[Establishment and validation of prediction models for human leukocyte antigen haplotypes and human leukocyte antigen genotypes].

Objective: To establish prediction models for human leukocyte antigen (HLA) haplotypes and HLA genotypes, and verify the prediction accuracy. Methods: The prediction models were established based on the characteristic of HLA haplotype inheritance and linkage disequilibrium (LD), as well as the invention patents and software copyrights obtained. The models include algorithm and reference databases such as HLA A-C-B-DRB1-DQB1 high-resolution haplotypes database, B-C and DRB1-DQB1 LD database, G group alleles table, and NMDP Code alleles table. The prediction algorithm involves data processing, comparison with reference data, filtering results, probability calculation and ranking, confidence degree estimation, and output of prediction results. The accuracy of the predictions was verified by comparing them with the correct results, and the relationship between prediction accuracy and the probability distribution and confidence degree of the predicted results was analyzed. Results: The HLA haplotypes and genotypes prediction models were established. The prediction algorithm included the prediction of A-C-B-DRB1-DQB1 haplotypes according to HLA-A, B, DRB1, C, DQB1 genotypes, the prediction of C and DQB1 high-resolution results according to A, B and DRB1 high-resolution results, and the prediction of A, B, DRB1, C and DQB1 high resolution results according to the A, B and DRB1 intermediate or low resolution results. Validation results of "Predicting A-C-B-DRB1-DQB1 haplotypes basing on HLA-A, B, DRB1, C, DQB1 genotypes" model: for 787 data, the accuracy was 94.0% (740/787) with 740 correct predictions, 34 incorrect predictions, and 13 instances with no predicted results. For 847 data, the accuracy was 100% (847/847). The 2 411 and 2 594 haplotype combinations predicted from 787 and 847 data were grouped according to confidence degree, the accuracy was 100% (48/48, 114/114) for a confidence degree of 1, 96.2% (303/315) and 97.8% (409/418) for a confidence degree of 2 respectively. Validation results of "Predicting A, B, DRB1 and C, DQB1 high-resolution genotypes basing on HLA-A, B, DRB1 high, intermediate, or low resolution genotypes" model: when predicting C and DQB1 high resolution genotypes basing on A, B, and DRB1 high resolution genotypes, 89.3% (1 459/1 634) of the predictions were correct. The accuracy for the top 2 predicted probability (GPP) ranking was 79.2% (1 156/1 459), and for the top 10, it was 95.0% (1 386/1 459). Furthermore, when GPP≥90% and GPP 50%-90%, the prediction accuracy was 81.3% (209/257) and 72.8% (447/614) respectively. The accuracy of predicting C and DQB1 high resolution genotypes basing on the results of A, B, and DRB1 high resolution genotypes from the China Marrow Donor Program was 87.0% (20/23). The accuracy of predicting A, B, DRB1, C, and DQB1 high resolution genotypes basing on the results of A, B, and DRB1 intermediate or low-resolution genotypes was 70.0% (7/10) and 52.5% (21/40) respectively. When predicting whether the patient is likely to have a HLA 10/10 matched donor, the accuracy of the top 2 GPP combinations with a proportion of ≥50% was 85.7% (6/7). Conclusions: When using A, B, DRB1, C, DQB1 genotypes to predict A-C-B-DRB1-DQB1 haplotype combinations, the results with a confidence degree of 1 and 2 are reliable. When predicting C and DQB1 genotypes according to A, B and DRB1 genotypes, the top 10 results ranked by GPP are reliable, and the top 2 results with GPP≥50% are more reliable.

[One case of adult-onset dystonia presenting with chronic progressive external ophthalmoplegia].

