Reproducible and High-Performance WOLEDs Based on Independent High-Efficiency Triplet Harvesting of Yellow Hot-Exciton ESIPT and Blue TADF Emitters.

Hot exciton organic light-emitting diode (OLED) emitters can balance the high performance of a device and reduce efficiency roll-off by fast reverse intersystem crossing from high-lying triplets (hRISC). In this study, an excited-state intramolecular proton transfer (ESIPT) fluorophore of 2-(benzo[d]thiazol-2-yl)-4-(pyren-1-yl)phenol (PyHBT) with the typical characteristic properties of a hot exciton is developed. With high efficiency of utilization of the exciton (91%), its yellow OLED exhibited high external quantum efficiency (EQE) of 5.6%, current efficiency (CE) of 16.8 cd A-1 , and power efficiency (PE) of 17.3 lm W-1 . The performance of the yellow emissive "hot exciton" ESIPT fluorophores is among the highest recorded. Due to the large Stokes shift of the ESIPT emitter, non-energy-transferred high-performance white OLEDs (WOLEDs) are developed, which are reproducible and highly efficient. This is possible because of the independent harvesting of most of the triplets in both complementary-color emitters without the interference of energy transfer. The PyHBT-based WOLEDs exhibit a maximum EQE of 14.3% and CE of 41.1 cd A-1 , which facilitates the high-yield mass production of inexpensive WOLEDs.

Prognostic value of sarcopenia in patients with lung cancer treated with epidermal growth factor receptor tyrosine kinase inhibitors or immune checkpoint inhibitors.

Objectives: It remains controversial whether sarcopenia has any significant impact on the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) or immune checkpoint inhibitors (ICIs) in patients with advanced non-small cell lung cancer (NSCLC). Therefore, in this study, we aimed to assess the association between sarcopenia and clinical outcomes in patients with advanced NSCLC receiving EGFR-TKIs or ICIs as a first-line therapy. Methods: We retrospectively enrolled 131 patients with advanced NSCLC treated with first-line EGFR-TKIs or ICIs between 1 March 2019 and 31 March 2021. To estimate sarcopenia, we calculated skeletal muscle index (SMI) as the ratio of skeletal muscle area (cm2) to height squared (m2). Associations between sarcopenia and overall survival (OS) and progression-free survival (PFS) were evaluated using the Kaplan-Meier method and log-rank tests, respectively. A Cox proportional hazards regression model was used to assess the factors associated with OS and PFS. The Student's t-test or Mann-Whitney U test was used to compare the SMI between patients with or without objective response and disease control. The chi-squared test was used to compare adverse events (AEs) between patients with and without sarcopenia. Results: Among the 131 patients, 35 (26.7%) were diagnosed with sarcopenia. Sarcopenia was an independent predictor of poor OS and PFS (p < 0.05) overall and in the EGFR-TKI- and ICI-treated cohorts. Among all patients, those with sarcopenia showed significantly shorter OS and PFS than those without sarcopenia (median OS and PFS: 13.0 vs. 26.0 months and 6.4 vs. 15.1 months; both p < 0.001). These associations were consistent across the subtypes of most clinical characteristics. Statistically significant differences between the objective response (OR) and non-OR groups were also observed in the mean SMI (OR group, 43.89 ± 7.55 vs. non-OR group, 38.84 ± 7.11 cm2/m2; p < 0.001). In addition, we observed similar results with disease control (DC) and non-DC groups (DC group, 42.46 ± 7.64 vs. non-DCR group, 33.74 ± 4.31 cm2/m2; p < 0.001). The AEs did not differ significantly between the sarcopenia and non-sarcopenia groups. Conclusion: Sarcopenia before treatment might be a significant predictor of poor clinical outcomes (shorter OS and PFS, fewer ORs, less DC) in patients with advanced NSCLC treated with EGFR-TKIs or ICIs as the first-line therapy.

Post-treatment serum triglyceride: An effective biomarker for body fat mass and overall survival in esophageal squamous cell cancer patients treated with chemoradiotherapy.

