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1.
Arch Microbiol ; 204(7): 428, 2022 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-35751720

RESUMEN

There are numerous factors restricting wide application of lactic acid bacteria (LAB) in dairy industry, causing urgent demands for novel bioprotectants. Protective effects and metabolites of Lactococcus lactis subsp. lactis (L. lactis) from ultraviolet (UV)-induced supernatant were investigated and the protective mechanism was explored. The strain viability of the group treated with the supernatant of continuous UV irradiation (V1) and the group with intermittent UV irradiation (V2) was 8.45 and 14.13 times of the control group, respectively. Further exploration on the protective of L. lactis supernatant, under different dose of UV treatment, showed it was dose-dependent. The condition for the supernatant with best protective effect was vertical distance 50.00 cm, horizontal distance 25.00 cm, intermittent UV irradiation (30 s interval 30 s) for 4.5 min (V2), which was chose for untargeted metabolite analysis. And that in V1 was for comparative study. There were 181 up-regulated metabolites in V1 and 161 up-regulated metabolites in V2, respectively. Most of the up-regulated metabolites were related to secondary metabolite synthesis, environmental microbial metabolism, antibiotic synthesis and amino acid biosynthesis. Notably, production of dithiothreitol (DTT) in V2 was 65.2-fold higher than that in the control group. Trehalose in ABC transporter pathway was also up-regulated in the metabolites induced by UV. Results indicated that L. lactis could adapt to the UV stress by adjusting metabolic pathways and producing special metabolites to protect itself. This research offers the basis for robust strain development and contributes to initial study on potential bioprotectant.


Asunto(s)
Lactococcus lactis , Adaptación Fisiológica , Lactococcus lactis/metabolismo
2.
Molecules ; 27(24)2022 Dec 16.
Artículo en Inglés | MEDLINE | ID: mdl-36558100

RESUMEN

Acetaminophen (APAP) toxicity is a common cause of hepatic failure, and the development of effective therapy is still urgently needed. Farnesoid X receptor (FXR), a member of the nuclear receptor superfamily, has been identified as a master gene for regulating enterohepatic metabolic homeostasis and has proven to be a promising drug target for various liver diseases. Through high-throughput chemical screening, the natural product 2-oxokolavenol was identified as a novel and selective FXR agonist. Further investigations revealed that 2-oxokolavenol exerts therapeutic efficacy against APAP-induced hepatocyte damage in an FXR-dependent manner. Mechanistically, 2-oxokolavenol forms two hydrogen bonds with M265 and Y369 of human FXR to compatibly fit into the ligand binding pocket of FXR, which potently leads to the recruitment of multiple co-regulators and selectively induces the transcriptional activity of FXR. Our findings thus not only reveal the direct target of natural product 2-oxokolavenol, but also provide a promising hit compound for the design of new FXR modulators with potential clinical value.


Asunto(s)
Acetaminofén , Hepatopatías , Humanos , Acetaminofén/metabolismo , Hepatopatías/metabolismo , Receptores Citoplasmáticos y Nucleares/genética , Receptores Citoplasmáticos y Nucleares/metabolismo , Hígado
3.
BMC Gastroenterol ; 21(1): 351, 2021 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-34556038

RESUMEN

BACKGROUND: Irreversible electroporation (IRE) is an emerging tissue ablation technique with widespread potential, especially for cancer treatment. Although the safety and efficacy of IRE for gastric tissue ablation have been demonstrated, there is a gap of knowledge regarding the effect of electroporation pulse (EP) on the physiology and histopathology of the stomach. This study applied EP to the stomach of healthy rats and investigated the digestive function, serum marker levels, and gastric tissue structure of EP-treated rats. METHODS: Ninety male rats were divided into nine groups and examined up to 28 days post-treatment. A single burst of electroporation pulse (500 V, 99 pluses, 1 Hz, 100 µs) was delivered to the stomachs of rats using a tweezer-style round electrode. Gastric emptying, small intestinal transit, and gastric secretion were measured to evaluate the digestive function. Serum marker levels were determined using ELISA. Haematoxylin-eosin, Masson trichrome, and immunofluorescence were performed for histopathological analysis. RESULTS: No  significant effect on gastric emptying or secretion was found post-EP, whereas the small intestinal transit decreased at 4 h and rapidly recovered to normal on 1-day post-EP. Further, serum TNF-α and IL-1ß levels temporarily changed during the acute phase but returned to baseline within 28 days. Moreover, histopathological analysis revealed that cell death occurred immediately post-EP in the ablation area, whereas the gastric wall scaffold in the ablation region remained intact post-EP. CONCLUSIONS: This study demonstrates the safety and efficacy of EP on the physiology and histopathology of the stomach and lays a foundation for more comprehensive applications of this technique.


