Giant cavernous aneurysms occluded by aneurysmal thrombosis, calcification, parent artery occlusion: A case report and review of literature.

BACKGROUND: Patients with giant intracranial aneurysms (GIAs) are at a high risk of rupture, morbidity, and mortality even after surgical or endovascular treatment. We described a case of a spontaneously occluded GIA secondary to gradual growth of the GIA, continuously progressed aneurysmal thrombosis, complete aneurysmal calcification and complete occlusion of the parent artery-the right internal carotid artery (RICA). CASE SUMMARY: A 72-year-old female patient complained of sudden pain in her right eye upon admission to our hospital. She had been diagnosed with a GIA [30 mm (axial) × 38 mm (coronal) × 28 mm (sagittal)] containing an aneurysmal thrombus located in the cavernous sinus segment of RICA diagnosed by magnetic resonance imaging (MRI), enhanced MRI, and magnetic resonance angiography more than 14 years ago. Later, with slow growth of the cavernous carotid GIA, aneurysmal thrombosis progressed continuously, spontaneous occlusion of the RICA, complete aneurysmal calcification, and occlusion of the GIA occurred gradually. She had no history of subarachnoid hemorrhage but missed the chance for endovascular therapy at an early stage. As a result, she was left with severe permanent sequelae from the injuries to the right cranial nerves II, III, IV, V1/V2, and VI. CONCLUSION: The risk of rupture of the cavernous carotid GIAs was relatively low and possibly further be reduced by the stasis flow and spontaneous occlusion of the parent artery internal carotid artery (ICA) induced by the mass effect of the cavernous carotid GIAs and the extremely rare aneurysmal calcification. However, nowadays, it is advisable to recommend early endovascular treatment for the cavernous carotid GIAs to prevent injuries to the surrounding intracranial nerves and occlusion of the ICA, mainly caused by the mass effect of the cavernous carotid GIAs.

Effect of the Number of Methyl Groups in DMOF on N2O Adsorption and N2O/N2 Separation.

Nitrous oxide (N2O), as the third largest greenhouse gas in the world, also has great applications in industry, so the purification of N2O from N2 in industrial tail gas is a crucial process for achieving environmental protection and giving full play to its economic value. Based on the polarity difference of N2O and N2, N2O adsorption was researched on DMOF series materials with different polarities and methyl numbers of the ligand. N2O adsorption at 0.1 bar is enhanced, attributed to an increase of the methyl group densities at the benzenedicarboxylate linker. Grand canonical Monte Carlo simulations demonstrate the key role of methyl groups within the pore surface in the preferential N2O affinity. Methyl groups preferentially bind to N2O and thus enhanced low (partial) pressure N2O adsorption and N2O/N2 separation. The result shows that DMOF-TM has the highest N2O adsorption capacity (19.6 cm3/g) and N2O/N2 selectivity (23.2) at 0.1 bar. Breakthrough experiments show that, with an increase of the methyl number, the coadsorption time and retention time also increase, and DMOF-TM has the best N2O/N2 separation performance.

Extra-abdominal infections caused by Comamonas kerstersii: Case report.

