OncoSplicing: an updated database for clinically relevant alternative splicing in 33 human cancers.

Alternative splicing (AS) represents a crucial method in mRNA level to regulate gene expression and contributes to the protein complexity. Abnormal splicing has been reported to play roles in several diseases, including cancers. We developed the OncoSplicing database for visualization of survival-associated and differential alternative splicing in 2019. Here, we provide an updated version of OncoSplicing for an integrative view of clinically relevant alternative splicing based on 122 423 AS events across 33 cancers in the TCGA SpliceSeq project and 238 558 AS events across 32 cancers in the TCGA SplAdder project. The new version of the database contains several useful features, such as annotation of alternative splicing-associated transcripts, survival analysis based on median and optimal cut-offs, differential analysis between TCGA tumour samples and adjacent normal samples or GTEx normal samples, pan-cancer views of alternative splicing, splicing differences and results of Cox'PH regression, identification of clinical indicator-relevant and cancer-specific splicing events, and downloadable splicing data in the SplAdder project. Overall, the substantially updated version of OncoSplicing (www.oncosplicing.com) is a user-friendly and registration-free database for browsing and searching clinically relevant alternative splicing in human cancers.

Proxalutamide in metastatic castration-resistant prostate cancer: Primary analysis of a multicenter, randomized, open-label, phase 2 trial.

We aim to assess the safety and efficacy of proxalutamide, a novel androgen receptor antagonist, for men with metastatic castration-resistant prostate cancer (mCRPC) in a multicenter, randomized, open-label, phase 2 trial. In our study, the enrolled mCRPC patients were randomized to 100, 200 and 300 mg dose groups at 1:1:1. The primary efficacy endpoint was prostate-specific antigen (PSA) response rate. The secondary endpoints included objective response rate (ORR), disease control rate (DCR) and time to PSA and radiographic progression. Safety and pharmacokinetics were also assessed. Finally, there were 108 patients from 17 centers being enrolled. By week 16, there were 13 (35.1%), 12 (36.4%) and 15 (42.9%) patients with confirmed 50% or greater PSA decline in 100 mg (n = 37), 200 mg (n = 33) and 300 mg (n = 35) groups, respectively. Among the 19 patients with target lesions at study entry, three (15.8%) had a partial response and 12 (63.2%) had stable disease. The ORRs of 20.0%, 22.2%, 0% and DCRs of 80.0%, 88.9%, 60.0% were, respectively, achieved in 100, 200 and 300 mg groups. By the maximum follow-up time of 24 weeks, there were 42.6% and 10.2% of cases experiencing PSA progression and radiographic progression, respectively. Overall, adverse events (AEs) were experienced by 94.4% of patients, most of which were mild or moderate. There were 28 patients experiencing ≥grade 3 AEs. The most common AEs were fatigue (17.6%), anemia (14.8%), elevated AST (14.8%) and ALT (13.0%), decreased appetite (13.0%). These findings preliminarily showed the promising antitumor activity of proxalutamide in patients with mCRPC with a manageable safety profile. The proxalutamide dose of 200 mg daily is recommended for future phase 3 trial (Clinical trial registration no. CTR20170177).

Development and validation of a clinic machine-learning nomogram for the prediction of risk stratifications of prostate cancer based on functional subsets of peripheral lymphocyte.

