Combined early palliative care for non-small-cell lung cancer patients: a randomized controlled trial in Chongqing, China.

Purpose: More effective approaches are needed to improve the prognosis of non-small-cell lung cancer (NSCLC) patients. Thus, we used the E-warm model to assess how early integration of interdisciplinary palliative care was related to the quality of life (QoL), psychological functioning, pain management, and nutrition factors of NSCLC patients. Methods: This randomized controlled trial enrolled 280 newly diagnosed NSCLC patients, which were randomly divided (1:1) into combined early palliative care (CEPC) and standard oncological care (SC) groups. At baseline and after 24 weeks, the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale, Hospital Anxiety and Depression Scale (HADS), and the Patient Health Questionnaire-9 (PHQ-9) were used to assess QoL and psychological function, respectively. The Numerical Rating Scale (NRS) and Patient-Generated Subjective Global Assessment (PG-SGA) were used to assess cancer patients' pain and nutrition levels. The primary outcome was overall survival (OS). Secondary outcomes comprised changes in the QoL, psychological functioning, pain, and nutrition state. The intention-to-treat method was applied for analysis. This study was registered at www.chictr.org.cn (ChiCTR2200062617). Results: Of the 140 patients enrolled in the CEPC and SC groups, 102 and 82 completed the research. The CEPC group presented higher QoL than the SC group (p < 0.05). Additionally, fewer patients presented depressive symptoms in the CEPC group than in the SC group (p < 0.05), as well as better nutritional status (p = 0.007) and pain management (p = 0.003). Compared to the SC group, CEPC patients had significantly longer OS (20.4 vs. 24.6 months, p = 0.042; HR: 0.19; 95% CI: 0.04-0.85, p = 0.029). Conclusion: With combined early palliative care, NSCLC patients lived longer, had better QoL, were psychologically stable, were in less pain, and were more nutritionally satisfied.

JK5G postbiotics attenuate immune-related adverse events in NSCLC patients by regulating gut microbiota: a randomized controlled trial in China.

Scope: This study aimed to evaluate the effects of JK5G postbiotics to regulate imbalanced gut microbiota and its impacts on the efficacy and incidence rate of immune-related adverse events (irAEs) in non-small-cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICIs). Methods: This randomized, double-blind, placebo-controlled trial was conducted in China and included non-squamous or squamous NSCLC patients without EGFR, ROS1, and ALK alteration, treatment-naive, and stage IIIb-IV. Patients were randomly (1:1) divided into two groups to receive four cycles (three weeks for each cycle) of programmed cell death-1 (PD-1) plus chemotherapy plus placebo (control group, n = 30) or to receive PD-1 plus chemotherapy plus JK5G postbiotics (JK5G group, n = 30). The primary endpoint was objective response rate. The secondary endpoints were quality of life (QoL), adverse effects, and the 16S DNA sequencing of gut microbiota, blood inflammatory cytokines, and lymphocyte subsets. This study was registered at www.chictr.org.cn (ChiCTR2200064690). Results: Sixty patients were enrolled. The objective response rate was 36.67% (11/30) in the control group and 50.00% (15/30) in the JK5G group (p = 0.297). The JK5G group had better QoL and nutritional levels, as well as lower depression symptoms than the control group (all p < 0.05). Moreover, the JK5G group had a lower incidence of anemia (63.33% vs. 13.33%, p < 0.001), decreased lymphocyte count (20.00% vs. 0%, p = 0.010), decreased appetite (53.33% vs. 16.67%, p = 0.003), nausea (33.33% vs. 6.67%, p = 0.010), and asthenia (30.00% vs. 6.67%, p = 0.017) than the control group. Moreover, JK5G attenuated gut microbiota imbalance, accompanied by increased Faecalibacterium, Ruminococcaceae, and fecal butyrate concentration, and diminished Escherichia-Shigella. Furthermore, JK5G administration significantly decreased the levels of pro-inflammatory markers, including TNF-α, IL-2, and C-reactive protein (CRP) (all p < 0.05). Significant increases in CD3+CD4+ T cells and CD4/CD8 ratio were observed in the peripheral blood of JK5G group patients (all p < 0.05). The enterotype data showed that patients were clustered into Blautia (E1) and Escherichia-Shigella (E2) enterotypes, and JK5G postbiotics intervention might be related to enterotype modulations. Conclusion: Our current findings indicated that JK5G postbiotics might attenuate irAEs, and enhance the QoL and nutrition levels of advanced NSCLC patients who received ICIs. JK5G postbiotics could also improve the gut microbiota structures and ameliorate the tumor microenvironment and inflammation. Clinical trial registration: www.chictr.org.cn, identifier ChiCTR2200064690.

