Ultrasound Shear Wave Elastography for Evaluation of Diaphragm Stiffness in Patients with Stable COPD: A Pilot Trial.

OBJECTIVES: Skeletal muscle dysfunction is one of the most common comorbidities in chronic obstructive pulmonary disease (COPD). The occurrence of respiratory failure in COPD is common and leads to the patient's death. The diaphragm is the most important muscle in the respiratory system and plays a key role in the onset of respiratory failure. This study explores the feasibility of ultrasound shear wave elastography (SWE) to measure diaphragmatic stiffness and evaluates its changes in COPD patients. METHODS: In total, 77 participants (43 patients with stable COPD and 34 healthy controls) were enrolled. All subjects underwent complete diaphragmatic ultrasound SWE measurements and pulmonary function tests. The diaphragmatic stiffness was indicated via diaphragmatic shear wave velocity (SWV) at functional residual capacity (FRC). A trained operator performed the ultrasound SWE examinations of the first 15 healthy controls thrice to assess the reliability of diaphragmatic SWE. RESULTS: A good to excellent reliability was found in diaphragmatic SWV at FRC (ICC = 0.93, 95%CI 0.82-0.98). As compared to the control group, the diaphragmatic SWV at FRC was considerably high in the COPD group (median 2.5 m/s versus 2.1 m/s, P = .008). Diaphragmatic SWV at FRC was linked to forced expiratory volume in one second (r = -0.30, P = .009), forced vital capacity (r = -0.33, P = .003), modified Medical Research Council score (r = 0.30, P = .001), and COPD assessment test score (r = 0.48, P < .001). CONCLUSIONS: Ultrasound SWE may be employed as an effective tool for quantitative evaluation of diaphragm stiffness and can help in personalized management of COPD, such as treatment guidance and follow-up monitoring.

Tetratrichomonas in pyopneumothorax.

Pleural trichomonosis is clinically rare, and very few cases of trichomonal empyema have been reported so far. A rare case of an 81-year-old woman with pyopeumothorax presenting with recurrent fever and macroscopic pyuria was present. Microscopic examination of the pleural effusion showed mobile flagellated protozoa which molecular methods identified as Tetratrichomonas. In addition, Streptococcus anginosus was discovered in pleural fluid cultures. Treatment with imipenem/cilastatin and metronidazole successfully eliminated the pathogens and led to relief of clinical symptoms. In the context of a review of the relevant literature, the clinical application of molecular methods in the diagnosis of pleural trichomonosis is underlined.

A novel machine learning model for efficacy prediction of immunotherapy-chemotherapy in NSCLC based on CT radiomics.

Lung cancer is categorized into two main types: non-small cell lung cancer (NSCLC) and small cell lung cancer. Of these, NSCLC accounts for approximately 85% of all cases and encompasses varieties such as squamous cell carcinoma and adenocarcinoma. For patients with advanced NSCLC that do not have oncogene addiction, the preferred treatment approach is a combination of immunotherapy and chemotherapy. However, the progression-free survival (PFS) typically ranges only from about 6 to 8 months, accompanied by certain adverse events. In order to carry out individualized treatment more effectively, it is urgent to accurately screen patients with PFS for more than 12 months under this treatment regimen. Therefore, this study undertook a retrospective collection of pulmonary CT images from 60 patients diagnosed with NSCLC treated at the First Affiliated Hospital of Wenzhou Medical University. It developed a machine learning model, designated as bSGSRIME-SVM, which integrates the rime optimization algorithm with self-adaptive Gaussian kernel probability search (SGSRIME) and support vector machine (SVM) classifier. Specifically, the model initiates its process by employing the SGSRIME algorithm to identify pivotal image features. Subsequently, it utilizes an SVM classifier to assess these features, aiming to enhance the model's predictive accuracy. Initially, the superior optimization capability and robustness of SGSRIME in IEEE CEC 2017 benchmark functions were validated. Subsequently, employing color moments and gray-level co-occurrence matrix methods, image features were extracted from images of 60 NSCLC patients undergoing immunotherapy combined with chemotherapy. The developed model was then utilized for analysis. The results indicate a significant advantage of the model in predicting the efficacy of immunotherapy combined with chemotherapy for NSCLC, with an accuracy of 92.381% and a specificity of 96.667%. This lays the foundation for more accurate PFS predictions and personalized treatment plans.

