Enhancing Circularly Polarized Luminescence in Quantum Dots through Chiral Coordination-Mediated Growth at the Liquid/Liquid Interface.

Here, we develop a novel methodology for synthesizing chiral CdSe@ZnS quantum dots (QDs) with enhanced circularly polarized luminescence (CPL) by incorporating l-/d-histidine (l-/d-His) ligands during ZnS shell growth at the water/oil interface. The resulting chiral QDs exhibit exceptional absolute photoluminescence quantum yield of up to 67.2%, surpassing the reported limits of 40.0% for chiral inorganic QDs, along with absorption dissymmetry factor (|gabs|) and luminescence dissymmetry factor (|glum|) values of 10-2, exceeding the range of 10-5-10-3 and 10-4-10-2, respectively. Detailed investigations of the synthetic pathway reveal that the interface, as a binary synthetic environment, facilitates the coordinated ligand exchange and shell growth mediated by chiral His-Zn2+ coordination complexes, leading to a maximum fluorescent brightness and chiroptical activities. The growth process, regulated by the His-Zn2+ coordination complex, not only reduces trap states on the CdSe surface, thereby enhancing the fluorescence intensity, but also significantly promotes the orbital hybridization between QDs and chiral ligands, effectively overcoming the shielding effect of the wide bandgap shell and imparting pronounced chirality. The proposed growth pathway elucidates the origin of chirality and provides insights into the regulation of the CPL intensity in chiral QDs. Furthermore, the application of CPL QDs in multilevel anticounterfeiting systems overcomes the limitations of replication in achiral fluorescence materials and enhances the system's resistance to counterfeiting, thus opening new opportunities for chiral QDs in optical anticounterfeiting and intelligent information encryption.

Quantum Dots with a Compact Amphiphilic Zwitterionic Coating.

Generally speaking, it is difficult to keep nanomaterials encapsulated in amphiphilic polymers like octylamine-grafted poly(acrylic acid) (OPA) compact in coating-layer, with a small hydrodynamic size. Here, we prepared stable hydrophilic quantum dots (QDs) via encapsulation in ∼3 nm-long amphiphilic and zwitterionic (AZ) molecules. After encapsulation with AZ molecules, the coated QDs are only 2.1 nm thicker in coating, instead of 5.4 nm with OPA. Meanwhile, the hydrodynamic sizes of CdSe/CdS, ZnCdSeS, ZnCdSe/ZnS, and CdSe/ZnS QDs encapsulated in AZ molecules (AZ-QDs) are less than 15 nm, and 6-7 nm smaller than those of QDs in OPA (OPA-QDs). Notably, both extracellular and intracellular nonspecific binding of AZ-QDs is approximately 100-folds lower than that of OPA-QDs.

Immunoprofiling of Severity and Stage of Bacterial Infectious Diseases by Ultrabright Fluorescent Nanosphere-Based Dyad Test Strips.

Bacterial infectious diseases are common clinical diseases that seriously threaten human health, especially in countries and regions with poor environmental hygiene. Due to the lack of characteristic clinical symptoms and signs, it is a challenge to distinguish a bacterial infection from other infections, leading to misdiagnosis and antibiotic overuse. Therefore, there is an urgent need to develop a specific method for detection of bacterial infections. Herein, utilizing ultrabright fluorescent nanospheres (FNs) as reporters, immunochromatographic dyad test strips are developed for the early detection of bacterial infections and distinction of different stages of bacterial infectious diseases in clinical samples. C-reactive protein (CRP) and heparin-binding protein (HBP) are quantified and assayed because their levels in plasma are varied dynamically and asynchronously during the progression of the disease. The detection limits of CRP and HBP can reach as low as 0.51 and 0.65 ng/mL, respectively, due to the superior fluorescence intensity of each FN, which is 570 times stronger than that of a single quantum dot. The assay procedure can be achieved in 22 min, fully meeting the needs of rapid and ultrasensitive detection in the field. This constructed strip has been successfully used to profile the stage and severity of bacterial infections by monitoring the levels of CRP and HBP in human plasma samples, showing great potential as a point-of-care biosensor for clinical diagnosis. In addition to bacterial infections, the developed ultrabright FN-based point-of-care testing can be readily expanded for rapid, quantitative, and ultrasensitive detection of other trace substances in complex systems.