RATIONALE: Comamonas kerstersii mainly causes intra-abdominal infections with favorable outcomes due to high antibiotic susceptibility. We report the first case of pneumonia caused by C Kerstersii, which promoted patient death, and a second urinary tract infection by C Kerstersii with extensive drug resistance. PATIENT CONCERNS: A 46-year-old male (Case 1) with craniocerebral injury underwent emergency decompressive craniectomy, but his condition deteriorated further and presented with discontinuous fever, small moist rales on both lungs, and respiratory failure. Retrospective average nucleotide identity (ANI) analysis of the genomic sequence of the sputum isolate identified it as C Kerstersii 12322-1, antimicrobial susceptibility testing (AST) revealed that it was sensitive to 18 of 21 tested antibiotics.An 82-year-old male (Case 2) with hypertrophic prostate experienced gradual obstruction during urination, and a urine test revealed WBC ++. Retrospective ANI analysis of the urine isolate identified it as C Kerstersii 121606, which was resistant to 18 of 21 tested antibiotics. DIAGNOSES: Case 1 was diagnosed empirically as pneumonia caused by C Kerstersii strain 12322-1 secondary to craniocerebral injury and confirmed by retrospective ANI analysis; case 2 was diagnosed empirically as urinary infection secondary to prostate hyperplasia caused by C Kerstersii strain 121606 confirmed by the retrospective ANI analysis. INTERVENTIONS: Case 1 was administered cefoxitin, cefodizime, imipenem-cilastatin sodium, and underwent comprehensive salvage management. Case 2 was administered doxycycline alone. OUTCOMES: Case 1 died partially because of untimely identification of the responsible bacteria-12322-1. Case 2 was cured even 121606 exhibited an extensive drug resistance feature. LESSONS: Except for intra-abdominal infections with good prognosis, we verified that C Kerstersii could also cause extra-abdominal infections, such as the first pneumonia case and urinary infection. It could promote patient death; actual infections were underestimated due to identification difficulties, posing a health threat due to the presence of extensive drug resistance.

Proteomic Analysis of the Supernatant from Bone Marrow Mesenchymal Stem Cells under High Glucose Conditions.

Diabetes mellitus hinders the process of bone regeneration by inhibiting the function of mesenchymal stem cells (MSCs) through elevated glucose levels, thereby impeding osteointegration. The stem cell niche (SCN) plays a crucial role in determining the fate of stem cells by integrating various signals. However, the precise mechanism by which high glucose levels affect the SCN and subsequently influence the function of MSCs remains unclear. In this study, we employed proteomic analysis to identify proteins with altered expression in the extracellular matrix (ECM), aiming to elucidate the underlying mechanism. Three cell supernatants were collected from bone marrow mesenchymal stem cells (BMSCs) or BMSCs stimulated with high glucose (BMSCs+Hg). A total of 590 differentially expressed proteins were identified, which were found to be associated with the ECM, including aging, autophagy, and osteogenic differentiation. The findings of our study indicate that elevated glucose levels exert an influence on the molecular aspects of the SCN, potentially contributing to a better comprehension of the underlying mechanism.

Development and validation of novel immune-inflammation-based clinical predictive nomograms in HER2-negative advanced gastric cancer.

Purpose: To explore the predictive value of multiple immune-inflammatory biomarkers including serum VEGFA and systemic immune-inflammation index (SII) in HER2-negative advanced gastric cancer (AGC) and establish nomograms for predicting the first-line chemotherapeutic efficacy, progression-free survival (PFS) and overall survival (OS) of patients with this fatal disease. Methods: From November 2017 to April 2022, 102 and 34 patients with a diagnosis of HER2-negative AGC at the First Affiliated Hospital of Bengbu Medical College were enrolled as development and validation cohorts, respectively. Univariate and multivariate analyses were performed to evaluate the clinical value of the candidate indicators. The variables were screened using LASSO regression analysis. Predictive models were developed using significant predictors and are displayed as nomograms. Results: Baseline VEGFA expression was significantly higher in HER2-negative AGC patients than in nonneoplastic patients and was associated with malignant serous effusion and therapeutic efficacy (all p<0.001). Multivariate analysis indicated that VEGFA was an independent predictor for first-line therapeutic efficacy and PFS (both p<0.01) and SII was an independent predictor for first-line PFS and OS (both p<0.05) in HER2-negative AGC patients. The therapeutic efficacy model had an R2 of 0.37, a Brier score of 0.15, and a Harrell's C-index of 0.82 in the development cohort and 0.90 in the validation cohort. The decision curve analysis indicated that the model added more net benefits than VEGFA assessment alone. The PFS/OS models had Harrell's C-indexes of 0.71/0.69 in the development cohort and 0.71/0.62 in the validation cohort. Conclusion: The established nomograms integrating serum VEGFA/SII and commonly available baseline characteristics provided satisfactory performance in predicting the therapeutic efficacy and prognosis of HER2-negative AGC patients.

Accumulative Rolling Mg/PLLA Composite Membrane with Lamellar Heterostructure for Enhanced Bacteria Inhibition and Rapid Bone Regeneration.

