Publications by authors named "Heng Zhao"

401 Publications

pN1 but not pN0/N2 predicts survival benefits of prophylactic cranial irradiation in small-cell lung cancer patients after surgery.

Ann Transl Med 2021 Apr;9(7):562

Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.

Background: Prophylactic cranial irradiation has been shown to reduce brain metastases and provide survival benefits in small-cell lung cancer (SCLC). However, its role in limited-stage SCLC patients after surgery remains unclear. Further, it is unknown whether the effect of prophylactic cranial irradiation is generalizable in these patients with different pathological nodal (N0-N2) stages, a state indicating the presence of tumor metastases.

Methods: We combined data from a single medical center and Surveillance, Epidemiology, and End Results database. Propensity score matching analyses were performed (1:2) to evaluate the role of prophylactic cranial irradiation in SCLC patients after surgery. Cox proportional hazards regression model was used to identify predictors of survival.

Results: 124 (18.7%) out of 664 surgically-treated SCLC patients received prophylactic cranial irradiation treatment. Within the entire cohort, multivariate Cox regression analysis identified dataset source, age, pathological T and N stages, adjuvant chemotherapy, resection type, and histology as independent prognostic factors for overall survival. Prophylactic cranial irradiation appeared to be associated with a better overall survival, but the difference is marginally significant (P=0.063). Further, we stratified patients based on the pathological N0-N2 stages using propensity score matching analyses, which showed that prophylactic cranial irradiation treatment was superior to non-prophylactic cranial irradiation treatment for surgically-treated SCLC patients with N1 stage only (univariate analysis: P=0.026; multivariate Cox: P=0.004), but not N0/N2 stage (univariate analysis: P=0.65 and P=0.28, respectively; multivariate Cox: P=0.99 and P=0.35, respectively).

Conclusions: Prophylactic cranial irradiation provides survival benefits for SCLC patients with pN1 after surgery but not with pathological N0/N2 stage. Our findings may provide helpful stratifications for clinical decision-making of prophylactic cranial irradiation intervention in SCLC patients.
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http://dx.doi.org/10.21037/atm-20-6984DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8105819PMC
April 2021

Anatomic study of carpal tunnel in adults using monoenergetic reconstruction of dual-energy computed tomography.

J Pak Med Assoc 2021 Feb;71(2(B)):663-671

Department of Radiology, Shengjing Hospital of China Medical University, Heping, Shenyang, China.

Objective: To seek optimal keV settings for imaging carpal tunnel in adults by dual-energy computed tomography (DECT) monoenergetic technique; to describe anatomic characteristics of carpal tunnel and to observe correlation between carpal bony and soft tissue structures.

Methods: DECT images of 20 wrists (11 left and 9 right wrists; 14 men, mean age 26.93±1.38 years, range 23 to 28, and 6 women, mean age 24.17 ± 0.98 years, range 23 to 26) were evaluated. Monoenergetic images were reconstructed at 42, 62, 82, 102, 122, and 142 keV. Image quality was assessed along a 5-point Likert scale, and the highest-quality images were chosen for quantitative analysis. Two musculoskeletal radiologists performed both analyses independently.

Results: The optimal energy spectrum with the best contrast-to-noise ratio (CNR) for monoenergetic images were at 62 keV (19 wrists, 95%) and 61 keV (1 wrist, 5%). There was substantial interobserver agreement between the readers in the 5-point Likert scale analysis of image quality (k= 0.793). Bland-Altman plots also indicated good agreement between observers in quantitative analysis. Intra-category 1 and 2 correlation was mostly discovered at hamate hook level and middle level of pisiform (P < 0.05), while bony and soft tissue structures partly reached correlation (P < 0.05).

Conclusions: The optimal energy spectrum for monoenergetic DECT imaging of carpal tunnel structures was 62 keV. DECT monoenergetic imaging could predict changes in soft tissue structures and demonstrate carpal tunnel anatomic structures.
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http://dx.doi.org/10.47391/JPMA.1203DOI Listing
February 2021

Prognostic index for estimating the survival benefit of postoperative radiotherapy in pathologic N2 non-small cell lung cancer: A real-world validation study.

Lung Cancer 2021 Apr 20;156:100-108. Epub 2021 Apr 20.

Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, No. 241 Huai-Hai Road, Shanghai 200030, China; Department of Radiation Oncology, Fudan University Shanghai Cancer Center, No. 270 Dong-An Road, Shanghai 200032, China. Electronic address:

Objectives: This study aimed to evaluate the effect of postoperative radiotherapy (PORT) in patients with resected pathologic N2 (pN2) non-small cell lung cancer (NSCLC) with different locoregional recurrence (LRR) risks.

Materials And Methods: The primary cohort and validation cohort were retrieved from two independent medical centres. Data for all consecutive patients with completely resected pathologic stage T1-3N2M0 NSCLC were analysed. Patients without PORT in the primary cohort were identified as a training set. Significant prognostic factors for LRR were identified by the Fine-Gray model to develop a prognostic index (PI) in the training set.

Results: The primary cohort consisted of 357 patients who met the eligibility criteria (training set, 287 patients without PORT). The external validation cohort consisted of 1044 patients who met the eligibility criteria (validation set, 711 patients without PORT). Heavy cigarette smoking history, clinical N2 status (cN2), and the number of positive lymph nodes >4 were identified as independent risk factors. The PI was computed as follows: PI=0.8*smoking history+0.5*cN2+0.7*the number of involved lymph nodes (reference level was assigned the value 1 and risk level the value 2). In the low-risk group (PI score< = 3), PORT showed a trend towards decreased LRR rates but not significantly improved overall survival (OS). In the high-risk group (PI score>3), PORT significantly reduced the risk of LRR and improved OS.

Conclusions: We constructed and validated a PI to predict individually the effect of PORT in patients with completely resected pN2 NSCLC. Patients with a higher PI score can benefit from PORT in terms of OS.
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http://dx.doi.org/10.1016/j.lungcan.2021.04.009DOI Listing
April 2021

The safety and immunogenicity of an inactivated SARS-CoV-2 vaccine in Chinese adults aged 18-59 years: A phase I randomized, double-blinded, controlled trial.

Vaccine 2021 05 9;39(20):2746-2754. Epub 2021 Apr 9.

Institute of Medical Biology, Chinese Academy of Medicine Sciences & Peking Union Medical College, Yunnan Key Laboratory of Vaccine Research and Development for Severe Infectious Diseases, Kunming 650118, China.

