Novel recombinant porcine enterovirus G viruses lacking structural proteins are maintained in pig farms in Japan.

Type 1 recombinant enterovirus G (EV-G), which carries the papain-like cysteine protease (PLCP) gene of torovirus between its 2C/3A regions, and type 2 recombinant EV-G, which carries the torovirus PLCP gene with its flanking regions having non-EV-G sequences in place of the viral structural genes, have been detected in pig farms in several countries. In a previous study, we collected 222 fecal samples from 77 pig farms from 2104 to 2016 and detected one type 2 recombinant EV-G genome by metagenomics sequencing. In this study, we reanalyzed the metagenomic data and detected 11 type 2 recombinant EV-G genomes. In addition, we discovered new type 2 recombinant EV-G genomes of the two strains from two pig farms samples in 2018 and 2019. Thus, we identified the genomes of 13 novel type 2 recombinant EV-Gs isolated from several pig farms in Japan. Type 2 recombinant EV-G has previously been detected only in neonatal piglets. The present findings suggest that type 2 recombinant EV-G replicates in weaning piglets and sows. The detection of type 1 recombinant EV-Gs and type 2 recombinant EV-Gs at 3-year and 2-year intervals, respectively, from the same pig farm suggests that the viruses were persistently infecting or circulating in these farms.

Research Progress of Pseudogenes in Hepatocellular Carcinoma / 肿瘤防治研究

Pseudogenes were initially thought to have no function and were called by aliases, such as "junk genes." With the emergence of large-scale genomics projects and more and more experimental studies, pseudogenes have been shown to play an important role in the occurrence and development of solid tumors, especially playing an important regulatory role in the occurrence and develepment of liver cancer, such as regulating the proliferation, apoptosis, invasion, metastasis, and immunity of liver cancer cells. Recent studies showed that pseudogenes can act as regulators of oncogenes and tumor suppressors in hepatocellular carcinoma (HCC) and can thus serve as prognostic markers and even therapeutic targets for this cancer type. In this review, we systematically summarize the mechanisms and functions of different pseudogenes in HCC and present their future prospects as therapeutic targets.

Predictive factors for re-bleeding of esophageal varices in hospitalized patients.

Bleeding due to esophageal varices is associated with high mortality and hospital costs. The incidence of morbidity and mortality can be reduced with appropriate treatment measures by identifying the predictors of re-bleeding at admission. Therefore, this study aimed to determine the risk factors for re-bleeding in hospitalized esophageal varices patients using factors included in the Child Turcotte Pugh (CTP) scoring system. In this cross-sectional study, 100 patients were evaluated for bleeding from esophageal varices. Some characteristics and variables were recorded, including age, gender, cause of disease, CTP classification score, and clinical, endoscopic, and laboratory findings. Patients were divided into two groups with and without bleeding from esophageal varices, and predictive factors were identified in both groups. Besides, a genetic predictor factor, i.e. plasminogen activator inhibitor type I (PAI-1), was evaluated by the Real-time PCR technique. Sixty-eight patients in the non-re-bleeding group with a mean age of 49.88 ± 16.42 years and 32 patients with a mean age of 54.22 ± 19.81 years were in the group with re-bleeding. Varicose vein size, encephalopathy, ascites, and CTP classification had a predictive effect on re-bleeding. Twelve people were in class A, 59 people in class B and 29 people in class C had CTP classification. The sensitivity of CTP, PAI-1 gene expression, and bilirubin in prediction through the ROC chart were calculated to be more than 85%, 61.4%, and 62%, respectively. In general, determining the degree and score of CTP at the time of referral of a patient with varicose hemorrhage provides valuable information on the risk of bleeding. Patients with class B CTP were strongly susceptible to re-bleeding in this study. Also, with increased bilirubin or ascites and more severe encephalopathy, the risk of bleeding is higher, and these people should be followed up.