The prevalence and associated risk factors of sleep disorder-related symptoms in pregnant women in China.

PURPOSE: The sleep disorder in pregnant women remains unfamiliar to perinatal care providers, resulting in lack of appropriate care. This study was designed to investigate the prevalence of sleep disorder-related symptoms in pregnant women and to identify the associated risk factors. METHODS: Married pregnant women were enrolled from their first trimester and followed up until delivery. Nonpregnant married healthy women were selected as controls. A survey questionnaire was administered to each of them. RESULTS: We successfully performed a survey to 1,993 pregnant women and 598 nonpregnant women. The overall prevalence of sleep disorder-related symptoms in pregnant women was significantly higher than the controls (56.1 vs. 29.9 %, P < 0.05). There was higher prevalence of snoring (30.2 %), observed sleep apnea (1.1 %), mouth breathing (23.7 %), nocturnal arousal (46.5 %), insomnia (35.1 %), and daytime sleepiness (52.6 %) in pregnant women. There were no significant differences of the prevalence of bruxism (7.0 vs. 6.7 %), sleep talking (8.1 vs. 7.2 %), and sleep walking (0.4 vs. 0.2 %) between the two groups (P > 0.05). Nocturnal sleep time (8.0 ± 1.3 h) was less in the third trimester compared with the nonpregnant women (8.2 ± 1.1 h) (P < 0.05). Smoking (OR = 3.39), drinking (OR = 2.40), allergic rhinitis/asthma (OR = 1.71), an obvious difference in neck circumference (OR = 1.11), and waistline (OR = 1.07) changes between the first and third trimesters were the risk factors for sleep disorder-related problems. CONCLUSIONS: There is a high prevalence of sleep disorder-related symptoms in pregnant women. Our data may provide a baseline for prevention and treatment of sleep disturbances in pregnant women.

Real-world tobacco cessation practice in China: findings from the prospective, nationwide multicenter China National Tobacco Cessation Cohort Study (CNTCCS).

Background: Tobacco cessation is proven to be the most effective and cost-effective strategy for smokers to reduce their risk of smoking-related disease and premature death. Providing effective, efficient, safe, and patient-centred tobacco cessation treatment to reach those who need them is a significant challenge. To date, only a few nationwide studies in China have assessed the overall clinical care practice and treatment outcome of tobacco cessation. Methods: This a prospective, nationwide, multicenter, cohort study covering all Eastern China, Northwest China, Central China, North China, Southwest China, Northeast China, and South China. Participants who were current smokers aged 18-85 years attending clinic for smoking cessation were included. All the participants were treated with 3-month cessation treatment and followed up for 3 months. Data were collected prospectively using online system. The primary outcome was 7-day point abstinence rate at 24 weeks, validated biochemically by an expired carbon monoxide level of less than 10 ppm. The participants lost to follow-up or not providing validation were included as non-abstainers. Findings: A representative sample of 3557 participants were recruited and 2943 participants were included into this analysis. These participants had mean age of 53.05 years, and 94.8% were males, with 75.8% showing symptoms of tobacco dependence. A total of 965 (32.8%) participants were treated with Bupropion + behavioural counselling, followed by 935 (31.8%) with behavioural counselling, 778 (26.4%) with Varenicline + behavioural counselling, 135 (4.6%) with alternative treatments + behavioural counselling, and 130 (4.4%) with nicotine replacement therapy (NRT) + behavioural counselling. After 3-month treatment and 3-month follow-up, 21.74% of the participants quit smoking at 24 weeks. In the multivariable-adjusted analyses, quitting smoking was significantly associated with female, higher socioeconomic status, poor health condition, different treatment received, and less smoking intensity. The tobacco cessation treatment varied widely across different areas of China. In particular, the areas with higher usage of cessation medication were associated with better cessation treatment outcome. Interpretation: The CNTCCS is the first large-scale nationwide cohort study of smoking cessation in China. Rich data collected from this prospective cohort study provided the opportunity to evaluate the clinical practice of tobacco cessation treatment in China. Funding: Chinese Academy of Medical Sciences (CAMS) Initiative for Innovative Medicine (CAMS 2021-I2M-1-010), Heilongjiang Provincial Science and Technology Key Program (2022ZXJ03C02), and National Key R&D Program of China (grant no. 2017YFC1309400).