Background: This study examined the safety and immunogenicity of an inactivated SARS-CoV-2 vaccine.

Method: In a phase I randomized, double-blinded, placebo-controlled trial involving 192 healthy adults 18-59 years old, two injections of three doses (50 EU, 100 EU, 150 EU) of an inactivated SARS-CoV-2 vaccine or placebo were administered intramuscularly at a 2- or 4-week interval. The safety and immunogenicity of the vaccine were evaluated.

Results: Vaccination was completed in 191 subjects. Forty-four adverse reactions occurred within 28 days, most commonly mild pain and redness at the injection site or slight fatigue. At days 14 and 28, the seroconversion rates were 87.5% and 79.2% (50 EU), 100% and 95.8% (100 EU), and 95.8% and 87.5% (150 EU), respectively, with geometric mean titers (GMTs) of 18.1 and 10.6, 54.5 and 15.4, and 37.1 and 18.5, respectively, for the schedules with 2-week and 4-week intervals. Seroconversion was associated with synchronous upregulation of antibodies against the S protein, N protein and virion and a cytotoxic T lymphocyte (CTL) response. No cytokines and immune cells related to immunopathology were observed. Transcriptome analysis revealed the genetic diversity of immune responses induced by the vaccine.

Interpretation: In a population aged 18-59 years in this trial, this inactivated SARS-CoV-2 vaccine was safe and immunogenic.

Trial Registration: CTR20200943 and NCT04412538.
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http://dx.doi.org/10.1016/j.vaccine.2021.04.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8040531PMC
May 2021

Cancer Associated Fibroblasts Promote Renal Cancer Progression Through a TDO/Kyn/AhR Dependent Signaling Pathway.

Front Oncol 2021 25;11:628821. Epub 2021 Mar 25.

Department of Radiology, The First Affiliated Hospital of University of South China, Hengyang, China.

Cancer associated fibroblasts (CAFs) play crucial roles in cancer development, however, the specific mechanisms of CAFs associated renal cancer progression remain poorly understood. Our study observed enriched CAFs in high degree malignant tumor tissues from renal cancer patients. These CAFs isolated from tumor tissues are prone to facilitate drugs resistance and promote tumor progression and . Mechanistically, CAFs up-regulated tryptophan 2, 3-dioxygenase (TDO) expression, resulting in enhanced secretion of kynurenine (Kyn). Kyn produced from CAFs could up-regulated the expression of aromatic hydrocarbon receptor (AhR), eventually resulting in the AKT and STAT3 signaling pathways activation. Inhibition of AKT signal prevented cancer cells proliferation, while inhibition of the STAT3 signal reverted drugs resistance and cancer migration induced by kynurenine. Application of AhR inhibitor DMF could efficiently suppress distant metastasis of renal cancer cells, and improve anticancer effects of sorafenib (Sor)/sunitinib (Sun), which described a promising therapeutic strategy for clinical renal cancer.
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http://dx.doi.org/10.3389/fonc.2021.628821DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8027476PMC
March 2021

The role of multiple SARS-CoV-2 viral antigens in a vaccine-induced integrated immune response.

Vaccine 2021 04 22;39(18):2500-2503. Epub 2021 Mar 22.

Institute of Medical Biology, Chinese Academy of Medicine Sciences & Peking Union Medical College, Yunnan Key Laboratory of Vaccine Research and Development for Severe Infectious Diseases, Kunming 650118, China. Electronic address:

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http://dx.doi.org/10.1016/j.vaccine.2021.03.067DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983451PMC
April 2021

Balancing Heterogeneous Image Quality for Improved Cross-Spectral Face Recognition.

Sensors (Basel) 2021 Mar 26;21(7). Epub 2021 Mar 26.

Molecular and Neuroimaging Engineering Research Center of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an 710071, China.

Matching infrared (IR) facial probes against a gallery of visible light faces remains a challenge, especially when combined with cross-distance due to deteriorated quality of the IR data. In this paper, we study the scenario where visible light faces are acquired at a short standoff, while IR faces are long-range data. To address the issue of quality imbalance between the heterogeneous imagery, we propose to compensate it by upgrading the lower-quality IR faces. Specifically, this is realized through cascaded face enhancement that combines an existing denoising algorithm (BM3D) with a new deep-learning-based deblurring model we propose (named SVDFace). Different IR bands, short-wave infrared (SWIR) and near-infrared (NIR), as well as different standoffs, are involved in the experiments. Results show that, in all cases, our proposed approach for quality balancing yields improved recognition performance, which is especially effective when involving SWIR images at a longer standoff. Our approach outperforms another easy and straightforward downgrading approach. The cascaded face enhancement structure is also shown to be beneficial and necessary. Finally, inspired by the singular value decomposition (SVD) theory, the proposed deblurring model of SVDFace is succinct, efficient and interpretable in structure. It is proven to be advantageous over traditional deblurring algorithms as well as state-of-the-art deep-learning-based deblurring algorithms.
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http://dx.doi.org/10.3390/s21072322DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8038120PMC
March 2021

DEAD-BOX RNA HELICASE 27 regulates microRNA biogenesis, zygote division, and stem cell homeostasis.

Plant Cell 2021 03;33(1):66-84

Key Laboratory of Plant Molecular Physiology, Institute of Botany, Chinese Academy of Sciences, Beijing 100093, China.

After double fertilization, zygotic embryogenesis initiates a new life cycle, and stem cell homeostasis in the shoot apical meristem (SAM) and root apical meristem (RAM) allows plants to produce new tissues and organs continuously. Here, we report that mutations in DEAD-BOX RNA HELICASE 27 (RH27) affect zygote division and stem cell homeostasis in Arabidopsis (Arabidopsis thaliana). The strong mutant allele rh27-1 caused a zygote-lethal phenotype, while the weak mutant allele rh27-2 led to minor defects in embryogenesis and severely compromised stem cell homeostasis in the SAM and RAM. RH27 is expressed in embryos from the zygote stage, and in both the SAM and RAM, and RH27 is a nucleus-localized protein. The expression levels of genes related to stem cell homeostasis were elevated in rh27-2 plants, alongside down-regulation of their regulatory microRNAs (miRNAs). Further analyses of rh27-2 plants revealed reduced levels of a large subset of miRNAs and their pri-miRNAs in shoot apices and root tips. In addition, biochemical studies showed that RH27 associates with pri-miRNAs and interacts with miRNA-biogenesis components, including DAWDLE, HYPONASTIC LEAVES 1, and SERRATE. Therefore, we propose that RH27 is a component of the microprocessor complex and is critical for zygote division and stem cell homeostasis.
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http://dx.doi.org/10.1093/plcell/koaa001DOI Listing
March 2021

Intermolecular Interaction Control Enables Co-optimization of Efficiency, Deformability, Mechanical and Thermal Stability of Stretchable Organic Solar Cells.

