A pilot study of neoadjuvant combination of anti-PD-1 camrelizumab and VEGFR2 inhibitor apatinib for locally advanced resectable oral squamous cell carcinoma.

Novel neoadjuvant therapy regimens are warranted for oral squamous cell carcinoma (OSCC). In this phase I trial (NCT04393506), 20 patients with locally advanced resectable OSCC receive three cycles of camrelizumab (200 mg, q2w) and apatinib (250 mg, once daily) before surgery. The primary endpoints are safety and major pathological response (MPR, defined as ≤10% residual viable tumour cells). Secondary endpoints include 2-year survival rate and local recurrence rate (not reported due to inadequate follow-up). Exploratory endpoints are the relationships between PD-L1 combined positive score (CPS, defined as the number of PD-L1-stained cells divided by the total number of viable tumour cells, multiplied by 100) and other immunological and genomic biomarkers and response. Neoadjuvant treatment is well-tolerated, and the MPR rate is 40% (8/20), meeting the primary endpoint. All five patients with CPS ˃10 achieve MPR. Post-hoc analysis show 18-month locoregional recurrence and survival rates of 10.5% (95% CI: 0%-24.3%) and 95% (95% CI: 85.4%-100.0%), respectively. Patients achieving MPR show more CD4+ T-cell infiltration than those without MPR (P = 0.02), and decreased CD31 and ɑ-SMA expression levels are observed after neoadjuvant therapy. In conclusion, neoadjuvant camrelizumab and apatinib is safe and yields a promising MPR rate for OSCC.

Thyroid follicular renal cell carcinoma excluding thyroid metastases: A case report.

BACKGROUND: Thyroid follicular renal cell carcinoma is a special type of renal cell carcinoma newly recognized in recent years. It has attracted attention because of its unique histology, immunophenotype, and clinical characteristics. It has a very low incidence, and the number of case reports available for review is limited. Moreover, a thyroid mass with type of tumour is rare. CASE SUMMARY: We report a case of a renal mass with a bilateral thyroid mass that was accidentally discovered in a 60-year-old man during physical examination. B-mode ultrasound showed a hypoechoic mass in the middle and lower parenchyma of the right kidney, and computed tomography showed an iso-density shadow tumour in the right kidney. Contrast agents had a significant continuous enhancement effect on the tumour, and the enhancement was not uniform. After partial nephrectomy, pathological analysis was performed to rule out the possibility that the renal tumour was caused by thyroid tumour metastasis. Needle biopsy of the thyroid tumour confirmed that the renal cell carcinoma was not related to the thyroid tumour. The patient was alive at the last postoperative follow-up. CONCLUSION: This is the third published case in which thyroid tumour biopsy was performed to confirm that thyroid follicular renal cell carcinoma is not thyroid related.

Primary renal small cell carcinoma: A case report.

BACKGROUND: Small cell carcinoma (SCC) is a malignant tumour that is frequently accompanied by extensive metastasis. Primary renal SCC has typical characteristics related to SCC and is extremely rare, with no uniform treatment standard. Clinical treatment is mainly based on the literature. Here we report the diagnosis and treatment of an interesting case of primary renal SCC. CASE SUMMARY: We report a tortuous course of treatment for a 68-year-old man. Four years before diagnosis, the patient developed continuous gross haematuria, during which he underwent several ureteral biopsies, ureteral stricture relief, and urine exfoliated cell examinations; however, SCC was not confirmed. One month before radical resection of the renal pelvic carcinoma, the severe haematuria recurred. Computed tomography revealed transitional cell carcinoma in the right kidney and right upper ureter. A preoperative examination exluded the possibility of a pulmonary origin of the tumour, and primary renal SCC was diagnosed. The postoperative pathology findings were suggestive of SCC. The patient was treated with combined chemotherapy but died of tumour progression at 7 mo postoperative. CONCLUSION: Our patient's disease onset in the context of a succession of regular testing and the fact that it occurred so quickly with perirenal encroachment immediately after diagnosis reveals the cruel and unforgiving side of the disease. Furthermore, patients with poor comprehensive treatment results require new treatment regimens.

Clinical and cVEMP Evaluation Predict Short-Term Residual Dizziness After Successful Repositioning in Benign Paroxysmal Positional Vertigo.