BACKGROUND: Non-invasive risk stratification contributes to the precise treatment of prostate cancer (PCa). In previous studies, lymphocyte subsets were used to differentiate between low-/intermediate-risk and high-risk PCa, with limited clinical value and poor interpretability. Based on functional subsets of peripheral lymphocyte with the largest sample size to date, this study aims to construct an easy-to-use and robust nomogram to guide the tripartite risk stratifications for PCa. METHODS: We retrospectively collected data from 2039 PCa and benign prostate disease (BPD) patients with 42 clinical characteristics on functional subsets of peripheral lymphocyte. After quality control and feature selection, clinical data with the optimal feature subset were utilized for the 10-fold cross-validation of five Machine Learning (ML) models for the task of predicting low-, intermediate- and high-risk stratification of PCa. Then, a novel clinic-ML nomogram was constructed using probabilistic predictions of the trained ML models via the combination of a multivariable Ordinal Logistic Regression analysis and the proposed feature mapping algorithm. RESULTS: 197 PCa patients, including 56 BPD, were enrolled in the study. An optimal subset with nine clinical features was selected. Compared with the best ML model and the clinic nomogram, the clinic-ML nomogram achieved the superior performance with a sensitivity of 0.713 (95% CI 0.573-0.853), specificity of 0.869 (95% CI 0.764-0.974), F1 of 0.699 (95% CI 0.557-0.841), and AUC of 0.864 (95% CI 0.794-0.935). The calibration curve and Decision Curve Analysis (DCA) indicated the predictive capacity and net benefits of the clinic-ML nomogram were improved. CONCLUSION: Combining the interpretability and simplicity of a nomogram with the efficacy and robustness of ML models, the proposed clinic-ML nomogram can serve as an insight tool for preoperative assessment of PCa risk stratifications, and could provide essential information for the individual diagnosis and treatment in PCa patients.

Metabolic classifications of renal cell carcinoma reveal intrinsic connections with clinical and immune characteristics.

BACKGROUND: Kidney cancer undergoes a dramatic metabolic shift and has demonstrated responsiveness to immunotherapeutic intervention. However, metabolic classification and the associations between metabolic alterations and immune infiltration in Renal cell carcinoma still remain elucidative. METHODS: Unsupervised consensus clustering was conducted on the TCGA cohorts for metabolic classification. GESA, mRNAsi, prognosis, clinical features, mutation load, immune infiltration and differentially expressed gene differences among different clusters were compared. The prognosis model and nomograms were constructed based on metabolic gene signatures and verified using external ICGC datasets. Immunohistochemical results from Human Protein Atlas database and Tongji hospital were used to validate gene expression levels in normal tissues and tumor samples. CCK8, apoptosis analysis, qPCR, subcutaneously implanted murine models and flowcytometry analysis were applied to investigate the roles of ACAA2 in tumor progression and anti-tumor immunity. RESULTS: Renal cell carcinoma was classified into 3 metabolic subclusters and the subcluster with low metabolic profiles displayed the poorest prognosis, highest invasiveness and AJCC grade, enhanced immune infiltration but suppressive immunophenotypes. ACAA2, ACAT1, ASRGL1, AKR1B10, ABCC2, ANGPTL4 were identified to construct the 6 gene-signature prognosis model and verified both internally and externally with ICGC cohorts. ACAA2 was demonstrated as a tumor suppressor and was associated with higher immune infiltration and elevated PD-1 expression of CD8+ T cells. CONCLUSIONS: Our research proposed a new metabolic classification method for RCC and revealed intrinsic associations between metabolic phenotypes and immune profiles. The identified gene signatures might serve as key factors bridging tumor metabolism and tumor immunity and warrant further in-depth investigations.

Management for Ureterovaginal Fistula: A Retrospective Study Comparing Early and Delayed Ureteral Reimplantation.

INTRODUCTION: The timing of surgical repair for ureterovaginal fistula (UVF) is under debate, here we introduce our experience to compare the safety and efficacy between early and delayed ureteral reimplantation for UVF. METHODS: Between January 2012 and January 2020, 22 patients who were diagnosed with UVF had received ureteral reimplantation. Baseline characteristics, history of previous abdominal surgery, operative profile, and follow-up data were collected and analyzed. RESULTS: Among 22 patients diagnosed with UVF, 12 patients received early ureteral reimplantation and others received delayed ureteral reimplantation. Both groups were comparable in baseline characteristics and detailed history of previous operations. The mean operative time of the early surgery group was 140.83 ± 35.28 min, while that of the delayed surgery group was 181.00 ± 43.83 min (p = 0.027). Patients of the early surgery group (183.33 ± 107.31 mL) had less blood loss compared with that of the delayed surgery group (285.00 ± 94.43 mL) (p = 0.030). After an overall mean follow-up of 34.55 months, the ureteral stricture rate of two groups was not statistically significantly different (16.67% in early repair vs. 40.00% in delayed repair, p = 0.348). CONCLUSION: With similar long-term outcomes, the early ureteral reimplantation had a shorter operative time and less blood loss. Moreover, the stress during the waiting period could be minimized. High-quality clinical studies with larger sample size are needed to confirm the superior nature of early surgery.