Small 2021 Mar 14:e2007011. Epub 2021 Mar 14.

State Key Laboratory for Mechanical Behavior of Materials Xi'an Jiaotong University, Xi'an, 710049, China.

Promoting efficiency, deformability, and life expectancy of stretchable organic solar cells (OSCs) have always been key concerns that researchers are committed to solving. However, how to improve them simultaneously remains challenging, as morphology parameters, such as ordered molecular arrangement, beneficial for highly efficient devices actually limits mechanical stability and deformability. In this study, the unfavorable trade-off among these properties has been reconciled in an all-polymer model system utilizing a mechanically deformable guest component. The success of this strategy stems from introducing a highly ductile component without compromising the pristine optimized morphology. Preferable interaction between two donors can maintain the fiber-like structure while enhancing the photocurrent to improve efficiency. Morphology evolution detected via grazing incidence X-ray scattering and in situ UV-vis absorption spectra during stretching have verified the critical role of strengthened interaction on stabilizing morphology against external forces. The strengthened interaction also benefits thermal stability, enabling the ternary films with small efficiency degradation after heating 1500 h under 80 °C. This work highlights the effect of morphology evolution on mechanical stability and provides new insights from the view of intermolecular interaction to fabricate highly efficient, stable, and stretchable/wearable OSCs.
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http://dx.doi.org/10.1002/smll.202007011DOI Listing
March 2021

Exercise-induced muscle damage: multi-parametric MRI quantitative assessment.

BMC Musculoskelet Disord 2021 Mar 2;22(1):239. Epub 2021 Mar 2.

Department of Radiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, China.

Background: To explore the value of magnetic resonance quantitative analysis using diffusion tensor imaging, T2 mapping, and intravoxel incoherent motion in the evaluation of eccentric exercise-induced muscle damage and to compare the effects of various eccentric exercise modes at different time points in rats.

Methods: A total of 174 Sprague-Dawley male rats were randomly divided into five groups: control, once-only exercise, continuous exercise, intermittent exercise, and once-fatigue exercise groups. Each experimental group was divided into seven time-subgroups: 0.5 h, 24 h, 48 h, 72 h, 96 h, 120 h and 168 h after exercise. The quadriceps femoris muscles were then scanned using magnetic resonance imaging. The apparent diffusion coefficient and fractional anisotropy values of diffusion tensor imaging, T2 values of T2 mapping, D and D* values of intravoxel incoherent motion and optical density values of desmin were measured. Associations among different eccentric exercise programmes, magnetic resonance imaging findings, and histopathological results were evaluated. Dunnett's test, two-way repeated measures analysis of variance, and Pearson correlation analysis were used for statistical analysis.

Results: Diffusion tensor imaging showed that the number of muscle fibre bundles decreased to varying degrees with different time points and eccentric exercises. Apparent diffusion coefficient values of the exercise groups showed a trend that first increased and then decreased, the opposite of fractional anisotropy. The specimens in all eccentric exercise programmes showed high signal T2 values after exercise, the highest among which was in the once-fatigue exercise group. D and D* in the experimental groups were significantly higher than those in the control group at 0.5-48 h after exercise. The apparent diffusion coefficient, fractional anisotropy, T2, D and D* values correlated with the optical density values of desmin.

Conclusions: Diffusion tensor imaging, T2 mapping, and intravoxel incoherent motion technology accurately reflect the degree of skeletal muscle damage and recovery associated with eccentric exercise. The degree of muscle damage was the lowest in the continuous exercise group and the highest in the once-fatigue exercise group, which may provide more information and guidance for the formulation of physical and athletic training programmes.
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http://dx.doi.org/10.1186/s12891-021-04085-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7927395PMC
March 2021

Coproduction of hydrogen and lactic acid from glucose photocatalysis on band-engineered ZnCdS homojunction.

iScience 2021 Feb 28;24(2):102109. Epub 2021 Jan 28.

Department of Chemical and Petroleum Engineering, University of Calgary, 2500 University Drive, NW, Calgary, Alberta T2N 1N4, Canada.

Photocatalytic transformation of biomass into value-added chemicals coupled with co-production of hydrogen provides an explicit route to trap sunlight into the chemical bonds. Here, we demonstrate a rational design of ZnCdS solid solution homojunction photocatalyst with a pseudo-periodic cubic zinc blende (ZB) and hexagonal wurtzite (WZ) structure for efficient glucose conversion to simultaneously produce hydrogen and lactic acid. The optimized ZnCdS catalyst consists of a twinning superlattice, has a tuned bandgap, and displays excellent efficiency with respect to hydrogen generation (690 ± 27.6 μmol·h·g), glucose conversion (~90%), and lactic acid selectivity (~87%) without any co-catalyst under visible light irradiation. The periodic WZ/ZB phase in twinning superlattice facilitates better charge separation, while superoxide radical (⋅O) and photogenerated holes drive the glucose transformation and water oxidation reactions, respectively. This work demonstrates that rational photocatalyst design could realize an efficient and concomitant production of hydrogen and value-added chemicals from glucose photocatalysis.
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http://dx.doi.org/10.1016/j.isci.2021.102109DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7881236PMC
February 2021

Using the Compressed Sensing Technique for Lumbar Vertebrae Imaging: Comparison with Conventional Parallel Imaging.

Curr Med Imaging 2021 Jan 26. Epub 2021 Jan 26.

Department of Radiology, Shengjing Hospital of China Medical University. China.

Objective: To compare conventional sensitivity encoding turbo spin-echo (SENSE-TSE) with compressed sensing plus SENSE turbo spin-echo (CS-TSE) in lumbar vertebrae magnetic resonance imaging (MRI).

Methods: This retrospective study of lumbar vertebrae MRI included 600 patients; 300 patients received SENSE-TSE and 300 patients received CS-TSE. The SENSE acceleration factor was 1.4 for T1WI, 1.7 for T2WI, and 1.7 for PDWI. The CS total acceleration factor was 2.4, 3.6, 4.0, and 4.0 for T1WI, T2WI, PDWI sagittal, and T2WI transverse, respectively. The image quality of each MRI sequence was evaluated objectively by the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) and subjectively on a five-point scale. Two radiologists independently reviewed the MRI sequences of the 300 patients receiving CS-TSE, and their diagnostic consistency was evaluated. The degree of intervertebral foraminal stenosis and nerve root compression was assessed using the T1WI sagittal and T2WI transverse images.