[Clinical observation on Tongdu Tiaoqi acupuncture combined with warming acupuncture for postoperative urinary retention].

OBJECTIVE: To compare the therapeutic effect of Tongdu Tiaoqi acupuncture (acupuncture for unblocking governor vessel and regulating qi ) combined with warming acupuncture, Tongdu Tiaoqi acupuncture, abdominal moxibustion and oral tamsulosin hydrochloride sustained release capsule on postoperative urinary retention. METHODS: A total of 120 patients with postoperative urinary retention were randomized into an acupuncture-moxibustion group, an acupuncture group, a moxibustion group and a medication group, 30 cases in each group. Tongdu Tiaoqi acupuncture combined with warming acupuncture were applied in the acupuncture-moxibustion group. Tongdu Tiaoqi acupuncture was applied at Baihui (GV 20), Shuigou (CV 26) etc. in the acupuncture group. Moxibustion was applied at Qihai (CV 6), Guanyuan (CV 4), Shuidao (ST 28) and Sanyinjiao (SP 6) in the moxibustion group. Tamsulosin hydrochloride sustained release capsule was given orally in the medication group. The treatment was once a day, and 5-day treatment was required in each group. Before and after treatment, the residual urine volume of bladder, the visual analogue scale (VAS) score and the time of first urethral catheter removal were observed, and the clinical efficacy was compared in the 4 groups. RESULTS: After treatment, the residual urine volume of bladder was decreased compared before treatment in the 4 groups (P<0.05), and that in the acupuncture-moxibustion group was less than the other 3 groups (P<0.05). After treatment, the VAS scores were decreased compared before treatment in the acupuncture-moxibustion group, the acupuncture group and the moxibustion group (P<0.05), and those in the 3 groups were lower than the medication group (P<0.05). The time of first urethral catheter removal in the acupuncture-moxibustion group was earlier than the other 3 groups (P<0.05). The total effective rate was 93.3% (28/30) in the acupuncture-moxibustion group, which was superior to 63.3% (19/30) in the acupuncture group, 60.0% (18/30) in the moxibustion group and 66.7% (20/30) in the medication group (P<0.05). CONCLUSION: The therapeutic effect of Tongdu Tiaoqi acupuncture combined with warming acupuncture on postoperative urinary retention is superior to simple acupuncture, abdominal moxibustion and tamsulosin hydrochloride sustained release capsule.

Spatiotemporal Quantification of Endosomal Acidification on the Viral Journey.

Many enveloped viruses utilize endocytic pathways and vesicle trafficking to infect host cells, where the acidification of virus-containing endosomes triggers the virus-endosome fusion events. Therefore, simultaneous correlation of intracellular location, local pH, and individual virus dynamics is important for gaining insight into viral infection mechanisms. Here, an imaging approach is developed for spatiotemporal quantification of endosomal acidification on the viral journey in host cells using a fluorescence resonance energy transfer based ratiometric pH sensor consisting of a photostable and high-brightness QD, pH-sensitive fluorescent dyes, and virus-binding proteins. Ratiometric analysis of sensor-based single-virus tracking data enables to dissect a two-step endosomal acidification process during the infection of influenza viruses and elucidates the occurrence of the fission and sorting of virus-containing endosomes to recycling endosomes after initial acidification. This technique should serve as a robust approach for in situ quantification of endosomal acidification on the viral journey.

Water-Soluble High-Quality Ag2Te Quantum Dots Prepared by Mutual Adaptation of Synthesis and Surface Modification for In Vivo Imaging.

