Multiple organ dysfunction after mitral valve replacement in a patient with systemic lupus erythematosus complicated by Libman-Sacks endocarditis: a case report and literature review.

This case report describes a 47-year-old woman with systemic lupus erythematosus (SLE) complicated by Libman-Sacks endocarditis (LSE) who developed multiple organ dysfunction after mitral valve replacement surgery. The patient presented with a 5-day history of cough, sputum, and fever. Transthoracic echocardiography showed significant vegetations on the mitral valve. Biopsy was performed, and the pathological diagnosis was SLE complicated by LSE. After the mitral valve replacement surgery, the patient developed clinical manifestations of hepatic and renal dysfunction, cardiopulmonary failure, oliguria, and shock. The clinical symptoms significantly improved after administration of mechanical ventilation, continuous renal replacement therapy, plasma exchange, anti-inflammatory and anti-infection treatments, immunomodulatory and immunosuppressive therapies, and low-molecular-weight heparin anticoagulation. Multiple organ dysfunction after mitral valve replacement in patients with SLE complicated by LSE has rarely been reported. This report discusses the clinical manifestations, pathogenesis, and treatment of this severe complication. We hope the sharing of our experience in this case will provide a clinical basis for the treatment of severe multiple organ dysfunction after mitral valve replacement in patients with SLE complicated by LSE.

Effectiveness of non-invasive chromosomal screening for normal karyotype and chromosomal rearrangements.

Purpose: To study the accuracy of non-invasive chromosomal screening (NICS) results, in normal chromosomes and chromosomal rearrangement groups and to investigate whether using trophoblast cell biopsy along with NICS, to choose embryos for transfer can improve the clinical outcomes of assisted pregnancy. Methods: We retrospectively analyzed 101 couples who underwent preimplantation genetic testing at our center from January 2019 to June 2021 and collected 492 blastocysts for trophocyte (TE) biopsy. D3-5 blastocyst culture fluid and blastocyst cavity fluid were collected for the NICS. Amongst them, 278 blastocysts (58 couples) and 214 blastocysts (43 couples) were included in the normal chromosomes and chromosomal rearrangement groups, respectively. Couples undergoing embryo transfer were divided into group A, in which both the NICS and TE biopsy results were euploid (52 embryos), and group B, in which the TE biopsy results were euploid and the NICS results were aneuploid (33 embryos). Results: In the normal karyotype group, concordance for embryo ploidy was 78.1%, sensitivity was 94.9%, specificity was 51.4%, the positive predictive value (PPV) was 75.7%, and the negative predictive value (NPV) was 86.4%. In the chromosomal rearrangement group, concordance for embryo ploidy was 73.1%, sensitivity was 93.3%, specificity was 53.3%, the PPV was 66.3%, and the NPV was 89%. In euploid TE/euploid NICS group, 52 embryos were transferred; the clinical pregnancy rate was 71.2%, miscarriage rate was 5.4%, and ongoing pregnancy rate was 67.3%. In euploid TE/aneuploid NICS group, 33 embryos were transferred; the clinic pregnancy rate was 54.5%, miscarriage rate was 5.6%, and ongoingpregnancy rate was 51.5%. The clinical pregnancy and ongoing pregnancy rates were higher in the TE and NICS euploid group. Conclusion: NICS was similarly effective in assessing both normal and abnormal populations. Identification of euploidy and aneuploidy alone may lead to the wastage of embryos due to high false positives. More suitable reporting methods for NICS and countermeasures for a high number of false positives in NICS are needed. In summary, our results suggest that combining biopsy and NICS results could improve the outcomes of assisted pregnancy.

A nickel(ii)-based one-dimensional organic-inorganic halide perovskite ferroelectric with the highest Curie temperature.