Results: The scan time was reduced from 7 min 28 s to 4 min 26 s with CSTSE. The median score of nerve root image quality was 5 (p > 0.05). The diagnostic consistency using CS-TSE images between the two radiologists was high for diagnosing lumbar diseases (κ > 0.75) and for evaluating the degree of lumbar foraminal stenosis and nerve root compression (κ = 0.882). No differences between SENSE-TSE and CS-TSE were observed for sensitivity, specificity, positive predictive value, or negative predictive value.

Conclusion: CS-TSE has potential for diagnosing lumbar vertebrae and disc disorders.
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http://dx.doi.org/10.2174/1573405617666210126155814DOI Listing
January 2021

Zebularine elevates STING expression and enhances cGAMP cancer immunotherapy in mice.

Mol Ther 2021 May 9;29(5):1758-1771. Epub 2021 Feb 9.

Fujian Key Laboratory of Innate Immune Biology, Biomedical Research Center of South China, College of Life Science, Fujian Normal University Qishan Campus, Fuzhou, Fujian Province 350117, China; Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Normal University, Fuzhou, Fujian 350117, China. Electronic address:

DNA methylation abnormality is closely related to tumor occurrence and development. Chemical inhibitors targeting DNA methyltransferase (DNMTis) have been used in treating cancer. However, the impact of DNMTis on antitumor immunity has not been well elucidated. In this study, we show that zebularine (a demethylating agent) treatment of cancer cells led to increased levels of interferon response in a cyclic guanosine monophosphate-AMP (cGAMP) synthase (cGAS)- and stimulator of interferon genes (STING)-dependent manner. This treatment also specifically sensitized the cGAS-STING pathway in response to DNA stimulation. Incorporation of zebularine into genomic DNA caused demethylation and elevated expression of a group of genes, including STING. Without causing DNA damage, zebularine led to accumulation of DNA species in the cytoplasm of treated cells. In syngeneic tumor models, administration of zebularine alone reduced tumor burden and extended mice survival. This effect synergized with cGAMP and immune checkpoint blockade therapy. The efficacy of zebularine was abolished in nude mice and in cGAS or STING mice, indicating its dependency on host immunity. Analysis of tumor cells indicates upregulation of interferon-stimulated genes (ISGs) following zebularine administration. Zebularine promoted infiltration of CD8 T cells and natural killer (NK) cells into tumor and therefore suppressed tumor growth. This study unveils the role of zebularine in sensitizing the cGAS-STING pathway to promote anti-tumor immunity and provides the foundation for further therapeutic development.
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http://dx.doi.org/10.1016/j.ymthe.2021.02.005DOI Listing
May 2021

Perioperative comparison of video-assisted thoracic surgery and open lobectomy for pT1-stage non-small cell lung cancer patients in China: a multi-center propensity score-matched analysis.

Transl Lung Cancer Res 2021 Jan;10(1):402-414

Department of Thoracic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Background: Compared with open surgery, video-assisted thoracic surgery (VATS) has innovated the concept of the minimally invasive approach for non-small cell lung cancer (NSCLC) patients in past decades. This present study aimed to compare the perioperative and lymph node dissection outcomes between VATS lobectomy and open lobectomy for pathological stage T1 (pT1) NSCLC patients from both surgical and oncologic perspectives.

Methods: This was a retrospective multicenter study. Patients who underwent surgical resection for pT1 NSCLC between January 2014 and September 2017 were retrospectively reviewed from 10 thoracic surgery centers in China. Perioperative and lymph node dissection outcomes of pT1 NSCLC patients who accepted VATS or open lobectomies were compared by propensity score matching (PSM) analysis.

Results: Of the 11,360 patients who underwent surgery for pT1 NSCLC, 7,726 were enrolled based on the selection criteria, including 1,222 cases of open lobectomies and 6,504 cases of VATS lobectomies. PSM resulted in 1,184 cases of open lobectomies and 1,184 cases of VATS lobectomies being well matched by common prognostic variables, including age, sex, and surgical side. VATS lobectomy led to better perioperative outcomes, including less blood loss (133.5±200.1 233.3±318.4, P<0.001), lower blood transfusion rate (2.4% 6.4%, P<0.001), shorter postoperative hospital stay (8.6±5.7 10.1±5.1, P<0.001), less chest drainage volume (1,109.5±854.0 1,324.1±948.8, P<0.001), and less postoperative complications (4.9% 8.2%, P<0.001). However, open lobectomy had better lymph node dissection outcomes than VATS, with increased lymph node dissection numbers (16.1±9.4 13.7±7.7, P<0.001) and more positive lymph nodes being dissected (1.5±3.9 1.1±2.5, P=0.002). Compared with VATS, open lobectomy harvested more lymph node stations (5.5±1.9 5.2±1.8, P=0.001), including more pathological N2 (pN2) lymph node stations (3.4±1.4 3.1±1.3, P<0.001).

Conclusions: VATS lobectomy was associated with better perioperative outcomes, such as less blood loss, lower blood transfusion rate, shorter postoperative hospital stay, less chest drainage volume and less postoperative complications. Open lobectomy has improved lymph node dissection outcomes, as more lymph nodes and positive lymph nodes were dissected for pT1 NSCLC patients during surgery.
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http://dx.doi.org/10.21037/tlcr-20-1132DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7867771PMC
January 2021

Structure-Performance Correlations over Cu/ZnO Interface for Low-Temperature Methanol Synthesis from Syngas Containing CO.

ACS Appl Mater Interfaces 2021 Feb 9;13(7):8191-8205. Epub 2021 Feb 9.

Department of Applied Chemistry, School of Engineering, University of Toyama, Gofuku 3190, Toyama 930-8555, Japan.

Cu/ZnO catalysts with varied Cu/(Cu + Zn) molar ratios were prepared by a facile solid-state method. The Cu/(Cu + Zn) molar ratio displayed a significant effect on the oxygen vacancy formation of the calcined catalysts, thereby influencing the CuO-ZnO interaction and the reducibility of CuO. The Cu/(Cu + Zn) molar ratio also exhibited a significant effect on Cu surface area, oxygen vacancy, the ratio of ZnO(002) plane to ZnO(100) plane, as well as the basicity and acidity of the reduced catalysts, thereby affecting the catalytic performance for low-temperature methanol synthesis from syngas containing CO. The correlations of methanol space time yield (STY) versus the physicochemical characteristics of Cu/ZnO catalysts were studied. The catalyst with equal amounts of Cu and Zn displayed the best catalytic activity owing to higher Cu surface area, more oxygen vacancy and ZnO(002) plane, as well as more moderately basic sites.
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http://dx.doi.org/10.1021/acsami.0c18600DOI Listing
February 2021

Finite element analysis of cemented prostheses for hip replacement in elderly patients with comminuted intertrochanteric fracture.