Near-infrared (NIR) in vivo fluorescence imaging has exhibited the distinct advantage of high optical resolution at deeper penetration into biological tissues. Ag2Te quantum dots (QDs), with a relatively narrow band gap, show great promise for fluorescence emission at long wavelengths in the second near-infrared (NIR-II) window for bioimaging. However, existing Ag2Te QDs have severely hindered the application of in vivo bioimaging due to their poor fluorescence brightness and stability, so it is important to prepare Ag2Te QDs with high quantum yield and stability as well as high biocompatibility in the NIR-II window. Herein, we designed an integrated method for the preparation of water-soluble Ag2Te QDs by mutual adaptation of QD synthesis and surface modification. We first synthesized high-quality Ag2Te QDs with different NIR-II emission wavelengths and the photoluminescence quantum yields (PLQYs) up to 6.51% by rapidly injecting the TBP-Te precursor into a hot solvent to form a highly fluorescent Ag2Te core. Then water-dispersible Ag2Te QDs were obtained by direct exchange of the hydrophobic Ag2Te QD surface ligands with thiol ligands. The PLQY of the water-soluble Ag2Te QDs obtained by this method can still be maintained at 4.94%. With these highly bright and stable Ag2Te QDs, the abdominal vessels, hindlimb arterial vessels, venous vessels, sacral lymph nodes, and tumor vessels were visualized non-invasively in vivo in the NIR-II window in mice. The results demonstrate that the integrated strategy of QD synthesis and modification provides valuable technical support for further in-depth applications of Ag2Te QDs.

Optical coherent tomographic angiographic pattern of the deep choroidal layer and choriocapillaris after photodynamic therapy for central serous chorioretinopathy.

PURPOSE: To study the changes in the choroidal vascular pattern of the deep choroidal layer and choriocapillaris in the eyes with central serous chorioretinopathy (CSC) before versus after photodynamic therapy (PDT) as visualized by optical coherence tomography angiography (OCTA). METHODS: This comparative case series study included patients who underwent a half-dose of PDT as a therapy for CSC. Using OCTA and manually shifting the reference level into the deep choroidal layer, we assessed the density of the deep choroidal vascular layer and choriocapillaris. RESULTS: The study included 20 patients (17 men; mean age, 43.3 ± 10.9 years), with two patients showing bilateral CSC. In the eyes affected by CSC, the mean vascular density of the deep choroidal layer and choriocapillaris increased significantly from 54.2 ± 6.7% at baseline to 58.0 ± 4.7% at 1 month after PDT (P = 0.002) and from 58.1 ± 2.7% at baseline to 60.5 ± 2.7% at 1 month after PDT (P = 0.004), respectively. The difference between affected and unaffected eyes was significantly larger at baseline than at 1 month after PDT (deep choroidal layer 4.79 ± 6.02 versus 0.39 ± 3.46, P = 0.002; choriocapillaris 4.26 ± 3.94 versus 1.25 ± 3.44, P = 0.002) and larger than at 3 months after baseline (n = 11 patients), when the affected and unaffected fellow eyes no longer differed significantly (P = 0.66 and P = 0.37, respectively). As a corollary, the width of the large choroidal vessels in the deep choroidal layer decreased after the PDT. Comparing assessments by two blinded examiners revealed a kappa value of 0.90, indicating a good agreement for examination of the deep choroidal layer. CONCLUSION: In conclusion, OCTA can be helpful to visualize the deep choroidal vascular layer by manually shifting the reference layer deeper into the choroid.

POLYPOIDAL CHOROIDAL VASCULOPATHY UPON OPTICAL COHERENCE TOMOGRAPHIC ANGIOGRAPHY.

PURPOSE: To study polypoidal lesions and branching choroidal vascular networks in eyes with polypoidal choroidal vasculopathy by optical coherence tomography (OCT)-based angiography (OCTA). METHODS: In the observational cross-sectional study, patients with polypoidal choroidal vasculopathy, as diagnosed by indocyanine green angiography, underwent OCTA. RESULTS: Thirty-two eyes of 31 patients with an age of 61.1 ± 7.6 years were included. Branching choroidal vascular networks were detected by indocyanine green angiography and OCTA in 25 of 32 (78 ± 73%) and in 30 of 32 (94 ± 4%) eyes, respectively, with a marginally significant difference (P = 0.06) in the detection rate between both techniques. A total of 72 polyps (area, 0.06 ± 0.06 mm; range, 0.01-0.27 mm) were detected by indocyanine green angiography, and they were consistently present on the OCTA images. By moving the reference level in the OCT angiograms to the corresponding layer, the polypoidal lesions showed cluster-like structures in 53 of 72 polypoidal lesions (74%). In 60 of the 72 polypoidal lesions (83%), cluster-like structures were detected in the en face structural OCT images at the reference plane of the OCTA images. On the cross-sectional OCT images, some internal channels of flow were seen in 50 of the 72 polypoidal lesions (69%). Larger size of the polypoidal lesions was associated with a higher prevalence of cluster-like structures on the OCTA images, some internal channels of flow on the en face structural images, and clustered vascular structures on the cross-sectional OCT images. CONCLUSION: In conclusion, OCTA is a useful technique for the noninvasive detection of branching choroidal vascular networks including visualization of details such as cluster-like structures and flow. In some eyes, OCTA was superior to indocyanine green angiography to detect polypoidal choroidal vasculopathy and to show branching choroidal vascular networks.

