Rosmarinic acid ameliorated oxidative stress, neuronal injuries, and mitochondrial dysfunctions mediated by polyglutamine and ɑ-synuclein in Caenorhabditis elegans models.

Numerous natural antioxidants have been developed into agents for neurodegenerative diseases (NDs) treatment. Rosmarinic acid (RA), an excellent antioxidant, exhibits neuroprotective activity, but its anti-NDs efficacy remains puzzling. Here, Caenorhabditis elegans models were employed to systematically reveal RA-mediated mechanisms in delaying NDs from diverse facets, including oxidative stress, the homeostasis of neural and protein, and mitochondrial disorders. Firstly, RA significantly inhibited reactive oxygen species accumulation, reduced peroxide malonaldehyde production, and strengthened the antioxidant defense system via increasing superoxide dismutase activity. Besides, RA reduced neuronal loss and ameliorated polyglutamine and ɑ-synuclein-mediated dyskinesia in NDs models. Further, in combination with the data and molecular docking results, RA may bind specifically to Huntington protein and ɑ-synuclein to prevent toxic protein aggregation and thus enhance proteostasis. Finally, RA ameliorated mitochondrial dysfunction including increasing adenosine triphosphate and mitochondrial membrane potential levels and rescuing mitochondrial membrane proteins' expressions and mitochondrial structural abnormalities via regulating mitochondrial dynamics genes and improving the mitochondrial kinetic homeostasis. Thus, this study systematically revealed the RA-mediated neuroprotective mechanism and promoted RA as a promising nutritional intervention strategy to prevent NDs.

Broiler Age Differently Affects Apparent Metabolizable Energy and Net Energy of Expanded Soybean Meal.

Accurately determining the energy values of ingredients is crucial for meeting energy requirements and achieving maximum production performance of animals. This study was conducted to measure the available energy values of three expanded soybean meals (ESBMs) for Arbor Acres male broilers from 14 to 16 day and 28 to 30 day using the difference method. A corn-soybean basal diet was formulated, and test diets were developed with 25% ESBMs as substitutes for energy-yielding ingredients. A completely randomized design was used for determining heat production and energy balance of broilers in 12 open-circuit respiration chambers, with six replicates per group. Prior to measurement, four (14 to 16 day) or two (28 to 30 day) birds per chamber were given a 4-day adaption to diets and chambers. The period lasted for 3 days to determine the apparent metabolizable energy (AME), nitrogen balance, gas exchanges, and heat production. Broilers fed test diets with 25% ESBM exhibited higher nitrogen intake (p < 0.05), nitrogen excreta (p < 0.05), and increased energy deposition as protein irrespective of age (p < 0.05). Furthermore, results showed that AME, nitrogen corrected AME (AMEn), and net energy (NE) values of 3 ESBMs averaged 10.48, 8.93, and 6.88 MJ/kg for broilers from 14 to 16 day, while averaged 11.91, 10.42, and 6.43 MJ/kg for broilers from 28 to 30 day. Broilers from 28 to 30 day showed significantly higher AMEn values but lower NE/AME values of ESBMs compared with those from 14 to 16 day (p < 0.05). Therefore, age-dependent energy values of a single ingredient should be considered in feed formulations to optimize economic returns.

Effects of quercetin and genistein on egg quality, lipid profiles, and immunity in laying hens.

BACKGROUND: After the peak laying stage, laying hens become susceptible to lipid accumulation and inflammatory reactions. The objective of this experiment was to examine the impact of quercetin and genistein on egg quality and lipid profiles in laying hens. A total of 240 Hy-Line Brown hens were randomly assigned to three dietary treatments. Each treatment had eight replicates, with ten hens in each replicate, and the hens were aged between 46 and 56 weeks. The test diets consisted of a corn-soybean meal-based basal diet, a basal diet supplemented with 300 mg kg-1 quercetin, and a basal diet supplemented with 300 mg kg-1 quercetin and 40 mg kg-1 genistein. RESULTS: Results showed that, separately, supplemental quercetin significantly improved egg quality (eggshell strength, albumen height, and Haugh unit, P < 0.05) and reduced the deposition of abdominal fat (P < 0.05). Our findings also showed that, separately or as a combination, supplemental quercetin and genistein significantly increased eggshell thickness (P < 0.05), decreased the levels of lipids in serum (low-density lipoprotein cholesterol, total cholesterol, total triglycerides, and non-esterified fatty acids, P < 0.05) and significantly increased serum immunoglobulins A and G (P < 0.05), and promoted the expression of splenic immune-related genes (IgA and IL-4, P < 0.05). CONCLUSION: This study confirmed that supplemental quercetin and genistein, either separately or in combination, can enhance eggshell thickness, lipid profiles, and immune function in aging hens. Moreover, both quercetin alone and quercetin + genistein exhibited similar abilities to lower lipid levels and improve immune function. © 2023 Society of Chemical Industry.