Developing composite materials with optimized mechanics, degradation, and bioactivity for bone regeneration has long been a crucial mission. Herein, a multifunctional Mg/Poly-l-lactic acid (Mg/PLLA) composite membrane based on the "materials plain" concept through the accumulative rolling (AR) method is proposed. Results show that at a rolling ratio of 75%, the comprehensive mechanical properties of the membrane in the rolling direction are self-reinforced significantly (elongation at break ≈53.2%, tensile strength ≈104.0 MPa, Young's modulus ≈2.13 GPa). This enhancement is attributed to the directional arrangement and increased crystallization of PLLA molecular chains, as demonstrated by SAXS and DSC results. Furthermore, the AR composite membrane presents a lamellar heterostructure, which not only avoids the accumulation of Mg microparticles (MgMPs) but also regulates the degradation rate. Through the contribution of bioactive MgMPs and their photothermal effect synergistically, the membrane effectively eliminates bacterial infection and accelerates vascularized bone regeneration both in vitro and in vivo. Notably, the membrane exhibits outstanding rat skull bone regeneration performance in only 4 weeks, surpassing most literature reports. In short, this work develops a composite membrane with a "one stone, four birds" effect, opening an efficient avenue toward high-performance orthopedic materials.

Porous nitrogen-doped reduced graphene oxide-supported CuO@Cu2O hybrid electrodes for highly sensitive enzyme-free glucose biosensor.

Constructing high-performance enzyme-free biosensors for detecting glucose is essential to preliminary diabetes diagnosis. Here, copper oxide nanoparticles (CuO@Cu2O NPs) were anchored in porous nitrogen-doped reduced graphene oxide (PNrGO) to construct CuO@Cu2O/PNrGO/GCE hybrid electrode for sensitive detection of glucose. Benefiting from the remarkable synergistic effects between the multiple high activation sites of CuO@Cu2O NPs and the dramatic properties of PNrGO with excellent conductivity and large surface area with many accessible pores, the hybrid electrode possesses outstanding glucose sensing performance that is far superior to those of pristine CuO@Cu2O electrode. The as-fabricated enzyme-free glucose biosensor displays prominent glucose sensitivity of 2,906.07 µA mM-1 cm-2, extremely low limit of detection of 0.13 µM, and wide linear detection of 3 µM-6.772 mM. In addition, excellent reproducibility, favorable long-term stability, and distinguished selectivity are obtained in the glucose detection. Importantly, this study provides promising results for continuous improvement of non-enzyme sensing applications.

Facile and rapid determination of oxalic acid by fading spectrophotometry based on Fe(III)-sulfosalicylate as colorimetric chemosensor.

Spectrophotometry is an economic and rapid method for detecting oxalic acid (OA), while the reported methods have some drawbacks, such as narrow linear range, long response time, delicate operation and required expensive reagents. Herein, we found that the as-synthesized Fe(III)-sulfosalicylate (FeSSA) could be used as an efficient colorimetric chemosensor to detect OA, and the established FeSSA-based fading spectrophotometry showed prominent advantages over the existing ones in detecting OA. The as-established method has wider linear range of 0.80-160 mg/L with regression coefficient ≥ 0.999, while the widest linear range is just 2.7-54 mg/L among the reported ones. Moreover, the method has low limit of detection (0.74 mg/L), extremely fast response (several seconds), satisfactory selectivity, high accuracy and precision. Most importantly, its reliability was further verified by employing it to determine OA concentration during the degradation process of organic pollutants. The measured OA concentration at any time interval was perfectly consistent with those determined by the well-recognized high performance liquid chromatography (HPLC). These confirmed that the FeSSA-based fading spectrophotometry is an efficient, simple, fast, accurate and economic method to determine OA in a wide concentration range.

Complete mineralization of phenolic compounds in visible-light-driven photocatalytic ozonation with single-crystal WO3 nanosheets: Performance and mechanism investigation.