Organic-inorganic halide perovskites (OIHPs) are very eye-catching due to their chemical tunability and rich physical properties such as ferroelectricity, magnetism, photovoltaic properties and photoluminescence. However, no nickel-based OIHP ferroelectrics have been reported so far. Here, we designed an ABX3 OIHP ferroelectric (3-pyrrolinium)NiCl3, where the 3-pyrrolinium cations are located on the voids surrounded by one-dimensional chains composed of NiCl6-face-sharing octahedra via hydrogen bonding interactions. Such a unique structure enables the (3-pyrrolinium)NiCl3 with a high spontaneous polarization (P s) of 5.8 µC cm-2 and a high Curie temperature (T c) of 428 K, realizing dramatic enhancement of 112 and 52 K compared to its isostructural (3-pyrrolinium)MCl3 (M = Cd, Mn). To our knowledge, remarkably, (3-pyrrolinium)NiCl3 should be the first case of nickel(ii)-based OIHP ferroelectric to date, and its T c of 428 K (35 K above that of BaTiO3) is the highest among all reported one-dimensional OIHP ferroelectrics. This work offers a new structural building block for enriching the family of OIHP structures and will inspire the further exploration of new nickel(ii)-based OIHP ferroelectrics.

Dzyaloshinskii-Moriya-Interaction-Like Behavior in Confined Permalloy Nanostructures via Coupled Magnetic Vortices.

Dzyaloshinskii-Moriya interaction (DMI), one of antisymmetric exchanges, originates from the combination of low structural symmetry and large spin-orbit coupling and favors magnetization rotations with fixed chirality. Herein, this work reports a DMI-like behavior in permalloy via coupled vortices in confined structures. Under the in-plane magnetic fields, continuous reversals of different coupled vortices are directly observed by in situ Lorentz transmission electron microscopy, and reproduced by complementary micromagnetic simulations. The statistical results show that coupled vortices with opposite chirality appear more frequently with the frequency up to about 60%. Such an asymmetric phenomenon mainly arises from a DMI-like behavior, associated with the increased total energy difference between different ground-state coupled vortices. Moreover, in the reversal process, the junction between disks accelerates the annihilation of vortices moving toward it and is also the starting point of vortex nucleation. These results provide an effective method to generate a DMI-like behavior in magnetic systems with symmetry breaking surface and benefit the future development of vortex-based spintronic devices.

Halogen Engineering To Realize Regulable Multipolar Axes, Nonlinear Optical Response, and Piezoelectricity in Plastic Ferroelectrics.

Compared with uniaxial molecular ferroelectrics, multiaxial ferroelectrics have better application prospects because they are no longer subject to the single-crystal form and have been pursued in recent years. Halogen engineering refers to the adjustment of halogens in materials at the atomic level, which can not only explore multiaxial ferroelectrics but also help to improve piezoelectrics, recently. In this work, we successfully synthesized and characterized three multiaxial plastic ferroelectrics through the precise molecular design from I to Cl, confirming the increase of the number of polar axes of ferroelectrics from 3 to 6, the increase of second-harmonic generation density from 2.1 times to nearly 6 times of monopotassium phosphate, and the increase of piezoelectric coefficient by 140%. This systematic work has proved that halogen engineering can not only enrich the family of multiaxial plastic ferroelectrics but also promote the further development of nonlinear optical and piezoelectric materials.

Saikosaponin D regulates apoptosis and autophagy of pancreatic cancer Panc-1 cells via Akt/mTOR pathway / 中国中药杂志

This study aims to investigate the effect and mechanism of saikosaponin D on the proliferation, apoptosis, and autophagy of pancreatic cancer Panc-1 cells. The cell counting kit(CCK-8) was used to examine the effects of 7, 10, 13, 16, 19, 22, 25, and 28 μmol·L~(-1) saikosaponin D on the proliferation of Panc-1 cells. Three groups including the control(0 μmol·L~(-1)), low-concentration(10 μmol·L~(-1)) saikosaponin D, and high-concentration(16 μmol·L~(-1)) saikosaponin D groups were designed. The colony formation assay was employed to measure the effect of saikosaponin D on the colony formation rate of Panc-1 cells. The cells treated with saikosaponin D were stained with hematoxylin-eosin(HE), and the changes of cell morphology were observed. Hoechst 33258 fluorescent staining was used to detect the effect of saikosaponin D on the cell apoptosis. The autophagy staining assay kit with MDC was used to examine the effect of saikosaponin D on the autophagy of Panc-1 cells. Western blot and immunocytochemistry(ICC) were employed to examine the effect of saikosaponin D on the expression levels and distribution of B-cell lymphoma-2(Bcl-2), Bcl-2-associated X protein(Bax), cysteine-aspartic acid protease-3(caspase-3), cleaved caspase-3, autophagy-associated protein Beclin1, microtubule-associated protein light chain 3(LC3), protein kinase B(Akt), phosphorylated protein kinase B(p-Akt), mammalian target of rapamycin(mTOR), and phosphorylated mammalian target of rapamycin(p-mTOR). The results showed that compared with the control group, saikosaponin D decreased the proliferation rate of Panc-1 cells in a dose-dependent and time-dependent manner. The colony formation rate of the cells significantly decreased after saikosaponin D treatment. Compared with the control group, the cells treated with saikosaponin D became small, accompanied by the formation of apoptotic bodies. The saikosaponin D groups showed increased apoptosis rate and autophagic vesicle accumulation. Compared with the control group, saikosaponin D up-regulated the expression of Bax, cleaved caspase3, Beclin1, LC3Ⅱ/LC3Ⅰ and down-regulated the expression of Bcl-2, caspase-3, p-Akt/Akt, and p-mTOR/mTOR. In addition, these proteins mainly existed in the cytoplasm. In conclusion, saikosaponin D can inhibit the proliferation and induce the apoptosis and autophagy of Panc-1 cells via inhibiting the Akt/mTOR pathway.

