Treatment and Prognosis of Anaplastic Thyroid Carcinoma: Experience from a Single Institution in China

Background

Anaplastic thyroid carcinoma (ATC), a highly aggressive malignancy, has a poor prognosis, and the consensus on the most effective treatment is needed.

Methods

Clinical data from all ATC patients treated in our institution over a 30-year period (between May 1980 and May 2010) were analyzed retrospectively with regard to mortality and survival rates (Kaplan–Meier). Multivariate analysis was performed using a Cox proportional hazards model.

Results

Sixty cases were analyzed. The overall 1- and 3-year survival rates were 35.0% and 22.9%, respectively. Univariate analysis showed that the best prognosis was seen in patients younger than 55 years, those without distant metastases, those with white blood cell (WBC) counts < 10.0 × 10⁹/L or blood platelet (PLT) counts < 300.0 × 10⁹/L at presentation, those who did not receive chemotherapy, and those who received radiotherapy doses ≥ 40 Gy or underwent surgery plus postoperative radiotherapy. According to multivariate analysis, the WBC count at first presentation and the type of therapeutic regimen independently influenced survival.

Conclusions

We found that the elevated peripheral PLT count may be an adverse prognostic factor of ATC patients. The prognosis for ATC is especially poor for patients with distant metastasis, a WBC count ≥ 10.0×10⁹/L, a PLT count ≥ 300.0 × 10⁹/L, or age ≥ 55 years. WBC count at presentation and surgery with or without postoperative radiotherapy independently influenced the prognosis. Intensive treatment combining surgery with postoperative radiotherapy is recommended for ATC patients with stage IVA/B disease.     

Timing of Surgical Intervention with Cochlear Implant in Patients with Large Vestibular Aqueduct Syndrome

Objectives

(1) To report the speech perception and intelligibility results of Mandarin-speaking patients with large vestibular aqueduct syndrome (LVAS) after cochlear implantation (CI); (2) to compare their performance with a group of CI users without LVAS; (3) to understand the effects of age at implantation and duration of implant use on the CI outcomes. The obtained data may be used to guide decisions about CI candidacy and surgical timing.

Methods

Forty-two patients with LVAS participating in this study were divided into two groups: the early group received CI before 5 years of age and the late group after 5. Open-set speech perception tests (on Mandarin tones, words and sentences) were administered one year after implantation and at the most recent follow-up visit. Categories of auditory perception (CAP) and Speech Intelligibility Rating (SIR) scale scores were also obtained.

Results

The patients with LVAS with more than 5 years of implant use (18 cases) achieved a mean score higher than 80% on the most recent speech perception tests and reached the highest level on the CAP/SIR scales. The early group developed speech perception and intelligibility steadily over time, while the late group had a rapid improvement during the first year after implantation. The two groups, regardless of their age at implantation, reached a similar performance level at the most recent follow-up visit.

Conclusion

High levels of speech performance are reached after 5 years of implant use in patients with LVAS. These patients do not necessarily need to wait until their hearing thresholds are higher than 90 dB HL or PB word score lower than 40% to receive CI. They can do it “earlier” when their speech perception and/or speech intelligibility do not reach the performance level suggested in this study.     

Real-Time Fluorescence Loop Mediated Isothermal Amplification for the Detection of Acinetobacter baumannii

Background

Detection of Acinetobacter baumannii has been relying primarily on bacterial culture that often fails to return useful results in time. Although DNA-based assays are more sensitive than bacterial culture in detecting the pathogen, the molecular results are often inconsistent and challenged by doubts on false positives, such as those due to system- and environment-derived contaminations. In addition, these molecular tools require expensive laboratory instruments. Therefore, establishing molecular tools for field use require simpler molecular platforms. The loop-mediated isothermal amplification method is relatively simple and can be improved for better use in a routine clinical bacteriology laboratory. A simple and portable device capable of performing both the amplification and detection (by fluorescence) of LAMP in the same platform has been developed in recent years. This method is referred to as real-time loop-mediated isothermal amplification. In this study, we attempted to utilize this method for rapid detection of A. baumannii.

