Comprehensive nutritional index for predicting overall survival in hepatocellular carcinoma patients after multiple transarterial chemoembolization.

BACKGROUND AND OBJECTIVES: Little is known about nutritional status in patients with hepatocellular carcinoma (HCC) after multiple rounds of transarterial chemoembolization (TACE). We established a comprehensive nutritional index (CNI) and evaluated its prognostic value for overall survival (OS) and time to progression (TTP). METHODS AND STUDY DESIGN: HCC patients (N=282) who underwent multiple TACE treatments were enrolled. CNI was established by principal component analysis based on body mass index, usual body weight percentage, hemoglobin, total lymphocyte count, and albumin; the cutoff value was determined by receiver operating characteristic curve and Youden index analysis. The correlation between CNI and treatment-related complications was analyzed with Spearman's method. The Kaplan-Meier method with log-rank test and Cox proportional hazards model were used to compare the prognostic values of CNI, prognostic nutritional index (PNI), and nutrition risk index (NRI) for OS and TTP. RESULTS: Nutritional status declined after repeated TACE (p<0.001). CNI (cutoff= 0.251) varied according to albumin-bilirubin grade, tumor size, and number of TACE treatments (p<0.001 or 0.025) and was negatively correlated with rate of serious complications (r=-0.185, p=0.002). Patients with low CNI had shorter OS (p=0.014) and TTP (p=0.007); high CNI predicted longer OS (hazard ratio [HR], 0.72; 95% confidence interval [CI]: 0.52-1.00, p=0.048) and TTP (HR, 0.69; 95% CI: 0.50-0.94, p=0.019). Post-treatment PNI and NRI were unrelated to prognosis (p>0.05). CONCLUSIONS: HCC patients have poor nutritional status after multiple TACE treatments, which predicts shorter OS and TTP. The prognostic performance of CNI is superior to those of PNI and NRI.

Preparation and Validation of a Longitudinally and Transversely Stiffened Panel Based on Hybrid RTM Composite Materials.

In the face of the difficulty in achieving high-quality integrated molding of longitudinally and transversely stiffened panels for helicopters by resin-matrix composite materials, we combine the prepreg process and the resin transfer molding (RTM) process to propose a hybrid resin transfer molding (HRTM) for composite stiffened panel structures. The HRTM process uses a mixture of prepreg and dry fabric to lay up a hybrid fiber preform, and involves injecting liquid resin technology. Using this process, a longitudinally and transversely stiffened panel structure is prepared, and the failure modes under compressive load are explored. The results show that at the injection temperature of the RTM resin, the prepreg resin dissolves slightly and has little effect on the viscosity of the RTM resin. Both resins have good miscibility at the curing temperature, which allows for the overall curing of the resin. A removable box core mold for the HRTM molding is designed, which makes it convenient for the mold to be removed after molding and is suitable for the overall molding of the composite stiffened panel. Ultrasonic C-scan results show that the internal quality of the composite laminates prepared using the HRTM process is good. A compression test proves that the composite stiffened panel undergoes sequential buckling deformation in different areas under compressive load, followed by localized debonding and delamination of the skin, and finally failure due to the fracture of the longitudinal reinforcement ribs on both sides. The compressive performance of the test specimen is in good agreement with the finite element simulation results. The verification results show that the HRTM process can achieve high-quality integrated molding of the composite longitudinally and transversely stiffened panel structure.

Influencing factors related to transcatheter arterial chemoembolization for hepatocellular carcinoma patients achieved tumor response.

Objective: To investigate the influencing factors of transcatheter arterial chemoembolization (TACE) on patients with hepatocellular carcinoma (HCC) for tumor response (complete and partial response, CR + PR). Methods: This research conducted a retrospective study of the hospital charts of patients treated with TACE successfully renewed from October 2014 to December 2015 at Sun Yat-sen University Cancer Center (Guangzhou, China). Univariate analysis (Chi-square test and repeated-measures ANOVA) selected nine influential tumor response factors from 22 core factors. The nine variables were included in a forward multiple logistic regression model predicting patients treated with TACE to achieve tumor response. Overall survival was calculated using the Kaplan-Meier method. Results: Data of 277 of 282 patients were included in the analysis. Nine variables were analyzed by univariate analysis and independently associated with tumor response (tumor capsule integrity, nausea and vomiting, microwave ablation, liver dysfunction, the absolute value of lymphocyte (LYM), alpha-fetoprotein, and gamma-glutamyl transpeptidase (GGT). By multivariate analysis, GGT (odds ratio [OR] =0.996), liver dysfunction (OR = 0.395), combined with microwave ablation (OR = 0.503), and tumor capsule integrity (OR = 1.894) were the significant predictors of the tumor response group compared with the standard deviation group (P < 0.05). Conclusions: This study suggests that TACE combined with ablation on patients with complete tumor capsules may have a better prognosis in tumor response and OS; additionally, liver dysfunction and nausea and vomiting were the independent predictors of tumor response.