Asunto(s)
Técnicas de Ablación , Electroporación , Animales , Frecuencia Cardíaca , Masculino , Ratas , Coloración y Etiquetado , Estómago
4.
Appl Microbiol Biotechnol ; 105(24): 9285-9295, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34778911

RESUMEN

Exposure to ionizing radiation (IR) tends to cause serious health concerns. Thus, radioprotective agents are vital for the population exposed to radiation. As microorganisms have the advantages of fast reproduction and no geographical restrictions, direct microbe-based and environmental induction compounds are thriving radioprotectants resources. Oxidative system and oxidase in Acetobacter pasteurianus are unique and intriguing, the radioprotective effect of the cell-free extract from A. pasteurianus (APE) and 60Coγ-treated extract (IRE) were comparatively investigated in the present study. The survival rate of A. pasteurianus with IRE addition was 149.1% in H2O2 damage test, while that with APE was only 10.4%. The viability of 60Coγ-treated AML-12 cells was increased by 18.8% with IRE addition, yet APE showed no significant radioprotective effect. Moreover, in 60Coγ-treated mice, IRE could significantly protect the white blood cell, improve the liver index, and attenuate the injuries of immune organs in mice. Administration of IRE significantly raised the activities of superoxide dismutase (SOD) and reduced the products of lipid peroxidation. These results clarified that gavage with APE and IRE presented notable antioxidant and radioprotective efficacy. A. pasteurianus showed appealing potential to be novel radioprotective bioagents and 60Coγ treatment on microbe could be a new method for the development of better radioprotectant. KEY POINTS: • 60Coγ induction could improve the radioprotective effect of APE. • IRE protected white blood cell in mice under IR. • IRE products have broad application prospects in radioprotection based on microbes.


Asunto(s)
Acetobacter , Protectores contra Radiación , Animales , Peróxido de Hidrógeno , Ratones , Radiación Ionizante , Protectores contra Radiación/farmacología
5.
Cytometry A ; 97(9): 900-908, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32307867

RESUMEN

We examined our hypothesis that high-intensity focused ultrasound (HIFU) treatment of pancreatic ductal adenocarcinoma (PDAC) in nude mice models may lead to an increased occurrence of hematogenous metastasis. The human PDAC cell line BxPC-3 transfected with mCherry was implanted into nude mice to establish orthotopic and subcutaneous xenograft (OX and SX) tumor models. Mice were exposed to HIFU when tumor sizes reached approximately 200-300 mm3 . The OX and SX tumor models were monitored continuously for tumor growth characteristics and hematogenous metastasis using in vivo flow cytometric (IVFC) detection of circulating tumor cells (CTCs) from the pancreas. We chose an appropriate mouse model to further examine whether or not HIFU increases the potential risk of hematogenous metastasis, using IVFC detection. Our results showed that the CTC number was greater in the OX model than in the SX model. The CTC number in the OX model increased gradually over time, whereas the CTC number in the SX model remained low. Therefore, the OX model was better for studying tumor metastasis by IVFC detection. We found significantly decreased CTC numbers and tumor volume after HIFU ablation. Our results showed the applicability of the PDAC OX tumor model for studying the occurrence of tumor metastasis due to the generation of CTCs. HIFU ablation substantially restricted PDAC hematogenous metastasis and provided effective tumor control locally. © 2020 The Authors. Cytometry Part A published by Wiley Periodicals Inc., on behalf of International Society for Advancement of Cytometry.