Ann Ital Chir 2020 ;91:679-687

Background: To determine postoperative stress distribution after cemented arthroplasty in elderly patients with comminuted intertrochanteric fracture, and assist in determining a rational prosthetic stem length.

Methods: A three-dimensional (3D) model of intertrochanteric fracture was established using the Mimics and Unigraphics modeling software, which included the 3D model of comminuted intertrochanteric fracture, two long-stem(#4,#5) and one short stem(#3) prostheses, and the mantle layer of cement. The bone defect of the calcar femorale was replaced with a 5-mm thick cement. Then, the 3D finite element model of those materials was established, boundary conditions of force were imposed, and material parameters were set. Accordingly, a finite element analysis was performed to this model in stress.

Results: (1) The stress of the femur in the three-stem replacement prosthesis models increased from proximal end to distal end in the same pattern, while a stress concentration region was found at 5 mm from within the distal tip of the short-stem prosthesis (#3), which had a peak value of 67.85 MPa. However, no stress concentration was found on the long-stem prosthesis model. (2) For the short-stem prosthesis, the stress distribution of the cement-prosthesis interface was significantly concentrated in the distal region around the prosthesis end, in which the peak value of the lateral interface exceeded the fatigue strength of the bone cement. However, the biomechanics for the long prosthesis was better appreciated.

Conclusion: Long prosthesis stems may theoretically be a better option for comminuted intertrochanteric fractures in elderly patients. However, the application of exceedingly long prosthesis stems would not be a better option.

Key Words: Comminuted intertrochanteric fracture, Elderly patients Finite element analysis, Prosthetic replacement.
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January 2020

Efficacy and safety of tripterygium glycosides for active moderate to severe Graves' ophthalmopathy: a randomised, observer-masked, single-centre trial.

Eur J Endocrinol 2021 Feb;184(2):277-287

Department of Endocrinology, Taikang Xianlin Drum Tower Hospital, Nanjing, Jiangsu Province, China.

Background: Tripterygium glycosides (TG) has been used to treat a spectrum of inflammatory and autoimmune diseases. Our preliminary studies have shown that TG is effective in the treatment of active Graves' ophthalmopathy (GO).

Objective: We aimed to compare the efficacy and tolerability of TG with intravenous methylprednisolone (iv.MP) in patients with active moderate-to-severe GO.

Methods: This study was an observer-masked, single-centre, block-randomised trial. Patients with active moderate-to-severe GO were randomly assigned to receive iv.MP (500 mg once per week for 6 weeks followed by 250 mg per week for 6 weeks) or with TG (20 mg tablet three times per day for 24 weeks). The primary endpoints were the overall response rate and the patients' quality of life at 12 and 24 weeks.

Results: In this study, 161 patients were enrolled and randomised from 2015 to 2019. A total of 79 were randomly assigned to receive iv.MP and 82 to receive TG. A greater overall response rate was found in the TG group compared with the iv.MP group at week 24 (90.2% vs 68.4%, P = 0.000). Similarly, the patients' quality of life of the TG group showed a significantly higher response than the iv.MP group at week 24 (89.02% vs 72.15%, P = 0.001). The TG therapy showed a better CAS response than the iv.MP (91.5% vs 70.9% improved, P < 0.05), and up to 91.2% of patients were inactive. Also, the TG group showed a significantly higher improved rate of diplopia, proptosis, visual acuity, soft tissue involved and the decrease of eye muscle motility than the iv.MP group at week 24. Significantly more patients in the iv.MP group than the TG group experienced adverse events.

Conclusion: Compared with iv.MP treatment, TG therapy is more effective and safer for patients with active moderate to severe GO.
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http://dx.doi.org/10.1530/EJE-20-0857DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7849376PMC
February 2021

The Influence of the COVID-19 Event on Deviant Workplace Behavior Taking Tianjin, Beijing and Hebei as an Example.

Int J Environ Res Public Health 2020 12 23;18(1). Epub 2020 Dec 23.

College of Management and Economics, Tianjin University, Tianjin 300072, China.

: Since the beginning of 2020, the Corona Virus Disease has broken out globally. This public health incident has had a great impact on the work and life of the public. : Based on the event system theory, this article explored the influence of the "COVID-19" event on emotional exhaustion and deviant workplace behaviors. Methods: This survey's objects are employees working in Tianjin, Beijing, Hebei affected by the epidemic. Using the questionnaire star, the online platform of the Marketing Research Office of Peking University and "snowball" methods 700 questionnaires were collected. : The response rate was 89.71% (n = 700). Female employees are more sensitive to the perceived event strength of the novel coronavirus pneumonia than male employees (F = 10.94, <0.001); Employees aged 30-40 affected by the epidemic have the highest level of emotional exhaustion (F = 5.22, < 0.01); A higher education level leads to a higher level of emotional exhaustion (F = 4.74, < 0.01); The emotional exhaustion is polarized with the annual family income (F = 4.099, < 0.01). : The novelty, disruption, criticality of the Corona Virus Disease event has had a positive impact on the emotional exhaustion of employees in the workplace; Emotional exhaustion plays a partly mediating role between event strength with constructive deviant behaviors, and destructive deviant behaviors. Emotional exhaustion has a positive effect on creative constructive deviant behaviors, challenging constructive deviant behaviors, and interpersonal destructive deviant behaviors. Emotional exhaustion has a negative impact on organizational destructive deviant behaviors, and has no significant impact on interpersonal constructive deviant behaviors.
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http://dx.doi.org/10.3390/ijerph18010059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794894PMC
December 2020

n-p Heterojunction of TiO-NiO core-shell structure for efficient hydrogen generation and lignin photoreforming.

J Colloid Interface Sci 2021 Mar 20;585:694-704. Epub 2020 Oct 20.