Objective: Residual dizziness (RD) is a frequent symptom with unknown pathogenesis, often complained about by the patients with benign paroxysmal positional vertigo (BPPV), even after a successful canalith repositioning procedure (CRP). This study aims to quantitatively evaluate the short-term RD severity and its risk factors in patients with BPPV after successful CRPs. Methods: In total two hundred and twenty patients with BPPV after successful CRPs (W0) were prospectively followed up for 1 week (W1). Besides demographics and serial neuropsychological assessments (including dizziness handicap inventory-DHI, etc.), patients also received cervical/ocular vestibular evoked myogenic potential (c/oVEMP) evaluation. RD was defined as patients with dizziness or imbalance, dizziness visual analog scale (VAS) >1, and without positional vertigo or nystagmus at W1. Demographic, clinical, and VEMPs differences were compared among the three groups: patients with minor (dizziness VAS 1-3) and moderate-to-severe RD (dizziness VAS > 3) and without RD. Results: The total frequency of RD at W1 was 49.1% (n = 108), with 32.3% (n = 71) minor, and 16.8% (n = 37) moderate-to-severe RD. Logistic regression analyses revealed that RD was closely associated with DHI status (OR = 2.101, P = 0.008) at W0, this effect was not present for minor RD. In addition to DHI score > 30 (OR = 4.898, P < 0.001) at W0, bilateral cVEMP absence (OR = 4.099, P = 0.005) was also an independent influential factor of moderate-to-severe RD. Conclusion: Our study highlights the importance of RD quantified evaluation. DHI score >30 and bilateral cVEMP absence could increase the risk of short-term moderate-to-severe RD.

Trend on dental caries status and its risk indicators in children aged 12 years in China: a multilevel analysis based on the repeated national cross-sectional surveys in 2005 and 2015.

BACKGROUND: This study aimed to explore the trend and risk indicators for dental caries of children aged 12 years in China based on national oral health survey data in 2005 and 2015. METHODS: Research data were from the two latest national oral health surveys conducted in mainland China, including 30 and 31 provinces, autonomous regions, and municipalities in 2005 and 2015, respectively. Children aged 12 years were clinically examined for dental caries and dental fluorosis according to the World Health Organization criteria. Sociodemographic characteristics and oral health-related behaviours were collected using questionnaires. Multilevel zero-inflated negative binomial regression model was used to investigate the association between dental caries severity and dental fluorosis, sociodemographic characteristics, and oral health-related behaviours. RESULTS: The final analyses included 12,350 and 27,818 children surveyed in 2005 and 2015, respectively. The standardized prevalence of dental caries increased from 27.05% (95% confidence interval [CI], 24.25-28.85) in 2005 to 37.92% (95% CI, 34.94-40.90) in 2015, and the respective standardized mean decayed, missing, filled teeth (DMFT) index scores increased from 0.50 (standard deviation [SD], 1.04) to 0.83 (SD, 1.45) (P < 0.001). Fujian province had the highest increase in dental caries, followed by Liaoning, Heilongjiang, Hainan, and Yunnan. Results revealed that children who were girls, more frequently experienced dental pain, and had more recent dental visits, had significantly higher DMFT scores after adjusting for the survey year and other variables (all P < 0.05). CONCLUSIONS: Dental caries of 12-year-old children in China deteriorated from 2005 to 2015, particularly in the northeast and southwest regions. Dental caries was associated with sex, dental pain, and dental service utilization.

[In vitro study of a new lasso device for intra-canal broken instrument removal].

PURPOSE: To collect facial stereo images of different lip protrusion by using three dimensional surface imaging device, and investigate facial aesthetic evaluation and differences between orthodontists, general dentists and laypeople. METHODS: In this study, one college student was recruited to take a three-dimensional image of the natural head and face. The software was simulated with a gradient of 2 mm to make the soft tissue lips move back and forth along the sagittal axis from the VSL line.The movement limit was 6 mm in front of and behind the VSL line. The observers included orthodontists, general dentists and laypeople. The data were analyzed with SAS 9.4 software package,visual analog scoring (VAS) was used for evaluation, and fixed-effect model was used for statistical analysis. RESULTS: The results showed that when the lip was on the VSL line, it got the highest scores amount all three groups and had no significant difference.When the lip became protrusive or retractive, it had negative impact on facial esthetics. There were significant differences in the scores of three groups in every 2mm of lip protrusion and lip retraction(P＜0.05). VAS 5 points or less were used as the unacceptable facial aesthetic score. The results showed that lip protrusion was 4 mm before the VSL line in the orthodontist group and less than 5 in the laypeople group . When the lip protruded 6mm before the VSL line and retracted 4 mm behind the VSL line, the scores of the three groups were lower than 5 points. The results also showed that male evaluation of lip protrusion 2 mm before the VSL line had a lower score than female; On the other hand, female evaluation of lip retraction behind the VSL line above 4mm had a lower score than male. CONCLUSIONS: Lip position has significant effect on facial aesthetics. Different observers had significant differences in the evaluation of lip position on facial aesthetics. It is suggested that orthodontists need more communication with patients in determining the target position of orthodontic treatment to improve treatment satisfaction.