Complete mineralization of phenolic compounds into CO2 and H2O is desirable for removing them in wastewater, but it is challenging due to the generated recalcitrant intermediates, which requires highly effective advanced oxidation process with proper catalysts. Herein, we found that single-crystal WO3 nanosheets (NSs)-based photocatalytic ozonation (PCO) can realize complete mineralization of phenols (phenol and 2-chlorophenol) under visible light irradiation. Almost 100% mineralization ratio of phenols was achieved through WO3 NSs-based PCO system within short time. By comparing their performances with those of polycrystalline WO3 nanoparticles, detecting and analyzing the intermediates, identifying the dominant radicals and conducting some electrochemical characterizations, the origin of superior catalytic activity of WO3 NSs was uncovered, the mineralization pathways and the overall mechanism were proposed. The excellent PCO performance of WO3 NSs was contributed to their nanosheet morphology with single-crystal microstructure and good dispersion, which can provide continuous interior channels for the photogenerated charge transport from the bulk to surface of WO3 NSs and enough active sites for the surface reactions triggered by these charges. This work puts forwards new ideas to design highly active photocatalysts for PCO and helps deepen understanding of the catalytic mechanism of PCO.

Approximation capabilities of neural networks on unbounded domains.

There is limited study in the literature on the representability of neural networks on unbounded domains. For some application areas, results in this direction provide additional value in the design of learning systems. Motivated by an old option pricing problem, we are led to the study of this subject. For networks with a single hidden layer, we show that under suitable conditions they are capable of universal approximation in Lp(R×[0,1]n) but not in Lp(R2×[0,1]n). For deeper networks, we prove that the ReLU network with two hidden layers is a universal approximator in Lp(Rn).

A Comparative Study of Seminars Combined with Case-Based Learning versus Lecture-Based Learning for Cancer Pain Teaching in Medical Oncology Internship.

PURPOSE: To determine whether the teaching method of seminars combined with case-based learning (CBL) is superior to the traditional lecture-based learning (LBL) for teaching cancer pain in medical oncology internship. METHODS: Sixty medical and nursing interns in the medical oncology department of our hospital were selected between January 2019 and December 2020. Thirty students received traditional LBL instruction as the control group, and 30 students received combined seminars and CBL instruction as the observation group. The teaching evaluation and assessment was performed by theoretical and practical examinations and questionnaires. RESULTS: In the after-class examination, case analysis, clinical practice and overall scores of the observation group were higher than those of the control group (all p < 0.001). Theoretical knowledge scores did not differ significantly between the two groups (p = 0.470). In the questionnaire regarding attitudes towards opioid use, the observation group had better perceptions of using opioids than the control group (all p < 0.01). In the meantime, students in the observation group outperformed the control group in four aspects: self-learning (p < 0.001), analytical and problem-solving (p < 0.001), clinical thinking (p = 0.001), and clinical practice (p = 0.002) abilities all improved, while stimulating learning interest (p = 0.184) and enhancing theoretical knowledge mastery (p = 0.221) were not significantly different from those of the control group. Overall, students in the observation group were more satisfied with the teaching, teaching methods and teacher performances than the control group (all p < 0.001). CONCLUSION: Compared to the LBL, the combination of seminars and CBL is a more effective teaching method for cancer pain management, which is worth further study.

One-step green fabrication of hierarchically porous hollow carbon nanospheres (HCNSs) from raw biomass: Formation mechanisms and supercapacitor applications.

Hierarchical porous hollow carbon nanospheres (HCNSs) were fabricated directly from raw biomass via a one-step method, in which HCNSs were obtained by thermal treatment of raw biomass in the presence of polytetrafluoroethylene (PTFE). The HCNSs possess coupling merits of uniformly distributed hollow spherical architectures, and high specific surface area, abundant accessible/open micropores and reasonable mesopores, the HCNS-based electrodes deliver high electrochemical capacitance. The formation mechanisms of pores and hollow core-shell structures were explored thoroughly, it is found that the key to the formation of hollow core-shell structure is the onset-pyrolysis temperature difference between raw biomass and PTFE. Moreover, the content of silica had significant effects on the textures of HCNSs, and HCNS with the largest SSA of 1984 m2/g was obtained. Accordingly, a possible mechanism of HCNSs formation was proposed here, where PTFE acted as the pore creation and nucleation agents and raw biomasses were the primary carbon precursors.