Transarterial Chemoembolization Combined with Tyrosine Kinase Inhibitors Plus Immune Checkpoint Inhibitors for Advanced Hepatocellular Carcinoma: A Propensity Score Matching Analysis.

Purpose: This study aimed to explore the clinical efficacy of transarterial chemoembolization (TACE) in combination with tyrosine kinase inhibitors (TKIs) plus immune checkpoint inhibitors (ICIs) (triple therapy) compared to TACE alone (monotherapy) for advanced hepatocellular carcinoma (HCC). Material and Methods: Data of consecutive advanced HCC patients receiving triple therapy or monotherapy at our center between January 2019 and December 2022 were collected and retrospectively analyzed. Propensity score matching (PSM) and subgroup analyses were performed to reduce the bias between the two groups. The primary outcomes of the study were the overall survival (OS) and progression-free survival (PFS). The secondary outcomes were the objective response rate (ORR) and disease control rate (DCR). Results: A total of 104 patients were enrolled in this study: 41 in the triple therapy group and 63 in the monotherapy group. After PSM analysis, each group included 37 patients. The median OS and PFS were significantly longer in the triple therapy group than in the monotherapy group in the whole cohort (median OS, 18.8 vs 11.7 months, P = 0.022; median PFS, 10.5 vs 6.4 months, P = 0.012) and after PSM (median OS, 19.6 vs 12.5 months, P = 0.030; median PFS, 10.5 vs 6.7 months, P = 0.008). Furthermore, the treatment modality was an independent prognostic factor for OS (hazard ratio [HR]: 0.449, 95% confidence interval [CI]: 0.240-0.840, P = 0.012) and PFS (HR: 0.406, 95% CI: 0.231-0.713, P = 0.002) according to the multivariate cox regression analysis. A greater ORR was also observed in the triple therapy group (ORR: 56.7% vs 32.4%, P = 0.035). No significant difference was observed in DCR between the two groups (83.7% vs 72.9%, P = 0.259). Conclusion: The triple therapy was superior to the monotherapy regarding OS, PFS, and ORR of advanced HCC patients.

Efficacy and safety of enhanced recovery after surgery protocol on minimally invasive bariatric surgery: a meta-analysis.

BACKGROUND: Enhanced recovery after surgery (ERAS), a multidisciplinary and multimodal perioperative care protocol, has been widely used in several surgical fields. However, the effect of this care protocol on patients receiving minimally invasive bariatric surgery remains unclear. This meta-analysis compared the clinical outcomes of the ERAS protocol and standard care (SC) in patients who underwent minimally invasive bariatric surgery. MATERIAL AND METHODS: PubMed, Web of Science, Cochrane Library, and Embase databases were systematically searched to identify literature reporting the effects of the ERAS protocol on clinical outcomes in patients undergoing minimally invasive bariatric surgery. All the articles published until 01 October 2022, were searched, followed by data extraction of the included literature and independent quality assessment. Then, pooled mean difference (MD) and odds ratio with a 95% CI were calculated by either a random-effects or fixed-effects model. RESULTS: Overall, 21 studies involving 10 764 patients were included in the final analysis. With the ERAS protocol, the length of hospitalization (MD: -1.02, 95% CI: -1.41 to -0.64, P <0.00001), hospitalization costs (MD: -678.50, 95% CI: -1196.39 to -160.60, P =0.01), and the incidence of 30-day readmission (odds ratio =0.78, 95% CI: 0.63-0.97, P =0.02) were significantly reduced. The incidences of overall complications, major complications (Clavien-Dindo grade ≥3), postoperative nausea and vomiting, intra-abdominal bleeding, anastomotic leak, incisional infection, reoperation, and mortality did not differ significantly between the ERAS and SC groups. CONCLUSIONS: The current meta-analysis indicated that the ERAS protocol could be safely and feasibly implemented in the perioperative management of patients receiving minimally invasive bariatric surgery. Compared with SC, this protocol leads to significantly shorter hospitalization lengths, lower 30-day readmission rate, and hospitalization costs. However, no differences were observed in postoperative complications and mortality.