Would Financial Development Help China Achieve Carbon Peak Emissions?

China has committed to reaching carbon peak before 2030. To realize the carbon peak goal, financial development plays an essential role in developing a green economy. Based on the panel data of 30 provinces in China from 2006 to 2019, this paper explores the impact of financial development on carbon intensity both theoretically and empirically. A financial development index system is constructed and computed using the entropy method. A spatial lag panel data model is employed to empirically test the interaction effect of financial development on carbon intensity. Moreover, the mediating effects of industrial upgrading and technological innovation are further investigated. The results show that: first, carbon intensity generates strong spatial spillover effects between provinces in China. Second, financial development significantly reduces carbon intensity, and is most pronounced in central China, followed by western and eastern China. Third, industrial upgrading and technological innovation are important channels to assist financial development in cutting down carbon intensity, and both produce positive spatial spillover effects. These findings suggest that inter-regional cooperation and coordination on financial development, industrial upgrading, and technological innovation are conducive to achieving low-carbon development targets. This research not only has practical significance to China, but also provides global reference value to other countries.

Bone Safety Profile of Steroidal Aromatase Inhibitor in Comparison to Nonsteroidal Aromatase Inhibitors in Postmenopausal Women with Breast Cancer: A Network Meta-Analysis.

Background and Objectives: Aromatase inhibitors (AIs) provide an alternative to tamoxifen as an adjuvant therapy for postmenopausal patients with breast cancer (BC). Large trials resulted better outcomes with AIs. Adjuvant therapy with AIs reduced the risk of relapse compared with tamoxifen. Systemic therapies for BC can interfere with bone turnover, either by affecting gonadal steroid hormone production or by inhibiting peripheral aromatization into estrogen. We aimed to evaluate the safety profile of bone-related events by comparing 3 AIs with tamoxifen and a placebo. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used for network meta-analyses (NMAs). Searches were performed using PubMed, Embase/Medline, Cochrane, and Ovid databases. Randomized controlled trials comparing tamoxifen and placebo or other AIs to steroidal or nonsteroidal AIs in patients with BC reporting bone-related safety events were included in NMA. NMA in a Bayesian approach was performed using R software (ver 3.2), Gemtc package. Results: Seventeen studies reporting 4 different bone-related endpoints were included. Although there was no statistical significance, treatment with exemestane lowered the incidence of bone pain (odds ratio [OR] vs. anastrozole and letrozole: 0.63, 0.54), fracture episodes (OR vs. anastrozole and letrozole: 0.84, 0.80), and osteoporosis (OR vs. anastrozole and letrozole: 0.85, 0.73) compared with letrozole and anastrozole. Reduction in bone mineral density was lesser in exemestane than in anastrozole (mean reduction in hip: 1.05; lumbar spine: 1.25). Treatment ranking with the surface under the cumulative ranking curve showed that exemestane was found to reduce the incidence of bone-related adverse events. Conclusion: A lower incidence of bone-related safety events was observed in patients treated with exemestane.

Assessing the Relationship between Resource Misallocation and Total Factor Productivity Based on Artificial Neural Network.

