treatment for de-novo coronary lesions, in terms of LLL and TVF, was unrelated to RVD.

Sex-Related Outcomes of Successful Drug-Coated Balloon Treatment in De Novo Coronary Artery Disease.

PURPOSE: Although drug-coated balloon (DCB) treatment is known to be effective for de novo lesions, the influence of sex on angiographic and clinical outcomes remains unknown. This study aimed to investigate the angiographic and clinical impact of DCB treatment in patients with de novo coronary lesions according to sex. MATERIALS AND METHODS: A total of 227 patients successfully treated with DCB were retrospectively enrolled and divided into two groups according to sex. The primary endpoint was late lumen loss (LLL) at 6-month angiography, and the secondary endpoint was target vessel failure (TVF), which included cardiac death, target vessel myocardial infarction, target lesion revascularization, and target vessel thrombosis. RESULTS: The study enrolled 60 women (26.4%) and 167 men (73.6%). Compared to men, women had a smaller vessel size, larger DCB to reference vessel ratio, and more dissections after DCB treatment (55.0% vs. 37.1%, p=0.016). Women also had a significantly higher LLL compared to men (0.12±0.26 mm vs. 0.02±0.22 mm, p=0.012) at the 6-month follow-up angiography. During a median follow-up of 3.4 years (range 12.7-28.9 months), TVF was similar (women 6.7% vs. men 7.8%, p=0.944). In multivariable analysis, women were independently associated with a higher LLL. CONCLUSION: LLL was higher in women, but there was no difference in TVF between women and men. Based on multivariable analysis, the women sex was an independent predictor of higher LLL (Impact of Drug-coated Balloon Treatment in de Novo Coronary Lesion; NCT04619277).

Spatial variability of sedimentary carbon in South Yellow Sea, China: impact of anthropogenic emission and long-range transportation.

During the last few decades, sedimentary carbons gain great concerns of research interest among the scientific committee worldwide due to their adverse impact on aquatic chemistry, ecology, and hence human health along with global climate change. In the present study, we investigated the spatial distribution of mass concentration of sedimentary carbon (viz. black carbon: BC, and its components, char and soot) along with their burial fluxes in the surface sediments of the South Yellow Sea (SYS). The concentration of sedimentary carbon is measured by using an emerging method of thermal/optical reflectance. The observed BC concentration is found in the range of 0.02-1.02 mg g-1 with a mean value of 0.49 ± 0.26 mg g-1. The mean burial fluxes of BC, char, and soot also have a similar spatial variation to their concentration with the mean value along with relative standard deviation (in bracket) 22.43 ± 12.49 (~ 56%), 5.90 ± 3.99 (~ 68%), and 16.53 ± 10.67 (65%), respectively. Relatively lower value of char/soot ratio, i.e., 0.48 ± 0.22, indicates the dominance of soot in surface sediments that could be mainly derived from the fossil fuel combustion which is further confirmed from emission inventory data suggesting maximum contribution, i.e., ~ 66-80%, of the total BC emission emitted from residential and industrial emission sources. The back trajectories analysis revealed a significant impact of long-range transportation on BC concentration in the surface sediments of SYS. Further study of BC concentrations in sea sediments and their interaction with other organic/inorganic compounds in continental shelves is highly needed for a better understanding of the global carbon cycle.

Impact of Dissection after Drug-Coated Balloon Treatment of De Novo Coronary Lesions: Angiographic and Clinical Outcomes.

PURPOSE: Dissection after plain balloon angioplasty is required to achieve adequate luminal area; however, it is associated with a high risk of vascular events. This study aimed to examine the relationship between non-flow limiting coronary dissections and subsequent lumen loss and long-term clinical outcomes following successful drug-coated balloon (DCB) treatment of de novo coronary lesions. MATERIALS AND METHODS: A total of 227 patients with good distal flow (Thrombolysis in Myocardial Infarction flow grade 3) following DCB treatment were retrospectively enrolled and stratified according to the presence or absence of a non-flow limiting dissection. The primary endpoint was late lumen loss (LLL) at 6-month angiography, and the secondary endpoint was target vessel failure (TVF, a composite of cardiac death, target vessel myocardial infarction, target vessel revascularization, and target vessel thrombosis). RESULTS: The cohort consisted of 95 patients with and 132 patients without a dissection. There were no between-group differences in LLL (90.8%) returning for angiography at 6 months (0.05±0.19 mm in non-dissection and 0.05±0.30 mm in dissection group, p=0.886) or in TVF (6.8% in non-dissection and 8.4% in dissection group, p=0.799) at a median follow-up of 3.4 years. In a multivariate analysis, the presence of dissection and its severity were not associated with LLL or TVF. Almost dissections (93.9%) were completely healed, and there was no newly developed dissection at 6-month angiography. CONCLUSION: The presence of a dissection following successful DCB treatment of a de novo coronary lesion may not be associated with an increased risk of LLL or TVF (Impact of Drug-coated Balloon Treatment in de Novo Coronary Lesion; NCT04619277).

[Epidemiological analysis of new cases of cysticercosis in Dali Prefecture, Yunnan Province from 2014 to 2017].