Construction of low intestinal bacteria model and its effect on laying performance and immune function of laying hens.

The objective of this study was to establish a low-bacteria intestinal model in chickens, and then to investigate the characteristics involving in immune function and intestinal environment of this model. A total of 180 twenty-one-week-old Hy-line gray layers were randomly allocated into 2 treatment groups. Hens were fed with a basic diet (Control), or an antibiotic combination diet (ABS) for 5 weeks. Results showed that the total bacteria in the ileal chyme were significantly dropped after ABS treatment. Compared with the Control group, the genus-level bacteria such as Romboutsia, Enterococcus, and Aeriscardovia were reduced in the ileal chyme of the ABS group (P < 0.05). In addition, the relative abundance of Lactobacillus_delbrueckii, Lactobacillus_aviarius, Lactobacillus_gasseri, and Lactobacillus_agilis in the ileal chyme were also descended (P < 0.05). However, Lactobacillus_coleohominis, Lactobacillus_salivarius, and Lolium_perenne were elevated in the ABS group (P < 0.05). Beyond that, ABS treatment decreased the levels of interleukin-10 (IL-10) and ß-defensin 1 in the serum, as well as the number of goblet cells in the ileal villi (P < 0.05). Additionally, the genes mRNA levels of the ileum such as Mucin2, Toll-like receptors 4 (TLR4), Myeloid differentiation factor 88 (MYD88), NF-κB, IL-1ß, Interferon-gama (IFN-γ), IL-4 and the ratio of IFN-γ to IL-4 were also down-regulated in the ABS group (P < 0.05). In addition, there were no significant changes about egg production rate and egg quality in the ABS group. In conclusion, dietary supplemental antibiotic combination for 5 weeks could establish a low intestinal bacteria model of hens. The establishment of a low intestinal bacteria model did not affect the egg-laying performance, while caused immune suppression in laying hens.

Comparative study of apparent metabolizable energy and net energy values of dephenolized cottonseed proteins for laying hens.

Optimizing the energy utilization of nutrients and ensuring maximum benefits are continuous goals for livestock producers. The net energy (NE) value of feed reflects its nutritional value in the precision feeding system. An experiment was conducted to determine the apparent metabolizable energy (AME) and NE values of 3 types of dephenolized cottonseed protein (DCP) for Hy Line Brown hens aged 42 to 45 weeks using the reference diet substitution method. A reference diet based on corn soybean meal was used to meet the nutritional needs of Hy Line Brown laying hens. To render the crude protein and energy values of the 3 test diets similar, 10.5%, 12%, and 16% of the gross energy yielding ingredients from the reference diet were replaced with DCP 1, DCP 2, and DCP 3, respectively. The birds were fed 4 diets during a 7-d adaptation period. After the dietary adaptation period, 2 birds per replicate from each treatment group were placed in an individual open circuit respiratory calorimetry chamber for a 3-d experimental period. Daily O2 consumption and CO2 production were recorded, and excreta samples were collected. The AME values of DCP 1, DCP 2, and DCP 3 were 3,049.05, 2,820.13, and 2,982.31 kcal/kg of dry matter (DM), respectively. The NE values of DCP 1, DCP 2, DCP 3 were 1,475.77, 1,910.31, and 1,905.37 kcal/kg of DM, respectively, and the NE:AME ratios were 48.40%, 67.74%, and 63.89%, respectively. Our data show that the AME value of DCP does not reflect the nutritional value of the feed. The NE value of DCP with a high ME value was not necessarily high.

A Case of Insidious Onset of Kimura Disease-associated Immunoglobulin A Nephropathy without Eosinophil Infiltration in the Renal Tissue.