Investigate thenovel coronaviruses in external environmentof COVID-19 / 中华实验和临床病毒学杂志

Objective To understand the distribution of novel coronaviruses in the external environment of confirmed COVID-19 cases. Methods Environmental surface swab specimens such as bed rails, doorknob, closestool, hand washing sink, table, locker,ward pager, mobile phone, cup, clothes, were collected from the sentinel hospital of COVID-19, and samples were collected for the nucleic acid detection by RT-PCR. Results A total of 150 environmental samples were collected from 30 confirmed COVID-19 cases, 6 samples were determined to be novel coronaviruses postive (positive rate 4.00%). The total 14 mobile phone showed 3 novel coronaviruses positive.Among the 30 confirmed COVID-19 cases, 6 cases (positive rate 20.00%)were found novel coronaviruses in the external environment. Conclusions Novel coronaviruses exists in external environment of confirmed COVID-19 cases, which indicates the potential risk of COVID-19 infection.

Detection of 2019-nCoV nucleic acid in different specimens from confirmed COVID-19 cases during hospitalization and after discharge / 中华微生物学和免疫学杂志

Objective:To investigate the positive rates of 2019-nCoV nucleic acid in different specimens from confirmed COVID-19 cases during hospitalization and after discharge.Methods:Patients with confirmed COVID-19 were enrolled from designated hospitals. Nasal swabs, throat swabs, and specimens of stool, urine and blood were collected during hospitalization. After the patients were discharged, nasal swabs, throat swabs and stool specimens were collected during follow-up. Real-time RT-PCR was used to detect 2019-nCoV nucleic acid.Results:This study involved 25 confirmed COVID-19 cases. During hospitalization, all patients tested positive in both nasal and throat swab 2019-nCoV nucleic acid tests, and nine of them (36.00%) were positive in stool specimen test. Urine and blood specimen test results were all negative. Nasal swabs, throat swabs and stool specimens were collected from each patient 7 d and 14 d after discharge. Two patients (8.00%) tested positive for 2019-nCoV nucleic acid again in nasal and throat swab tests on 7 d, while all stool specimen tests were negative. No 2019-nCoV nucleic acid was detected in nasal swabs, throat swabs or stool samples on 14 d.Conclusions:2019-nCoV nucleic acid was detected in stool samples of confirmed COVID-19 cases during hospitalization. Nasal and throat swab nucleic acid tests turned positive again in some patients after discharge.

The impact of nutritional therapy on patients with locoregionally advanced nasopharyngeal carcinoma / 中华临床营养杂志

Objective To evaluate the impact of nutritional therapy during radiotherapy for patients with locoregionally advanced (Ⅲ-ⅣB) nasopharyngeal carcinoma (NPC) and identify factors that might influence nutritional status of the patients.Methods We retrospectively reviewed 117 patients with locoregionally advanced NPC (Ⅲ-ⅣB) treated with radical radiotherapy between December 2015 and March 2016 at Zhejiang Cancer Hospital.The patients were grouped into those who received nutritional therapy and those who did not during radiotherapy.Chi-square test was used for both inter-and intra-group comparison of nutritional status before (T0),during (T1) and after radiotherapy (T3).The patients were then grouped into those who experienced substantial weight loss (＞5％) and those who did not (≤5％),and Logistic regression was used to analyze factors that were potentially correlated with weight loss.Results Nutritional indicators were all on the decrease (T2 vs.T0,T1 vs.T0,P＜0.001),including weight,body mass index (BMI),albumin,pre-albumin (PA),and prognostic nutritional index (PNI).There was no significant difference between the group who received nutritional therapy and the one who did not in weight,albumin,PA,and PNI at a given time point (P＞ 0.05),but patients in nutritional therapy group completed radiotherapy in fewer days than those in the control group (45.8 d vs.46.0 d,P=0.023).Logistic regression revealed that patients with radiation-induced oral mucositis of grade≥3 (Odds ratio=3.232,P=0.021,95％ CI=1.198-8.820) and drop of pre-albumin by ＞15％ (Odds ratio=2.442,P=0.041,95％ CI=1.036-5.757) had greater risk of developing nutritional impairment.Conclusions Radiation-induced oral mucositis of grade≥3 might lead to deteriorating nutritional impairment in patients with locoregionally advanced NPC during radiotherapy,and drop of pre-albumin by ＞ 15％ was correlated with weight loss.Current nutritional support fell short of improving nutritional impairment during radiotherapy.