Biomass chemical looping gasification for syngas production using modified hematite as oxygen carriers.

Syngas is a clean energy carrier and a major industrial feedstock. In this paper, syngas was produced via biomass chemical looping gasification (CLG) process. Hematite, the most common Fe-based oxygen carrier (OC), was modified with different metal oxides (CeO2, CaO and MgO) by the impregnation method. The hematite modified by CeO2, CaO and MgO was namely as CeO2-hematite (CeO2-H), CaO-hematite (CaO-H) and MgO-hematite (MgO-H), respectively. The introduction of CeO2, CaO and MgO enhanced the reactivity of lattice oxygen of hematite. The optimum condition for syngas production had been explored as the mass ratio of oxygen carrier to biomass (O/B) of 0.2, the mass ratio of steam to biomass (S/B) of 0.75 and temperature of 800°C in the biomass CLG process. The CeO2-H exhibited the most wonderful performance compared to that for CaO-H and MgO-H. The crystal composition of OC influenced greatly in the CLG process. CeFeO3 had a good oxygen mobility property and lattice oxygen releasing capacity due to the most oxygen vacancy distributed on the OC surface and the most active lattice oxygen, which is conducive to the biomass chemical looping gasification process for syngas production, leading to the highest gasification efficiency of 95.86% and gas yield of 1.20 m3/kg of the three. Cyclic test proved that CeO2-H had well sintering resistance and cyclic performance.

MiR-5195-3p functions as a tumor suppressor in prostate cancer via targeting CCNL1.

BACKGROUND: Accumulating evidence indicates that miR-5195-3p exerts tumor-suppressive roles in several tumors. However, the clinical significance and biological function of miR-5195-3p in prostate cancer (PCa) have not been reported yet. METHODS: The expression levels of miR-5195-3p and Cyclin L1 (CCNL1) were determined using quantitative real-time PCR in clinical specimens and cell lines. The clinical significance of miR-5195-3p in patients with PCa was evaluated using Kaplan-Meier survival analysis and Cox regression models. Cell proliferation and cell cycle distribution were measured by CCK-8 assay and flow cytometry, respectively. The association between miR-5195-3p and CCNL1 was analyzed by luciferase reporter assay. RESULTS: MiR-5195-3p expression levels were significantly downregulated in 69 paired PCa tissues compared with matched adjacent normal tissues. The decreased miR-5195-3p expression was associated with Gleason score and TNM stage, as well as worse survival prognosis. The in vitro experiments showed that miR-5195-3p overexpression suppressed the proliferation and cell cycle G1/S transition in PC-3 and DU145 cells. Elevated miR-5195-3p abundance obviously impaired tumor formation in vivo using PC-3 xenografts. Mechanistically, CCNL1 was a direct target of miR-5195-3p in PCa cells, which was inversely correlated with miR-5195-3p in PCa tissues. Importantly, CCNL1 knockdown imitated, while overexpression reversed, the effects of miR-5195-3p overexpression on PCa cell proliferation and cell cycle G1/S transition. CONCLUSIONS: Our data suggest that miR-5195-3p functions as a tumor suppressor by targeting CCNL1 in PCa.

Comparison of Thulium Laser Resection of Bladder Tumors and Conventional Transurethral Resection of Bladder Tumors for Non-Muscle-Invasive Bladder Cancer.

INTRODUCTION: The thulium laser resection of bladder tumors (TmLRBT) was increasingly used in the treatment of non-muscle-invasive bladder cancer (NMIBC) recently, and here we report the relevant outcomes of our institution to evaluate its efficacy and safety. METHODS: We retrospectively collected the data of NMIBC patients who underwent either TmLRBT or transurethral resection of bladder tumor (TURBT). The baseline characteristics and perioperative outcomes were compared in these 2 groups. RESULTS: The TmLRBT had a higher rate of detrusor identification than TURBT (97.4 vs. 87.6%, p = 0.001). After screening, 134 patients who underwent TmLRBT and 152 patients who received TURBT were enrolled in the analysis, and their baseline characteristics were similar. During the TURBT, 24 (15.8%) obturator nerve reflexes and 9 (5.9%) bladder perforations occurred, while none happened during the TmLRBT. After surgery, TmLRBT patients had fewer postoperative gross hematuria (38.1 vs. 96.7%, p < 0.001) and postoperative irrigation (27.6 vs. 92.7%, p < 0.001), and its irrigation duration was significantly shorter (2.3 vs. 3.3 day, p < 0.001). During the follow-up, no significant difference in the recurrence rate was detected (p = 0.315). CONCLUSIONS: TmLRBT is a safer technique than conventional TURBT in the treatment of NMIBC, and it could offer better specimens for pathologic assessment while the cancer control was not compromised.