Dissecting the Genetic Basis of Resistance to Soybean Cyst Nematode Combining Linkage and Association Mapping.

A set of 585 informative single-nucleotide polymorphism (SNP) loci was used to genotype both a panel of diverse accessions and a set of recombinant inbred lines (RILs) bred from the cross Zhongpin03-5373 (ZP; resistant to SCN) × Zhonghuang13 (ZH; susceptible). The SNP loci are mostly sited within genic sequence in regions of the soybean [ (L.) Merr.] genome thought to harbor genes determining resistance to the soybean cyst nematode (SCN, Ichinohe). The three strongest quantitative trait nucleotides (QTNs) identified by association mapping (AM) involved the genes (a component of the multigene locus ), and (an paralog), as well as some other loci with smaller effects. The linkage mapping (LM) analysis performed using the RILs revealed two putative quantitative trait loci (QTL): one mapping to and the other to an paralog; both of these loci were also identified by AM. The former locus explained 25.5% of the phenotypic variance for SCN resistance and the latter 5.8%. In combination, the two major loci acted nonadditively, providing a high level of SCN resistance.

De novo assembly of soybean wild relatives for pan-genome analysis of diversity and agronomic traits.

Wild relatives of crops are an important source of genetic diversity for agriculture, but their gene repertoire remains largely unexplored. We report the establishment and analysis of a pan-genome of Glycine soja, the wild relative of cultivated soybean Glycine max, by sequencing and de novo assembly of seven phylogenetically and geographically representative accessions. Intergenomic comparisons identified lineage-specific genes and genes with copy number variation or large-effect mutations, some of which show evidence of positive selection and may contribute to variation of agronomic traits such as biotic resistance, seed composition, flowering and maturity time, organ size and final biomass. Approximately 80% of the pan-genome was present in all seven accessions (core), whereas the rest was dispensable and exhibited greater variation than the core genome, perhaps reflecting a role in adaptation to diverse environments. This work will facilitate the harnessing of untapped genetic diversity from wild soybean for enhancement of elite cultivars.

[Changes of choroidal thickness in central serous chorioretinopathy].

OBJECTIVE: To determine the quantitative changes of choroidal thickness in central serous chorioretinopathy. METHODS: Cross-sectional study. Twenty-three patients with unilateral central serous chorioretinopathy (CSC) in acute and chronic stages were diagnosed after fluorescein angiography, indocyanine angiography and enhanced depth imaging optical coherence tomography (EDI OCT). EDI OCT scan across the fovea was performed in each eye and the result was compared with that from an age-, sex-matched and spherical equivalent-matched control subject. Subfoveal thickness of choroid was calculated by a onboard software in HRA2. RESULTS: Choroidal thickness in the CSC eyes and the fellow eyes was (464.43 ± 97.15) µm and (399.91 ± 124.01) µm, respectively. No significant difference between the two groups (t = 4.653, P < 0.05). Choroidal thickness was (313.09 ± 70.67) µm in the control group. There was statistically significant difference in thickness between the CSC group and the control group (t = 5.077, -2.085; P < 0.05). Choroidal thickness in the fellow eyes with choroidal vascular hyperpermeability was (506.44 ± 75.66) µm, which was differed significantly (t = 4.749, P < 0.05)from the non-hypermeability eyes (331.43 ± 97.94) µm. CONCLUSIONS: Subfoveal choroid thickness in the symptomatic eye and the fellow eyes in CSC group is thicker than that of the control group. The subfoveal choroidal thickness of eyes with hypermeability is thicker than that in the non-hypermeability eyes. EDI-OCT is a noninvasive procedure which can be used to evaluate the choroidal hypermeability in CSC.