State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Wuhan University of Technology, 122 Luoshi Road, 430070 Wuhan, Hubei, China; Laboratory of Inorganic Materials Chemistry (CMI), University of Namur, 61 rue de Bruxelles, B-5000 Namur, Belgium. Electronic address:

Hydrogen evolution from biomass photoreforming has been widely recognized as a promising strategy for relieving the pressure from energy crisis and environmental pollution, as it could generate sustainable H and value-added bioproducts simultaneously. Combining p-type semiconductors with n-type semiconductors to form n-p heterojunction is an effective strategy to improve the photocatalytic quantum efficiency by enhancing the separation of photogenerated electrons and holes, which could greatly facilitate the realization of such biomass photorefinery concept. However, the incompact contact between the n-type and p-type semiconductors often induces the aggregation of photogenerated electrons and holes. In this work, we design and synthesize an ultrafine n-p heterojunction TiO-NiO core-shell structure to overcome the incompact contact in the n-p interface. When the n-p heterojunction photocatalysts are evaluated for photocatalytic water splitting and biomass lignin photoreforming respectively, the as-fabricated TiO-NiO nanocomposite with 3.25% NiO demonstrates the highest hydrogen generation of 23.5 mmol h g from water splitting and H (0.45 mmol h g) and CH (0.03 mmol h g) cogeneration with reasonable amount of fatty acids (palmitic acid and stearic acid) production from lignin photoreforming. The excellent photocatalytic activity is ascribed to the synergistic effects of high crystallinity of TiO ultrafine nanoparticles, core-shell structure and n-p heterojunction with NiO nanoclusters. This present work demonstrates a simple and efficient method to fabricate ultrafine n-p heterojunction core-shell structure for noble-metal free catalyst for both water splitting and biomass photoreforming.
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http://dx.doi.org/10.1016/j.jcis.2020.10.049DOI Listing
March 2021

Effective Radiotherapy in Tracheobronchial Adenoid Cystic Carcinoma with Positive Surgical Margin.

Ann Thorac Surg 2020 Dec 18. Epub 2020 Dec 18.

Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China. Electronic address:

Background: The study aimed to evaluate the role of postoperative radiotherapy (PORT) in the treatment of trachea and main bronchus adenoid cystic carcinoma (ACC) with a positive surgical margin.

Methods: Patients with pathologically confirmed trachea or main bronchus ACC operated on at Shanghai Chest Hospital were enrolled. Survival, univariate, and multivariate analyses were performed. Chi-square test was applied to analyze the failure patterns among different groups (R0/0: negative margin resection without PORT; R1/0: positive margin resection without PORT; R1/1: positive margin resection with PORT).

Results: From January 2001 to December 2014, 77 patients were deemed eligible for the study. Pairwise comparisons showed that the overall survival rate of group R1/1 was comparable to that of group R0/0 (P=0.438), while significantly longer than the rate of group R1/0 (P=0.032). Besides, the local disease-free survival rate of group R1/1 was much higher than that of group R0/0 (P=0.023) and R1/0 (P=0.001). Cox multivariate analysis identified the radiological feature(P=0.012) and PORT (P=0.006) as significantly favorable prognostic factors for locoregional disease-free survival. By contrast, for overall survival, PORT (P=0.032) was the only corresponding variable identified by univariate analysis. Furthermore, PORT significantly decreased the locoregional recurrence rate (P=0.002) but not distant metastases (P=1.000).

Conclusions: PORT helped patients with tracheobronchial ACC and microscopic positive surgical margins to achieve a similar outcome as patients with complete resection. R0 resection may not be necessary for tracheobronchial ACC if it's hard to be completely resected.
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http://dx.doi.org/10.1016/j.athoracsur.2020.11.033DOI Listing
December 2020

Efficacy of an inactivated bivalent vaccine for enterovirus 71 and coxsackievirus A16 in mice immunized intradermally.

Vaccine 2021 01 17;39(3):596-604. Epub 2020 Dec 17.

Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Kunming 650118, China. Electronic address:

Human hand, foot, and mouth disease (HFMD), an important infectious disease in children, is caused mainly by enterovirus 71 (EV71) and coxsackievirus A16 (CA16). In this study, a bivalent inactivated EV71/CA16 vaccine is developed and evaluated in immunized BALB/c mice injected through the intradermal route. Q-RT-PCR detection of the mRNA of immune signal molecules in local epithelial tissues inoculated with the vaccine indicates activation of innate immunity, which includes upregulation of immune-related chemokines, interferons and CD molecules. Further, the finding that neutralizing antibodies and specific T cellular responses were elicited in adult mice after two immunizations with the vaccine at a 28-day interval, which endowed offspring mice to defend a viral challenge, suggests the successful induction of specific protective antiviral immunity. All these data suggest that immunization with this bivalent EV71/CA16 vaccine via the intradermal route elicits effective immunity against EV71 and CA16 infection.
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http://dx.doi.org/10.1016/j.vaccine.2020.11.070DOI Listing
January 2021

Effective Inhibition of -Amplified Group 3 Medulloblastoma Through Targeting EIF4A1.

Cancer Manag Res 2020 3;12:12473-12485. Epub 2020 Dec 3.

Department of Pediatric Neurosurgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.

Purpose: In medulloblastoma (MB), group 3 (G3) patients with amplification tend to exhibit worse prognosis, thus creating a need for novel effective therapies. As the driver and crucial dependency for -amplified G3-MB, has been proven to be a prospective therapeutic target. Here, we aimed to identify novel effective therapeutic strategies against -amplified G3-MB via targeting translation.

Materials And Methods: Major components of translation initiation complex eIF4F were subjected to MB tumor dataset analysis, and was identified to be a potential therapeutic target of -amplified G3-MB. Validation was performed through genetic or pharmacological approaches with multiple patient-derived tumor models of -amplified G3-MB in vitro and in vivo. Underlying mechanisms were further explored by Western blot, quantitative real-time PCR and mass spectrometry (MS) analyses.

Results: MB tumor datasets analyses showed that was significantly up-regulated in G3-MB patients relative to normal cerebella, positively correlated with in G3-MB at transcriptional level and a crucial cancer dependency in -amplified G3-MB cells. Targeting with a CRISPR/Cas9 approach or small-molecule inhibitor silvestrol effectively attenuated growth in multiple preclinical models of -amplified G3-MB via blocking proliferation and inducing apoptosis. Mechanistically, EIF4A1 inhibition effectively impeded expression at translational level, and its potency was positively associated with MYC level. Whole-proteome MS analysis of silvestrol-treated cells further unveiled other biological functions and pathways influenced by EIF4A1 inhibition.