Asunto(s)
Tratamiento con Ondas de Choque Extracorpóreas , Células Neoplásicas Circulantes , Neoplasias Pancreáticas , Animales , Humanos , Ratones , Ratones Desnudos , Páncreas , Neoplasias Pancreáticas/terapia
6.
Environ Monit Assess ; 192(6): 387, 2020 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-32436015

RESUMEN

Global climate change and human activities aggravate the frequency of flood disasters. Flood risk includes natural flood risk and risk of economic and social disasters, which is displayed intuitively by flood risk zonation maps. In this paper, we take the disaster-causing factors, the disaster environment, the disaster-bearing body, and the disaster prevention and mitigation capability into consideration comprehensively. Eleven influencing indexes including annual maximum 3-day rainfall and rainfall in flood season are selected, and the virtual sown area of crops is innovated. Taking the Huaihe River Basin (HRB) as the research area, the flood risk prediction of the basin is explored by using the long short-term memory (LSTM). The results show that LSTM can be successfully applied to flood risk prediction. The short-term prediction results of the model are good, and the area where the risk is seriously underestimated (the high and very high risk are identified as the very low risk) accounts for only 0.98% of the total basin on average. The prediction results can be used as a reference for watershed management organizations, so as to guide future flood disaster prevention.


Asunto(s)
Desastres , Inundaciones , Medición de Riesgo , Monitoreo del Ambiente , Humanos , Ríos
7.
Adv Sci (Weinh) ; 11(8): e2305608, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38095542

RESUMEN

As a vital project of forward chemical genetic research, target deconvolution aims to identify the molecular targets of an active hit compound. Chemoproteomics, either with chemical probe-facilitated target enrichment or probe-free, provides a straightforward and effective approach to profile the target landscape and unravel the mechanisms of action. Canonical methods rely on chemical probes to enable target engagement, enrichment, and identification, whereas click chemistry and photoaffinity labeling techniques improve the efficiency, sensitivity, and spatial accuracy of target recognition. In comparison, recently developed probe-free methods detect protein-ligand interactions without the need to modify the ligand molecule. This review provides a comprehensive overview of different approaches and recent advancements for target identification and highlights the significance of chemoproteomics in investigating biological processes and advancing drug discovery processes.


Asunto(s)
Descubrimiento de Drogas , Etiquetas de Fotoafinidad , Ligandos , Descubrimiento de Drogas/métodos , Etiquetas de Fotoafinidad/química , Química Clic
8.
Med Ultrason ; 26(2): 197-204, 2024 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-38805623

RESUMEN

AIMS: Accurate prediction of preeclampsia could improve maternal outcomes. However, the role of uterine artery Doppler ultrasound in predicting preeclampsia remains unclear. MATERIALS AND METHODS: We comprehensively searched several electronic databases, including PubMed, EMBASE, the Cochrane Library, and Web of Science, covering studies published from the time of database creation to September 23, 2023. Studies on the predictive value of uterine artery Doppler ultrasound for preeclampsia were included. The primary pregnancy outcome was preeclampsia. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 scoring scale. RESULTS: The use of resistance index (RI) for predicting preeclampsia demonstrated the highest sensitivity of 0.73 (95% confidence interval [CI], 0.30-0.94) and specificity of 0.90 (95% CI, 0.72-0.97), with a pooled area under the curve value of 0.91 (95% CI, 0.88-0.93). The use of pulsatility index (PI) for predicting preeclampsia showed a sensitivity of 0.65 (95% CI, 0.45-0.81) and specificity of 0.88 (95% CI, 0.77-0.94). Furthermore, preeclampsia prediction via notching showed a sensitivity of 0.54 (95% CI, 0.38-0.68) and specificity of 0.89 (95% CI, 0.79-0.95). CONCLUSIONS: These findings highlight the varying predictive performance of different preeclampsia indices. PI and RI demonstrated moderate-to-high sensitivity and specificity, whereas notching exhibited relatively lower sensitivity but comparable specificity. Further research and validation are warranted to consolidate these results and enhance the accuracy of preeclampsia prediction.