Effect of long-term cryopreservation on physiological characteristics, antioxidant activities and lipid peroxidation of red seabream (Pagrus major) sperm.

The aim of this study was to determine the effect of long-term cryopreservation on physiological characteristics, the antioxidant activities and lipid peroxidation of red seabream sperm which were respectively cryopreserved with 15% dimethylsulfoxide (Me(2)SO) for 1 month, 13 months, 26 months, 48 months and 73 months. The motility and fertility of post-thaw sperm decreased with the storage time going on. The highest motility (87.67±2.52%) was obtained in sperm cryopreserved for 1 month and the lowest (50.67±5.31%) was in sperm for 73 months. There were no significant differences (p<0.05) in fertilization rates of sperm cryopreserved for 1 month (71.33±8.84%), 13 months (69.22±1.02%) and 26 months (60.33±2.33%); however, the sperm fertility decreased significantly for 48 months (47.22±3.89%) and 73 months (39.56±0.69%) storage. In addition, superoxide dismutase (SOD) activities of sperm were at a stable level for less than 26 months storage, then, decreased significantly after 48 months storage. Catalase (CAT) activities of sperm cryopreserved for 13 months, 26 months, 48 months and 73 months were significantly lower than that for 1 month. There were no significant differences in the malondialdehyde (MDA) level of sperm for less than 13 months storage. After 26 months storage, the concentration of MDA increased significantly, and the highest concentration (3.22±0.05 nmol/mgprot) was obtained in 73 months storage sperm.

Three-dimensional conformal radiation therapy for esophageal squamous cell carcinoma: is elective nodal irradiation necessary?

PURPOSE: To evaluate the local control, survival, and toxicity associated with three-dimensional conformal radiotherapy (3D-CRT) for squamous cell carcinoma (SCC) of the esophagus, to determine the appropriate target volumes, and to determine whether elective nodal irradiation is necessary in these patients. METHODS AND MATERIALS: A prospective study of 3D-CRT was undertaken in patients with esophageal SCC without distant metastases. Patients received 68.4 Gy in 41 fractions over 44 days using late-course accelerated hyperfractionated 3D-CRT. Only the primary tumor and positive lymph nodes were irradiated. Isolated out-of-field regional nodal recurrence was defined as a recurrence in an initially uninvolved regional lymph node. RESULTS: All 53 patients who made up the study population tolerated the irradiation well. No acute or late Grade 4 or 5 toxicity was observed. The median survival time was 30 months (95% confidence interval, 17.7-41.8). The overall survival rate at 1, 2, and 3 years was 77%, 56%, and 41%, respectively. The local control rate at 1, 2, and 3 years was 83%, 74%, and 62%, respectively. Thirty-nine of the 53 patients (74%) showed treatment failure. Seventeen of the 39 (44%) developed an in-field recurrence, 18 (46%) distant metastasis with or without regional failure, and 3 (8%) an isolated out-of-field nodal recurrence only. One patient died of disease in an unknown location. CONCLUSIONS: In patients treated with 3D-CRT for esophageal SCC, the omission of elective nodal irradiation was not associated with a significant amount of failure in lymph node regions not included in the planning target volume. Local failure and distant metastases remained the predominant problems.

[Clinical analysis of macular disease involved by Coats disease].