Asymmetric Supercapacitors Based on Hierarchically Nanoporous Carbon and ZnCo2O4 From a Single Biometallic Metal-Organic Frameworks (Zn/Co-MOF).

Metal-organic framework (MOF)-derived nanoporous carbons (NPCs) and porous metal oxide nanostructures or nanocomposites have gathered considerable interest due to their potential use in supercapacitor (SCs) applications, owing to their precise control over porous architectures, pore volumes, and surface area. Bimetallic MOFs could provide rich redox reactions deriving from improved charge transfer between different metal ions, so their supercapacitor performance could be further greatly enhanced. In this study, "One-for-All" strategy is adopted to synthesize both positive and negative electrodes for hybrid asymmetric SCs (ASCs) from a single bimetallic MOF. The bimetallic Zn/Co-MOF with cuboid-like structures were synthesized by a simple method. The MOF-derived nanoporous carbons (NPC) were then obtained by post-heat treatment of the as-synthesized Zn/Co-MOF and rinsing with HCl, and bimetallic oxides (ZnCo2O4) were achieved by sintering the Zn/Co-MOF in air. The as-prepared MOF-derived NPC and bimetallic oxides were utilized as negative and positive materials to assemble hybrid ASCs with 6 M KOH as an electrolyte. Owing to the matchable voltage window and specific capacitance between the negative (NPC) and positive (ZnCo2O4), the as-assembled ASCs delivered high specific capacitance of 94.4 F/g (cell), excellent energy density of 28.6 Wh/kg at a power density of 100 W/kg, and high cycling stability of 87.2% after 5,000 charge-discharge cycles. This strategy is promising in producing high-energy-density electrode materials in supercapacitors.

Insight into the Intermolecular Interaction and Free Radical Polymerizability of Methacrylates in Supercritical Carbon Dioxide.

High pressure in situ Fourier transfer infrared/near infrared technology (HP FTIR/NIR) along with theoretical calculation of density functional theory (DFT) method was employed. The solvation behaviors and the free radical homopolymerization of methyl methacrylate (MMA), methacrylate acid (MAA), trifluoromethyl methacrylate (MTFMA) and trifluoromethyl methacrylate acid (TFMAA) in scCO2 were systematically investigated. Interestingly, the previously proposed mechanism of intermolecular-interaction dynamically-induced solvation effect (IDISE) of monomer in scCO2 is expected to be well verified/corroborated in view that the predicted solubility order of the monomers in scCO2 via DFT calculation is ideally consistent with that observed via HP FTIR/NIR. It is shown that MMA and MAA can be easily polymerized, while the free radical polymerizability of MTFMA is considerably poor and TFMAA cannot be polymerized via the free radical initiators. The α trifluoromethyl group (-CF3) may effectively enhance the intermolecular hydrogen bonding and restrain the diffusion of the monomer in scCO2. More importantly, the strong electron-withdrawing inductive effect of -CF3 to C=C may distinctly decrease the atomic charge of the carbon atom in the methylene (=CH2). These two factors are believed to be predominantly responsible for the significant decline of the free radical polymerizability of MTFMA and the other alkyl 2-trifluoromethacrylates in scCO2.

miR­337­3p inhibits gastric tumor metastasis by targeting ARHGAP10.