For interpretation of China's economy, total factor productivity is considered as one of the crucial aspects which is generally dependent on innovation in technologies especially those driven by both scientific research and efficiency of the methodology or process which is dedicated for the allocation of numerous resources available, among enterprises. It is important to note that various factors, which are either directly or indirectly involved, to cause misallocation of the resources to the enterprises, are overly complex. Therefore, an affective mechanism is needed to be realized which is capable of resolving these issues with the available resources and infrastructures. In this paper, we have focused on the construction or development of an artificial neutral network (ANN) based evaluation model to study the impact of resource misallocation on total factor productivity. Likewise, we have conducted a counterfactual experiment, i.e., simulation only, to thoroughly examine the relationship between two very important factors, that is, (i) resource misallocation and (ii) total factor productivity. To do this, we are aiming at investigating the growth potential of total factor productivity when there is no resource misallocation. After comparing 8 industries in different regions, we conclude that the contribution of capital and labor distortion to total factor productivity is the highest in the eastern region of China with -0.036 and 0.065, respectively, followed by the northeast, central, and western regions. In the experiment, China's total factor productivity growth potential could reach 1.1296, if there is no resource misallocation. The results in this paper would shed some lights on the paths to improve resource allocation efficiency and total factor productivity.

Cost-effectiveness analysis of glecaprevir/pibrentasvir regimen for treating Chinese patients with chronic hepatitis C genotype 1 and genotype 2 infection.

BACKGROUND: Hepatitis C virus (HCV) infection is an important health threat in China to which direct acting antivirals (DAAs) are very effective. In 2019, another novel DAA glecaprevir/pibrentasvir (GLE/PIB) was officially approved. Knowledge of its cost-effectiveness would be informative for clinical decision-making but has not been evaluated. This study aims to evaluate the cost-effectiveness of GLE/PIB to inform policy-making on drug reimbursement and HCV eradication. METHODS: Markov models were developed from the payers' perspective and simulated the lifetime experience of adult patients chronically infected with HCV genotype 1 or genotype 2. Two regimens, GLE/PIB and pegylated interferon (pegIFN) plus ribavirin (RBV), were compared in cost and quality adjusted life years (QALY) with both outcomes being discounted to 2020 values. The incremental cost-effectiveness ratio (ICER) was computed to reflect the incremental benefit of GLE/PIB versus pegIFN + RBV. The robustness of the model outcomes was examined using deterministic and probabilistic sensitivity analysis (PSA) to identify influential parameters and to assess the probability of GLE/PIB being cost-effective. The GDP per capita in China in 2019 ($10,275) was used as the threshold for cost-effectiveness. RESULTS: For the entire target population, GLE/PIB was the dominant regimen attaining a cost-saving of $255 and 1.17 more QALYs relative to pegIFN + RBV. The finding was more pronounced for HCV genotype 1 infection by saving $1,656 and creating 1.37 more QALYs. At the $10,275 threshold, the probability of GLE/PIB being cost-effective was 99.32% overall and 99.85% for HCV genotype 1 infection. The age of starting DAA treatment, price of pegIFN + RBV, cost of cirrhosis treatment and duration of the GLE/PIB regimen were the five most influential factors. For the patients with HCV genotype 2 infection, the ICER of GLE/PIB was $12,914/QALY with 95% confidence interval of $4,047/QALY to $37,640/QALY. The GLE/PIB regimen statistically cannot be ruled out as a cost-effective option for HCV genotype 2 infection. CONCLUSIONS: GLE/PIB is a cost-effective strategy to treat chronic HCV genotype 1 and HCV genotype 2 infection in China. This regimen should be initiated at a younger age to maximize its value. To achieve national eradication, it may be timely to consider replacing pegIFN + RBV with DAAs, such as GLE/PIB, as the first-line treatment.

Effects of skin care habits on the development of rosacea: A multi-center retrospective case-control survey in Chinese population.