We report a case of adult-onset dystonia presenting with chronic progressive external ophthalmoplegia. The patient had ptosis in both eyes, particularly the left eye, for no obvious reason since the age of 10, which was progressively aggravated. The clinical diagnosis was chronic progressive external ophthalmoplegia. However, whole gene sequencing revealed the mitochondrial A3796G missense mutation, so the patient was clearly diagnosed as adult-onset dystonia and given treatment to reduce blood glucose and improve muscle metabolism. The A3796G mutation in the ND1 subunit of the mitochondrial complex leading to ophthalmoplegia is relatively rare, requiring a combination with genetic testing for confirmation of diagnosis.

BAP18 induces growth of non-small-cell lung carcinoma through upregulating transcriptional level of CCND1/2.

OBJECTIVE: To elucidate the biological function of BAP18 (BPTF-associated protein of 18 kDa) in non-small-cell lung carcinoma (NSCLC) and the molecular mechanism. PATIENTS AND METHODS: Relative levels of BAP18 in NSCLC tissues were detected by quantitative real-time polymerase chain reaction (qRT-PCR), and its influence on pathological characteristics of NSCLC patients was analyzed. Correlation between BAP18 and Ki67 levels in NSCLC was assessed by Pearson correlation test. Furthermore, Kaplan-Meier curves were depicted for revealing survival difference in NSCLC patients expressing high or low level of BAP18. Relative levels of BAP18, CCND1, CCND2 and CCND3 in A549 and H1299 cells transfected with siBAP18 were determined, as well as colony number. In addition, after knockdown of protein level of BAP18 in A549 and H1299 cells by lentivirus transfection, cell cycle progression was examined. Co-regulation of BAP18 and CCND1/2 on cell growth of NSCLC was finally detected. RESULTS: BAP18 was upregulated in NSCLC tissues, especially cases with advanced stage (III-IV) or large tumor size (>5 cm). BAP18 was closely linked to tumor size, TNM staging and lymphatic metastasis in NSCLC. Knockdown of BAP18 reduced transcriptional levels of CCND1 and CCND2 in A549 and H1299 cells. Furthermore, knockdown of BAP18 delayed transition from G1 to S phase, and weakened growth of NSCLC cells. CONCLUSIONS: BAP18 triggers the progression of NSCLC by regulating transcriptional activities of CCND1/2, which may be a potential target for the treatment and diagnosis of NSCLC.

Arbuscular mycorrhizal fungi improve the growth and disease resistance of the invasive plant Wedelia trilobata.

AIMS: Arbuscular mycorrhizal fungi (AMF) are symbiotic partners of many invasive plants, however, it is still unclear how AMF contribute to traits that are important for the successful invasion of their host and how environmental factors, such as nutrient conditions, influence this. This study was to explore the effects of Glomus versiforme (GV) and Glomus mosseae (GM) on the growth and disease resistance of the invasive plant Wedelia trilobata under different nutrient conditions. METHODS AND RESULTS: We found that GV and GM had higher root colonization rates resulting in faster W. trilobata growth under both low-N and low-P nutrient conditions compared to the normal condition. Also, the colonization of W. trilobata by GV significantly reduced the infection area of the pathogenic fungus Rhizoctonia solani under low-N conditions. CONCLUSIONS: These results demonstrated that AMF can promote the growth and pathogenic defence of W. trilobata in a nutrient-poor environment, which might contribute to their successful invasion into certain type of habitats. SIGNIFICANCE AND IMPACT OF THE STUDY: In this study, we report for the first time that AMF can promote growth and disease resistance of W. trilobata under nutrient-poor environment, which contribute to a better understanding of plant invasion.

Multidisciplinary advisory teams to manage multidrug-resistant tuberculosis: the example of the French Consilium.