Water Corrosion of Tungsten Target for Accelerator-Driven Neutron Source.

The water corrosion of tungsten as a target material can affect the safe operation of accelerator-driven neutron source. This paper reported the corrosion behaviors of tungsten in ultrapure water and tap water for 7, 14, 21, 30 and 60 days. Moreover, ICP-MS, XRD, XPS, SEM-EDS and LSCM were used to analyze the components in solutions, crystalline structures, chemical compositions and surface morphologies. It was found that the dissolution of tungsten, due to corrosion, reached its maximum between 30 days and 60 days in both solutions. The cube-shape substance, CaWO4, was the main corrosion product after tungsten in tap water. The tungsten oxide was changed from WO3 to WO2 during the corrosion of tungsten in ultrapure water. Compared with tungsten in ultrapure water, tungsten in tap water had its surface completely destroyed, with a dense diamond shape. Therefore, based on the analysis from this study, the corrosion mechanisms of tungsten in ultrapure and tap water were revealed.

Influence of Film Coating Thickness on Secondary Electron Emission Characteristics of Non-Evaporable Getter Ti-Hf-V-Zr Coated Open-Cell Copper Foam Substrates.

The application of vacuum materials with low secondary electron yield (SEY) is one of the effective methods to mitigate the electron cloud (EC). In this study, the Ti-Hf-V-Zr non-evaporable getter (NEG) film was deposited on open-cell copper foams with different pore sizes for the suppression of electron multipacting effects. Besides, the influence of the film thickness on the secondary electron emission (SEE) characteristics of Ti-Hf-V-Zr NEG film-coated open-cell copper foam substrates was investigated for the first time. The results highlighted that all uncoated and NEG-coated foamed porous copper substrates achieved a low SEY (<1.2), which reduced at least 40% compared to the traditional copper plates, and the foamed porous coppers with 1.34-µm-thick NEG coating had the lowest SEY. Moreover, the surface chemistry and the morphological and structural properties of foamed porous coppers of different pore sizes with and without Ti-Hf-V-Zr NEG films were systematically analyzed.

Whole exome sequencing identified a novel POT1 variant as a candidate pathogenic allele underlying a Li-Fraumeni-like family.

Background: Li-Fraumeni syndrome (LFS) and Li-Fraumeni-like (LFL) syndrome are rare hereditary diseases characterized by predisposition to a diverse spectrum of cancer types, primarily sarcoma. The pathogenic variants underlying the majority of LFL cases remain to be explored. Methods: We performed whole-exome sequencing (WES) on 13 core members of a large LFL family with highly aggregated incidences of cancers, including cases with sarcoma, non-small cell lung cancer and cardiac angiosarcoma, and conducted a comprehensive literature review of candidate gene associations in LFS/LFL syndromes or sarcoma to identify potential pathogenic germline variants. Results: No germline variants in the best-known LFL/LFS-associated gene TP53 were detected. Of all the genes associated with LFS/LFL or sarcoma that we have surveyed, we identified a novel p.P35L germline variant in POT1 (protection of telomeres 1). Germline and somatic alterations in POT1 have been implicated in a series of familial cancers, including angiosarcoma, glioma, melanoma and colorectal cancer. This particular variant is located in the telomere-binding OB1 domain, which is important in maintaining the proper telomere length, and showed high conservation across different POT1 orthologues. No record of the variant was found in any of the 1000 genomes, ExAC, gnomAD, dpSNP and COSMIC databases. Prediction algorithms and in silico structural analysis suggested completely disrupted protein structure and function of POT1 in the presence of this mutation. Conclusions: Leveraging WES, we identified a novel germline risk allele, p.P35L in POT1, that likely predisposes to LFL syndrome. Our results support the routine testing of POT1 and other LFL/LFS-associated genes in the risk populations to enable early cancer diagnosis, prevention and intervention.

Enhanced open-circuit voltages and efficiencies: the role of oxidation state of molybdenum oxide buffer layer in polymer solar cells.