Methodology and Significant Findings

Species-specific primers were designed to test the utility of this method. Clinical samples of A. baumannii were used to determine the sensitivity and specificity of this system compared to bacterial culture and a polymerase chain reaction method. All positive samples isolated from sputum were confirmed to be the species of Acinetobacter by 16S rRNA gene sequencing. The RealAmp method was found to be simpler and allowed real-time detection of DNA amplification, and could distinguish A. baumannii from Acinetobacter calcoaceticus and Acinetobacter genomic species 3. DNA was extracted by simple boiling method. Compared to bacterial culture, the sensitivity and specificity of RealAmp in detecting A. baumannii was 98.9% and 75.0%, respectively.

Conclusion

The RealAmp assay only requires a single unit, and the assay positivity can be verified by visual inspection. Therefore, this assay has great potential of field use as a molecular tool for detection of A. baumannii.     

Hsa-miR-34b/c rs4938723 T>C and hsa-miR-423 rs6505162 C>A Polymorphisms Are Associated with the Risk of Esophageal Cancer in a Chinese Population

Esophageal cancer is the eighth most common cancer and sixth leading cause of cancer associated death worldwide. Besides environmental risk factors, genetic factors might play an important role in the esophageal cancer carcinogenesis. We conducted a hospital based case–control study to evaluate the genetic susceptibility of functional single nucleotide polymorphisms (SNPs) in the microRNAs on the development of esophageal cancer. A total of 629 esophageal squamous cell carcinoma (ESCC) cases and 686 controls were recruited for this study. The hsa-miR-34b/c rs4938723 T>C, pri-miR-124-1 rs531564 C>G, pre-miR-125a rs12975333 G>T and hsa-miR-423 rs6505162 C>A genotypes were determined using Ligation Detection Reaction (LDR) method. Our results demonstrated that hsa-miR-34b/c rs4938723 CC genotype had a decreased risk of ESCC. The association was evident among patients who never drinking. Hsa-miR-423 rs6505162 C>A might associated with a significantly increased risk of ESCC in patients who smoking. These findings indicated that functional polymorphisms hsa-miR-34b/c rs4938723 T>C and hsa-miR-423 rs6505162 C>A might alter individual susceptibility to ESCC. However, our results were obtained with a limited sample size. Future larger studies with other ethnic populations are required to confirm current findings.     

Salt-Restriction-Spoon Improved the Salt Intake among Residents in China

Objective

To evaluate the effect of an improved salt-restriction spoon on the attitude of salt-restriction, the using rate of salt-restriction-spoon, the actual salt intake, and 24-hour urinary sodium excretion (24HUNa).

Design

A community intervention study.

Setting

Two villages in Beijing.

Participants

403 local adult residents being responsible for home cooking.

Intervention

Participants were randomly assigned to the intervention group or the control group. Those in the intervention group were provided with an improved salt-restriction-spoon and health education, and were informed of their actual salt intake and 24HUNa. Not any intervention was given to those in the control group.

Main Outcome Measures

The scores on the variables of Health Belief Model, the using rate of salt-restriction-spoon, the actual salt intake, and 24HUNa.

Analysis

Covariance analyses, Chi-square tests, Student’s t tests, and repeated measures analyses of variance.

Results

After 6 months of intervention, the intervention group felt significantly less objective barriers, and got access to significantly more cues to action as compared to the control group. The using rate and the correctly using rate of salt-restriction-spoon were significantly higher in the intervention group. The daily salt intake decreased by 1.42 g in the intervention group and by 0.28 g in the control group, and repeated measures analysis of variance showed significant change over time (F = 7.044, P<0.001) and significant difference between groups by time (F = 2.589, P = 0.041). The 24HUNa decreased by 34.84 mmol in the intervention group and by 33.65 mmol in the control group, and repeated measures analysis of variance showed significant change over time (F = 14.648, P<0.001) without significant difference between groups by time (F = 0.222, P = 0.870).