Weakly coupled graded index heterogeneous nineteen-core few-mode fiber.

We propose a novel heterogeneous nineteen-core four-mode fiber. The heterogeneous core arrangement and trench-assisted structure can significantly suppress inter-core crosstalk (XT). In order to control the number of modes in the core, a low refractive index area is introduced in the core. The number of LP modes and the effective refractive index difference (Δneff) of adjacent modes in the core are controlled by changing the refractive index distribution of the core and the parameters of the low refractive index area in the core. And the mode state of low intra-core crosstalk is successfully realized in the graded index core. After the optimization of fiber parameters, each core can stably transmit four LP modes under the optimal fiber parameters, and the inter-core crosstalk of LP02 mode is less than -60 dB/km. Finally, the effective mode area (Aeff) and dispersion (D) of nineteen-core four-mode fiber in C+L band are described. The results show that the nineteen-core four-mode fiber is suitable for terrestrial and undersea communication systems, data centers, optical sensors and other fields.

Effect of Electroacupuncture on the Treatment of Pneumonia in Patients with Hypertensive Intracerebral Hemorrhage.

OBJECTIVE: Pneumonia is a serious postoperative complication of hypertensive intracerebral hemorrhage (HICH), and there is no specific treatment for pneumonia. In this study, we conducted randomized controlled trials to evaluate the effects of electroacupuncture (EA) on the treatment of pneumonia in patients with HICH. METHODS: An equal number of patients with HICH complicated with pneumonia (n = 80 in total) were randomly placed in either the EA group (EA treatment and routine basic treatment) or the control group (routine basic treatment). After 14 days of treatment, clinical symptoms and signs, blood oxygen saturation, the level of inflammatory factors, the effective rate, the scores of the Barthel Index, National Institutes of Health Stroke Scale and Glasgow Coma Scale, the hospitalization time, and expenses were compared between the groups. RESULTS: The general information of the patients in the control and EA groups were similar. After 14 days of intervention, the patients in the EA group showed better symptom and sign scores, blood oxygen saturation levels, Barthel Index scores, Glasgow Coma Scale scores, and National Institutes of Health Stroke Scale scores than the patients in the control group. Furthermore, the EA treatment also lowered the levels of inflammatory factors and white blood cell count. Additionally, the patients in the EA group showed higher effective rates than those in the control group. CONCLUSIONS: EA benefits the treatment of pneumonia in patients with HICH.

Trench-assisted 12-core 5-LP mode fiber with a low refractive index circle and a high refractive index ring.

We propose a homogeneous five-mode twelve-core fiber with a trench-assisted structure, combining a low refractive index circle and a high refractive index ring (LCHR). The 12-core fiber utilizes the triangular lattice arrangement. The properties of the proposed fiber are simulated by the finite element method. The numerical result shows that the worst inter-core crosstalk (ICXT) can achieve at -40.14 dB/100 km, which is lower than the target value (-30 dB/100 km). Since adding the LCHR structure, the effective refractive index difference between LP21 and LP02 mode is 2.8 × 10-3, which illustrates that the LP21 and LP02 modes can be separated. In contrast to without the LCHR, the dispersion of LP01 mode has an apparent dropping, which is 0.16 ps/(nm·km) at 1550 nm. Moreover, the relative core multiplicity factor can reach 62.17, which indicates a large core density. The proposed fiber can be applied to the space division multiplexing system to enhance the fiber transmission channels and capacity.

Preparation and transmission characteristics of seven-core few-mode fiber with low loss and low inter-core crosstalk.