Objectives: Although lipids have been assessed for their possible roles in cancer survival prediction, studies on the association between serum triglyceride (TG) levels and the prognosis of esophageal squamous cell carcinoma (ESCC) patients are limited. This study aimed to evaluate whether serum TG is associated with outcomes in patients with ESCC and investigate any interaction between serum TG and clinical parameters, especially body fat mass. Materials and methods: We conducted a prospective case study on patients diagnosed with ESCC between March 2012 and November 2018. We measured patients' serum TG levels before and after treatment. The association between serum TG and overall survival (OS) was evaluated using hazard ratios. We sought to determine a threshold point using optimal stratification. Survival analysis was performed using Kaplan-Meier curves and a Cox proportional hazards model. Results: Of the 257 participants diagnosed with ESCC, 200 (77.8%) were men. Median follow-up time was 22.4 months (range 3.3-92.4 months). Using univariate Cox proportional hazard analysis and subsequent multivariate analysis, post-TG levels, Karnofsky performance scores, T stages, and chemotherapy cycles were shown to be independent prognostic factors for OS (p < 0.05). The post-TG cut-off point to best classify patients with respect to time to mortality was 1.47 mmol/L. A post-TG level of ≥ 1.47 mmol/L could independently predict a better OS (hazard ratio: 0.55, 95% confidence interval: 0.37-0.79). The associations were consistent across the subtypes of clinical parameters. Furthermore, the post-body mass index, post-subcutaneous adipose tissue area, post-visceral adipose tissue area, post-total adiposity tissue area, and post-total adipose density exhibited a strong positive association with post-TG levels. Conclusion: Post-TG levels were found to be a significant positive prognostic biomarker for body fat mass and OS in ESCC patients.

Lymph drainage and cervical fascia anatomy-oriented differential nodal CTV delineation at the supraclavicular region for esophageal cancer and nasopharyngeal cancer.

PURPOSE: To determine the differences in supraclavicular lymph node metastasis between esophageal cancer (EC) and nasopharyngeal cancer (NPC) and explore the feasibility of differential supraclavicular clinical target volume (CTV) contouring between these two diseases based on the involvement of different fascial spaces. MATERIALS AND METHODS: One hundred patients with supraclavicular nodes positive for EC or NPC were enrolled, and their pre-treatment images were reviewed. The distribution patterns of nodes between the two diseases were compared in the context of node levels defined by the 2017 Japanese Esophageal Society and 2013 International Consensus on Cervical Lymph Node Level Classification. Grouping supraclavicular nodes based on sub-compartments formed by the cervical fascia was discussed, and the feasibility of differential CTV contouring based on the differences in the involvement of these sub-compartments between EC and NPC was explored. RESULTS: The 2013 Consensus on cervical node levels and 2017 Japanese Esophageal Society node station could not practically guide supraclavicular CTV contouring. We divided the supraclavicular space into six sub-compartments: the para-esophageal space (PES), carotid sheath space (CSS), sub-thyroid pre-trachea space (STPTS), pre-vascular space (PVS), and vascular lateral space (VLS) I and II. EC mainly spread to the PES, STPTS, CSS, and VLS I, whereas NPC tended to spread to the CSS, VLS I, and VLS II. These combinations of sub-compartments may help constitute the supraclavicular CTVs for EC and NPC. CONCLUSIONS: The fascia anatomy-based sub-compartments sufficiently distinguished metastasis to the supraclavicular space between EC and NPC, thus facilitating differential CTV contouring between these two diseases.

Level Ib CTV delineation in nasopharyngeal carcinoma based on lymph node distribution and topographic anatomy.

BACKGROUND AND PURPOSE: To analyze the distribution pattern of lymph nodes (LNs) metastasis of level Ib in nasopharyngeal cancer (NPC) and propose shrinkage of clinical target volume (CTV) boundaries to avoid unnecessary radiation for some space with very low-risk of involvement. MATERIALS AND METHODS: Pretreatment images of pathologically proven NPC patients were reviewed and those with positive level Ib LN metastasis was enrolled. The geometric center of each level Ib LN in the neck was marked on a template CT. The spatial relationship of nodes with key structures in level Ib was analyzed. Modified level Ib CTV according to the 2013 International CTV consensus was proposed based on the LN distribution pattern. A PlanIQ Feasibility DVH module was implemented to evaluate the feasibility analysis of the best possible sparing of organs at risk (OAR) with modified Ib CTV. RESULTS: A total of 1518 NPC patients were reviewed and 54 with positive level Ib nodes were enrolled. Four sub-level anatomical regions were defined within the gross area of level Ib. Of 106 positive nodes identified, none, one, 88, and 17 were found in the intraglandular (IG), medial mandibular (MM), supra perivascular (SP), and infra perivascular (IP) sub-level, respectively. This study proposes sparing the IG and MM sub-level and including the area within a specified distance from the submandibular gland (11 mm for SP, 17 mm for IP) for CTV coverage. Compared with planning based on CTV-consensus, planning based on CTV-proposed results in a significantly reduced CTV volume, and mean dose (Dmean) of both the ipsilateral SMG and bilateral SLG. CONCLUSIONS: Based on detailed analysis of the relationship between positive node distribution and several important anatomical structures, modified level Ib CTV for prophylactic irradiation was proposed to reduce the dose of OAR irradiation.