Dosimetric and clinical factors for predicting acute radiation oral mucositis in locally advanced nasopharyngeal carcinoma patients treated with intensity?modulated radiotherapy with concurrent chemotherapy / 中华放射肿瘤学杂志

Objective To prospectively determine the dosimetric and clinical factors for predicting the risk of acute radiation oral mucositis ( ROM ) in patients receiving intensity?modulated radiotherapy ( IMRT) with concurrent chemotherapy for local advanced nasopharyngeal carcinoma. Methods Ninety?two patients who were treated with IMRT with concurrent chemotherapy from 2015 to 2016 for local advanced nasopharyngeal carcinoma were included in this study, and their acute ROM was scored according to the RTOG criteria. Grade≥3 ROM was used as a surrogate marker for severe mucositis, which was defined as a toxicity endpoint. The clinical data were reviewed, and the dose?volume histograms ( DVHs) of the patients were exported from the IMRT planning system. Optimal thresholds for predicting the incidence of severe ROM were evaluated by the area under the receiver operating characteristic ( ROC) curve ( AUC) . Results The incidence of severe ROM was 21%(19/92). Weight loss and V30 of the oral mucosa were determined as the independent predictors for severe ROM ( P=0017 and 0003, respectively) . The optimal cut?off point and AUC of V30 of the oral mucosa as a predictor for severe ROM were 7316%( 0842 sensitivity and 0671 specificity) and 0753( P=0001) , respectively. Conclusion Weight loss and V30 of the oral mucosa are predictors for severe ROM.

Dosimetric parameters predicting grade ≥3 acute oral mucosal toxicity induced by radiation:an independent validation study comparing oral cavity versus mucosal surface contouring / 中华放射肿瘤学杂志

Objective To investigate whether the mucosal surface volume can be an alternative to the oral cavity volume for predicting grade 3/4 acute oral mucosal toxicity in patients with locally advanced nasopharyngeal carcinoma(LANPC). Methods A total of 92 patients with LANPC who underwent intensity-modulated radiotherapy(IMRT)and concurrent chemotherapy were enrolled in this study. The delineation of the oral mucosa was performed using oral cavity contours(OCC)or mucosal surface contours(MSC). Dosimetric comparisons of toxicity were performed based on the obtained dose-volume histograms(DVHs). The receiver operating characteristic(ROC)curve and logistic regression analysis were used to do statistical analysis of the data obtained from the two different contour methods. Results Both contouring methods showed a significant dose-volume association between oral mucosal exposure and acute oral mucosal toxicity. Logistic regression analysis showed that body weight loss was the independent associated factor for grade 3/4 toxicity in both OCC group and MSC group(P=0.017 and 0.005). And the independent correlation factors for dosimetric parameters in OCC group and MSC group were V30(P=0.003)and V50(P=0.003),respectively. The area under the ROC curve(AUC)of OCC at V30was 0.753(P=0.001)and the AUC of MSC at V50was 0.714(P=0.004). Conclusions DVH analysis of mucosal surface volume can accurately predict grade≥3 oral mucosal toxicity in patients with LANPC who receive IMRT and concurrent chemotherapy. However, OCC is superior to MSC in clinical application.