Several microRNAs (miRNAs) are known as regulatory molecules involved in gastric tumor metastasis. The expression of miR­337­3p was revealed to be downregulated in metastatic gastric tumor cells. Overexpression of miR­337­3p in gastric cancer cells resulted in the reduction of their invasive abilities. To characterize the functions of miR­337­3p, miR­337­3p was expressed in a metastatic lymph node­derived gastric tumor cell line, SGC­7901. Overexpression of miR­337­3p reduced the viability of cells but had no effects on the cell cycle. Wound healing and Transwell migration assays revealed that miR­337­3p inhibited the migration capacity of cells. miR­337­3p was capable of binding to the 3'­untranslated region of a cytoskeleton­associated molecule, ARHGAP10. Overexpression of miR­337­3p reduced the mRNA and protein levels of ARHGAP10 and the co­expression of ARHGAP10 and miR­337­3p resulted in the recovery of cell migration capacity. Furthermore, the injection of miR­337­3p­overexpressing SGC­7901 cells into an immunodeficient mouse model resulted in a decrease in tumor metastasis in the liver and lungs. The present results indicated that miR­337­3p regulates gastric tumor metastasis by targeting the cytoskeleton­associated protein ARHGAP10.

The antibiotic resistance and pathogenicity of a multidrug-resistant Elizabethkingia anophelis isolate.

Elizabethkingia anophelis 12012-2 PRCM was isolated from a patient with multiple organ dysfunction syndrome and lower respiratory tract infection in China. Minimum inhibitory concentration (MIC) analysis demonstrated that it was resistant to 20 antibiotics including trimethoprim/sulfamethoxazole and ciprofloxacin, which were effective for the elimination of other Elizabethkingia infections. To investigate multidrug resistance and pathogenicity mechanisms, we analyzed genome features of 12012-2 PRCM and compared them to the other Elizabethkingia species. The draft genome size was 4.02 Mb with a GC content of 32%, comparable to that of other E. anophelis strains. Phylogenetic analysis showed that E. anophelis 12012-2 PRCM formed a sister group with E. anophelis 502, distinct from clades formed by other clinical and environmental E. anophelis isolates. E. anophelis 12012-2 PRCM contained multiple copies of ß-lactamase genes as well as genes predicted to function in antimicrobial efflux. It also contained 92 genes that were potentially involved in virulence, disease, and defense, and were associated with resistance and pathogenicity. Comparative genomic analysis showed high homology among three clinical and two environmental E. anophelis strains having a variety of similar antibiotic resistance and virulence factor genes, and similar genomic structure. Applications of this analysis will contribute to understanding the antibiotic resistance and pathogenic mechanisms of E. anophelis infections, which will assist in the management of infections as it increases in prevalence.

Comparative genomic analysis of Myroides odoratimimus isolates.

Myroides odoratimimus is an important nosocomial pathogen. Management of M. odoratimimus infection is difficult owing to the multidrug resistance and the unknown pathogenesis mechanisms. Based on our previous genomic sequencing data of M. odoratimimus PR63039 (isolated from a patient with the urinary tract infection), in this study, we further performed comparative genomic analysis for 10 selected Myroides strains. Our results showed that these Myroides genome contexts were very similar and phylogenetically related. Various prophages were identified in the four clinical isolate genomes, which possibly contributed to the genome evolution among the Myroides strains. CRISPR elements were only detected in the two clinical (PR63039 and CCUG10230) isolates and two environmental (CCUG12700 and H1bi) strains. With more stringent cutoff parameters in CARD analysis, the four clinical M. odoratimimus contained roughly equal antibiotic resistance genes, indicating their similar antibiotic resistance profiles. The three clinical (CCUG10230, CCUG12901, CIP101113) and three environmental (CCUG12700, L41, H1bi) M. odoratimimus strains were speculated to carry the indistinguishable virulent factors (VFs), which may involve in the similar pathogenesis mechanism. Moreover, some VFs might confer to the high capacity of dissemination, attacking tissue cells and induction of autoimmune complications. Our results facilitate the research of antibiotic resistance and the development of therapeutic regimens for the M. odoratimimus infections.

Factors relevant to the prognosis of patients with esophageal cancer who received intensity-modulated radiotherapy.