Clinical characteristics and risk factors of fatal patients with COVID-19: a retrospective cohort study in Wuhan, China.

BACKGROUND: The coronavirus disease 2019 (COVID-19) has caused a global pandemic, resulting in considerable mortality. The risk factors, clinical treatments, especially comprehensive risk models for COVID-19 death are urgently warranted. METHODS: In this retrospective study, 281 non-survivors and 712 survivors with propensity score matching by age, sex, and comorbidities were enrolled from January 13, 2020 to March 31, 2020. RESULTS: Higher SOFA, qSOFA, APACHE II and SIRS scores, hypoxia, elevated inflammatory cytokines, multi-organ dysfunction, decreased immune cell subsets, and complications were significantly associated with the higher COVID-19 death risk. In addition to traditional predictors for death risk, including APACHE II (AUC = 0.83), SIRS (AUC = 0.75), SOFA (AUC = 0.70) and qSOFA scores (AUC = 0.61), another four prediction models that included immune cells subsets (AUC = 0.90), multiple organ damage biomarkers (AUC = 0.89), complications (AUC = 0.88) and inflammatory-related indexes (AUC = 0.75) were established. Additionally, the predictive accuracy of combining these risk factors (AUC = 0.950) was also significantly higher than that of each risk group alone, which was significant for early clinical management for COVID-19. CONCLUSIONS: The potential risk factors could help to predict the clinical prognosis of COVID-19 patients at an early stage. The combined model might be more suitable for the death risk evaluation of COVID-19.

Clinical characteristics and risk factors associated with COVID-19 disease severity in patients with cancer in Wuhan, China: a multicentre, retrospective, cohort study.

BACKGROUND: COVID-19 has spread globally. Epidemiological susceptibility to COVID-19 has been reported in patients with cancer. We aimed to systematically characterise clinical features and determine risk factors of COVID-19 disease severity for patients with cancer and COVID-19. METHODS: In this multicentre, retrospective, cohort study, we included all adult patients (aged ≥18 years) with any type of malignant solid tumours and haematological malignancy who were admitted to nine hospitals in Wuhan, China, with laboratory-confirmed COVID-19 between Jan 13 and March 18, 2020. Enrolled patients were statistically matched (2:1) with patients admitted with COVID-19 who did not have cancer with propensity score on the basis of age, sex, and comorbidities. Demographic characteristics, laboratory examinations, illness severity, and clinical interventions were compared between patients with COVID-19 with or without cancer as well as between patients with cancer with non-severe or severe COVID-19. COVID-19 disease severity was defined on admission on the basis of the WHO guidelines. Univariable and multivariable logistic regression, adjusted for age, sex, comorbidities, cancer type, tumour stage, and antitumour treatments, were used to explore risk factors associated with COVID-19 disease severity. This study was registered in the Chinese Clinical Trial Register, ChiCTR2000030807. FINDINGS: Between Jan 13 and March 18, 2020, 13 077 patients with COVID-19 were admitted to the nine hospitals in Wuhan and 232 patients with cancer and 519 statistically matched patients without cancer were enrolled. Median follow-up was 29 days (IQR 22-38) in patients with cancer and 27 days (20-35) in patients without cancer. Patients with cancer were more likely to have severe COVID-19 than patients without cancer (148 [64%] of 232 vs 166 [32%] of 519; odds ratio [OR] 3·61 [95% CI 2·59-5·04]; p<0·0001). Risk factors previously reported in patients without cancer, such as older age; elevated interleukin 6, procalcitonin, and D-dimer; and reduced lymphocytes were validated in patients with cancer. We also identified advanced tumour stage (OR 2·60, 95% CI 1·05-6·43; p=0·039), elevated tumour necrosis factor α (1·22, 1·01-1·47; p=0·037), elevated N-terminal pro-B-type natriuretic peptide (1·65, 1·03-2·78; p=0·032), reduced CD4+ T cells (0·84, 0·71-0·98; p=0·031), and reduced albumin-globulin ratio (0·12, 0·02-0·77; p=0·024) as risk factors of COVID-19 severity in patients with cancer. INTERPRETATION: Patients with cancer and COVID-19 were more likely to deteriorate into severe illness than those without cancer. The risk factors identified here could be helpful for early clinical surveillance of disease progression in patients with cancer who present with COVID-19. FUNDING: China National Natural Science Foundation.