OBJECTIVE: To study the characteristic and rule of macular disease involved by Coats disease and macular changes after photocoagulation. METHODS: A retrospective study was performed on patients firstly diagnosis in our hospital from October 2004 to June 2007. 25 cases (26 eyes) were included in this study. Enrollment criteria: all the cases had examination of regular anterior segment and indirect biomicroscopy associated with fluorescein angiography and optical coherence tomography. The relationship among macular disease extent, distance from macular to peripheral disease, ratio of retinal vessel leakage scale to the whole retina, and different age group was analyzed through cumulative odds logistic regression with SAS 8.0. RESULTS: The distance between the border of macular disease and posterior border of peripheral leakage ranges from 0-9 PD. There was negative relationship between macular disease extent and the distance from macular to peripheral disease (chi(2) = 7.3212, P = 0.0068). The ratio of retinal leakage scale to the whole retina ranges from 1/8 to 1/1. There was positive relationship between macular disease extent and ratio of retinal vessel leakage scale to the whole retina (chi(2) = 4.8853, P = 0.0271). Macular disease extent shows no significant difference between different age group (chi(2) = 0.1491, P = 0.6994). The follow-up time after photocoagulation range from 1 to 4 years. 10 cases (11 eyes) of macular edema complicated with hard exudate showed apparent decrease in size and extent of macular disease. The best corrected visual acuity stay unchanged or get better. CONCLUSIONS: Macular disease involved in Coats disease progresses from peripheral fundus to posterior pole, early diagnosis and treatment can avoid or reduce the incidence of macular disease. The key point of treatment is to photocoagulated the dilated blood vessel.

[Analysis of clinical features of choroidal neovascularization].

OBJECTIVE: To investigate the clinical features of choroidal neovascularization (CNV) in different classifications. METHODS: In this retrospective case series, 393 eyes of 312 patients with CNV between May 2005 and March 2007 in our department was classified based on their etiology, location, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) findings. RESULTS: The relative frequency of various causes in CNV was as follows: there were 153 cases (49.04%) from age-related macular degeneration (AMD) , 94 cases (30.13%) from idiopathic CNV, 37 cases (11.86%) from pathologic myopia, 15 cases (4.81%) from inflammatory disorders, 7 cases (2.24%) from polypoidal choroidal vasculopathy (PCV), 3 cases (0.96%) from angioid streaks and 1 case (0.32%) from either hereditary disease or trauma or tumor, respectively. The majority cases from AMD was male (64.71%), whereas most from pathologic myopia, idiopathic CNV and inflammatory disorders were female (78.38%, 73.40%, 73.33%). The age range of the cases from AMD was 49-95 years (68.73 +/- 8.31), and 98.04% of them were at least 50 years old. Patients with idiopathic CNV aged 13-43 years old (29.86 +/- 6.45), and 84.04% of them were between 20 and 40 years old. The sex (chi2 = 57.17, P<0.05) and age (F=172.57, P< 0.05) had significant difference in each etiological group. FFA showed that CNV in 43.48% from AMD and 66.67% from PCV were occult and non-classic. CNV in 91.67% from pathologic myopia, 76.19% from inflammatory disorders and 95.00% from idiopathic CNV was classic. In each group, most of the CNV was subfoveal type (58.00%-100.00%), followed by juxtafoveal type (0%-35.00%). In the ICGA of 54 eyes with AMD, 11 eyes (20.37%) were occult CNV (plaque, spot and mixed CNV), 17 eyes (31.48%) were CNV fibrosis. CNV was active in most cases. The frequency of active and inactive CNV in AMD was approximately 61.11% and 37.04%, respectively, no lesions were noted in 1 eye (1.85%) in ICGA. CONCLUSIONS: The clinical characteristics and frequency of various types of CNV are different due to different causes. Classification of CNV based on its etiology, FFA and ICGA findings, location, and activity in detail is important for the diagnosis, treatment and prognosis judgment in CNV.

[Clinical observation on Tongdu Tiaojin needling method for treatment of blepharoptosis].

OBJECTIVE: To compare therapeutic effects of Tongdu Tiaojin needling method and routine acupuncture method on blepharoptosis. METHODS: Fifty-eight cases of blepharoptosis were randomly divided into an observation group and a control group, 29 cases in each group. The observation group was treated by Tongdu Tiaojin needling method with Baihui (GV 20), Fengchi (GB 20), Houxi (SI 3), Yintang (EX-HN 3) selected, and the control group by routine acupuncture method with Cuanzhu (BL 2), Yangbai (GB 14), Sizhukong (TE 23) selected. They were treated for 3 courses and one course was constituted by 10 sessions. RESULTS: The cured rate of 41.4% and the effective rate of 82.8% in the observation group were better than 24.1% and 48.2% in the control group (P<0.05); after treatment, the palpebral fissure widened and the level of the palpebra superior shading the cornea was alleviated in the two groups, but the observation group was superior to the control group (P<0.05). CONCLUSION: Tongdu Tiaojin needling method has a definite therapeutic effect on blepharoptosis.