Conclusion: Our investigation shows that interrupting translation by EIF4A1 inhibition could be a potential effective therapeutic approach when treating patients with -amplified G3-MB.
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http://dx.doi.org/10.2147/CMAR.S278844DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7721120PMC
December 2020

A nomogram to predict short-term outcome of radiotherapy or chemoradiotherapy based on pre/post-treatment inflammatory biomarkers and their dynamic changes in esophageal squamous cell carcinoma.

Int Immunopharmacol 2021 Jan 18;90:107178. Epub 2020 Nov 18.

Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China; Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China. Electronic address:

Objective: We initially aimed to investigate pre/post-treatment inflammatory biomarkers (pre/post-IBs) and their dynamic changes (delta-IBs) on the short-term outcome (STO) of radiotherapy or chemoradiotherapy in esophageal squamous cell carcinoma (ESCC). Furthermore, a nomogram was built to provide an accurate prediction of STO.

Methods: The STO using the treatment response evaluation was assessed according to RECIST 1.1 at 1 month after radiotherapy or chemoradiotherapy. The IBs (absolute lymphocyte counts (ALC), neutrophil/lymphocyte (NLR), platelet/lymphocyte (PLR), and lymphocyte/monocyte (LMR)) and clinical variables were collected and analyzed from 398 ESCC patients at Shandong Cancer Hospital between 2015 and 2019. The nomogram was then established for predicting STO.

Results: Pre-ALC and pre-LMR significantly increased, pre-NLR and pre-PLR significantly decreased during radiotherapy or chemoradiotherapy (all P < 0.001). Meanwhile, there was a positive correlation between delta-NLR as well as delta-PLR (r = 0.621) and delta-LMR (r = 0.613), whereas a negatively correlated between delta-LMR and delta-PLR (r = -0.573). Multivariate analysis indicated that gender [OR, 0.473; 95%CI, 0.274-0.816; P = 0.007], pre-ALC [OR, 0.554; 95%CI, 0.335-0.915; P = 0.021], pre-NLR [OR, 3.176; 95%CI, 1.733-5.823; P < 0.001], post-NLR [OR, 2.418; 95%CI, 1.271-4.600; P = 0.007] and delta-NLR [OR, 1.929; 95%CI, 1.035-3.595; P = 0.039] were statistically significant with STO. And c-index of the nomogram established by combining all independent predictors for STO was 0.770 [95%CI, 0.719-0.820].

Conclusion: Pre-NLR, pre-ALC, post-NLR, and delta-NLR were significant with STO in ESCC patients treated with radiotherapy or chemoradiotherapy. Further, pre-NLR had the best predictive value, and the developed nomogram with superior prediction ability for STO could assist in patients counseling and guide to make individual treatments.
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http://dx.doi.org/10.1016/j.intimp.2020.107178DOI Listing
January 2021

Video-assisted thoracoscopic surgery lobectomy might be a feasible alternative for surgically resectable pathological N2 non-small cell lung cancer patients.

Thorac Cancer 2021 01 18;12(1):21-29. Epub 2020 Nov 18.

Department of Thoracic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.

Background: The majority of previous studies of the clinical outcome of video-assisted thoracoscopic surgery (VATS) versus open lobectomy for pathological N2 non-small cell lung cancer (pN2 NSCLC) have been single-center experiences with small patient numbers. The aim of this study was therefore to investigate these procedures but in a large cohort of Chinese patients with pathological N2 NSCLC in real-world conditions.

Methods: Patients who underwent lobectomy for pN2 NSCLC by either VATS or thoracotomy were retrospectively reviewed from 10 tertiary hospitals between January 2014 and September 2017. Perioperative outcomes and overall survival of the patients were analyzed. Cox regression analysis was performed to identify potential prognostic factors. Propensity-score analysis was performed to reduce cofounding biases and compare the clinical outcomes between both groups.

Results: Among 2144 pN2 NSCLC, 1244 patients were managed by VATS and 900 by open procedure. A total of 305 (24.5%) and 344 patients died during VATS and the thoracotomy group during a median follow-up of 16.7 and 15.6 months, respectively. VATS lobectomy patients had better overall survival when compared with those undergoing the open procedure (P < 0.0001). Multivariate COX regression analysis showed VATS lobectomy independently favored overall survival (HR = 0.75, 95% CI: 0.621-0.896, P = 0.0017). Better perioperative outcomes, including less blood loss, shorter drainage time and hospital stay, were also observed in patients undergoing VATS lobectomy (P < 0.05). After propensity-score matching, 169 patients in each group were analyzed, and no survival difference were found between the two groups. Less blood loss was observed in the VATS group, but there was a longer operation time.

Conclusions: VATS lobectomy might be a feasible alternative to conventional open surgery for resectable pN2 NSCLC.

Key Points: Significant findings of the study: VATS lobectomy has comparative OS in pN2 NSCLC versus open procedure in resectable patients.

What This Study Adds: VATS lobectomy might be feasible for pN2 NSCLC.
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http://dx.doi.org/10.1111/1759-7714.13680DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779187PMC
January 2021

Acupoint Injection for Nonspecific Chronic Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Studies.

Evid Based Complement Alternat Med 2020 28;2020:3976068. Epub 2020 Oct 28.

Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, Yunnan, China.

Introduction: Nonspecific chronic low back pain (NCLBP) became a public health and economic problem. Acupoint injection was used widely for patients with NCLBP. However, there were inconsistent results on the efficacy for these people. Therefore, this review was performed to systematically assess the efficacy and safety of acupoint injection.

Materials And Methods: The literature sources were collected via EMBASE, Medline, CENTRAL, CINAHL, CNKI, VIP, Wanfang, and Sino-Med Database from their inception to October 13, 2019. Endnote X7, widely used document management software, was used to manage and screen the literature sources. Each record was screened according to the predetermined inclusion criteria by two review authors independently. Quality assessment tool, "Risk of table," was used to assess the quality of the included studies according to the recommendation of the . Data extraction was performed by one reviewer and verified by another reviewer. Any disagreement was addressed via consulting with a third reviewer in the abovementioned processes. All procedures were performed according to the .

Results: This review included 13 studies involving 1381 patients with NCLBP. Quantitative analysis results indicated that there is no sufficient evidence that acupoint injection can improve the pain of patients with low back pain based on two trails: Visual Analogue Scale (VAS: MD = -1.33, 95% confidence interval (95% CI) -3.30 to 0.64, =0.18, random-effect model). When assessing the effectiveness of acupoint injection therapy, the results indicated that acupoint injection can improve the effective rate for nonspecific chronic low back pain (OR = 3.64, 95% CI 2.4 to 5.21, < 0.0001, fixed-effect model).