Seven-core five-mode fiber and single-core five-mode fiber with the same core structure by high and low refractive index double rings are prepared based on plasma chemical vapor deposition. The transmission characteristics of the single-core few-mode fiber and the seven-core few-mode fiber are measured and characterized by building an experimental platform. The prepared single-core few-mode fiber can stably transmit five LP modes at 1550 nm, which not only has low loss characteristics, but also has excellent bending resistance. Furthermore, the transmission loss of the prepared seven-core fiber is lower than 0.4 dB/km, and the inter-core crosstalk is lower than -50 dB/km, which realizes the high-density and low-crosstalk transmission of the multi-core fiber. The prepared seven-core few-mode fiber can solve the capacity limitation of single-mode fiber, which will contribute the development of future communication systems.

Temporal and spatial characterization of negative regulatory T cells in HIV-infected/AIDS patients raises new diagnostic markers and therapeutic strategies.

BACKGROUND: Negative regulatory T cells (Tregs) not only deplete effector T cells but also inhibit the clearance of HIV during infection, which may allow Tregs to be used as informative diagnostic markers. To facilitate both diagnosis and treatment, a thorough understanding of these regulators by characterizing them on temporal and spatial scales is strongly required. METHODS: Hundred HIV-infected/AIDS patients, including 87 males, with an average age of 35.8 years, as well as 20 healthy controls, were enrolled. Flow cytometry was used to analyze CD3+T cells, CD4+T cells, and CD8+T cells to evaluate the immune status of the participants. Then, a group of representative negative regulatory T cells, including CD4+PD-1+T cells, CD4+PD-1high T cells, CD8+PD-1+T cells, and CD4+CD25high Tregs was also analyzed to explore their effects on disease progression and intercorrelation. RESULTS: The percentages of CD4+ PD-1+ T cells and CD4+ CD25high Tregs increased in patients with the same ultrahigh significance. Temporally, the patients with both intermediate-stage and late-stage disease had higher percentages of CD4+ PD-1+ T cells; however, the percentage of CD4+ CD25high Tregs only increased in the patients with late-stage disease. In addition, CD4+ PD-1+ T cells but not CD4+ CD25high Tregs were negatively correlated with the absolute CD4+ T cell count. Spatially, no correlations between CD4+ PD-1+ T cells and CD4+ CD25high Tregs were observed, which suggests these Tregs function differently during immunosuppression. CONCLUSIONS: This study characterized negative regulatory T cells in HIV-infected/AIDS patients at both temporal and spatial scales and found that CD4+ CD25+ Tregs and CD4+ PD-1+ T cells could be used as potential diagnostic markers for identifying different disease stages and monitoring disease progression.

A versatile platform for the highly efficient preparation of graphene quantum dots: photoluminescence emission and hydrophilicity-hydrophobicity regulation and organelle imaging.

In this work, a versatile platform for the highly efficient preparation of graphene quantum dots (GQDs) with diverse properties was developed. First of all, an excess amount of oxidants and an additional high temperature step of the Hummers' method for the synthesis of graphene oxide (GO) was applied to obtain nanosized graphene oxide (NGO). Then, high quality GQDs (quantum yields up to 18.2%) with different photoluminescence emission wavelengths, adjustable hydrophilicity-hydrophobicity, and selective cell organelle imaging capacity can be facilely achieved through a one-pot hydrothermal reaction between the NGO and ammonia, fatty primary amines, or amino-substituted organelle targetable compounds, respectively. The superior features of the as-developed method are extremely high conversion ratio (ca. 60 wt% from graphite to the functional GQDs) and great expandability. Such a high conversion ratio is deemed to be due to effectively decreasing aggregation of the NGO (in comparison with GO) during the post-treatment process. This work provides a robust strategy for the highly efficient preparation of GQDs with diverse properties and functions, and is believed to be beneficial for boosting their applications in the future.

Risk factors of latent tuberculosis infection and immune function in health care workers in Suzhou, China.