Late course accelerated hyperfractionated radiotherapy plus concurrent chemotherapy for squamous cell carcinoma of the esophagus: a phase III randomized study.

PURPOSE: Late course accelerated hyperfractionated (LCAF) radiotherapy (RT) is as effective as standard chemoradiotherapy for nonsurgical management of locally advanced esophageal squamous cell carcinoma (SCC). We have evaluated further the efficacy of concurrent LCAF RT and chemotherapy. METHODS AND MATERIALS: In all, 111 eligible patients with esophageal SCC were randomized to receive LCAF alone (LCAF) or concurrent LCAF and chemotherapy (LCAT+CT) between March 1998 and July 2000. All patients received conventional fractionation irradiation of 1.8 Gy per day, to a dose of 41.4 Gy/23 fractions in 4-5 weeks, followed by accelerated hyperfractionated irradiation using reduced fields, 1.5 Gy/fractions twice a day, to a dose of 27 Gy in 18 days. Thus, the total dose was 68.4 Gy/41 fractions in 44 days. Fifty-four patients in the LCAF+CT arm had an additional four cycles of chemotherapy using cisplatin 25 mg/m(2) daily and fluorouracil (5-FU) 600 mg/m(2) daily on Days 1-3 every 4 weeks starting on the same day that LCAF was delivered. RESULTS: The median survival was 23.9 months (95% confidence [CI], 20.1-27.7) for the LCAF arm and 30.8 months (95% CI, 17.6-44.1) for the LCAF+CT arm, respectively. Survival rates at 1, 3, and 5 years of the LCAF arm were 77%, 39%, and 28%, respectively, while those of the LCAF+CT arm were 67%, 44%, and 40%, respectively (p = 0.310). Grades 3 and 4 acute toxicities occurred in 46% and 25% of the patients in the LCAF arm and the LCAF+CT arm, respectively; 6% of the patients in the combined arm had Grade 5 acute toxicities, whereas none was noted in the LCAF alone arm. CONCLUSIONS: Late course accelerated hyperfractionation was effective for locally advanced esophageal SCC. There was a trend toward better survival among patients who received intensified treatment with concurrent chemotherapy. Further randomized studies with a larger number of patients should be carried out, but additional measures must be taken to reduce the higher mortality rate due to chemotherapy-related acute toxicities.

[Expression of vascular endothelial growth factor and its receptor in experimental choroidal neovascularization in rat].

OBJECTIVE: To study the expressions of vascular endothelial growth factor and its receptor FLK1 in krypton laser-induced choroidal neovascularization (CNV) in Brown Norway rat. METHODS: Thirty anesthetized male Brown Norway rats received krypton laser (647 nm, 360 mW, 50 micro m, 0.05 s) to induce CNV. Fundus fluorescein angiography examinations were performed just before euthanasia on days 3, 7, 14, 21, 28 and 56 after laser photocoagulation. The retina was processed for histopathology analysis. VEGF mRNA, VEGF and FLK1 expressions were demonstrated using in situ hybridization and immunohistochemistry staining respectively. RESULTS: VEGF mRNA expression was mainly observed in the vascular endothelial cells, the ganglion cells, the inner nuclear layers, the retinal pigment epithelial cells in normal retina and the vascular endothelial cells of normal choroid of BN rat. VEGF mRNA expressed in the vascular endothelial cells, the ganglion cells, the inner nuclear layers, lesion of outer nuclear layers in retina on days 3 after photocoagulation, but CNV wasn't detected. The level of VEGF mRNA expression in retina was decreased after 3 days (P < 0.01). CNV was firstly observed on day 7 after photocoagulation by FFA and histopathology. The area and density of positively stained cells for VEGF mRNA in CNV were increased during the development of CNV (P < 0.01) and no significant change after days 21 (P > 0.05). FLK1 was detected in the vascular endothelial cells, the ganglion cells of normal retina and the vascular endothelial cells of choroid. The staining of FLK1 was positive in laser induced CNV after days 7, the level of the receptor expression was increased during the development of CNV (P < 0.01) and was not significantly changed after days 21 (P > 0.05). CONCLUSIONS: VEGF and its receptor FLK1 accumulation and combination in the lesion of retina and choroid are related to choroidal neovascularization induced by laser.