Molybdenum oxide (MoO x ) is widely used as a buffer layer in optoelectronic devices to improve the charge extraction efficiency. The oxidation state of MoO x plays an important role in determining its electrical properties. However, there are few studies on the oxidation state to further guide the optimization of the MoO x buffer layer. In this work, inverted-structured polymer solar cells (PSCs) with a MoO x buffer layer were fabricated. Post-air annealing was used to control the cation valence state in MoO x . X-ray photoelectron spectroscopy (XPS), ultraviolet photoelectron spectroscopy (UPS), atomic force microscopy (AFM) and transient photocurrent (TPC) were employed to study the valence state, energy level, morphology of the MoO x layers and the photovoltaic property and charge transfer efficiency of the devices. It was found that the oxidation state was effectively improved by the post-annealing process. As a result, the work function of MoO x was raised and the hole mobility was improved. The open-circuit voltages and the efficiencies of PTB7-Th:PC71BM based PSCs were enhanced from 0.77 V and 8.66% to 0.81 V and 10.01%, respectively. The results show that high oxidation state MoO x provides optimized energy level alignment, reduced defects and better charge transfer efficiency, which is more in line with the requirement of buffer layer materials for optoelectronic applications.

Depositing a Titanium Coating on the Lithium Neutron Production Target by Magnetron Sputtering Technology.

Lithium (Li) is one of the commonly used target materials for compact accelerator-based neutron source (CANS) to generate neutrons by 7Li(p, n)7 Be reaction. To avoid neutron yield decline caused by lithium target reacting with the air, a titanium (Ti) coating was deposited on the lithium target by magnetron sputtering technology. The color change processes of coated and bare lithium samples in the air were observed and compared to infer the chemical state of lithium qualitatively. The surface topography, thickness, and element distribution of the coating were characterized by SEM, EDS and XPS. The compositions of samples were inferred by their XRD patterns. It was found that a Ti coating with a thickness of about 200 nanometers could effectively isolate lithium from air and stabilize its chemical state in the atmosphere for at least nine hours. The Monte Carlo simulations were performed to estimate the effects of the Ti coating on the incident protons and the neutron yield. It turned out that these effects could be ignored. This research indicates that depositing a thin, titanium coating on the lithium target is feasible and effective to keep it from compounds' formation when it is exposed to the air in a short period. Such a target can be installed and replaced on an accelerator beam line in the air directly.

The Characterization of Silicone-Tungsten-Based Composites as Flexible Gamma-Ray Shields.

Robots are very essential for modern nuclear power plants to monitor equipment conditions and eliminate accidents, allowing one to reduce the radiations on personnel. As a novel robot, a soft robot with the advantages of more degrees of freedom and abilities of continuously bending and twisting has been proposed and developed for applications in nuclear power industry. Considering the radiation and high-temperature environment, the overall performance improvement of the flexible materials used in the soft nuclear robot, such as the tensile property and gamma-ray shielding property, is an important issue, which should be paid attention. Here, a flexible gamma-ray shielding material silicone-W-based composites were initially doped with nano titanium oxide and prepared, with the composition of 20 silicone-(80-x) W-(x) TiO2, where x varied from 0.1 to 2.0 wt.%. Structural investigations on SEM and EDS were performed to confirm the structure of the prepared composites and prove that all the chemicals were included in the compositions. Moreover, the tensile property of the composites at 25, 100, and 150 °C were investigated to study the effect of working temperature on the flexibility of the compositions. The attenuation characteristics including the linear attenuation coefficients and mass attenuation coefficients of the prepared silicone-W or silicone-W-TiO2-based composites with respect to gamma ray were investigated. The stability of the silicone-tungsten-TiO2-based composite at high temperature was studied for the first time. In addition, the influence of nano TiO2 additive on the property's variation of silicone-W-based composites was initially studied. The comparison of the properties such as the tensile elongation, thermal stability, and gamma-ray shielding of the synthesized silicone-W and silicone-W-TiO2 composites showed that the addition of nano TiO2 powders could be useful to develop novel gamma-ray-shielding materials for radiation protection of soft robots or other applications for which soft gamma-ray-shielding materials are needed.

Functional Connectivity of Attention-Related Networks in Drug-Naïve Children With ADHD.