Percutaneous microwave ablation of renal cell carcinoma: practice guidelines of the ultrasound committee of Chinese medical association, interventional oncology committee of Chinese research hospital association.

Imaging-guided percutaneous microwave ablation (MWA) with high thermal efficiency comprises rapid, successful management of small renal cell carcinomas (RCCs) in selected patients. Ultrasound Committee of Chinese Medical Association, Interventional Oncology Committee of Chinese Research Hospital Association developed evidence-based guidelines for MWA of RCCs after systematically reviewing the 1969-2019 literature. Systematic reviews, meta-analyses, randomized controlled trials, cohort, and case-control studies reporting MWA of RCCs were included and levels of evidence assessed. Altogether, 146 articles were identified, of which 35 reported percutaneous MWA for T1a RCCs and 5 articles for T1b RCCs. Guidelines were established based on indications, techniques, safety, and effectiveness of MWA for RCCs, with the goal of standardizing imaging-guided percutaneous MWA treatment of RCCs. Key points Microwave ablation is recommended for managing small renal cell carcinoma in selected patients. Imaging protocols are tailored based on the procedural plan, guidance, and evaluation. Patient's selection evaluation, updated technique information, clinical efficacy, and complications are recommended to standardize management. A joint task force (multidisciplinary team) summarized the key elements of the standardized report.

NT5E inhibition suppresses the growth of sunitinib-resistant cells and EMT course and AKT/GSK-3ß signaling pathway in renal cell cancer.

We aimed to explore the mechanisms of sunitinib-resistance in renal cell cancer (RCC) and provide new therapeutic evidence and biomarkers for RCC treatment using human clear-cell renal cell carcinoma (ccRCC) cell line, 786-O. Microarray analysis, quantitative real time PCR (qRT-PCR), Western blot, and immunohistochemistry were used to detect Ecto-5'-nucleotidase (NT5E) expressions in sunitinib-resistant tissues in RCC. 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide, Thiazolyl Blue Tetrazolium Bromide (MTT), cell-count kit 8 (CCK-8), wound healing, and Transwell assays were used to investigate the influences of sunitinib and NT5E on 786-O cell line and sunitinib-resistant 786-O cell line (S786-O). Protein expressions related to epithelial-mesenchymal transition (EMT) and AKT/GSK-3ß signaling pathway in 786-O cells and S786-O cells were determined by Western blot. In vivo experiment was performed using NCr-nu/nu mice to explore the effects of NT5E on cell growth and EMT signal in sunitinib environment. NT5E expression was upregulated in sunitinib-resistant RCC tissues and cells. NT5E downregulation repressed RCC cell proliferation, migration as well as invasion. EMT course and AKT/GSK-3ß signal pathway both in vitro and in vivo in sunitinib environment was suppressed to varying degrees via NT5E inhibition. NT5E inhibition could suppress the growth of sunitinib-resistant RCC cells and restrain EMT course and AKT/GSK-3ß signal pathway in sunitinib environment in RCC. © 2018 IUBMB Life, 71(1):113-124, 2019.

Secondary Management for Recurrent Ureteropelvic Junction Obstruction after Pyeloplasty: A Comparison of Re-Do Robot-Assisted Laparoscopic Pyeloplasty and Conventional Laparoscopic Pyeloplasty.