Conclusion: There is insufficient evidence to indicate that acupoint injection therapy could improve the pain for patients with NCLBP. However, the level of evidence was downgraded to "very low quality" because of the poor methodological quality and clinical heterogeneity. The results should be interpreted with caution. Higher quality RCTs with more appropriate comparison, more objective outcome instruments, and adequate follow-up periods are necessary to assess the efficacy of acupoint injection for NCLBP. The PROSPERO Research registration identifying number is CRD42019119158.
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http://dx.doi.org/10.1155/2020/3976068DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7641697PMC
October 2020

Reproductive Outcomes of In Vitro Fertilization-Intracytoplasmic Sperm Injection after Transcervical Resection of Adhesions: A Retrospective Cohort Study.

J Minim Invasive Gynecol 2020 Nov 12. Epub 2020 Nov 12.

Center for Reproductive Medicine, Cheeloo College of Medicine (Drs. Yao, Yu, Y. Zhang, and Yan). Electronic address:

Study Objective: To investigate pregnancy and obstetric outcomes of patients with intrauterine adhesions (IUAs) after treatment with in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) and fresh embryo transplantation after transcervical resection of adhesions (TCRA).

Design: Retrospective cohort study.

Setting: University-based reproductive medical center.

Patients: A total of 535 patients with IUAs and with a history of TCRA and 1605 matched patients without a history of IUAs underwent IVF-ICSI and received fresh embryo transfers.

Interventions: Between January 2014 and December 2018, all patients underwent IVF-ICSI treatment and received fresh embryo transfers.

Measurements And Main Results: The patients in the TCRA group were matched with the control group according to strict criteria. Pregnancy and obstetric outcomes were compared. There were no significant differences in clinical pregnancies, ectopic pregnancies, live births, preterm births, and obstetric outcomes between the 2 groups (p >.05). However, the TCRA group had a higher risk of miscarriage than the control group (p = .048).

Conclusion: TCRA improved the reproductive outcomes of patients with IUAs, but the risk of miscarriage was higher than that in the general population. To avoid miscarriage, careful monitoring is critical for pregnant patients with a history of TCRA who undergo embryo transfers during IVF treatment.
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http://dx.doi.org/10.1016/j.jmig.2020.10.029DOI Listing
November 2020

Randomized, double-blinded and placebo-controlled phase II trial of an inactivated SARS-CoV-2 vaccine in healthy adults.

Clin Infect Dis 2020 Nov 9. Epub 2020 Nov 9.

Institute of Medical Biology, Chinese Academy of Medicine Science & Peking Union Medical College, Yunnan Key Laboratory of Vaccine Research and Development for Severe Infectious Diseases, Kunming, China.

Background: We evaluated an inactivated SARS-CoV-2 vaccine for immunogenicity and safety in adults aged 18-59 years.

Methods: In this randomized, double-blinded and controlled trial, healthy adults received a medium (MD) or a high dose (HD) of the vaccine at an interval of either 14 days or 28 days. Neutralizing antibody (NAb) and anti-S and anti-N antibodies were detected at different times, and adverse reactions were monitored for 28 days after full immunization.

Results: A total of 742 adults were enrolled in the immunogenicity and safety analysis. Among subjects in the 0, 14 procedure, the seroconversion rates of NAb in MD and HD groups were 89% and 96% with GMTs of 23 and 30, respectively, at day 14 and 92% and 96% with GMTs of 19 and 21, respectively at day 28 after immunization. Anti-S antibodies had GMTs of 1883 and 2370 in MD and 2295 and 2432 in HD group. Anti-N antibodies had GMTs of 387 and 434 in MD group and 342 and 380 in HD group. Among subjects in the 0, 28 procedure, seroconversion rates for NAb at both doses were both 95% with GMTs of 19 at day 28 after immunization. Anti-S antibodies had GMTs of 937 and 929 for MD and HD group, and anti-N antibodies had GMTs of 570 and 494 for MD and HD group, respectively. No serious adverse events were observed during the study period.

Conclusion: Adults vaccinated with inactivated SARS-CoV-2 vaccine had NAb as well as anti-S/N antibody, and had a low rate of adverse reactions.

Clinical Trials Registration: NCT04412538.
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http://dx.doi.org/10.1093/cid/ciaa1703DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7717222PMC
November 2020

Total Lung-sparing Surgery for Tracheobronchial Low-grade Malignancies.

Ann Thorac Surg 2020 Oct 20. Epub 2020 Oct 20.

Thoracic-Surgery Unit, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy.

Background: Total lung-sparing tracheobronchial sleeve resections are a step forward in the treatment of low-grade bronchial tumors in which minimal resection margins are required to achieve complete control of the disease.

Methods: This study retrospectively collected data on patients who underwent total lung-sparing procedures for low-grade tracheobronchial tumors at 2 thoracic surgical centers from January 1984 to October 2019.

Results: The study included 98 patients, 46 -female (47%) and 52 -male (53%), with a median age of 39 years (range, 7 to 70 years). Thirty-four patients underwent operative endoscopy before surgery (32 had laser treatment, and 2 had endobronchial stenting). The surgical resections were as follows: 9 (9%), tracheal carina; 18 (18%), second carina; 31 (32%), left main bronchi; 25 (26%), right main bronchi; and 15 (15%), intermediate bronchus. The median length of the resected bronchus was 2.2 cm. The median postoperative in-hospital stay was 8 days, and no perioperative mortality was observed. Postoperative complications were recorded in 26-patients (27%). The final histologic classification was as follows: 37 typical carcinoids (38%); 10 atypical carcinoids (10%); 29 adenoid cystic carcinomas (30%); 15 mucoepidermoid carcinomas (15%); 6 inflammatory myofibroblastic tumors (6%); and 1 glomic tumor (1%). Twenty-two patients had positive resection margins and underwent adjuvant radiotherapy. Three patients with adenoid cystic carcinoma had recurrences (1 local and 2 systemic). After a median follow-up time of 54.5 months (range, 4 to 360 months), the overall actuarial 5-year survival was 97%.

Conclusions: Total lung-sparing tracheobronchial sleeve resection for low-grade malignant disease requires advanced surgical skills, but the hospital morbidity and mortality are very low. This technique is adequate and safe for highly selected patients with low-grade endobronchial malignant diseases, and its use should be encouraged in experienced centers.
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http://dx.doi.org/10.1016/j.athoracsur.2020.08.035DOI Listing
October 2020