Clinical and Oculomotor Correlates With Freezing of Gait in a Chinese Cohort of Parkinson's Disease Patients.

Accumulating evidence suggests that freezing of gait (FOG) is a unique gait disturbance in Parkinson's disease (PD), and its pathophysiology is not fully elucidated. The present study aims to investigate the clinical and oculomotor associations with FOG in Chinese PD patients. From Jan 2017 to Dec 2019, a total of 210 PD patients were consecutively registered for FOG evaluation based on item-3 of the Freezing of Gait Questionnaire (FOGQ). We explored the demographic, motor, and non-motor symptom differences in FOG positive (PD+FOG, n = 45) vs. negative (PD-FOG, n = 165) group. In addition, 40 PD patients and 37 healthy controls (HC) also underwent oculomotor test via videonystagmography (VNG). Visually guided saccade (VGS) latency, saccade accuracy and gain in smooth pursuit eye movement (SPEM) at three frequencies of horizontal axis were compared among PD+FOG (n = 20), PD-FOG (n = 20), and HC (n = 37). Compared with PD-FOG, PD+FOG had longer disease duration, more severe motor symptoms, lower cognitive scores, more severe depressive and autonomic impairments, as well as higher daily levodopa equivalent dosage. FOG occurred more frequently in patients with wearing-off. VNG subgroup analysis demonstrated that PD+FOG had prolonged saccade latency and decreased saccade accuracy relative to PD-FOG or HC. SPEM gain at 0.1 and 0.2 Hz was also decreased in PD+FOG compared with HC. Furthermore, prolonged saccade latency was correlated with higher FOGQ scores in PD patients. Our results verify that PD with FOG patients suffer from more severe motor and non-motor symptoms, indicating more extensive neurodegeneration. Prolonged saccade latency could be a practical oculomotor parameter both for identification and progression of FOG in PD.

Regional consistency and sample size considerations in a multiregional equivalence trial.

The main objective of a confirmatory multiregional clinical trial (MRCT) is to demonstrate the overall efficacy of test drugs in all participating regions as well as to evaluate the possibility of extrapolating the overall results to each region. With the emergence of the demands of biosimilar drugs development, some guidelines recommended using equivalence design to demonstrate the comparability of efficacy between biosimilar and reference drugs. Previous discussions about assessing regional consistency in MRCT are mainly focused on superiority or non-inferiority designs, while the extensions to equivalence designs were limited. In this work, we proposed a flexible regional consistency criterion for the MRCT with equivalence design. Based on this criterion, sample size determination and sample allocation were also discussed.

Seasonal variation of idiopathic benign paroxysmal positional vertigo correlates with serum 25-hydroxyvitamin D levels: a six-year registry study in Shanghai, China.

Seasonal variation of benign paroxysmal positional vertigo (BPPV) occurrence has been reported in recent years. Whether the seasonality of BPPV also exists in Chinese patients and whether it correlates with serum vitamin D levels is unexplored. We retrospectively analyzed the data of 1269 new-onset idiopathic BPPV patients registered in our vertigo outpatient clinic over a six-year period. Additionally, serum 25-hydroxyvitamin D levels during this period were measured in 877 patients by chemiluminescence immunoassay. We delineated the changing trend of the monthly BPPV patient numbers and serum 25-hydroxyvitamin D levels, and the correlation between them was explored. December to next March is the top 4 months with higher BPPV patient numbers. The median BPPV patient numbers in winter group were higher than those in summer group (20 vs. 16 patients, p < 0.05). Median 25-hydroxyvitamin D levels in winter group were much lower than those in summer group (16.3 vs. 20.8 ng/ml, p < 0.001) and autumn group (16.3 vs. 19.3 ng/ml, p < 0.05). A moderate negative correlation was observed between median serum 25-hydroxyvitamin D levels and BPPV patient numbers each month. The onset of BPPV also shows a seasonal fluctuation in Chinese patients. This phenomenon may be related to serum vitamin D levels.

[Assessing the influence of chin prominence on perceived facial aesthetics among three groups of observers].