SETTING: The World Health Organization (WHO) recommends that multidrug-resistant tuberculosis (MDR-TB) treatment should be managed in collaboration with multidisciplinary advisory committees (consilia). A formal national Consilium has been established in France since 2005 to provide a centralised advisory service for clinicians managing MDR-TB and extensively drug-resistant (XDR-TB) cases.OBJECTIVE: Review the activity of the French TB Consilium since its establishment.DESIGN: Retrospective description and analysis of the activity of the French TB Consilium.RESULTS: Between 2005 and 2016, 786 TB cases or contacts of TB cases were presented at the French TB Consilium, including respectively 42% and 79% of all the MDR-TB and XDR-TB cases notified in France during this period. Treatment regimens including bedaquiline and/or delamanid were recommended for 42% of the cases presented at the French TB Consilium since 2009. Patients were more likely to be presented at the French TB Consilium if they were born in the WHO Europe Region, had XDR-TB, were diagnosed in the Paris region, or had resistance to additional drugs than those defining XDR-TB.CONCLUSION: The French TB Consilium helped supervise appropriate management of MDR/XDR-TB cases and facilitated implementation of new drugs for MDR/XDR-TB treatment.

The invasive tree staghorn sumac affects soil N2 -fixing bacterial communities in north China.

Soil N2 -fixing bacterial communities (SNB) can enhance soil N availability and the invasiveness of invaders. Some invaders display different degrees of invasion across different climate regions. Given that bacterial communities may change with different climate regions, it is important to understand soil micro-ecological mechanisms driving the successful invasion of invaders across different climate regions. This study performed cross-site comparisons to comprehensively analyse effects of the invasive tree staghorn sumac (Rhus typhina L.) on the structure of SNB. In north China, we selected three sites within two sampling regions (a warm temperate region and a cold temperate region). Staghorn sumac invasion did not significantly affect soil physicochemical properties and the diversity and richness of SNB. LEfSe analysis showed that numerous SNB taxa changed significantly during staghorn sumac invasion. This may be attributed in part to the selective effects of allelochemicals released by staghorn sumac via leaf litter and/or root exudates. Consequently, staghorn sumac invasion may alter the structure, rather than the diversity and richness, of SNB to facilitate its invasion process by establishing a favourable soil microenvironment in the invaded habitats. The number of species and richness of SNB under staghorn sumac invasion were significantly lower in the warm temperate region than in the cold temperate region. A possible reason for the increased diversity and richness of SNB under staghorn sumac invasion in the cold temperate region may be because staghorn sumac in the cold temperate region can provide more nutrients into the soil sub-ecosystem, presumably to support a higher diversity and richness of SNB via the nutritional requirements of SNB. The changed structure of SNB under staghorn sumac invasion, especially across different climate regions, may play an important role in its successful invasion across most regions of north China.

Semi-dominant mutation in the cysteine-rich receptor-like kinase gene, ALS1, conducts constitutive defence response in rice.

Plants have evolved a sophisticated two-branch defence system to prevent the growth and spread of pathogen infection. The novel Cys-rich repeat (CRR) containing receptor-like kinases, known as CRKs, were reported to mediate defence resistance in plants. For rice, there are only two reports of CRKs. A semi-dominant lesion mimic mutant als1 (apoptosis leaf and sheath 1) in rice was identified to demonstrate spontaneous lesions on the leaf blade and sheath. A map-based cloning strategy was used for fine mapping and cloning of ALS1, which was confirmed to be a typical CRK in rice. Functional studies of ALS1 were conducted, including phylogenetic analysis, expression analysis, subcellular location and blast resistance identification. Most pathogenesis-related (PR) genes and other defence-related genes were activated and up-regulated to a high degree. ALS1 was expressed mainly in the leaf blade and sheath, in which further study revealed that ALS1 was present in the vascular bundles. ALS1 was located in the cell membrane of rice protoplasts, and its mutation did not change its subcellular location. Jasmonic acid (JA) and salicylic acid (SA) accumulation were observed in als1, and enhanced blast resistance was also observed. The mutation of ALS1 caused a constitutively activated defence response in als1. The results of our study imply that ALS1 participates in a defence response resembling the common SA-, JA- and NH1-mediated defence responses in rice.