Conclusions

The intervention effect was acceptable, therefore, the improved salt-restriction-spoon and corresponding health education could be considered as an alternative for salt reduction strategy in China and other countries where salt intake comes mainly from home cooking.     

Temperature Sensitivity and Basal Rate of Soil Respiration and Their Determinants in Temperate Forests of North China

The basal respiration rate at 10°C (R₁₀) and the temperature sensitivity of soil respiration (Q₁₀) are two premier parameters in predicting the instantaneous rate of soil respiration at a given temperature. However, the mechanisms underlying the spatial variations in R₁₀ and Q₁₀ are not quite clear. R₁₀ and Q₁₀ were calculated using an exponential function with measured soil respiration and soil temperature for 11 mixed conifer-broadleaved forest stands and nine broadleaved forest stands at a catchment scale. The mean values of R₁₀ were 1.83 µmol CO₂ m⁻² s⁻¹ and 2.01 µmol CO₂ m⁻² s⁻¹, the mean values of Q₁₀ were 3.40 and 3.79, respectively, for mixed and broadleaved forest types. Forest type did not influence the two model parameters, but determinants of R₁₀ and Q₁₀ varied between the two forest types. In mixed forest stands, R₁₀ decreased greatly with the ratio of coniferous to broadleaved tree species; whereas it sharply increased with the soil temperature range and the variations in soil organic carbon (SOC), and soil total nitrogen (TN). Q₁₀ was positively correlated with the spatial variances of herb-layer carbon stock and soil bulk density, and negatively with soil C/N ratio. In broadleaved forest stands, R₁₀ was markedly affected by basal area and the variations in shrub carbon stock and soil phosphorus (P) content; the value of Q₁₀ largely depended on soil pH and the variations of SOC and TN. 51% of variations in both R₁₀ and Q₁₀ can be accounted for jointly by five biophysical variables, of which the variation in soil bulk density played an overwhelming role in determining the amplitude of variations in soil basal respiration rates in temperate forests. Overall, it was concluded that soil respiration of temperate forests was largely dependent on soil physical properties when temperature kept quite low.     

高糖和bFGF对骨髓间充质干细胞成骨分化的影响

目的：骨组织的形成是一个复杂的过程,受多种因素的影响,糖尿病所导致的持续高血糖对于成骨分化的影响机制尚不明确,以及在此分化过程中的各种细胞因子的作用机理仍不明了,现拟通过体外成骨诱导环境,观察高糖和碱性成纤维细胞生长因子（fibroblastgrowthfactorbFGF）对人骨髓间充质干细胞（humanmesenchymalstemcellshMSCs）成骨分化的影响。方法：hMSC在5．5mmol／L和25mmol／L葡萄糖浓度下培养6天,使用cck一8法测定各组细胞增殖情况;hMSC在两种糖浓度下成骨诱导28天,通过碱性磷酸酶（ALP）活性检测、茜素红染色、钙结节半定量检测,对比各组成骨分化活性;在两种糖浓度成骨诱导液中加入10ng／mlbFGF,使用RT—PCR技术检测各组细胞OCN、OPNmRNA表达差异。结果：高糖较正常糖浓度细胞增殖率下降,ALP活性降低,茜素红染色钙结节量减少,RT—PCR检测结果显示25mmol／L组OCN、OPNmRNA表达量低于5．5mmol／L组,加入bFGF后,25mmol／L组仍低于5．5mmol／L组,与未添加bFGF同葡萄糖组比较表达增加。结论：高糖使hMSC增殖能力下降,在成骨分化的过程中ALP活性降低,成骨相关基因OCN、OPN表达量下降,证明了高糖对hMSC成骨分化具有抑制作用,当加入bFGF后,改善了高糖对hMSC的抑制作用,提示糖尿病条件下高糖的存在是导致hMSC成骨分化能力下降的不利因素,同时初步证明了bFGF参与了成骨分化的过程,从而为在分子水平探讨糖尿病患者种植义齿骨结合形成相关机制奠定初步的基础．．     