Late-course accelerated hyperfractionated radiotherapy for localized esophageal carcinoma.

PURPOSE: To evaluate the long-term survival results and patterns of failure for localized carcinoma of the esophagus receiving late-course accelerated hyperfractionated (LCAF) radiotherapy (RT). METHODS AND MATERIALS: We studied 201 patients with histologically confirmed squamous cell carcinoma of the esophagus who were treated with LCAF RT between August 1994 and January 2000. The design of the radiation fields was based on the diagnosis by computed tomography and barium examination. All patients received conventionally fractionated RT at 1.8 Gy/d, five fractions weekly for the first two-thirds of treatment to a dose of about 41.4 Gy in 23 fractions within 4-5 weeks. This was followed by LCAF RT using reduced fields, 1.5 Gy/fraction twice daily with a 6-h interval between fractions, to a dose of about 27 Gy within 9 days. Thus, the total dose was 68.4 Gy in 41 fractions within 44 days. RESULTS: The incidence of Grade 3-5 acute radiation-induced bronchitis was 4.0% (8 cases), 3.0% (6 cases), and 0%, respectively. The incidence of Grade 3-5 acute radiation-induced esophagitis was 14.9% (30 cases), 0.5% (1 case), and 0%. Ten patients (5%) died of late complications. The 1-year, 3-year, and 5-year overall survival rate was 73%, 34%, and 26%, respectively. The 1-year, 3-year, and 5-year local control rate was 77%, 58%, and 56%, respectively. The main site of first failure was locoregional failure and distant metastasis (including lymph node metastasis from regional recurrence). Of 201 patients, 77 (38.4%) had local disease alone or with distant metastasis as the first failure, and 70 patients (34.9%) had distant metastasis and/or lymph node metastasis alone or with local failure as the first failure. CONCLUSION: The LCAF regimen offers similar local control and survival to standard chemotherapy plus RT, such as was delivered in the Radiation Therapy Oncology Group studies 85-01 and 94-05.

[Expression and signification of pigment epithelium-derived factor in experimental choroidal neovascularization of rat].

OBJECTIVE: To investigate the expression and signification of pigment epithelium-derived factor in choroidal neovascularization (CNV) induced by krypton laser on Brown Norway rat. METHODS: Five groups of 30 rats were photocoagulated by krypton laser in single eye to induce CNV. 3 days, 1 week, 2 weeks, 3 weeks and 4 weeks after photocoagulation, The retina was processed for histopathology, in situ hybridization of PEDF mRNA, immunohistochemistry of PEDF and FVIIIR:Ag. RESULTS: CNV was formed 1 week after photocoagulation, and reached its peak at 3 weeks. PEDF mRNA, PEDF expressed in the ganglion cells, inner nuclear layer, retinal pigment epithelial cells in normal BN retina. After photocoagulation, the expression of PEDF mRNA and PEDF was observed in the ganglion cells, inner nuclear layer, retinal pigment epithelial cells, and the lesions of outer nuclear layer and choroid; the expression of PEDF in the lesions was weaker than that at the edge of the lesions. From 3 days to 4 weeks, the expression density of FVIIIR:Ag gradually increased, however, the expression density of PEDF mRNA and PEDF in the lesions decreased (P < 0.05). The expression of FVIIIR:Ag was inversely correlated with that of PEDF during the development of CNV (r = -0.84, P < 0.05). CONCLUSIONS: CNV is inversely correlated with PEDF. The down-regulation of PEDF may be one of the main reasons for the formation and development of CNV.