Thomson scattering measurements on DIII-D using in-vessel laser mirrors and lenses to diagnose a new divertor location.

Translatable in-vessel mirrors have enabled the DIII-D Thomson scattering system to diagnose the divertor plasma in high triangularity shaped plasmas. Previous divertor Thomson scattering measurements in DIII-D were restricted to spatial locations along a Nd:YAG laser beam that was directed through a vertical port. This only allowed measurements to be made in low triangularity shaped plasmas. The new mirrors re-route the laser underneath floor tiles to a position of smaller major radius as necessary for high triangularity plasmas. New in-vessel collection optics transmit scattered light from regions inaccessible to external lenses. Damage to mirrors and high stray light levels are challenges that were overcome to successfully make these measurements. Through the careful use of baffles and light shields, stray light leakage into polychromator detector channels was reduced to negligible levels, allowing temperature measurements below 1 eV. The system is described and the initial results presented.

Measurements of DIII-D poloidal field by fiber-optic pulsed polarimetry.

A new technique for measuring the spatial and temporal structure of the poloidal field is presented, whereby the magnetic field causes the polarization of light traveling through an optical fiber to rotate via the Faraday effect by an amount proportional to the strength of the field oriented along the fiber. In fiber optic pulsed polarimetry, changes in the polarization of the backscatter light from the fiber are detected, thereby permitting measurement of the field as a function of position along the fiber. In this proof-of-principle experiment, specially prepared single-mode fibers with weak fiber Bragg gratings were installed in the poloidal direction on the outside of the thermal blanket on DIII-D. Light at 532 nm from a mode-locked Nd:YAG laser was injected into the optical fibers. The laser repetition rate was 895 kHz with a pulse length of <10 ps, resulting in ∼1 µs temporal resolution. A photodetector system measured the Stokes polarization components necessary to determine the amount of polarization rotation. For this experiment, bandwidth limitations of the detectors resulted in a spatial resolution of ≈2 cm. The measured temporal and spatial distributions of the poloidal field are consistent with inductive probe measurements and Elastodynamic Finite Integration Technique reconstructions of the spatial distribution. This demonstrates the ability of this technique to provide real-time detection of the temporal and spatial variations of the poloidal field. Besides revealing more detailed information about the plasma, this new diagnostic capability can also help in detecting instabilities in real time, thereby enabling enhanced machine protection.

Tests of a full-scale ITER toroidal interferometer and polarimeter (TIP) prototype on the DIII-D tokamak (invited).

A full-scale ITER toroidal interferometer and polarimeter (TIP) prototype, including an active feedback alignment system, has been installed and tested on the DIII-D tokamak. In the TIP prototype, a two-color interferometry measurement of line-integrated density is carried out at 10.59 µm and 5.22 µm using a CO2 and quantum cascade laser, respectively, while a separate polarimetry measurement of the plasma-induced Faraday effect is made at 10.59 µm. The TIP prototype is equipped with a piezo tip/tilt stage active feedback alignment system that minimizes noise in the measurement and keeps the diagnostic aligned throughout DIII-D discharges. The measured phase resolution for the polarimeter and interferometer is 0.05° (100 Hz bandwidth) and 1.9° (1 kHz bandwidth), respectively. The corresponding line-integrated density resolution for the vibration-compensated interferometer is δnL = 1.5 × 1018 m-2, and the magnetic field-weighted line-integrated density from the polarimeter is δnBL = 1.5 × 1019 Tm-2. Both interferometer and polarimeter measurements during DIII-D discharges compare well with the expectations based on calculations using Thomson scattering measured density profiles and magnetic equilibrium reconstructions. Additionally, larger bandwidth interferometer measurements show that the diagnostic is a sensitive monitor of core density fluctuations with demonstrated measurements of Alfvén eigenmodes and tearing modes.

HLA common and well-documented alleles in China.