Unresected small lymph node assessment predicts prognosis for patients with pT3N0M0 thoracic esophageal squamous cell carcinoma.

BACKGROUND: The role of unresected small lymph nodes (LNs) which may contain metastases for thoracic esophageal squamous cell carcinoma (TESCC) has not been addressed. The aim of the study was to investigate the role of unresected small LNs assessment using computed tomography (CT) in prognostic estimates of pT3N0M0 TESCC patients. METHODS: Between January 2009 and December 2017, 294 patients who underwent esophagectomy with R0 resection at Sichuan Cancer Hospital were retrospectively examined, and the last follow-up time was July 2018. Patients were classified into CT-suspect and CT-negative groups according to the shortest diameter and the shape (axial ratio) of the unresected small LNs on preoperative CT. The Kaplan-Meier method was used to compare survival differences in prognostic factors. Univariate and multivariate analyses were performed to identify prognostic factors for survival and recurrence. RESULTS: Eighty-four patients (28.6%) were classified as CT-suspect group according to the diagnostic criteria; survival analysis suggested that CT-suspect group of patients had a relatively poorer prognosis (P<0.05). Cox regression analysis indicated that unresected small LNs status, tumor grade, and postoperative adjuvant therapy were independent prognostic factors for patients with pT3N0M0 TESCC (P<0.05). Further analysis shown the rates of total recurrence (TR) and locoregional recurrence (LR) in the CT-suspect group were significantly higher than that in the CT-negative group (TR, P<0.001; LR, P<0.001). Among the LRs, the rate of supraclavicular lymph node recurrence in the CT-suspect group was significantly higher than that in the CT-negative group (P<0.001). CONCLUSIONS: Unresected small lymph node assessment is critically important and predict prognosis for pT3N0M0 TESCC patients.

Pyocyanin Inhibits Chlamydia Infection by Disabling Infectivity of the Elementary Body and Disrupting Intracellular Growth.

The obligate intracellular bacterium Chlamydia is a widespread human pathogen that causes serious problems, including (but not limited to) infertility and blindness. Our search for novel antichlamydial metabolites from marine-derived microorganisms led to the isolation of pyocyanin, a small compound from Pseudomonas aeruginosa Pyocyanin is an effective antichlamydial for all three Chlamydia spp. tested. It has a 50% inhibitory concentration (IC50) of 0.019 to 0.028 µM, which is comparable to the IC50 of tetracycline. At concentrations as low as 0.0039 µM, pyocyanin disables infectivity of the chlamydial elementary body (EB). At 0.5 µM or higher concentrations, the continuous presence of pyocyanin also inhibits chlamydial growth in the inclusion during later stages of the developmental cycle. Oxidative stress, a major known antimicrobial mechanism of pyocyanin, appears to be responsible only for the inhibition of bacterial growth and not for the disinfection of EBs. Pyocyanin is well-tolerated by probiotic vaginal Lactobacillus spp. Our findings suggest that pyocyanin is of therapeutic value for chlamydial infections and can serve as a valuable chemical probe for studying chlamydial biology.

Association between neutrophil-to-lymphocyte ratio and differentiated thyroid cancer: a meta-analysis.

