EGFR mutations and clinical outcomes of chemotherapy for advanced non-small cell lung cancer: a meta-analysis.

BACKGROUND: This meta-analysis was performed to assess whether epidermal growth factor receptor (EGFR) mutation status was associated with objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) in patients with advanced non-small cell lung cancer (NSCLC) treated with chemotherapy. METHOD: We systematically identified eligible articles investigating the effects of chemotherapy in patients with NSCLC stratified by EGFR mutation status. The summary risk ratio (RR) for ORR and hazard ratios (HRs) for both PFS and OS were calculated using the inverse variance formula of meta-analysis. RESULTS: Identification for the current meta-analysis: 5 prospective studies (n=875) and 18 retrospective studies (n=1934) for ORR; 2 prospective studies (n=434) and 10 retrospective studies (n=947) for PFS; 2 prospective studies (n=438) and 7 retrospective studies (n=711) for OS. The ORR was significantly higher in patients with EGFR mutations in prospective studies (RR=1.42; 95% confidence interval [CI], 1.16-1.74; P=0.001), but not in retrospective studies (RR=1.12; 95% CI, 0.96-1.32; P=0.146). There was no obvious association between EGFR mutations and PFS both in prospective (HR=0.84; 95% CI: 0.65-1.09; P=0.197) and retrospective (HR=1.02; 95% CI: 0.87-1.18; P=0.838) studies. Association between EGFR mutations and OS was also not seen in prospective studies (HR=0.74; 95% CI: 0.27-2.05; P=0.566), but was seen in retrospective studies (HR=0.48; 95% CI: 0.33-0.72; P<0.001; I(2)=75.9%; P<0.001) with significant heterogeneity. CONCLUSION: EGFR mutations in advanced NSCLC may be associated with higher ORRs to chemotherapy, but may have nothing to do with PFS and OS. Further prospective studies are required to identify the influence of EGFR mutations on chemotherapy effects in advanced NSCLC.

[Structural equation model analysis of risk factors for low back pain among greenhouse vegetable-planting farmers].

OBJECTIVE: To explore the risk factors of low back pain (LBP) among greenhouse vegetable planting farmers and estimate the level of the effects. METHODS: A self-made questionnaire based on the Dutch Musculoskeletal Questionnaire and the Nordic Questionnaire was conducted to 639 greenhouse vegetable planting farmers and then structural equation model was used to analyze the risk factors of LBP in SmartPLS software. RESULTS: The coefficient of determination of the model was 0.827, and the structural coefficients of dynamic loads, static loads, force exertion, ergonomic environment and repetitive loads on LBP were 0.21, 0.43,0.27, 0.045 and 0.034 respectively, and the total effects of the above latent variables on LBP were 0.21, 0.43,0.27, 0.33 and 0.034 respectively. CONCLUSION: The main risk factors of LBP among greenhouse vegetable planting farmers were static loads, ergonomic environment, force exertion and dynamic loads.

[Analyzing the factors of influencing the musculoskeletal disorders of greenhouse vegetable farmers].

OBJECTIVE: To study the prevalence of musculoskeletal disorders (MSDs) among greenhouse vegetable farmers and to explore the risk factors of MSDs. METHODS: A household questionnaire survey was conducted to investigate 203 greenhouse vegetable farmers and 127 non-greenhouse vegetable farmers in February, 2011. RESULTS: The one-year prevalence rates of MSDs were 70.0% and 33.9% among greenhouse vegetable farmers and non-greenhouse vegetable farmers, respectively. The three main positions of MSDs in greenhouse farmers were low back, knee (s) and shoulder (s). Age, working years, body weight and usage of rolling machine were statistically associated with MSDs of greenhouse farmers, ORadj values were 1.17, 1.82, 1.08 and 0.07, respectively. CONCLUSIONS: The prevalence of MSDs is high in greenhouse workers. Low back pain, knee (s), and shoulder (s) disorders are the main disorders. Age, working years, body weight and usage of rolling machine are main risk factors for the development of MSDs in greenhouse farmers.

In vitro refolding/unfolding pathways of amphioxus insulin-like peptide: implications for folding behavior of insulin family proteins.

Amphioxus insulin-like peptide (AILP) belongs to the insulin superfamily and is proposed as the common ancestor of insulin and insulin-like growth factor 1. Herein, the studies on oxidative refolding and reductive unfolding of AILP are reported. During the refolding process, four major intermediates, P1, P2, P3, and P4, were captured, which were almost identical to those intermediates, U1, U2, U3, and U4, captured during the AILP unfolding process. P4 (U4) has the native disulfide A20-B19; P1 (U1), P2 (U2), and P3 (U3) have two disulfide bonds, which include A20-B19. Based on the analysis of the time course distribution and properties of the intermediates, we proposed that fully reduced AILP refolded through 1SS, 2SS, and 3SS intermediate stages to the native form; native AILP unfolded through 2SS and 1SS intermediate stages to the full reduced form. A schematic flow chart of major oxidative refolding and reductive unfolding pathways of AILP was proposed. Implication for the folding behavior of insulin family proteins was discussed. There may be seen three common folding features in the insulin superfamily: 1) A20-B19 disulfide is most important and formed during the initial stage of folding process; 2) the second disulfide is nonspecifically formed, which then rearranged to native disulfide; 3) in vitro refolding and unfolding pathways may share some common folding intermediates but flow in opposite directions. Furthermore, although swap AILP is a thermodynamically stable final product, a refolding study of swap AILP demonstrated that it is also a productive intermediate of native AILP during refolding.