Objective: This study aimed to explore alterations of seed-based functional connectivity (FC) in dorsal attention network (DAN), ventral attention network (VAN), and default mode network (DMN) in ADHD children. Method: A voxel-based comparison of FC maps between 46 drug-naïve children with ADHD and 31 healthy controls (HCs) and correlation analysis between connectivity features and behavior were performed. Results: Compared with the HCs, children with ADHD were characterized by hyperconnectivity between DAN and regions of DMN and by hyperconnectivity between DMN and a set of regions involved in somatosensory, visual, and auditory cortices. No significant group different FC was found between VAN and the whole brain. Higher FC between DMN and somatosensory, visual, and auditory cortex was associated with better performance in attention and executive function. Conclusion: The dysregulation of networks in children with ADHD not only involves the DAN and DMN but also the somatosensory, motor, visual, and auditory networks.

[The pathological effects of snoring on pregnant women].

OBJECTIVE: To discuss the pathological effect of snoring on pregnant women in Wenzhou area. METHODS: The study was performed between January 2006 and February 2008, 601 women with pregnancies being in clinic or the ward were surveyed about snoring occur, measuring physiological and biochemical parameters in the 13th, 28th week of pregnancy and before delivery, recording the complication and pregnancy outcome. According to their pregnancy and snoring occur, they were divided into the first, the second and the third trimester snoring group and non-snoring group. RESULT: Compared with the non-snoring group, The BMI, abdominal perimeter, the neck circumference and systolic blood pressure in snoring group of every trimester increased significantly (P<0.05). There were no significant differences about the hip circumference of snoring group in the first trimester (P>0.05), but they increased significantly in the second and the third trimester (P<0.05). There were no significant differences about the diastolic blood pressure of snoring group in the first and the second trimester (P>0.05), but they increased significantly in the third trimester (P<0.05). There were no significant differences about the snoring group's BMI, abdominal perimeter, the neck circumference, the hip circumference and blood pressure between the groups of every trimester (P>0.05). Compared with the non-snoring group, the incidence of snoring group's gestational hypertension, premature birth and abdominal delivery increased significantly every trimester of pregnancy (P<0.05). There were no significant differences Between the snoring groups of every trimester (P>0.05). CONCLUSION: The snore makes pregnant women physiological characteristics changed, the incidence of gestational hypertension, premature delivery and abdominal delivery increased. So we should pay more attentions to them in their perinatal stage.

Mechanical and Electrical Characteristics of WB2 Synthesized at High Pressure and High Temperature.

Single-phase tungsten diboride (WB2) was synthesized at high pressure and high temperature. The different grain sizes ranging from 300 nm to 3 µm were successfully obtained in WB2 by controlling the experimental conditions. The effects of grain size on hardness and resistivity properties were investigated. The Vickers hardness of WB2 was modulated with grain size. The maximum asymptotic Vickers hardness is 25.5 GPa for WB2 with a grain size of 300 nm which is a 10% increase compared to WB2 with a grain size of 3 µm. The optimal electrical resistivity of WB2 was 10-7 Ωm with the biggest grain size of 3 µm, which is ascribed to low grain boundary density. The superior properties of hardness and electrical resistivity demonstrate that WB2 should be a new functional hard material replacing WC which is widely used in industrial production.

The Activation of Ti-Zr-V-Hf Non-Evaporable Getter Films with Open-Cell Copper Metal Foam Substrates.

Secondary electron emission (SEE) inhibition and vacuum instability are two important issues in accelerators that may induce multiple effects in accelerators, such as power loss and beam lifetime reduction. In order to mitigate SEE and maintain high vacuum simultaneously, open-cell copper metal foam (OCMF) substrates with Ti-Zr-V-Hf non-evaporable getter (NEG) coatings are first proposed, and the properties of surface morphology, surface chemistry and secondary electron yield (SEY) were analyzed for the first time. According to the experimental results tested at 25 °C, the maximum SEY (δmax) of OCMF before and after Ti-Zr-V-Hf NEG film deposition were 1.25 and 1.22, respectively. The XPS spectra indicated chemical state changes of the metal elements (Ti, Zr, V and Hf) of the Ti-Zr-V-Hf NEG films after heating, suggesting that the NEG films can be activated after heating and used as getter pumps.

Crocin ameliorates chronic obstructive pulmonary disease-induced depression via PI3K/Akt mediated suppression of inflammation.