The association between neutrophil-to-lymphocyte ratio (NLR) and differentiated thyroid cancer (DTC) is undecided. To rectify this question, we conducted a systematic meta-analysis based on 7 prospective cohort studies published between 2013 and 2015, comprising 7349 patients. Six of these cohorts included pretreatment (baseline) NLR data for patients with thyroid nodules. The meta-analysis of these 6 cohorts showed that the NLR of patients with DTC (4617 cases) was statistically similar to patients with benign nodules only (1666 cases), with a mean difference (MD) of 0.19 (95% CI: -0.09 to 0.46; I2 = 93%; P < 0.001). No significant difference in NLR was found between patients with DTC and patients with benign nodules. Two studies addressed an association between NLR and papillary thyroid carcinoma in patients stratified by age <45 and ≥45 years (496 and 891 cases, respectively); the pooled MD was 0.09 (95% CI: -0.37 to 0.55; I2 = 92.2%, P < 0.001). An elevated NLR seems not a reliable indicator of progressing DTC in patients with goiters, and there was no difference in NLR between patients aged <45 years and those aged ≥45 years. Well-designed and large-scale investigations are warranted to understand the value of NLR in the prognosis of DTC.

[Biological relativity of imaging of CT perfusion for pancreases to pancreatic cancer].

OBJECTIVE: To explore the relationships between perfusion values of pancreatic cancers and the microvessel density of tumors (MVD) and vessel endothelial growth factor (VEGF), and the clinical value of multiple-slice spiral CT perfusion imaging in diagnosing pancreatic cancers. METHODS: Forty-two people with normal pancreas and eighteen patients with pancreatic cancers underwent multiple-slice spiral CT perfusion examinations. The time-density curve (TDC) of the region of interest (ROI) was drawn with the software equipped in the spiral CT. The CT perfusion parameters of the ROI peak reinforcement values were calculated, including blood flow (BF), blood volume (BV), time to start (TTS), time to peak (TTP), permeability, and mean of the patlak blood volume (pBV). Twenty patients (11 with pancreatic cancers and 9 with chronic pancreatitis) were chosen for CD34 and VGEF antibody immunohistochemistry staining on the same layers of pancreatic tissues as the CT perfusion targeted. The associations between the imaging of CT perfusion and MVD and VFGF were examined. RESULTS: The patients with pancreatic cancers had lower BF, VB, and pBV, and higher permeability than the normal controls (P<0.01). No differences appeared between the two groups in time to start and time to peak (P>0.05). The difference in average MVD of the 9 patients with chronic pancreatitis (13.8 +/- 9.6), and the 11 patients with pancreatic cancers (30.5 +/- 14.8) was statistically significant. Eight patients with pancreatic cancers showed strong positive VEGF and three showed weak positive VEGF. Only one patient with chronic pancreatitis showed strong positive VEGF while eight showed weak positive VEGF. The difference in positive rate of VEGF between the two groups of patients was statistically significant (P<0.01). The MVD in patients with pancreatic cancers (median 40.2) was correlated with BF (median 26.9), TTS (median 14.8), and TTP (median 145.3) (r=0.42, 0.63, and 0.45, respectively). The expression of VGEF (median 4.3) was negatively correlated with BV (r=-0.39). CONCLUSION: Imaging of CT perfusion has certain clinical value for diagnosing pancreatic cancers. The imaging of CT perfusion reflects the MVD and VEFG in the tumor tissues.

[CT and MR imaging differences between intrahepatic cholangiocarcinoma and hepatocellular carcinoma with invasions to billary tracts].

OBJECTIVE: To identify the CT and MR imaging differences between intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC) with invasions to biliary tracts. METHODS: Eighteen patients with ICC and 32 HCC patients with invasions to biliary tracts confirmed by postoperative pathological diagnosis were enrolled in the study. All of the patients underwent CT or MR examinations. The image features about the tumor and the biliary tracts were analyzed retrospectively. RESULTS: The imaging features of ICC were: faint rim-like enhancement and no enhancement of the masses. The ICC invasions to biliary tracts were shown as severe dilation of biliary tracts, coarse-to-fine or separation of dilated tracts, thickened and enhanced walls, dilation of biliary tract encased in the mass. The HCCs showed quick fill-in and wash-out of the contrast media in the mass. The imaging features of HCC with invasions to biliary tracts were: mild dilated tracts, compressed and extruded tracts, thickening of the wall of dilated tracts and enhancement of the walls. The location of the dilated tracts were mostly alongside of the tumors. The chi square tests revealed significant differences between ICC and HCC in the above features (P<0.05). CONCLUSION: CT or MR imaging may help differentiate ICC and HCC with invasions to biliary tracts.