Asunto(s)
Preeclampsia , Ultrasonografía Doppler , Arteria Uterina , Femenino , Humanos , Embarazo , Preeclampsia/diagnóstico por imagen , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Ultrasonografía Doppler/métodos , Ultrasonografía Prenatal/métodos , Arteria Uterina/diagnóstico por imagen
9.
J Mater Chem B ; 12(24): 5884-5897, 2024 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-38775254

RESUMEN

Pancreatic cancer is an aggressive and highly fatal malignant tumor. Recent studies have shown that cancer stem cells (CSCs) play an important role in resisting current therapeutic modalities. Furthermore, CD133 is highly expressed in CSCs. High-intensity focused ultrasound (HIFU) is a promising non-invasive therapeutic strategy for unresectable pancreatic cancers. In our study, we synthesized targeted CD133 organosilane nanomicelles by encapsulating perfluorohexane (PFH). The CD133 antibody on the surface could specifically bind to CD133-positive pancreatic cancer cells and selectively concentrate in pancreatic cancer tumor tissues. PFH was introduced to improve the ablation effect of HIFU due to its liquid-gas phase transition properties. By combining with the dorsal skinfold window chamber model (DSWC) of pancreatic cancer in nude mice, multiphoton fluorescence microscopy was used to evaluate the targeting effect of nanomicelles on pancreatic cancer tumor tissue. These multifunctional nanomicelles synergistically affected HIFU treatment of pancreatic cancer, providing an integrated research platform for diagnosing and treating pancreatic cancer with HIFU.


Asunto(s)
Antígeno AC133 , Ultrasonido Enfocado de Alta Intensidad de Ablación , Ratones Desnudos , Micelas , Neoplasias Pancreáticas , Animales , Neoplasias Pancreáticas/diagnóstico por imagen , Neoplasias Pancreáticas/patología , Neoplasias Pancreáticas/terapia , Antígeno AC133/metabolismo , Ratones , Humanos , Línea Celular Tumoral , Fluorocarburos/química , Fluorocarburos/farmacología , Ratones Endogámicos BALB C , Nanopartículas/química
10.
Int J Nanomedicine ; 18: 2539-2552, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37207110

RESUMEN

Background: Pancreatic cancer is regarded as one of the most lethal types of tumor in the world, and optional way to treat the tumor are urgently needed. Cancer stem cells (CSCs) play a key role in the occurrence and development of pancreatic tumors. CD133 is a specific antigen for targeting the pancreatic CSCs subpopulation. Previous studies have shown that CSC-targeted therapy is effective in inhibiting tumorigenesis and transmission. However, CD133 targeted therapy combined with HIFU for pancreatic cancer is absent. Purpose: To improve therapeutic efficiency and minimize side effects, we carry a potent combination of CSCs antibody with synergist by an effective and visualized delivery nanocarrier to pancreatic cancer. Materials and Methods: Multifunctional CD133-targeted nanovesicles (CD133-grafted Cy5.5/PFOB@P-HVs) with encapsulated perfluorooctyl bromide (PFOB) in a 3-mercaptopropyltrimethoxysilane (MPTMS) shell modified with poly ethylene glycol (PEG) and superficially modified with CD133 and Cy 5.5 were constructed following the prescribed order. The nanovesicles were characterized for the biological and chemical characteristics feature. We explored the specific targeting capacity in vitro and the therapeutic effect in vivo. Results: The in vitro targeting experiment and in vivo FL and ultrasonic experiments showed the aggregation of CD133-grafted Cy5.5/PFOB@P-HVs around CSCs. In vivo FL imaging experiments demonstrated that the nanovesicles assemble for the highest concentration in the tumor at 24 h after administration. Under HIFU irradiation, the synergistic efficacy of the combination of the CD133-targeting carrier and HIFU for tumor treatment was obvious. Conclusion: CD133-grafted Cy5.5/PFOB@P-HVs combined with HIFU irradiation could enhance the tumor treatment effect not only by improving the delivery of nanovesicles but also by enhancing the HIFU thermal and mechanical effects in the tumor microenvironment, which is a highly effective targeted therapy for treating pancreatic cancer.