BACKGROUND: Certain cosmetic habits may trigger or aggravate rosacea, while there is little published epidemiologic evidence to support this point. PURPOSE: To examine if daily skin care habits have an effect on the development of rosacea in Chinese population. METHODS: A multi-center retrospective case-control survey of 1,245 rosacea cases and 1,538 skin-healthy controls was conducted in China. Participants completed the questionnaire comprised of demographic characteristics, socioeconomic data and daily skin care habits. Data were collected retrospectively and analyzed using the chi-square test and t-test. Multivariate logistic regression analyses were used to predict rosacea. RESULTS: The multivariate logistic regression analysis highlighted some results: Dry, oily or mixed skin (OR = 6.3-6.9, P< .001), the usage of foaming cleanser (OR = 1.45, 95%CI 1.115-1.886, P = .01), make up more than 6 times a week (OR = 2.839, 95%CI 1.962-4.108, P< .001), using facial mask more than 4 times a week (OR = 2.56-3.069, P< .001), facial treatments at beauty salon more than once a week (OR = 4.946, 95%CI 2.005-12.198, P = .0018) and using beauty salon products (OR = 2.334, 95%CI 1.435-3.976, P = .0018) are positively correlated with the development of rosacea. Using of moisturizing products (OR = 0.602, 95%CI 0.386-0.983, P = .035) and sunscreen cream (OR = 0.303-0.507, P< .001 or P = .0167 for different frequency) presented significantly negative correlations with rosacea. Frequency of cleansing showed a nonlinear association with rosacea: using facial cleansers 1~3 times per week (OR = 0.647, 95%CI 0.429-0.975, P = .038) showed beneficial effects while using facial cleanser excessively (twice or more daily) (OR = 2.131, 95%CI 1.394-3.256, P< .001) positively correlated to rosacea strongly. CONCLUSIONS: Excessive use of facial cleanser (twice or more a day) and facial mask (more than 4 times a week), frequent makeup (more than 6 times a week), regular skin care in beauty salon (more than once a week), and using beauty salon products were closely correlated to the development of rosacea in Chinese population.

Study on Toxic Effect of the Extract from Tripterygium hypoglaucum on Embryo-fetal Development of New Zealand Rabbits / 中国药房

OBJECTIVE：To study the toxic effect of the extract from Tripterygium hypoglaucum on pregnant animal and embryo-fetal development . METHODS ：Successfully mated New Zealand female rabbits were randomly divided into solvent control group，positive control group （cyclophosphamide，20 mg/kg）and T. hypoglaucum extract high-dose ，medium-dose and low- dose groups（15.0，7.50，3.75 g/kg，by the amount of crude drug ）according to their body weight ，with 18 rabbits in each group at least. The female rabbits in solvent control group and T. hypoglaucum extract groups were given water or the corresponding T. hypoglaucum extract solution from 6th to 18th day of pregnancy ，5 mL/kg，once a day. Positive control group was given cyclophosphamide subcutaneously into the neck from 10th to 13th day of pregnancy ，1 mL/kg，once a day. According to the related requirements of Technical Guidelines for the Study of Drug Reproductive Toxicity ，the general situation ，body weight ，body weight increase and food intake of female rabbits were observed and recorded during the experiment ，and euthanasia was carried out on 28th day of pregnancy ；the relative indexes of main organs ，fetal uterus ，placenta uterus ，placenta，ovary，implantation gland ， absorption fetus ，stillbirth，live fetus and corpus luteum were observed and recorded after anatomy ；the relative indexes of body weight，appearance，visceral and skeletal alterations of the fetus were detected . RESULTS ：Compared with solvent control group ， the body weight ，body weight increase ，food intake ，main organs ，pregnancy of pregnant rabbits ，as well as reproductive function，embryo formation ，fetal growth and development ，appearance，visceral and skeletal development indexes in T. hypoglaucum extract groups had no significant abnormal changes （P＞0.05）；above indexes in the positive control group had significant changes （P＜0.05），and significant maternal toxicity and embryotoxicity were found. CONCLUSIONS ：T. hypoglaucum extract 15.00-3.75 g/kg（by the amount of crude drug ）have no significant maternal toxicity ，embryotoxicity or fetal development toxicity to New Zealand rabbits.

Mechanism-Property Correlation in Coordination Polymer Crystals toward Design of a Superior Sorbent.