原生质体诱变选育高产异抗坏血酸菌株

以灰黄青霉菌(Penicillium griseofulvum HL)为出发菌株,试验得到灰黄青霉原生质体制备的优化条件为:菌体培养48h,用0.7mol/L的NaC1溶液作为渗透压稳定剂,用0.5％的蜗牛酶+0.5％的纤维素酶,在pH为6,30℃条件下酶解3h,所得原生质体数最多,达到3.14×107/ml.原生质体再生的最佳条件为采用双层平板培养法,在用0.7mol/L的蔗糖溶液配制的改进察氏培养基上其再生率最高,达到24.93％.灰黄青霉原生质体经过紫外线诱变,DES诱变,紫外线-DES诱变复合诱变,紫外线-氯化锂复合诱变选育异抗坏血酸高产菌株,通过对再生平板上长出的诱变菌株进行初筛和摇瓶复筛,最终获得一株异抗坏血酸产量较高的菌株ZD4,其产量为5.28mg/ml,提高到出发菌株产量(1.08 mg/ml)的488.9％,且连续传代6代遗传稳定.     

Extending the coverage of spectral libraries: A neighbor‐based approach to predicting intensities of peptide fragmentation spectra

Searching spectral libraries in MS/MS is an important new approach to improving the quality of peptide and protein identification. The idea relies on the observation that ion intensities in an MS/MS spectrum of a given peptide are generally reproducible across experiments, and thus, matching between spectra from an experiment and the spectra of previously identified peptides stored in a spectral library can lead to better peptide identification compared to the traditional database search. However, the use of libraries is greatly limited by their coverage of peptide sequences: even for well‐studied organisms a large fraction of peptides have not been previously identified. To address this issue, we propose to expand spectral libraries by predicting the MS/MS spectra of peptides based on the spectra of peptides with similar sequences. We first demonstrate that the intensity patterns of dominant fragment ions between similar peptides tend to be similar. In accordance with this observation, we develop a neighbor‐based approach that first selects peptides that are likely to have spectra similar to the target peptide and then combines their spectra using a weighted K‐nearest neighbor method to accurately predict fragment ion intensities corresponding to the target peptide. This approach has the potential to predict spectra for every peptide in the proteome. When rigorous quality criteria are applied, we estimate that the method increases the coverage of spectral libraries available from the National Institute of Standards and Technology by 20–60%, although the values vary with peptide length and charge state. We find that the overall best search performance is achieved when spectral libraries are supplemented by the high quality predicted spectra.     

靶向肿瘤新生血管纳米粒的构建和质量控制

目的：制备F56多肽修饰的长春新碱纳米粒（F56-VCR-NP）,并建立其质量控制方法。方法：乳化－溶剂挥发法优化制备F56．VCR-NP：HPLC法测定其载药量、包封率,透射电镜下观察其形态,激光粒度分析仪测定其粒径和Zeta电位,CBQCA试剂盒测定纳米粒表面多肽密度,XPS进行表面元素分析。结果：优化制备的F56－VCR-NP粒径约为153nm,Zeta电位为－20．8mv,包封率为21．4％,载药量为1．9％,多肽连接效率为26．3％。结论：以聚乙二醇－聚乳酸（PEG-PLA）为原料,长春新碱为模型药物,成功制备出纳米粒子,并建立起有效的质量控制方法,对该实验样品进行了表征。结果表明此类纳米粒子尺寸均匀,表面多价连接F56多肽,载药量和包封率稳定可控,工艺成熟。