The American Society for Histocompatibility and Immunogenetics HLA common and well-documented (CWD) catalog, CWD 2.0.0 catalog and European Federation for Immunogenetics (EFI) CWD catalog have been published, which are useful for improving the accuracy of HLA genotyping in laboratories. Here, we studied the Chinese HLA CWD catalog. A total of 812 211 unrelated volunteer donors from the China Marrow Donor Program (CMDP) were analyzed. Six hundred seventy-six alleles at the HLA-A, -B, -C, -DRB1, and -DQB1 loci were defined as CWD alleles in the Chinese population, including 159 common and 517 well-documented alleles. The distribution of HLA alleles in the Chinese CWD catalog is different from that in the EFI CWD catalog. Thirty-two percent (215/676) of CWD alleles in the Chinese CWD catalog are shared with those in the EFI CWD catalog. Fifty-six percent (380/676) of alleles in the Chinese CWD catalog are not found in the EFI CWD catalog, while 655 alleles in the EFI CWD catalog are neither common nor well-documented alleles in the Chinese CWD catalog. The Chinese CWD catalog described in this study may help to improve high-resolution histocompatibility testing for CMDP-accredited laboratories in China. However, to accommodate an increasing number of HLA alleles, this Chinese CWD catalog should be regularly updated.

Genetic contribution of suppressor of cytokine signalling polymorphisms to the susceptibility to infection after traumatic injury.

Suppressor of cytokine signalling (SOCS) proteins are crucial negative regulators in many signalling pathways and are implicated in the pathogenesis of infectious diseases. The purpose of this study was to uncover possible associations of common polymorphisms within SOCS genes with infectious outcomes after traumatic injury. A total of 1087 trauma patients (Chongqing cohort 806 and Yunnan cohort 281) were recruited and followed-up for the development of infectious outcomes, such as sepsis and multiple organ dysfunction syndrome (MODS). Twelve selected single nucleotide polymorphisms (SNPs) were screened by pyrosequencing to determine their genotypes and associations with infectious complications. Among the 12 selected SNPs, only the cytokine-inducible Src homology (SH2) domain protein (CISH) promoter rs414171 polymorphism was found consistently to be associated statistically with the incidence of sepsis and MOD score in the two cohorts, despite analysing the SNPs independently or in combination. Further, patients with a T allele had significantly lower CISH expression and lower production of tumour necrosis factor (TNF)-α, but higher production of interleukin (IL)-10. Luciferase assay confirmed that the A→T variant in the rs414171 polymorphism inhibited the transcriptional activities of the CISH gene significantly. The CISH rs414171 polymorphism is associated significantly with susceptibility to sepsis and MODS in traumatic patients, which might prove to be a novel biomarker for indicating risk of infectious outcomes in critically injured patients.

The Paris System for urine cytology in upper tract urothelial specimens: A comparative analysis with biopsy and surgical resection.

INTRODUCTION: The Paris System (TPS) has recently been used in classification of urinary tract cytological specimens. Upper urinary tract (UUT) specimens are cytologically challenging. The utility of TPS was investigated in evaluating UUT specimens and its correlation with subsequent histological follow-up. METHOD: From 2014 to 2017, 324 cytology cases of UUT from 179 patients were retrieved. Concurrent or subsequent biopsy or resection within a 2-month period was available in 125 cases from 74 patients. RESULT: None of the cases with a cytology of low-grade urothelial neoplasm was found to have a high-grade urothelial carcinoma (HGUC) on biopsy. Among the 19 atypical urothelial cells (AUC) cytology cases, the histology is heterogeneous (seven benign, one atypia, five low-grade lesion, and six HGUC). The risk of HGUC for each cytological diagnostic category are 0% for non-diagnostic/unsatisfactory, 6% for negative for HGUC, 27.3% for AUC, 0% for low-grade urothelial neoplasm, 48% for suspicious for HGUC and 95% for positive HGUC. When we considered cytology cases with suspicious or positive for HGUC interpretations as positive, the performance of TPS in predicting high grade urothelial carcinoma on histology had values of: 78.6% sensitivity, 86% specificity, 80.5% positive predictive value and 84.5% negative predictive value. CONCLUSION: More than one-third of the UUT cytological cases were classified as AUC and approximately 1/15 as suspicious or positive for HGUC. Based on UUT cytology specimens, the risk of malignancy of each cytological diagnostic category of TPS was comparable to those reported in the literature. The use of TPS in evaluating UUT cytology specimens was specific and sensitive in identifying patients with HGUC by histology.