Asunto(s)
Neoplasias Pancreáticas , Ultrasonido , Humanos , Neoplasias Pancreáticas/terapia , Colorantes , Ultrasonografía , Línea Celular Tumoral , Antígeno AC133 , Células Madre Neoplásicas , Microambiente Tumoral , Neoplasias Pancreáticas
11.
JACS Au ; 2(12): 2830-2838, 2022 Dec 26.
Artículo en Inglés | MEDLINE | ID: mdl-36590256

RESUMEN

Farnesoid X receptor (FXR), a member of the nuclear receptor superfamily, plays an important role in maintaining or reversing metabolic homeostasis during the development of liver diseases. However, developing FXR modulators to intervene in FXR-related diseases is still an unmet clinical need. Therefore, it is significant to develop novel small-molecule agonists for drug discovery targeting FXR. Through a high-throughput chemical screen and follow-up biological validations, we first identified the natural product Fargesone A (FA) as a potent and selective FXR agonist. The limited, variable supply of FA from natural product isolation, however, has impeded its biological exploration and potential drug development. Accordingly, we have developed a biomimetic and scalable total synthesis of FA in nine steps that provides a solution to the supply of FA. Enabled by chemical synthesis, the in vivo efficacy of FA has been further investigated. The results showed that FA alleviates hepatocyte lipid accumulation and cell death in an FXR-dependent manner. Moreover, treatment of bile duct ligation (BDL)-induced liver disorder with FA ameliorates pathological features in mice. Therefore, our work lays the foundation to develop new small-molecule FXR agonists as a potential therapy for liver diseases.

12.
Dis Model Mech ; 15(7)2022 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-35645166

RESUMEN

Diagnostic tools for the early detection of renal injury caused by hyperuricemia are still lacking. Here, we investigated whether contrast-enhanced ultrasound (CEUS) could be used as a diagnostic tool for hyperuricemic nephropathy (HN). In the HN rat model, CEUS detected a significant decline in renal cortical perfusion compared with that in control rats. Peak intensity (PI) values correlated significantly with serum KIM-1 levels and fibrosis scores in HN rats. An early decline in PI values was also observed in chronic kidney disease (CKD) stage 1 patients with HN compared with the controls (61.1±4.52 dB versus 65.80±7.10 dB) and correlated with renal function in the patients with HN. In contrast, an increase in time to reach PI values was detected in HN patients with stage 1 CKD (15.14±1.75 s versus 14.52±4.75 s) and was more pronounced in CKD stage 4 patients (67.32±3.29 s). CEUS was able to detect abnormal renal perfusion in early CKD with HN, which correlated with renal function decline, suggesting that CEUS could be used as a noninvasive tool for assessing renal function in patients with HN.


Asunto(s)
Hiperuricemia , Insuficiencia Renal Crónica , Animales , Medios de Contraste , Hiperuricemia/complicaciones , Hiperuricemia/diagnóstico por imagen , Riñón/diagnóstico por imagen , Riñón/fisiología , Ratas , Insuficiencia Renal Crónica/diagnóstico por imagen , Ultrasonografía/métodos , Ácido Úrico
13.
Front Genet ; 12: 650863, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34262592

RESUMEN

BACKGROUND: The number of diet induced obese population is increasing every year, and the incidence of type 2 diabetes is also on the rise. Histone methylation and acetylation have been shown to be associated with lipogenesis and obesity by manipulating gene expression via the formation of repression or activation domains on chromosomes. OBJECTIVE: In this study, we aimed to explore gene activation or repression and related biological processes by histone modification across the whole genome on a high-fat diet (HFD) condition. We also aimed to elucidate the correlation of these genes that modulated by histone modification with energy metabolism and inflammation under both short-term and long-term HFD conditions. METHOD: We performed ChIP-seq analysis of H3K9me2 and H3K9me3 in brown and white adipose tissues (WATs; subcutaneous adipose tissue) from mice fed with a standard chow diet (SCD) or HFD and a composite analysis of the histone modification of H3K9me2, H3K9me3, H3K4me1 and H3K27ac throughout the whole genome. We also employed and integrated two bulk RNA-seq and a single-nuclei RNA sequencing dataset and performed western blotting (WB) to confirm the gene expression levels in adipose tissue of the SCD and HFD groups. RESULTS: The ChIP-seq and transcriptome analysis of mouse adipose tissues demonstrated that a series of genes were activated by the histone modification of H3K9me2, H3K9me3, H3K4me1, and H3K27ac in response to HFD condition. These genes were enriched in Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways involved in lipogenesis, energy metabolism and inflammation. Several genes in the activated mitogen-activated protein kinase (MAPK) pathway might be related to both inflammation and energy metabolism in mice, rats and humans fed with HFD for a short or long term, as showed by bulk RNA-seq and single nuclei RNA-seq datasets. Western blot analyses further confirmed the increased expression of MET, VEGFA and the enhanced phosphorylation ratio of p44/42 MAPK upon HFD treatment. CONCLUSION: This study expanded our understanding of the influence of eating behavior on obesity and could assist the identification of putative therapeutic targets for the prevention and treatment of metabolic disorders in the future.