BACKGROUND: The Chinese government has pay attention about tuberculosis infection among medical staff in infectious disease hospitals, but the effects have not yet been reported. This study will explore latent infection and immune function in the medical staff and systematically analyze the associated influencing factors. METHODS: Ninety-four medical staffs were enrolled and 20 medical staffs were defined as low risk group and others were high risk group. We used IFN-γ release assay and flow cytometry to analyze the latent TB infection status and immune function. Logistic regression analyses were performed to identify the independent risk factors of latent TB infection. RESULTS: This study explored and compared the infection status of medical workers and found that the rate of positive TB-IGRA results was higher among high risk group than in low risk group. Working environment, occupational history and work type were risk factors for TB infection in hospital. This study also found that high risk group had higher IFN-γ expression and a lower ratio of CD4+ to CD8+ T cells and further analysis found that this immune disorder is associated with wards and occupations. CONCLUSIONS: This study through rigorous sample collection and analysis found the risk factors of latent tuberculosis infection in health care workers. This finding may provide a theoretical basis to be used by the countries with a high TB burden to further improve their strategies for the prevention of TB infections in hospitals and may give an indication for improving the personal health of medical staff in infectious disease hospitals.

Development of an indirect competitive enzyme-linked immunosorbent assay (icELISA) using highly specific monoclonal antibody against paclitaxel.

Paclitaxel, the major active component of the yew tree, is used as an important anti-cancer agent. To obtain the monoclonal antibody (MAb) against paclitaxel for paclitaxel determination using immunoassay, 7-xylosyltaxol was conjugated to the carrier protein bovine serum albumin (BSA) to construct the immunogen, and the ratio of hapten in XylTax-BSA conjugate was determined by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. After immunization of mice with this conjugate, hybridomas secreting MAbs against paclitaxel were obtained by fusing the splenocytes with the mouse myeloma cell line SP2/0. After hybridoma screening, the anti-paclitaxel MAb 3A3 was obtained, which showed a relatively high specificity to paclitaxel (cross-reactivities against other naturally occurred taxanes: 7-xylosyltaxol, 31.8%; cephalomannine, 6.17%; baccatin III, 10-deacetyl-baccatin III, 1-hydroxybaccatin I, 13-acetyl-9-dihydrobaccatin III and 1-acetoxyl-5-deacetyl-baccatin I, <0.11%). Using the MAb 3A3, we established an indirect competitive enzyme-linked immunosorbent assay (icELISA) for paclitaxel determination with a detection range of 0.098-312.5 µg ml(-1). Determination of paclitaxel contents in various yew tree samples with this icELISA resulted in recovery rates ranging from 92 to 94.8%, and intra- and inter-assay variations of 3.6 and 4.7%, respectively. This icELISA provides a valuable method of paclitaxel determination for various purposes.

[Quality inspection of commercial Bupluri Radix samples in Guangzhou: an ELISA for determining saikosaponin A content using anti-saikosaponin A monoclonal antibody].

OBJECTIVE: To inspect the quality of commercially available Chaihu (Bupluri Radix, a common traditional Chinese herbal drug) in Guangzhou by determining the content of saikosaponin A (SSa) using enzyme-linked immunosorbent assay (ELISA). METHODS: A competitive ELISA system using mouse anti-saikosaponin A monoclonal antibody was established for determining SSa content. Commercial samples of Chaihu were obtained from 10 drug stores in Guangzhou, and SSa contents in the methanol extracts of these samples were determined using the ELISA system. RESULTS: The detection range of this competitive assay was 0.16-2.5 µg/ml for determining SSa contents. In the 10 commercial Chaihu samples, SSa contents in the methanol extract determined by this method ranged from 0.32 µg/mg to 6.87 µg/mg, and 3 samples showed a SSa content lower than the minimum requirement documented in the Chinese Pharmacopeia. CONCLUSION: This competitive ELISA is sensitive, rapid, economic and environment-friendly for SSa determination, especially suitable for batch determination. The results of SSa detection for the commercial Chaihu samples demonstrate an uneven quality of Chaihu in Guangzhou market, suggesting the necessity of more rigorous quality control measures for this drug.

[Immunodetection of ginsenoside Rb1 in rat serum].