OBJECTIVE: To describe and analyze our experience with secondary robot-assisted laparoscopic pyeloplasty (RALP) and conventional laparoscopic pyeloplasty (LP) in treating recurrent ureteropelvic junction obstruction (UPJO) after primary pyeloplasty. METHODS: Patients who underwent secondary RALP or LP for recurrent UPJO were retrospectively analyzed. Baseline characteristics, detailed history of previous pyeloplasty, operative profile and follow-up data were collected and analyzed. RESULTS: Among 29 patients presented with recurrent UPJO, 15 patients underwent secondary RALP. Both groups (RALP or LP) were comparable in baseline characteristics and detailed history of previous pyeloplasty. The mean operative time, suturing time, and hospitalization time of patients in RALP group were significantly less than those in LP group. The mean operative time of RALP group was 2.1 h, while the mean operative time of LP group was 3.23 h. The average suturing time of LP (62.43 min) is about 3 times that of RALP (21.47 min). The overall mean follow-up data was 23 months. The success rate of the RALP group and LP group was 87.7 and 85.7% respectively. CONCLUSION: Compared to LP, RALP may be a better choice for the treatment of recurrent UPJO. Further high-quality clinical studies are needed to confirm the superior nature of RALP.

Androgen-receptor splice variant-7-positive prostate cancer: a novel molecular subtype with markedly worse androgen-deprivation therapy outcomes in newly diagnosed patients.

Androgen-deprivation therapy has been the standard treatment for metastatic and locally advanced prostate cancer, but the majority of patients will progress to castration-resistant prostate cancer within 2-3 years. Unlike the case in breast cancer, no clinically validated biomarker has been used to predict the outcomes of androgen-deprivation therapy. To evaluate androgen-receptor splice variant-7 (AR-V7) detection in newly diagnosed advanced prostate cancer and describe the distinctive prognosis of this novel molecular subtype, this study retrospectively enrolled 168 newly diagnosed prostate cancer patients from 2003 to 2015 who received androgen-deprivation therapy. AR-V7 immunohistochemical staining was performed with a monoclonal antibody, and AR-V7 expression was determined using Immune-Reactive Score data. The association between nuclear AR-V7 expression and prognosis was determined. Multiple cause-specific Cox regression and stratified cumulative incidences were used to analyze the prognosis risk. Among the 168 patients, 32 (19%) were AR-V7-positive. Compared with the AR-V7-negative patients, the AR-V7-positive patients had significantly lower prostate-specific antigen response rates (P<0.001) to androgen-deprivation therapy and a much shorter time to castration-resistant prostate cancer (P<0.0001). In Kaplan-Meier analysis, the AR-V7-positive group showed markedly lower castration-resistant prostate cancer progression-free survival (P<0.0001) and much lower cancer-specific (P<0.0001) and overall survival (P<0.0001) both in all enrolled patients and in patients with metastases. AR-V7 positivity was a significant predictor of castration-resistant prostate cancer progression in multiple Cox regression (hazard ratio: 4.826; 95% CI: 2.960-7.869; P<0.001). AR-V7 immunohistochemical detection in newly diagnosed prostate cancer patients who are planning to receive androgen-deprivation therapy, especially those with metastases, is necessary and valuable for prognostic assessment. AR-V7-positive prostate cancer should be considered a novel prostate cancer subtype that should be distinguished upon initial biopsy. The main limitation of this study is its observational nature.

Recent Advances in Nanowire-Based, Flexible, Freestanding Electrodes for Energy Storage.

The rational design of flexible electrodes is essential for achieving high performance in flexible and wearable energy-storage devices, which are highly desired with fast-growing demands for flexible electronics. Owing to the one-dimensional structure, nanowires with continuous electron conduction, ion diffusion channels, and good mechanical properties are particularly favorable for obtaining flexible freestanding electrodes that can realize high energy/power density, while retaining long-term cycling stability under various mechanical deformations. This Minireview focuses on recent advances in the design, fabrication, and application of nanowire-based flexible freestanding electrodes with diverse compositions, while highlighting the rational design of nanowire-based materials for high-performance flexible electrodes. Existing challenges and future opportunities towards a deeper fundamental understanding and practical applications are also presented.

Heavy Metal Exposure Alters the Uptake Behavior of 16 Priority Polycyclic Aromatic Hydrocarbons (PAHs) by Pak Choi ( Brassica chinensis L.).