A methodology was developed to design superior sorbents of oxoanions. To integrate the high efficiency of chemisorption, selectivity, and recyclability into one sorbent, understanding the nature of oxoanions-sorbent interactions and the structural evolution of the sorbents is essential. Three cationic Ag(I) coordination polymers (CPs) are synthesized for dichromate (Cr2O72-) removal, and three distinct oxoanion-exchange mechanisms are identified, namely, the replacement, breath, and reconstruction processes, depending on the degree of framework distortion induced by the dichromate-CP interactions. The single crystal to single crystal transformation during the oxoanion exchange has been investigated by using single-crystal X-ray diffraction and energy-dispersive X-ray microanalysis. The replacement process, due to a weak chemisorption, shows excellent recyclability at the cost of reduction of efficiency and selectivity of adsorption. The reconstruction process may achieve a high efficiency and selectivity, but it loses recyclability. Due to the formation of a Ag-O(dichromate) bond and the breathing effect of the framework, the sorbent with the breath mechanism shows both superior efficiency and high recyclability in dichromate removal. The study of perrhenate (ReO4-) removal using the same CPs demonstrates that one CP performing the reconstruction process during dichromate removal turns to the breath process in removal of perrhenate anions. These results of mechanism-property correlation provide an insight into improvement of the methodology to fabricate a superior CP sorbent for oxoanion removal.

Establishment of gastric cancer SGC-7901 cell line with stable lncRNA BC002811 silencing / 医学研究生学报

Objective The aim of this study was to construct a recombinant lentivirus-mediated short hairpin RNA (shRNA) expression vector targeting the long non-coding RNA (lncRNA) BC002811 and establish a gastric cancer SGC-7901 cell line with stable BC002811 down-regulation. Methods Three small interfering RNAs (siRNA) were designed and synthesized. The best sequence for RNA interference was selected by real-time quantitative PCR (qPCR) and inserted into the lentiviral vector pLVX-shRNA2. After identification by DNA sequencing, the lentiviral vectors carrying BC002811 shRNA were packaged in HEK293T cells. The lentiviral particles were collected to infect human gastric cancer SGC-7901 cells. After screened by limiting dilution analysis, the SGC-7901 cell line with stable BC002811 down-regulation was established, the expression level of BC002811 detected by qPCR, and the effect of BC002811 on the proliferation of the cells analyzed by MTS. Results The results of qPCR showed that BC002811 siRNA-1 was the most effective siRNA sequence, with a knockdown efficiency of 87%. The recombinant lentiviral vector was packaged in the HEK293T cells with a viral titer of 3.7 × 108 TU/mL in the shRNA-1 group as compared with 4.5 × 108 TU/mL in the control. The expression of BC002811 in the shRNA-1 group was only 10% of that in the control group (P < 0.01), which indicated the successful establishment of the gastric cancer SGC-7901 cell line with stable BC002811 down-regulation. BC002811 knockdown significantly inhibited the proliferation of the SGC-7901 cells in the shRNA-1 group as compared with the control. Conclusion A recombinant lentiviral vector expressing BC002811 shRNA was successfully constructed and the gastric cancer cell line SGC-7901 with stable BC002811 silencing was established.

The clinical reports on adrenal insufficiency of patients with advanced solid tumors accepting anti-PD-1 antibody, SHR-1210 therapy / 中华肿瘤杂志

Objective@#To investigate the adrenocortical function changes of patients with advanced solid tumors who received the anti- programmed cell death protein-1 (PD-1) antibody, SHR-1210 therapy.@*Methods@#The clinical data of 98 patients with advanced solid tumors who were enrolled in a prospective phase I trial of SHR-1210 therapy at our institution between April 27, 2016 and June 8, 2017 were collected. The levels of plasma adrenocorticotropic hormone (ACTH) and cortisol were evaluated in 96 patients. The clinical manifestations, laboratory tests and radiologic data were collected to define the immune-related adrenal insufficiency.@*Results@#Until December 14th, 2018, no SHR-1210 related primary adrenal insufficiency occurred, and the incidence of immune-related secondary adrenal insufficiency was 1.0% among the 96 patients, which was identified as grade 2. No patient developed grade 3-4 adrenal insufficiency. The main clinical manifestations of the patient who was diagnosed as secondary adrenal insufficiency were grade 2 fatigue, anorexia and headache.The patient developed fatigue and anorexia at the 267th day after receiving the first dose of SHR-1210, the hypocortisolism occurred on the 279th day, and the headache emerged on the 291th day. The anorexia of patient who treated by physiological replacement doses of glucocorticoid since the 457th day was attenuated.The patient whose cortisol level was still below the normal limit continued to accept the hormone replacement therapy up to 776 days after the initial administration of SHR-1210.@*Conclusions@#The incidence of SHR-1210 related adrenal insufficiency of patients with advanced solid tumors is low, and the symptoms can be effectively ameliorated by hormone replacement therapy. The potential adverse outcome of adrenal insufficiency following immunotherapy should be noticed by clinicians to avoid the occurrence of adrenal crisis.