OBJECTIVE: To understand the basic information and epidemic characteristics of new cases of cysticercosis in Dali Prefecture, Yunnan Province, so as to provide the evidence for formulating the prevention and control strategy of cysticercosis. METHODS: The data of inpatients in the Dali Parasitic Disease Prevention and Control Center from 2014 to 2017 were collected and the eligible data of new cases of cysticercosis were analyzed by the epidemiological method. RESULTS: There were 1 552 patients with cysticercosis, including 549 new cases of cysticercosis. Among the new cysticercosis patients, most were neurocysticer-cosis cases (484 / 549, 88.16%). The symptoms included epilepsy and headache (51.73%), headache (40.98%), and dizziness (18.76%). The new cysticercosis patients were mainly middle-aged male farmers of Bai nationality, and they were distributed in all counties (cities) of Dali Prefecture, especially in Eryuan County (26.78%), and Dali City (19.49%). The annual incidence rate was 4.423/105 in 2014, 3.837/105 in 2015, 3.765/105 in 2016, and 3.442/105 in 2017, and there was no significance among the different years'incidence ( χ2 = 4.595, P > 0.05). CONCLUSIONS: Dali Prefecture is still an endemic area of cysticercosis. Therefore, the monitoring, prevention and control of the disease should be strengthened.

Author Correction: The Incipient Motion Features of Sediment from Yangtze Estuary: Annular Flume Experiments.

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has not been fixed in the paper.

The Incipient Motion Features of Sediment from Yangtze Estuary: Annular Flume Experiments.

In this study, annular flume experiments are carried out, using the sediment samples collected from Yangtze estuary. The incipient velocity and the incipient shear stress of three different groups of median grain size of sediment are given. The turbulent kinetic energy method (TKE) is used to determine the bed shear stress (τ), by evaluating variations in the suspended sediment concentration (SSC) within the water column. The suspended sediment concentration increases with the increase of the bed shear stress. When the sediment concentration reaches a certain concentration, the rate of change in τ obviously slows down. As the concentration increasing again, the bed shear stress grows rapidly with different growth rate attributed to different grain size. The results of the experiments indicate that SSC and grain size have strong influence on τ.

Identification of a chitinase-producing bacterium C4 and histopathologic study on locusts.

In order to develop the potential of chitinase-producing micro-organisms as biocontrol agents for insect pests, five chitinase-producing bacterial strains (C1, C2, C3, C4 and C5) previously isolated from soil samples were chosen to infect grassland locusts. The data showed that the mortality rate of locusts fed with strain C4 was significantly higher than that of other groups, and its pathogenicity was confirmed by Koch's law. Midgut tissues of locusts infected with C4 were examined with a light microscope. Apparent histopathologic changes in midgut cells partly explained the pathogenesis of locusts. Therefore, strain C4 was considered to be a potential biocontrol agent. To determine the taxonomic position of C4, physiological and biochemical characteristics were determined and molecular identification was performed. The 16S rDNA gene of C4 was amplified, cloned and sequenced. Comparative sequence analysis demonstrated that C4 corresponded to the genera Sanguibacter, Oerskovia and Cellulomonas. On the basis of phenotypic characterization and sequence similarity analysis, strain C4 was more closely related to the genus Sanguibacter. This chitinase-producing strain C4, which closely corresponds to the species of the genus Sanguibacter and is pathogenic to locusts, is here reported for the first time.

Evaluating quality and its determinants in lipid control for secondary prevention of heart disease and stroke in primary care: a study in an inner London Borough.

OBJECTIVES: To assess quality of management and determinants in lipid control for secondary prevention of cardiovascular disease (CVD) using multilevel regression models. DESIGN: Cross-sectional study. SETTING: Inner London borough, with a primary care registered population of 378,000 (2013). PARTICIPANTS: 48/49 participating general practices with 7869 patients on heart disease/stroke registers were included. OUTCOME MEASURES: (1) Recording of current total cholesterol levels and lipid control according to national evidence-based standards. (2) Assessment of quality by age, sex, ethnicity, deprivation, presence of other risks or comorbidity in meeting both lipid measurement and control standards. RESULTS: Some process standards were not met. Patients with a current cholesterol measurement >5 mmol/L were less likely to have a current statin prescription (adjusted OR=3.10; 95% CI 2.70 to 3.56). They were more likely to have clustering of other CVD risk factors. Women were significantly more likely to have raised cholesterol after adjustment for other factors (adjusted OR=1.74; 95% CI 1.53 to 1.98). CONCLUSIONS: In this study, the key factor that explained poor lipid control in people with CVD was having no current prescription record of a statin. Women were more likely to have poorly controlled cholesterol (independent of comorbid risk factors and after adjusting for age, ethnicity, deprivation index and practice-level variation). Women with CVD should be offered statin prescription and may require higher statin dosage for improved control.

Papulonecrotic Tuberculid with Positive Acid-fast Bacilli.

Two patients suffered from 'boils' on their arms and/or thighs for several months. A diagnosis of papulonecrotic tuberculid (PNT) was made based on clinical, laboratory parameters, histopathology, and a prompt response to multi-drug anti-tuberculosis treatment. We checked the pathological sections carefully and finally found a small amount of positive acid-fast bacilli. We analyzed the clinical and histopathological features of PNT in order to offer reference of preventing and controlling the disease.