Polycyclic aromatic hydrocarbons (PAHs) and heavy metals (HMs) are predominant pollutants normally coexisting at electronic waste dumping sites or in agricultural soils irrigated with wastewater. The accumulation of PAHs and HMs in food crops has become a major concern for food security. This study explored the hydroponic uptake of 16 priority PAHs and 5 HMs (Cd, Cr, Cu, Pb, and Zn) by pak choi ( Brassica chinensis L.). PAHs exhibited stronger inhibition on pak choi growth and physiological features than HMs. Five HMs were categorized into high-impact HMs (Cr, Cu, and Pb) and low-impact HMs (Cd and Zn) with distinct behavior under the coexposure with PAHs, and low-impact HMs showed synergistic toxicity effects with PAHs. Coexposure to PAHs and HMs slightly decreased the uptake and translocation of PAHs by pak choi, possibly attributing to the commutative hindering effects on root adsorption or cation-π interactions. The bioconcentration factors in PAHs + HMs treatments were independent of the octanol-water partition coefficient ( Kow), owing to the cation-π interaction associated change of Kow and induced defective root system. This study provides new insights into the mechanisms and influential factors of PAHs uptake in Brassica chinensis L. and gives clues for reassessing the environmental risks of PAHs in food crops.

Does previous abdominal surgery adversely affect perioperative and oncologic outcomes of laparoscopic radical cystectomy?

BACKGROUND: Laparoscopic radical cystectomy (LRC) has been shown to have less estimated blood loss (EBL), transfusion rate, narcotic analgesic requirement, earlier return of bowel function, and shorter hospital stay. The aim of this study was to investigate the feasibility, peri-operative and oncologic outcomes of laparoscopic radical cystectomy (LRC) in patients with previous abdominal surgery (PAS). METHODS: We retrospectively reviewed 243 patients undergoing open radical cystectomy (ORC) or LRC with bilateral pelvic lymph node dissection and urinary diversion or cutaneous ureterostomy at a single center from January 2010 to December 2015. Demographic parameters, intra-operative variables, peri-operative records, pathologic outcomes, and complication rate were reviewed to assess the impact of PAS on peri-operative and oncologic outcomes. RESULTS: Patients in both ORC and LRC subgroups were homogeneous in terms of demography characteristics including age, gender, BMI, ASA score, and comorbidity. Estimated blood loss (EBL) was higher in patients with PAS undergoing ORC compared to those with no PAS (P = 0.008). However, there was no significant difference of EBL among patients undergoing LRC with or without PAS (P = 0.896). There was no statistical difference in peri-operative parameters and pathological outcomes. Patients with PAS undergoing ORC and ileal conduit had a higher vascular injury rate (P = 0.017). Comparing patients with PAS performed by LRC and ORC, the number of patients with the vascular injury was higher in ORC groups regardless of the type of diversion (ileal conduit, P = 0.001, cutaneous ureterostomy, P = 0.025). There is no significant difference in other complications. CONCLUSION: The presence of adhesions from PAS is not a contraindication to LRC. Patients with PAS may benefit from LRC with lower estimated blood loss, fewer transfusion rates, and vascular injuries. Furthermore, the overall oncologic outcomes and complication rate are similar between LRC and ORC patients with PAS.

Pure Small Cell Carcinoma of Prostate: A Report of 8 Cases.

PURPOSE: To describe characteristics of pure small cell carcinoma of prostate (SCCP) and assess the prognostic factors. PATIENTS AND METHODS: We summarized data of pure SCCP from published studies and ours and made Kaplan-Meier analysis and Cox regression to evaluate prognosis factors. RESULTS: A total of 2,213 patients with prostate cancer was identified, of which eight (0.36%) patients were pure SCCP. The mean age at diagnosis was 61 years old. And there were 2 patients diagnosed at 34 and 50 years old respectively. Symptoms of these patients were similar to patients with prostate adenocarcinoma. Serum prostate specific antigen of 7 patients was at normal level. Five patients received chemotherapy, average overall survival (OS) was 9.75 months; 3 only received conservative treatment, average OS was 4 months. By univariate and multivariate Cox analysis, chemotherapy is an independent predictor of survival. Kaplan-Meier analysis demonstrated that chemotherapy was associated with longer OS. CONCLUSION: Clinical characteristics, examination and treatment strategy of pure SCCP are very different from prostate adenocarcinoma. According to the data from published studies and from our studies, the average survival of patients receiving chemotherapy is longer than those who received other treatment modalities.