A second tubulin binding site on the kinesin-13 motor head domain is important during mitosis.

Kinesin-13s are microtubule (MT) depolymerases different from most other kinesins that move along MTs. Like other kinesins, they have a motor or head domain (HD) containing a tubulin and an ATP binding site. Interestingly, kinesin-13s have an additional binding site (Kin-Tub-2) on the opposite side of the HD that contains several family conserved positively charged residues. The role of this site in kinesin-13 function is not clear. To address this issue, we investigated the in-vitro and in-vivo effects of mutating Kin-Tub-2 family conserved residues on the Drosophila melanogaster kinesin-13, KLP10A. We show that the Kin-Tub-2 site enhances tubulin cross-linking and MT bundling properties of KLP10A in-vitro. Disruption of the Kin-Tub-2 site, despite not having a deleterious effect on MT depolymerization, results in abnormal mitotic spindles and lagging chromosomes during mitosis in Drosophila S2 cells. The results suggest that the additional Kin-Tub-2 tubulin biding site plays a direct MT attachment role in-vivo.

Adverse reactions and their management in the treatment of malignant tumors using cytokine-induced killer cells.

OBJECTIVE: To identify the causes and the corresponding management of adverse reactions during the treatment of malignant tumors using cytokine-induced killer cells. METHODS: From January 2012 to December 2012, 441 patients received a total of 1,393 autologous cytokine-induced killer cell transfusion cycles in our department. The adverse reactions after the procedures were observed (assessed using the National Cancer Institute Common Toxicity version 2.0), and targeted care and health education were delivered by nurses. RESULTS: All treatment sessions were successfully completed, and the following adverse reactions were found: grade 1/3 fever in 1.36% (19/1,393) patients; grade 2/3 fever in 0.86% (12/1,393) patients; grade 2/3 chills in 0.65% (9/1,393) patients; and grade 1/3 dizziness in 0.29% (4/1,393) patients. CONCLUSIONS: After timely intervention of the adverse reactions, all patients were treated successfully. The best timing of the CIK cell therapy for cancer patients is when the tumor burden, or the number of tumor cells, reaches the minimal level after the end of surgery, chemotherapy and radiation therapy.

N-linked glycosylation influences on the catalytic and biochemical properties of Penicillium purpurogenum ß-d-glucuronidase.

To study the influence of N-linked carbohydrate moiety on the catalytic and biochemical properties of glycosylated enzyme, a recombinant ß-d-glucuronidase (PGUS-P) from Penicillium purpurogenum as a model glycoprotein, was deglycosylated with peptide-N-glycosidase F (PNGase-F) under native conditions. The enzymatic deglycosylation procedure resulted in the complete removal of carbohydrate moiety. Compared with the glycosylated PGUS-P, the deglycosylated PGUS-P exhibited 20-70% higher activity (p<0.05) within pH 6-9, but 15-45% lower activity (p<0.05) at 45-70°C. The apparent decrease in the thermal stability of the deglycosylated enzyme was reflected by a decrease in the denaturation temperature (T(d)) values determined by differential scanning calorimetry (DSC). The removal of N-linked glycans also reduced enzyme's sensitivity to certain metal ions. The deglycosylated PGUS-P displayed lower K(m) vaules, but higher k(cat)/K(m) ratios than the glycosylated isoform towards glycyrrhizin. The consequent conformational changes were also determined by circular dichroism (CD) and fluorescence spectroscopy which revealed no significant difference in the secondary but a slight dissimilarity between the tertiary structures of both isoforms of PGUS-P.