Kimura disease (KD), also known as eosinophilic lymphogranuloma, is a rare chronic inflammatory or allergic disease. It can present with immune-related diseases such as nephrotic syndrome, asthma, and ankylosing spondylitis. In this study, we report a case of KD combined with immunoglobulin A nephropathy that first presented as a mass in the inguinal region, followed by recurrent renal involvement. Previous reports suggested that renal involvement caused by KD was due to direct infiltration of eosinophils; however, in this case, no eosinophil infiltration was found in the renal tissue after renal biopsy. This observation reminds us to approach the case from an immune-related molecular perspective to investigate the exact cause of renal damage due to KD.

Dietary Soy Saponin Improves Antioxidant and Immune Function of Layer Hens.

The objective of this study was to determine the effects of dietary soy saponin (SS) on the antioxidant and immune functions of laying hens. Two hundred seventy 22-week-old Hy-line gray layers were randomly allocated into three treatment groups: a control group (Control) fed a basal diet with low soybean meal and groups supplemented with 50 and 500 mg/kg SS (50 SS and 500 SS). After ten weeks, eight chickens from each treatment group were anesthetized and sacrificed to collect tissue samples. In the 50 and 500 SS groups, results showed that the levels of superoxide dismutase (SOD) in serum and spleen were elevated, and the content of malondialdehyde (MDA) in serum decreased. The mRNA levels of genes such as NF-E2-related factor 2 (Nrf-2) in the ileum and Nrf-2 and SOD in the spleen were also upregulated. In addition, the skin irritation index of phytohemagglutinin (PHA), the number of serum white blood cells, and lymphocytes were elevated in the two groups. At the same time, the number of monocytes in the blood increased in the 50 SS group, and it was significantly higher in the 500 SS group. In addition, the mRNA levels of lysozyme (LYZ) and IFN-γ in the spleen were upregulated, similar to the mRNA levels of zinc finger protein A20 (A20) in the ileum. Furthermore, the mRNA levels of NF-κB and IL-6 in the ileum were downregulated. In conclusion, with supplementation of 50 and 500 mg/kg SS in low soybean meal diets, the antioxidant, and immune functions of laying hens were improved. More importantly, the target for SS to exert biological effects on laying hens may be in the intestine and spleen tissues.

Soya saponin fails to improve the antioxidation and immune function of laying hens with antibiotics treated.

Soya saponin (SS) helps to improve antioxidant and immune function of body, and intestinal bacteria might play an important role here. In the present study, the co-occurring network of the ileal flora was analyzed with 50 mg/kg SS supplemented to the diet, and Romboutsia was found to have evolved into a dominant flora. In addition, the co-occurring network of the flora was changed with the combined antibiotic treated, and the unidentified-cyanobacteria developed into the dominant flora, whereas the relative abundance of Romboutsia was dropped. Dietary SS failed to elevate the relative abundance of Romboutsia with antibiotics treated, at the same time, it was not helpful for the antioxidant and immune function of laying hens. While dietary SS had a little help on the egg-laying performance. Intestinal bacteria did play a key role in the biological functions of SS on laying hens. In conclusion, SS failed to improve the antioxidation and immune function of laying hens with antibiotics treated.

Metabolizable and Net Energy Values of Expanded Cottonseed Meal for Laying Hens and Broiler Chickens.

Three experiments were conducted to determine the metabolizable energy (ME) and net energy (NE) values of expanded cottonseed meal (ECSM) for broilers aged 14-16 days (Experiment 1), broilers aged 28-30 days (Experiment 2), and 45-week-old Hy-Line Brown hens (Experiment 3). Reference diets based on corn-soybean meal were used to meet the nutritional needs of the birds. The test diets contained ECSM as basis, which was used to replace 18.5% of the gross energy-yielding ingredients from the reference diet. The birds were fed a commercial feed before the experimental period. After the dietary adaptation period, six birds per replicate (Experiment 1) and two birds per replicate (Experiments 2 and 3) for each treatment group were placed in an individual open-circuit respiratory calorimetry chamber for 3 days. Daily O2 consumption and CO2 production were recorded, and excreta samples were collected. The ME and NE values of ECSM were determined using the substitution method. The apparent metabolizable energy (AME) values of ECSM for experiments 1, 2, and 3 were 2605.85, 2178.31, and 2782.60 kcal/kg of dry matter (DM), respectively. The NE values were 1655.23, 1196.64, and 1538.19 kcal/kg of DM, respectively. The NE:AME ratios of ECSM were 63.52%, 54.93%, and 55.29%, respectively. Our data showed that the ME and NE values of ECSM differed across various growth stages and types of chickens. These results demonstrate that the appropriate ME and NE should be used in the design of different feed formulas for specific growth stages and types of chickens.