Clinical observation of thyroid-related adverse events induced by anti-PD-1 antibody SHR-1210 in patients with advanced solid tumor / 中华肿瘤杂志

Objective@#To assess the incidence and characteristics of thyroid dysfunction during anti-Programmed cell death 1 receptor (PD-1) antibody SHR-1210 therapy in patients with advanced solid tumor.@*Methods@#The medical records of 98 patients who initiated SHR-1210 treatment between April 27, 2016 and June 8, 2017 in the phase 1 trial to evaluate the safety, efficacy, and pharmacokinetics of SHR-1210 in patients with advanced solid tumors were retrospectively reviewed. Serological tests of thyroid stimulating hormone (TSH) and free thyroxine (fT4) were measured at baseline and prior to each SHR-1210 administration.@*Results@#A total of 86 patients had normal thyroid function before the first dose of SHR-1210 treatment. Nine out of 86 (10.5%) patients developed new onset hypothyroidism from euthyroid state. 12 patients presented thyroid dysfunction at baseline, 10 of whom were subclinical hypothyroid and 2 were hypothyroidism. Four out of 10 patients developed hypothyroidism from subclinical hypothyroid. Most patients with hypothyroidism were asymptomatic. Thyroid dysfunction occurred early (median, 55days) after the initiation of SHR-1210. The severity of hypothyroidism were all grade 1-2. No grade 3-4 hypothyroidism occurred. No patients discontinue the treatment of SHR-1210 due to clinical impact of the thyroid dysfunctions.@*Conclusions@#Thyroid-related adverse events were common during anti-PD-1 antibody SHR-1210 treatment . The incidence of hypothyroidism is lower in patients with euthyroid state than in patients with thyroid dysfunction at baseline during SHR-1210 treatment . Thyroid function can be improved after thyroid hormone replacement. During SHR-1210 treatment, it is necessary to pay attention to monitor the thyroid function, especially in the patients with thyroid dysfunction at baseline.@*Trial registration@#Chinese Clinical Trial Registry, 2016L01455

Tracking the Superefficient Anion Exchange of a Dynamic Porous Material Constructed by Ag(I) Nitrate and Tripyridyltriazole via Multistep Single-Crystal to Single-Crystal Transformations.

To avoid the instability and inefficiency for anion-exchange resins and layered double-hydroxides materials, we present herein a flexible coordination network [Ag(L243)](NO3)(H2O)(CH3CN) (L243 = 3-(2-pyridyl)-4-(4-pyridyl)-5-(3-pyridyl)-1,2,4-triazole) with superefficient trapping capacity for permanganate, as a group-7 oxoanion model for radiotoxic pertechnetate pollutant. Furthermore, a high-throughput screening strategy has been developed based on concentration-gradient design principle to ascertain the process and mechanism for anion exchange. Significantly, a series of intermediates can be successfully isolated as the qualified crystals for single-crystal X-ray diffraction. The result evidently indicates that such a dynamic material will show remarkable breathing effect of the three-dimensional host framework upon anion exchange, which mostly facilitates the anion trapping process. This established methodology will provide a general strategy to discover the internal secrets of complicated solid-state reactions in crystals at the molecular level.