BACKGROUND: The aim of this study was to evaluate the clinical factors relevant to the prognosis of patients with esophageal cancer who received intensity-modulated radiotherapy (IMRT). METHODS: The data of 60 patients admitted to our hospital from January 2014 to December 2015 with pathologically confirmed esophageal cancer were retrospectively reviewed. All patients received IMRT. Patients were divided into groups according to two-year survival: those who survived > 2 years after treatment, and those who died within 2 years of treatment. The potential clinical factors relevant to prognosis were evaluated by logistic regression analysis. RESULTS: Single factor analysis showed that lesion length (P < 0.05), tumor diameter (P < 0.05), T stage (P < 0.05), N stage (P < 0.05), and combined chemotherapy (P < 0.05) were associated with the prognosis of esophageal cancer patients who received IMRT. Logistic regression analysis demonstrated that T stage (odds ratio = 3.62; P < 0.05) and N stage (odds ratio = 2.98; P < 0.05) were independent factors relevant to prognosis. CONCLUSION: T stage and N stage influence the long-term curative effects of IMRT for esophageal cancer. The higher the stage, the lower the two-year survival rate.

Genomic insights of Pannonibacter phragmitetus strain 31801 isolated from a patient with a liver abscess.

Pannonibacter phragmitetus is a bioremediation reagent for the detoxification of heavy metals and polycyclic aromatic compounds (PAHs) while it rarely infects healthy populations. However, infection by the opportunistic pathogen P. phragmitetus complicates diagnosis and treatments, and poses a serious threat to immunocompromised patients owing to its multidrug resistance. Unfortunately, genome features, antimicrobial resistance, and virulence potentials in P. phragmitetus have not been reported before. A predominant colony (31801) was isolated from a liver abscess patient, indicating that it accounted for the infection. To investigate its infection mechanism(s) in depth, we sequenced this bacterial genome and tested its antimicrobial resistance. Average nucleotide identity (ANI) analysis assigned the bacterium to the species P. phragmitetus (ANI, >95%). Comparative genomics analyses among Pannonibacter spp. representing the different living niches were used to describe the Pannonibacter pan-genomes and to examine virulence factors, prophages, CRISPR arrays, and genomic islands. Pannonibacter phragmitetus 31801 consisted of one chromosome and one plasmid, while the plasmid was absent in other Pannonibacter isolates. Pannonibacter phragmitetus 31801 may have a great infection potential because a lot of genes encoding toxins, flagellum formation, iron uptake, and virulence factor secretion systems in its genome. Moreover, the genome has 24 genomic islands and 2 prophages. A combination of antimicrobial susceptibility tests and the detailed antibiotic resistance gene analysis provide useful information about the drug resistance mechanisms and therefore can be used to guide the treatment strategy for the bacterial infection.

Efficacy and Safety of Vinorelbine Plus Cisplatin vs. Gemcitabine Plus Cisplatin for Treatment of Metastatic Triple-Negative Breast Cancer After Failure with Anthracyclines and Taxanes.

BACKGROUND This study aimed to compare the efficacy and safety of vinorelbine plus cisplatin (NP regimen) vs. gemcitabine plus cisplatin (GP regimen) for treatment of metastatic TNBC after failure with anthracyclines and taxanes. MATERIAL AND METHODS A total of 48 patients with metastatic TNBC that failed in anthracyclines and taxanes treatment were enrolled and randomly grouped. Patients in the NP group (n=22) were given 25 mg/m² vinorelbine on days 1 and 8 and 25 mg/m² cisplatin on days 2-4 of each 21-day cycle, while subjects in the GP group (n=26) were administered 1000 mg/m² gemcitabine on days 1 and 8 and 25 mg/m² cisplatin on days 2-4 of each 21-day cycle. The treatment response and adverse events were compared between the 2 groups every 2 cycles. RESULTS The ORR, DCR, and median TTP were 45.5%, 77.3%, and 5 months in the NP group, and 46.2%, 80.8%, and 5.2 months in the GP group, and no significant differences were observed in ORR, DCR, and median TTP between the 2 groups (P>0.05). The major adverse events included grade I-II bone marrow inhibition, gastrointestinal reactions, and phlebitis, and a lower incidence of thrombocytopenia and rash and a higher incidence of phlebitis was found in the NP group than in the GP group (P<0.05). CONCLUSIONS Either NP or GP regimen is active and tolerated in treatment of metastatic TNBC with anthracyclines and/or taxanes resistance, which may be used as a salvage treatment for metastatic TNBC.