14.
Sci Rep ; 10(1): 17848, 2020 10 20.
Artículo en Inglés | MEDLINE | ID: mdl-33082509

RESUMEN

To evaluate the imaging features of subungual glomus tumors using 18 MHz high-frequency ultrasound with CDFI (Color Doppler Flow Imaging). 20 patients treated by surgical resection and examined by ultrasound between January 2008 and December 2019. All eligible cases are divided into two groups: Group A used the probe frequency of 9-14 MHz from January 2008 to December 2014, and Group B used the probe frequency of 18 MHz from January 2015 to December 2019. Patient demographics, clinical records, pathologic specimens and sonography features were reviewed. 50% of tumors in Group A and 100% of tumors in Group B showed clear boundary and regular shape. Blood flow signals were identified inside 50% tumors in Group A (3 in 6), all 14 cases with blood flow signals detected in Group B (14 in 14,100%). 2 cases were misdiagnosed and 1 case escaped diagnosis in Group A, no case was misdiagnosed in Group B. The accuracy of diagnosis rate of Group B is significantly higher than that of Group A. 18-MHz ultrasound combined with CDFI may be a practical useful tool for detecting subungual glomus tumors. More importantly 18-MHz ultrasound can obviously improve the diagnostic accuracy.


Asunto(s)
Tumor Glómico/diagnóstico por imagen , Enfermedades de la Uña/diagnóstico por imagen , Ultrasonografía Doppler en Color/métodos , Adulto , Femenino , Tumor Glómico/patología , Humanos , Masculino , Persona de Mediana Edad , Enfermedades de la Uña/patología , Estudios Retrospectivos , Sensibilidad y Especificidad , Adulto Joven
15.
Oncotarget ; 8(46): 80453-80460, 2017 Oct 06.
Artículo en Inglés | MEDLINE | ID: mdl-29113316

RESUMEN

We investigated the efficacy and optimal period for using magnetic resonance imaging (MRI) to detect effects of sub-threshold focused ultrasound (FUS) irradiation. Nude mice bearing pancreatic cancer xenografts were subjected to MRI and pathology examnation before, and 24 h, 48 h, 2 weeks after irradiation, which were used to evaluate therapeutic effects of FUS. Tumor volumes were lower post-treatment than control group (P < 0.05). The T1WI turbo spin echo (T1WI-TSE) sequence was similar signal before and after treatment. On T1 enhanced scanning sequence (T1WI-SPIR) imaging, ablation lesions appeared as patchy areas of low signal after 24 h and 48 h. After 2 weeks, the ablation lesions contained low signal areas with clear borders. Hematoxylin and eosin (HE) staining revealed small vessels at ablation lesions with no obvious boundary between cell injury areas and normal tumor cells areas in early-stage, while revealed obvious boundaries 2 weeks post-treatment. Terminal deoxynucleotidyl transferase-modified, dUTP nick-end labeling (TUNEL) staining showed cell apoptosis in early-stage, and revealed reduced apoptotic cells and increased necrotic cell areas 2 weeks later. These findings indicate sub-threshold FUS induces pancreatic cancer cell apoptosis and inhibits tumor growth. Contrast-enhanced MRI delineated the ablation lesions better 2 weeks post-treatment than early stage.

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