Clinical analysis of small cell carcinoma of the bladder in Chinese: nine case reports and literature reviews.

BACKGROUND: Small cell carcinoma of the bladder (SCCB) is a kind of rare and highly aggressive tumor that is present in an advanced stage and has a propensity for early metastasis. The main presenting symptom of SCCB is hematuria. Surgery, chemotherapy, and radiotherapy, either alone or as a part of combined therapy, have been used as the treatment. The aim of this study is to present our experience with 9 SCCB patients who were treated with different modalities and to share the findings upon reviewing the literatures for patients with SCCB reported in 56 literatures in Chinese. METHODS: We retrospectively evaluated 9 patients with SCCB from February 1980 to January 2014 in Tongji Hospital, Huazhong University of Science and Technology. The general characteristics, clinical manifestations, the pathological and immunohistochemical characteristics, treatment options, and prognostication in those eligible manuscripts were analyzed. In order to gain a better understanding of the clinical features of SCCB, another 119 cases reported in 56 articles were reviewed together (from January 1979 to March 2014). And a retrospective analysis was performed. RESULTS: All the 9 cases in Tongji Hospital were successfully operated, and the tissue samples were sent for pathological examination. All the tumor tissues contained small cell carcinoma components. 4 cases coexisted with other histologic types of bladder cancers, and 2 out of the 9 cases had three different cell components. All the patients had muscle invasion, and 4 cases showed lymph nodes metastasis, 3 cases showed invasion of neighboring structures (seminal vesicle or uterus), and 1 case was highly suspected of liver metastasis. Immunohistochemistry results showed that PCK, Syn, NSE, and CD56 were all positive, but LCA was negative. After operations, 3 patients underwent chemotherapy and only 1 patient received postoperative radiotherapy. Patients were followed up, ranging from 3 to 84 months and the median survival time was 33 months. The leading cause of death was tumor recurrence or metastasis, while 2 patients are still alive. According to the published literature, the pathological stage, immunohistochemical markers, and survival curves of all the 128 cases were also retrospectively analyzed. CONCLUSIONS: SCCB is different from transitional cell carcinoma (TCC) of the bladder. It has its unique cytology, immunohistochemistry, and ultrastructural features. Its diagnosis relies on pathological examination and immunohistochemistry. The current main treatment for SCCB is surgery combined with chemotherapy. Since the disease develops early metastasis easily, the overall prognosis of this cancer is poor. Further research need to clarify the molecular pathogenesis so that novel therapies can be developed for this rare cancer.

Effects of pretreatments on thickened waste activated sludge and rice straw co-digestion: Experimental and modeling study.

In order to maximize the biogas production from thickened waste activated sludge (TWAS), co-digestion of TWAS and rice straw (RS) was studied and the application of thermal/thermo-alkaline and NaOH/H2O2 to TWAS and RS, respectively, was evaluated. The batch experiments were conducted at three different TWAS/RS (volume basis) ratios of 1:3, 1:1 and 3:1, respectively. Furthermore, the modified Gompertz model was introduced to predict the biogas yield and evaluate the kinetic parameters. The highest biogas production (409.2 L/kg VSadded) was achieved from co-digestion of TWASthermo-alkaline and RSNaOH at mixing ratio of 1:1, which is greater by 42.2% and 5.9% than that of digesting TWASthermo-alkaline, and RSNaOH alone, respectively. The highest VS removal rate was obtained from the co-digestion of TWASthermo-alkaline and RSNaOH at mixing ratio of 1:3, which is greater by 55.8% and 14.0% than those of mono-digestion. The modified Gompertz model (R(2): 0.993-0.998 and 0.993-0.999 for mono- and co-digestions, respectively) showed a good fit to the experimental results and the estimated parameters indicating that the pretreatments and co-digestion of substrates markedly improved the biogas production rate.