Responses of the soil fungal communities to the co-invasion of two invasive species with different cover classes.

Soil fungal communities play an important role in the successful invasion of non-native species. It is common for two or more invasive plant species to co-occur in invaded ecosystems. This study aimed to determine the effects of co-invasion of two invasive species (Erigeron annuus and Solidago canadensis) with different cover classes on soil fungal communities using high-throughput sequencing. Invasion of E. annuus and/or S. canadensis had positive effects on the sequence number, operational taxonomic unit (OTU) richness, Shannon diversity, abundance-based cover estimator (ACE index) and Chao1 index of soil fungal communities, but negative effects on the Simpson index. Thus, invasion of E. annuus and/or S. canadensis could increase diversity and richness of soil fungal communities but decrease dominance of some members of these communities, in part to facilitate plant further invasion, because high soil microbial diversity could increase soil functions and plant nutrient acquisition. Some soil fungal species grow well, whereas others tend to extinction after non-native plant invasion with increasing invasion degree and presumably time. The sequence number, OTU richness, Shannon diversity, ACE index and Chao1 index of soil fungal communities were higher under co-invasion of E. annuus and S. canadensis than under independent invasion of either individual species. The co-invasion of the two invasive species had a positive synergistic effect on diversity and abundance of soil fungal communities, partly to build a soil microenvironment to enhance competitiveness of the invaders. The changed diversity and community under co-invasion could modify resource availability and niche differentiation within the soil fungal communities, mediated by differences in leaf litter quality and quantity, which can support different fungal/microbial species in the soil.

Sensitization of TRAIL-resistant cervical cancer cells through combination of TRAIL and fucoxanthin treatments.

OBJECTIVE: Cervical cancer, the second most common cause of cancer death in women worldwide, is a malignant neoplasm arising from cells originating in the cervix uteri. Currently, surgery combined with chemo- and radiotherapy is the major therapeutic approach for women with early-stage cervical cancer. However, recurrent cervical cancers from acquired chemo-resistance remain a major cause of therapeutic failure. MATERIALS AND METHODS: In this study, we assessed the effects of the combination of TRAIL with fucoxanthin, which has been reported to suppress the cervical cancer cells growth on the cervical cancer treatments. HeLa cells, SiHa cells, and CaSki cells were used as in vitro model. Mice xenograft was used as in vivo model. TRAIL-resistant cells were generated from CaSki cell line. The activity of PI3K/Akt pathway was detected by Western blot. Cell viability was measured by MTT assay. RESULTS: We observed TRAIL-resistant cervical cancer cells were more sensitive to fucoxanthin treatments. By establishing a TRAIL-resistant cell line from CaSki, we found the TRAIL-resistant cells showed upregulated PI3K/Akt pathway. Moreover, CaSki TRAIL-resistant cells were more sensitive to the combination of TRAIL with either Akt inhibitor or fucoxanthin than treatment with TRAIL or fucoxanthin alone. Our in vitro and in vivo xenograft experiments demonstrate that the combination of TRAIL with fucoxanthin showed synergistically inhibitory effects on cervical cancer cells. CONCLUSIONS: The findings of this study suggest that the combined use of fucoxanthin and TRAIL might be a useful strategy against TRAIL-resistant cervical cancer.