OBJECTIVE: To establish a novel immunoassay for qualitative detection of ginsenoside Rb1 in rat serum. METHODS: Anti-G-Rb1 monoclonal antibody (mAb) was through a hybridoma approach. Rat serum containing G-Rb1 was deproteinized with methanol to prepare the sample for testing, which was loaded onto polyethersulfone (PES) membrane and developed in the mixture of acetonitrile, water and acetic acid (25:75:1). After treatment with NaIO(4), the membrane was transferred to 1% BSA solution for immobilization of G-Rb1. The membrane was subsequently treated with anti-G-Rb1 mAb solution, followed by addition of peroxidase-labeled goat anti-mouse IgG and color development using 4-chloro-1-naphthol-0.03% H(2)O(2). RESULTS: On the PES membrane, a clear blue spot representing G-Rb1 occurred where the rat serum for testing and the standard G-Rb1 samples were blotted. The limit of this immunodetection was 0.25 microg. CONCLUSION: This immunoassay has greater specificity and reliability than thin-layer chromatography with a sensitivity similar to that of high-performance liquid chromatography, and does not require sophisticated equipment for convenient G-Rb1 detection in rat serum.

[Determination of stachydrine and leonurine in Herba Leonuri by ion- pair reversed-phase high-performance liquid chromatography].

OBJECTIVE: To establish a high-performance liquid chromatography (HPLC) for determining stachydrine and leonurine contents in the crude drug of Yimu Cao, a Chinese motherwort herb(Herba Leonuri, the aerial part of Leonurus japonicus). METHODS: The sample was obtained from the crude drug by ultrasonic extraction with ethanol after decolorization with ethyl acetate. YMC-Park CN column (250.0 mm x 4.6 mm) was used with the mobile phase for stachydrine of 0.00125 mol/L SDS:C2H5CN (90:10) at the flow rate of 1.5 ml/min with the wavelength for detection of 201.7 nm, and that for leonurine of 0.00125 mol/L SDS (containing 0.05% HClO4):CH4OH(90:10) at the flow rate of 1 ml/min with the wavelength for detection of 282 nm. The sensitivity was 0.1 AUFs and the column temperature was 20 degrees Celsius;. RESULTS: With the injection amount (mg) as the abscissa and the peak area as the ordinate, the regression equation of the calibration curve for stachydrine was Y=1,187.542 3X-168.9822, and that for leonurine was Y=5,202.654X-221.141 (r=0.9998) with the linearity scope of 2.5-12.5 mg, detective limit of 0.15 mg, and recovery of (99.03+/-2.744) %. The analysis of extracted drug samples from 18 regions indicated that the alkaloids contents in Yimu Cao varied significantly, i.e. stachydrine within a range of 0.1%-0.2% while leonurine content, which was much lower, within 0.01%-0.05%. In general, the alkaloid contents were higher in the drug produced in northern China than in those produced in southern China. L. japonicus and the variant L. japonicus albiflorus had total alkaloid contents around 0.3%, which was higher than the contents of other species. CONCLUSION: As a convenient and feasible means for determining the alkaloid contents in Yimu Cao, HPLC produces accurate and reliable results and can be more effective than the formerly used methods.

Detection of autoantibodies in the serum of primary hepatocarcinoma patients.

OBJECTIVE: To study the significance of detecting autoantibodies in primary hepatocarcinoma (PHC) patients. METHODS: Autoantibodies were detected by indirect immunofluorescence assay. Antigens and antibodies of HBV were determined by enzyme immune assay. Antibody to HCV IgG was detected by enzyme-linked immunoabsorbent assay. RESULTS: The positive rate of autoantibody was 27.3% (38/139) in 139 PHC patients. The main type of autoantibodies in PHC was anti-nuclear antibody (36/38, 94.7%), others included anti-smooth muscle antibody(2/38, 5.3%), anti-mitochondria antibody (1/38, 2.6%), anti-midbody antibody (1/38, 2.6%, and anti-liver cell membrane antibody (2/38, 5.3%). CONCLUSIONS: Detecting autoantibodies in PHC patients is of significance in studying the mechanism of autoimmune reaction and etiology in PHC. The diversity of autoantibodies might result from a wide variety of etiological factors involved in PHC development, and from a wide variety of overexpressed or mutated proteins involved in repeated cycles of necrosis and regeneration in hepatocarcinoma development.