Clinical studies have indicated the co-occurrence of chronic obstructive pulmonary disease (COPD) and psychiatric disorders, for example, comorbid depression. However, the underlying mechanism is rarely addressed. The present study aimed to investigate the mechanism of COPD-induced depression and the psychological and physiological effects of crocin, an active constituent of Crocus sativus L. C57BL/6 mice were randomly exposed to cigarette smoke for 7 weeks to establish COPD animal model. Crocin (50 mg/kg), Dexamethasone (2 mg/kg) and IGF-1 (2 mg/kg) were respectively injected to mice once a day. The FEV1/FVC ratio and the mean alveolus area of lung tissue demonstrated the COPD model was successfully established by cigarette smoke. Crocin administration significantly reversed markers of depression [loss of body weight, sucrose preference, and elevation of immobile time in tail-suspension tests (TST) and in forced swimming tests (FST)]. Besides, crocin treatment significantly inhibited the numbers of inflammatory cells (macrophages, neutrophils, and lymphocytes), suppressed the infiltration of peribronchial inflammatory cells, and reduced the concentration of proinflammatory cytokines in bronchoalveolar lavage (BAL) fluid and lung tissue. Crocin also reduced proinflammatory cytokines in the hippocampus. In exploring associated mechanisms, we discovered that crocin blunted cigarette smoke-induced IκB phosphorylation and degradation, and NF-κBp65 nuclear translocation. IGF-1, an activator of PI3K, abrogated the effect of crocin against cigarette smoke-induced activation of the NF-κB pathway. Together, these results showed that an inflammatory mechanism might be involved in the pathogenesis of COPD with comorbid depression. Crocin exhibited significant effects through the regulation of PI3K/Akt-mediated inflammatory pathways.

A comparison of EGFR mutation status in tissue and plasma cell-free DNA detected by ADx-ARMS in advanced lung adenocarcinoma patients.

BACKGROUND: Previous studies have shown that there are different methods used to detect the epidermal growth factor receptor (EGFR) mutation status in plasma cell-free DNA (cfDNA) for advanced lung adenocarcinoma patients including the ADx-Amplification Refractory Mutation System (ADx-ARMS). We explored the performance of the ADx-ARMS in detecting the EGFR mutations in cfDNA. METHODS: This prospective cohort study enrolled patients who presented with advanced (stage IIIb/IV) lung adenocarcinoma. EGFR mutations in plasma cfDNA and tumor tissues by ADx-ARMS were detected. Next-generation sequencing (NGS) in plasma was performed in patients with inconsistent gene region mutations in the plasma and matched tissue samples. We calculated the clinical parameters of the ADx-ARMS for EGFR mutation status in the plasma of cfDNA, using the tumor tissues as the standard for measurement. The objective response rate (ORR) and progression-free survival (PFS) were also calculated for patients receiving first-generation EGFR-tyrosine kinase inhibitors (TKIs) therapy. RESULTS: In total, 203 patients were included in the final analysis. Mutations were discovered in 58.6% (119/203) of the tumor tissues and 31.0% (63/203) were detected EGFR mutations in both tumor tissues and matched plasma. The sensitivity and the specificity setting for detecting the EGFR mutations in the plasma using the ADx-ARMS were configured to 52.9% and 98.8%. An ORR of 64.8% was observed among the 71 patients who were identified as being EGFR-positive in their tumor tissues, who had received treatments using Gefitinib or Icotinib. Next, the ORR was observed to be 69.0% among the 42 patients with an EGFR mutation in their plasma. The median PFS of the patients with an EGFR mutation in tumor tissues and plasma were 10.0 vs. 11.0 months (P=0.175). The median PFS of the patients with an EGFR wild-type in the plasma was 8.7 months, which was significantly shorter than the EGFR mutant-type in plasma (P=0.001). CONCLUSIONS: Using ADx-ARMS as an approach with high specificity but moderate sensitivity to detect the EGFR mutations in plasma cfDNA and EGFR mutation status in plasma cfDNA using the ADx-ARMS can predict the tumor response for EGFR-TKIs.

Dynamics of Plasma EGFR T790M Mutation in Advanced NSCLC: A Multicenter Study.