Long non-coding RNA CRNDE is a novel tumor promoter by modulating PI3K/AKT signal pathways in human gastric cancer.

OBJECTIVE: Long non-coding RNA CRNDE (CRNDE) recently emerged as a carcinogenic promoter in various cancers including gastric cancer (GC). However, the functions and molecular mechanisms of CRNDE to GC are still largely unclear. The aim of this study was to investigate the clinical significance and functional mechanisms of CRNDE expression in GC. PATIENTS AND METHODS: The expression of CRNDE was detected by quantitative Real-time PCR (qRT-PCR) in GC specimens and cell lines. The correlation between the CRNDE expression and clinicopathological parameters was investigated. Survival rate was determined with Kaplan-Meier and statistically analyzed with the log-rank method between groups. Subsequently, the significance of survival variables was analyzed using the Cox multivariate proportional hazards model. Then, MTT and Transwell assays were used to assess cell proliferation, migration and invasion capacity. Finally, Western blot analysis was performed to explore the effects of CRNDE knockdown on the PI3K/Akt pathway. RESULTS: We observed that expression of CRNDE was higher in GC tissues and cells compared with the normal gastric tissue and normal gastric cell lines. High expression of CRNDE was correlated with invasion depth (p = 0.006), TNM stage (p = 0.010) and lymph node metastasis (p = 0.005). Furthermore, high CRNDE expression was associated with shorter overall survival (p = 0.0066) of GC patients. Multivariate analysis confirmed that high CRNDE expression was a significant independent predictor of poor survival in GC. In vitro assay indicated that knockdown of CRNDE inhibited cell proliferation, migration and invasion of GC. Finally, the data of Western blot showed that CRNDE exerted its oncogenic role by affecting PI3K/AKT signaling pathways. CONCLUSIONS: Our findings indicate that CRNDE plays an important role in promoting GC progression and may represent a novel prognostic biomarker in GC.

Comparative study of radiotherapy plus erlotinib versus chemoradiotherapy for elderly patients with esophageal cancer: a propensity score-matched analysis.

This study compared the efficiency and safety of radiotherapy plus erlotinib with concurrent chemoradiotherapy (CCRT) based on paclitaxel plus cisplatin in elderly esophageal cancer patients. The eligible patients were retrospectively enrolled at Wenzhou Medical University cancer center from January 2005 to December 2011. Propensity score matching generated a matched cohort (1:1) composed from radiotherapy plus erlotinib and CCRT groups. The efficiency and safety were compared between two groups. Multivariable analysis was used to identify significant prognostic factors. Thirty-four patients treated with radiotherapy plus erlotinib were matched with patients who received CCRT. Radiotherapy plus erlotinib group showed better treatment compliance compared with the CCRT group (91.2% vs. 67.6%, hazard ratio [HR] 0.202, 95% confidence interval [CI] 0.051-0.809; P = .016). No significant overall response rate differences were found between the two groups (88.2% vs. 79.4%, HR 0.514, 95% CI 0.135-1.952; P = .323). The 5-year overall survival (OS) rate was 23.5% vs. 19.2% for patients treated with CCRT or radiotherapy plus erlotinib (HR 1.008, 95% CI 0.574-1.768; P = .979). The 5-year progression-free survival (PFS) rate was 16.8% versus 17.1% for patients treated with CCRT or radiotherapy plus erlotinib, respectively (HR 0.978, 95% CI 0.576-1.662; P = .934). The rate of severe hematologic toxicities in the CCRT group was significantly higher than that in the radiotherapy plus erlotinib group (HR 4.306, 95% CI 1.066-17.389; P = .031). Late toxicities were similar between radiotherapy plus erlotinib group and the CCRT group. Multivariate analysis showed that T stage (HR 1.730, 95% CI 1.062-2.816; P = .028), M stage (HR 2.859, 95% CI 1.407-5.811; P = .004), and complete response (HR 2.154, 95% CI 1.190-3.901; P = .011) were independent prognostic factors associated with OS. In conclusion, the present study suggested radiotherapy plus erlotinib should be a preferable modality compared with CCRT, with similar survival outcomes but better treatment compliance and less toxicities.