Involved-field radiotherapy versus elective nodal irradiation in combination with concurrent chemotherapy for locally advanced non-small cell lung cancer: A prospective randomized clinical study / 中华放射肿瘤学杂志

ObjectiveTo evaluate the local failure and the impact on survival by prospectively comparing involved field radiotherapy (IFRT) and elective nodal irradiation (ENI) in combination with concurrent chemotherapy for locally advanced non-small cell lung cancer ( LA-NSCLC ).Methods LANSCLC patients were treated with 2 cycles of carboplatin ( AUC =5 - 6,d1 ) combined with paclitaxel ( 175mg/m2 ),followed assessment without distant metastasis,then randomized into IFRT (45 patients) or ENI (54 patients) arm.IFRT included primary tumor,ipsilateral hilar and positive mediastinal lymph nodes;ENI included the primary lesion,ipsilateral hilar,hilateral mediastinal lymph node drainage and bilateral supraclavicular area.The prescription dose was given as high as possible with V20 ≤35％ and spinal cord dose ≤50 Gy,combined weekly paclitaxel 40 mg/m2 concurrent chemotherapy.The Kaplan-Meier method was used to estimate survival data and the log-rank method was used to test distribution of survival time between arms.ResultsThe follow-up rate was 99％.49,29 and 17 patients were followed-up for 1-,2-and 3-year,respectively.More patients from group IFRT received ＞60 Gy than ENI (49％ vs.26％,x2 =5.59,P =0.018 ).The local failure rates were 29％ and 36％,respectively ( x2 =0.46,P =0.497 ).The 1-,2-and 3-year local tumor progression-free survival rates were 76％,69％,65％ and 80％,53％,49％ ( x2 =0.74,P =0.389),respectively; the 1-,3-and 5-year overall survival rates were 80％,41％,33％ and 69％,32％,13％ (x2 =3.97,P =0.046),respectively.There were no significant differences in acute and late toxicities between the arms ( x2 =3.910 - 0.155,P =0.142 - 0.925 ).ConclusionsIFRT improved radiation dose and survival rate and did not increase the failure of elective lymph node region compared with ENI.The toxicities were no differences between IFRT and ENL Further investigation with big size sample is warranted.

Results of induction chemotherapy followed by three-dimensional conformal radiotherapy and con current weekly paclitaxel for stage Ⅲ non-small cell lung cancer / 中华放射肿瘤学杂志

Objective To evaluate the toxicity and efficacy of induction chemotherapy(ICT)followed by three-dimensional conformal radiotherapy(3 DCRT)plus concurrent weekly paclitaxel for inoperable non-small cell lung cancer(NSCLC). Methods Patients with stage Ⅲ NSCLC in favorable conditions were treated with 2 to 4 cycles of carboplatin(AUC=5-6,d1)combined with paclitaxel(175 mg/m2,d1),then followed by weekly paclitaxel(40 mg/m2)and concurrent 3DCRT within 3-4 weeks.The prescription dose of radiotherapy was given as high as possible while total lung V20≤31% and total dose of the spinal cord ≤50 Gy. Results ICT was well tolerated.During the concurrent chemoradiotherapy,the treatment of 4 patients was ended ahead of the schedule because of severe pulmonary and cardiac toxicities:the treatment of 2 patients was delayed for 7 and 12 days because of fatigue.Leucopenia(33/56)was in grade 1-2 except 1 patient in grade 3.Lymphocytopenia was severe(54/56,42 in grade 3).Three patients developed grade 3 acute radiation-induced esophagitis.and 3 developed grade 3-4 radiation-induced pneumonitis.There was one patients each who developed grade 2,3,and 4 late esophagealdamage,respectively.Nine developed grade 2 pulmonary fibrosis.The overall response rate was 69.7%.The 1-year overall survival rate was 72.3%.The 1-year local progression-free survival rate was 62.7%. Conclusions The schedule of ICT followed by weekly paclitaxel and concurrent 3DCRT can be well tolerated by most of the favorable patients with stageⅢ NSCLC.and the toxicity is tolerable. Results of this study are encouraging, though long-term results should be followed up.