Dietary soya saponin improves the lipid metabolism and intestinal health of laying hens.

Soya saponin (SS) is a natural active substance of leguminous plant, which could improve lipid metabolism and regulate immune function. Intestinal flora might play a key role in the biological functions of SS. The objective of this study was to measure the effects of dietary SS on immune function, lipid metabolism, and intestinal flora of laying hens with or without antibiotic treated. The experiment was designed as a factorial arrangement of 3 dietary SS treatments × 2 antibiotic treatments. Birds were fed a basal diet (CON) or a low-SS diet (50 SS) containing 50 mg/kg SS, or a high-SS diet (500 SS) containing 500 mg/kg SS. Birds were cofed with or without antibiotics. The growth experiment lasted for 10 wk. Results showed that birds fed the 50 mg/kg SS diet tended to have lower abdominal fat rate. The gene expression of liver X receptor-α (LxR-α) in liver and serum total cholesterol (TC) were dropped, and the gene expression of acyl-CoA thioesterase 8 (ACOT8) in liver were upregulated. Compared with CON group, the levels of lysozyme, IL-10, and transforming growth factor (TGF-ß) in the serum were elevated as along with gene expression of IL-10, TGF-ß, and LYZ in ileum of both 50 and 500 SS group. However, the level of secretory immunoglobulin A (sIgA) and Mucin-2 in the ileum were downregulated in the 500 SS group. Additionally, Lactobacillus and Lactobacillus gasseri were the dominant bacteria in the 50 SS group, whereas the relative abundance of Lactobacillus was dropped in the 500 SS group. With combined antibiotics treatment, the α-diversity of bacteria was reduced, and the biological effects of SS were eliminated. In conclusion, the lipid metabolism, immune function, and intestinal flora of the laying hens were improved with the dietary supplementation of 50 mg/kg SS. But dietary 500 mg/kg SS had negative effects on laying hens.

Soya saponin improves egg-laying performance and immune function of laying hens.

BACKGROUND: Soya saponin (SS), an active compound in soybean meals, has been widely studied in the medical field. However, it was considered as an anti-nutritional factor in poultry diets. The objective of this experiment was to measure the effects of dietary SS using three dietary treatments on egg-laying performance and immune function of laying hens. Birds were fed a low soybean meal basal diet (CON), a low-SS diet (50 SS) containing 50 mg/kg SS, or a high-SS diet (500 SS) containing 500 mg/kg SS for 10 weeks. At the end of the 5th and 10th week of the trial, samples were collected for analysis. RESULTS: Results showed that with 50 mg/kg SS supplementation, the egg production rate, feed conversion ratio (FCR), and eggshell quality tended to be improved. Serum follicle stimulating hormone (FSH) and Interleukin-4 (IL-4) levels were also elevated as well as the peripheral blood LPS stimulation index, the proportion of B lymphocytes, and antibody titer of bovine serum albumin (BSA). We also found that mRNA levels of follicle stimulating hormone receptor (FSHR) in ovarian, nuclear transcription factor kappa B (NF-κB), Transforming growth factor (TGF-ß) and interferon γ (IFN-γ) in spleen were up-regulated at the end of the trial. Additionally, dietary 50 mg/kg SS improved the ileal flora via up-regulating the relative abundance of Lactobacillus, Romboutsia and Lactobacillus delbrueckii. Although the immune related indicators were improved with 500 mg/kg SS supplemented, it seemed to have a negative influence on the laying-performance. Specifically, serum alanine aminotransferase (ALT), alkaline phosphatase (ALP), and the ratio of IFN-γ to IL-4 were increased in the 500 SS group at the end of the trial. The mRNA levels of gonadotropin releasing hormone 1 (GnRH1) in Hypothalamus, the estrogen related receptor (ERR) in ovaries were downregulated as well as the egg production rate during the trial with 500 mg/kg SS supplemented. CONCLUSIONS: The egg production performance was improved by dietary supplemented with 50 mg/kg SS via increasing ovarian FSHR transcription level and serum estrogen level. A beneficial shift in intestinal microflora was recorded, and the immune function of laying hens was also improved with 50 mg/kg SS supplementation. Surprisingly, the long-term supplementation of 500 mg/kg SS exerted a negative impact on the laying performance and physiological functions of the liver of laying hens.