[History and development of carbonization of Chinese materia medica and exploration on its mechanism of hemostatic action].

The first material recorded about hair charcoal is seen in Nei jing (Inner Canon). It has a history of over 2 000 years for the carbonization of Chinese materia medica. There were controversies on this matter and its clinical application was seldom seen and underdeveloped. After the Yuan Dynasty, the main theory of carbonic herbs for hemostasis, and keeping the nature of the medicines after carbonization was gradually formed, and physicians of generations began to conduct in-depth research. Through repeated practice and verification, people summed up the suitable species of Chinese materia medica and its principle for carbonization. The methods and degree of carbonization of Chinese materia medica are reasonably discussed, with its principle and basis for application primarily interpreted.

Impact and clinical significance of Embosphere microsphere artery embolization therapy in serum VEGF expression level of women patients with uterine fibroids.

OBJECTIVE: We aimed to investigate the effect of Embosphere microsphere artery embolization on the serum level of vascular endothelial growth factor (VEGF) in patients with uterine fibroid. PATIENTS AND METHODS: From March 2014 to December 2015, 128 women in child-bearing age with uterine intramural fibroids were enrolled in the patient group. At the same time, 128 healthy cases in child-bearing age were randomly selected and enrolled in the control group. Enzyme-linked immunosorbent assay was used to measure the serum level of VEGF, and immunohistochemical staining method was used to study the expression of VEGF in the uterine fibroids. Embosphere microsphere artery embolization surgery was performed on cases in the patient group. RESULTS: The serum level of VEGF in the patient group was significantly higher than that of the control group. Immunohistochemical staining results showed that in the control group, VEGF expression level in uterine fibroid tissue was significantly higher. Compared with before the treatment, tumor diameter in the patient group reduced significantly 3 months after the treatment. Erythrocyte count, hemoglobin, and menstrual blood volume increased significantly 6 months after treatment. CONCLUSIONS: Serum VEGF level can be considered as a marker for uterine fibroid, and by using VEGF as a marker we can increase the probability of early diagnosis. We showed that, compared with hysterectomy, Embosphere microsphere embolization had an evident advantage and might be an excellent candidate to replace hysterectomy.

Anatomical structure of the coracohumeral ligament and its effect on shoulder joint stability.

BACKGROUND: In this study, coracohumeral ligament (CHL) specimens were carefully dissected to observe its length, width, thickness and tension at different positions of the shoulder joint, thereby elucidating its effects on shoulder joint stability. MATERIALS AND METHODS: Fresh frozen shoulder joints from 40 normal adult cadaveric specimens were dissected to reveal the CHL. With the shoulder joints placed at different positions, the length of the CHL and the width and thickness of the middle part of the ligament were measured. The changes in tension of the CHL were also observed. When the shoulder joint maintained the neutral position, the length of the CHL was 52.23 ± 1.02 mm and the width and thickness of the middle part of the ligament were 15.95 ± 0.59 mm and 1.46 ± 0.06 mm, respectively. RESULTS: When the shoulder joint moved from the neutral position to 90° external rotation, from the neutral position to 30° adduction or from the neutral position to 30° flexion/extension or when the shoulder joint is pulled down with a 5 kg weight, the CHL was elongated and thinned, maintaining a strained state. When the shoulder joint moved from the neutral position to 90° internal rotation, from the neutral position to 90° abduction or from the neutral position to 30° flexion/ extension, the CHL was shortened and thickened, maintaining a relaxed state. CONCLUSIONS: The CHL may limit the external rotation, adduction and downward movement of the shoulder joint and the process from the neutral position to the 30° flexion/extension, maintaining shoulder joint stability.