PURPOSE: To assess the influence of chin prominence on facial aesthetics with 3D images, to investigate the cognitive boundaries of chin prominence among orthodontists, general dentists and laypeople and compare the variance of their cognitive data, in order to provide quantitative reference for selection of clinical treatment. METHODS: A 3D facial image was obtained by 3dMD. The soft tissue pogonion point was altered in 2 mm increments from -10 to 10 mm with Geomagic Wrap 2015, in order to represent retrusion and protrusion of the chin. These images were rated by orthodontists, general dentists and laypeople with VAS scores. Multivariate mixed linear regression was used to analyze the influence of gender, age and chin prominence on VAS scores, and whether there were differences among different groups with SAS 9.4 software package. ANOVA was also applied for comparison of each prominence. RESULTS: This study was composed of 243 subjects, including 90 orthodontists, 101 general dentists and 52 laypeople. Chin prominence had significant effect on VAS scores. VAS scores decreased by 0.8910 for each unit increase in chin retrusion and decreased by 1.0958 for each unit increase in chin protrusion（P<0.01）. Desire for treatment started when chin retrusion exceeded 6 mm in orthodontist group and layperson group, 4 mm in general dentist group, and chin protrusion reached 6 mm in all groups（VAS scores <5）. There was no significant difference in the scores among orthodontists, general dentists and laypeople with the variance of chin prominence, and there was no significant difference in gender and age. CONCLUSIONS: Chin prominence had significant effect on facial aesthetics. Soft tissue pogonion point located on the zero meridian was considered as the most attractive. Treatment needs increased significantly when chin protrusion reached 6 mm or chin retrusion exceeded 6 mm. There was no significant difference in the assessment among orthodontists, general dentists and laypeople.

UV-Cross-linkable Donor-Acceptor Polymers Bearing a Photostable Conjugated Backbone for Efficient and Stable Organic Photovoltaics.

High-performance photovoltaic polymers bearing cross-linkable function together with a photorobust conjugated backbone are highly desirable for organic solar cells to achieve both high device efficiency and long-term stability. In this study, a family of such polymers is reported based on poly[(2,5-bis(2-hexyldecyloxy)phenylene)- alt-(5,6-difluoro-4,7-di(thiophen-2-yl)benzo[ c]-[1,2,5]thiadiazole)] (PPDT2FBT), a high-performance photovoltaic donor-acceptor polymer, with different contents of terminal vinyl-appended side chains for cross-linking. The polymers were named PPDT2FBT-V x and prepared by varying the feeding ratio ( x mol %, x = 0, 5, 10, and 15) of the vinyl-appended monomer in polymerization. It was found that the vinyl integration did not sacrifice the original high photovoltaic performance of the polymers, as evidenced by comparable average power conversion efficiencies (PCEs) (6.95, 7.02, and 7.63%) observed for optimized devices based on PPDT2FBT-V0, PPDT2FBT-V5, and PPDT2FBT-V10, respectively, in blending with [6,6]-phenyl-C71-butyric acid methyl ester (PC71BM). Unlike thermal cross-linking that greatly reduced device efficiency, UV cross-linking has proven to be an effective way to achieve both high device efficiency and thermostability for PPDT2FBT-V10 solar cells. UV-cross-linked PPDT2FBT-V10 solar cells displayed an initial average PCE of 5.28% and almost no decrease upon heat treatment at 120 °C for 40 h. Morphology studies revealed that UV-cross-linking did not only alter initial nanophase separation but also suppressed morphology evolution by aggregation in bulk heterojunction blend films. Photo-cross-linking requires material photostability. It is therefore worthwhile to note that these polymers and their blends with PC71BM were found to be extremely photostable, even upon continuous exposure to concentrated sunlight (up to 200 suns), and UV-cross-linking does not hamper this photostability. Further studies found that the devices fabricated with the UV-cross-linked PPDT2FBT-V10/PC71BM active layer can endure continuous light exposure to a solar simulator without deteriorating their performance.

[A high transmittance material in UVc band].

Spectral characteristics of an organic material in acid with different concentrations were investigated in the solution of a proper acid concentration. The results showed that at 252 nm the transmittance T = 56.5%, but at 290 nm the material had a strong absorption peak (epsilon > 10(4) L. (mol.cm)-1). The absorbance A280-298 nm > 8, i.e. T280-298 nm < 10(-8). The band width was about 16 nm. Therefore, this material has conspicuous characteristics such as high transmittance and deep cutoff in the background in ultraviolet-c band. The transmission peak can be shifted in the range of 251-260 nm by changing the pH value of the solution and selecting solution with a different polarity. By analyzing the spectra of the material in acid we found that the two original absorption peaks disappeared, and a new strong absorption peak appeared at 290 nm. Moreover, it seems to be some relation between the two absorption peak intensity and the new peak, which needs to be further studied. Using this result, we can produce high quality UV-filters of this material with traditional coating and colour glass technology.