The treatment and prognosis of peripheral primitive neuroectodermal tumor / 中华肿瘤杂志

Objective@#To evaluate the treatment and prognosis of peripheral primitive neuroectodermal tumor (pPNET).@*Methods@#From March 2006 to April 2015, 47 patients with pPNET who had undergone chemotherapy in our hospital were enrolled. The clinical data and survival information of these patients were collected and interpreted retrospectively to analyze the effect of each treatment on the survival of patients.@*Results@#The median overall survival (OS) for whole group was 23.5 months, and 5-year survival rate was 33.8%. In the patients who underwent radical surgery, the median OS was 70.4 months, the 5-year survival rate was 54.4%, the median disease-free survival (DFS) was 23.1months, and 5-year DFS rate was 34.4%. Sixteen patients had recurrences or metastasis after surgery. Eighty-one percent of them (13/16) occurred within 2 years after surgery. The difference of median OS between patients who got adjuvant chemotherapy and those who did not was statistically significant (P=0.04). But the difference of median PFS between these two groups was not statistically significant (P=0.057). There was no statistically significant difference for median OS (P=0.619) and median DFS (P=0.191) between patients who got adjuvant radiotherapy and those who did not. The recurrence rate between these two groups was not statistically significant (P=0.40). The median OS and PFS for 34 patients who received first-line palliative chemotherapy was 10.7 months and 3.2 months. 1-year and 2-year survival rates were 48.0% and 17.8%. The response rate and clinical benefit rate for first-line chemotherapy was 53.1% and 75.0%. The median PFS and OS for patients who received platinum-based regimens were 3.3 months and 14.5 months. The median PFS and OS for patients who got non-platinum regimens were 2.7 months and 10.3 months. There was no significant difference of PFS and OS between platinum-based and non-platinum regimens. Palliative surgery and radiotherapy did not improve the OS of pPNET this cohort.@*Conclusions@#Comprehensive treatment including chemotherapy, radiotherapy and surgery is the standard treatment model for early pPNET patients. Adjuvant chemotherapy significantly improved the overall survival of early pPNET patients. Chemotherapy is the main treatment for patients with advanced pPNET. Platinum-based chemotherapy seem to be a good option.

Endoscopic decompression of the optic canal for traumatic optic neuropathy / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Traumatic optic neuropathy (TON) is a serious complication of head trauma with the incidence rate of 0.5%-5%. The aim of this study was to investigate the therapeutic efficacy of endoscopic decompression of the optic canal for optic nerve injuries.</p><p><b>METHODS</b>In this study, 11 patients treated in our hospital from January 2009 to January 2015 with the visual loss resulting from TON were retrospectively reviewed for preoperative vision, visual evoked potential (VEP) scan, surgical approach, postoperative visual acuity, complications, and follow-up results.</p><p><b>RESULTS</b>All these patients received endoscopic decompression of the optic canal. At the 3-month follow- up, the visual acuity improvement rate of the 11 patients was 45.5%. The vision acuity of 2 cases improved from hand movement to 0.08 and 0.3 after operation. Another patient's vision acuity returned to 0.05 compared to light sensation preoperatively. Two cases had finger counting before surgery but they had a vision acuity of 0.4 and light sensation respectively after surgery. However, the other 6 cases' vision did not improve after surgery.</p><p><b>CONCLUSION</b>Endoscopic decompression of the optic canal is an effective way to cure TON. VEP could be used as an important reference for preoperative and prognosis evaluation. Operative time after trauma is only a relative condition that may affect the therapeutic effect of optic canal decompression. Poor results of this procedure may be related to the severity of the optic nerve injury.</p>

Analysis of clinical features of painless aortic dissection.

The clinical characteristics of painless aortic dissection were investigated in order to improve the awareness of diagnosis and treatment of atypical aortic dissection. The 482 cases of aortic dissection were divided into painless group and pain group, and the data of the two groups were retrospectively analyzed. The major clinical symptom was pain in 447 cases (92.74%), while 35 patients (7.26%) had no typical pain. The gender, age, hypertension, hyperlipidemia, diabetes, smoking and drinking history had no statistically significant differences between the two groups (P>0.05). The proportion of Stanford type A in painless group was significantly higher than that in pain group (48.57% vs. 21.03%, P=0.006). The incidence of unconsciousness in the painless group was significantly higher than that in the pain group (14.29% vs. 3.58%, P=0.011). The incidence of hypotension in painless group was significantly higher than that in pain group for 4.26 folds (P=0.01). Computed tomography angiography (CTA) examination revealed that the incidence of aortic arch involved in the painless group was significantly higher than that in the pain group (19.23% vs. 5.52%, P=0.019). It was concluded that the incidence of painless aortic dissection was higher in Stanford A type patients, commonly seen in the patients complicated with hypotension and unconsciousness. CTA examination revealed higher incidence of aortic arch involvement.