BACKGROUND: Droplet digital polymerase chain reaction (ddPCR) is an emerging technology for quantitative cell-free DNA oncology applications. However, a ddPCR assay for the epidermal growth factor receptor (EGFR) p.Thr790Met (T790M) mutation suitable for clinical use remains to be established with analytical and clinical validations. OBJECTIVE: We aimed to develop and validate a new ddPCR assay to quantify the T790M mutation in plasma for monitoring and predicting the progression of advanced non-small-cell lung cancer (NSCLC). METHODS: Specificity of the ddPCR assay was evaluated with genomic DNA samples from healthy individuals. The inter- and intraday variations of the assay were evaluated using mixtures of plasmid DNA containing wild-type EGFR and T790M mutation sequences. We assessed the clinical utility of the T790M assay in a multicenter prospective study in patients with advanced NSCLC receiving tyrosine kinase inhibitor (TKI) treatment by analyzing longitudinal plasma DNA samples. RESULTS: We set the criteria for a positive call when the following conditions were satisfied: (1) T790M mutation frequency > 0.098% (3 standard deviations above the background signal); (2) at least two positive droplets in duplicate ddPCR reactions. Among the 62 patients with advanced NSCLC exhibiting resistance to TKI treatment, 15 had one or more serial plasma samples that tested positive for T790M. T790M mutation was detected in the plasma as early as 205 days (median 95 days) before disease progression, determined by imaging analysis. Plasma T790M concentrations also correlated with intervention after disease progression. CONCLUSIONS: We developed a ddPCR assay to quantify the T790M mutation in plasma. Quantification of longitudinal plasma T790M mutation may allow noninvasive assessment of drug resistance and guide follow-up treatment in TKI-treated patients with NSCLC. TRIAL REGISTRATION: Clinical Trials.gov identifier: NCT02804100.

Fabrication and Characterization of Short Silicon Nitride Fibers from Direct Nitridation of Ferrosilicon in N2 Atmosphere.

Short silicon nitride fibers were fabricated by direct nitridation of ferrosilicon in N2 atmosphere, and their structure and possible growth mechanism were characterized and investigated. The rod-like fibers which were α-Si3N4 with a low degree of crystallization and a high aspect ratio had a diameter of about 4 µm and a length close to a few millimeters. Belt-like fibers with a width about 5 µm and a thickness about 1 µm were also found in the nitrides. Scanning electron microscope (SEM), transmission electron microscope (TEM), high resolution transmission electron microscope (HRTEM), and selected area electron diffraction (SAED) investigations indicated that the fibers were single-crystalline α-Si3N4 with few amorphous distributed in the edge region, and the fibers grew by vapor⁻liquid⁻solid (VLS) mechanism.

The performance of serum cryptococcal capsular polysaccharide antigen test, histopathology and culture of the lung tissue for diagnosis of pulmonary cryptococcosis in patients without HIV infection.

BACKGROUND: Clinicians may fail to make an early diagnosis of pulmonary cryptococcosis (PC) without HIV infection. Serum cryptococcal capsular polysaccharide antigen (CrAg) test, histopathology and culture of lung tissue play different roles in diagnosis of PC. OBJECTIVE: To investigate the performance of serum CrAg test, histopathology and culture of the lung tissue in diagnosis of PC without HIV infection. PATIENTS/METHODS: From January 2011 to September 2017, patients with proven PC were recruited from a teaching hospital in southern China. Those patients with HIV infection, PC confirmed by surgery or PC with probable or possible diagnosis were excluded from the study. Latex agglutination test and CrAg lateral flow assay were used for detection of serum CrAg. Lung biopsy and needle aspiration were performed under computed tomography guidance. RESULTS: Eighty-nine patients with proven PC including 41 male (46.1%) and 48 female (53.9%) were enrolled. Fifty-one (57.3%) patients had underlying disease. Positive CrAg test was found in 83 (93.3%) cases. Among six cases with negative CrAg test, PC was confirmed by histology in two cases and positive culture in four cases. The histopathological results of 77 (86.5%) cases revealed cryptococcal granuloma and 12 cases showed chronic inflammation, which was confirmed by positive culture. Among 65 cases, the diseased tissue of 46 (70.8%) cases presented Cryptococcus neoformans in the culture and one case was diagnosed with lung cancer coexisting with PC. CONCLUSION: Our findings showed that serum CrAg test is rapid and sensitive in diagnosing PC, histology is important for confirming PC and culture plays a complementary role. Biopsied lung tissue should be submitted for cultures whenever feasible.