The genetic and phylogenetic analysis of a highly pathogenic influenza A H5N6 virus from a heron, southern China, 2013.

The H5N6 highly pathogenic avian influenza viruses (HPAIVs) have circulated within poultry in China since 2013. Infections of H5N6 in wild birds were reported since 2014. In order to investigate the infection history of H5N6 in wild birds, we conducted a retrospective analysis of H5 positive wild bird samples collected in 2013, the year H5N6 was discovered in poultry. We isolated a new HPAI H5N6 virus from a dead heron collected in 2013. The virus had high identity in all eight gene sequences to those collected from poultry in 2013 (for example, A/chicken/Shenzhen/1845/2013, 99.1%-99.7%). Our findings revealed that H5N6 HPAIVs infected wild birds in southern China since the emergence of H5N6 in poultry in 2013. The co-circulation of H5N6 between wild birds and poultry is very close, and should raise our attention more.

[The p53-p21(waf1) pathway and centrosome amplification in oral squamous cell carcinomas].

OBJECTIVE: To elucidate the possible role of p53-p21(waf1) pathway for centrosome amplification in oral squamous cell carcinoma (OSCC). METHODS: Formalin-fixed, paraffin-embedded tissues of 8 cases of normal oral epithelium tissues and 27 cases of OSCC tissues were examined for the expression of p21(waf1) and mutated p53 proteins by flow cytometry and immunohistochemistry, and centrosome status was investigated by indirect immunofluorescence double staining with antibodies to centrosome protein gamma-tubulin and cytokeratin. The correlation between p21(waf1), p53 and centrosome amplification in OSCC was statistically analyzed by SPSS 12.0. RESULTS: All normal oral epithelium tissues showed normal centrosomes (1-2 centrosomes per cell)in epithelium cells, while 21 out of 27 cases (78%) of OSCC showed the evidence of centrosome amplification characterized by supernumerary centrosomes ( >2 centrosomes per cell) in a fraction of tumor cells. The quantity of p21(waf1) protein was lower in OSCC with centrosome amplification [(0.878 +/- 0.081)] than that in OSCC without centrosome amplification [(0.952 +/- 0.018), t = 3.838, P < 0.01], and negative correlations were found between the quantity of p21(waf1) protein and the degree of centrosome amplification (r = -0.472, P < 0.05), as well as the positive staining of p53 (r = -0.491, P < 0.01). CONCLUSIONS: p53-p21(waf1) pathway might involve in centrosome duplication cycle in OSCC. Down-regulated p21(waf1) protein, via p53 transactivation-dependent mechanism, was likely a contributing factor towards centrosome amplification in OSCC.

[Cyclin E overexpression and centrosome amplification in squamous cell carcinoma of oral cavity].

OBJECTIVE: To study the correlation between cyclin E protein overexpression and centrosome amplification in oral squamous cell carcinoma (OSCC). METHODS: Formalin-fixed, paraffin-embedded tissues from 12 normal oral epithelium cases and 46 cases of OSCC were studied. Their centrosome status was analyzed by indirect immunofluorescence double staining with antibodies to centrosome protein gamma-tubulin and cytokeratin. The expression of cyclin E protein was studied by immunohistochemical methods. The correlation between cyclin E protein expression and centrosome amplification in OSCC was statistically analyzed by SPSS 12.0. RESULTS: Thirty-seven of the 46 OSCC cases (80.4%) studied showed evidence of centrosome amplification, as signified by enlargement and/or increase in number of centrosomes, while normal oral epithelium possessed centromeres of normal size and number. Positive staining for cyclin E protein was observed in 30 of the 46 OSCC cases (65.2%), while all the normal oral epithelium cases were cyclin E protein-negative. The percentage of centrosome amplification in OSCC with positive cyclin E protein staining (90.0%, 27/30) was higher than that in OSCC with negative cyclin E protein staining (62.5%, 10/16) (chi(2) = 5.014, P < 0.05). Centrosome amplification showed positive correlation with cyclin E protein overexpression (r = 0.330, P < 0.05). CONCLUSION: Up-regulation of cyclin E protein may represent one of the possible mechanisms for centrosome amplification in OSCC.