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关键词： Primary renal tumour   Renal cell carcinoma   Nivolumab   Cytoreductive nephrectomy   Immune checkpoint inhibitors  

摘要： Primary tumour response may impact therapeutic strategies in metastatic renal cell carcinoma (mRCC) but remains unknown in the era of immune checkpoint inhibitors. We aimed to describe the response of the primary tumour in patients who did not undergo upfront cytoreductive nephrectomy (uCN) and were treated with nivolumab in the GETUG-AFU-26 NIVOREN phase 2 trial. Primary tumour response was prospectively assessed, as well as the overall response rate (ORR), progression-free survival (PFS), and overall survival (OS). Among 720 patients, 111 did not undergo uCN, mainly patients with intermediate (45%) and poor (49%) International mRCC Database Consortium (IMDC) risk. In the 111 patients, nivolumab was used in the second line for 63% of patients and the third line or more for 37%, with an ORR of 16% (95% confidence interval ICI] 1025%);with a median follow-up of 24.5 mo (95% CI 21.6-27.1), median PFS was 2.7 mo (95% CI 2.5-4.0) and median OS was 15.9 mo (95% CI 9.5-19.8). A total of 67 patients had an evaluable primary renal lesion, four of whom (6%) experienced shrinkage of more than 30%. Overall, patients who did not undergo uCN had adverse baseline characteristics and nivolumab activity against the primary tumour was limited. Patient summary: In this report, we observed that nivolumab was associated with a limited response of the primary tumour in previously treated patients with metastatic kidney cancer. (c) 2021 Published by Elsevier B.V. on behalf of European Association of Urology.

关键词： arborizing vessels   basal cell carcinoma   BCC   blue-white veil   concentric structures   corkscrew vessels   dermatoscopy   dermoscopy   dotted vessels   glomerular vessels   hairpin vessels   infiltrative basal cell carcinoma   large blue-grey ovoid nests   leaf-like areas   morpheaform basal cell carcinoma   multiple blue-grey dots and globules   multiple in-focus dots   multiple small erosions   nodular basal cell carcinoma   nonpigmented basal cell carcinoma   pigmented basal cell carcinoma   polymorphous vessels   rosettes   shiny white structures   shiny white-red structureless background   short-fine telangiectasia   spoke wheel areas   superficial basal cell carcinoma   ulceration  

摘要： Background: Multiple studies have reported on dermoscopic structures in basal cell carcinoma (BCC) and its subtypes, with varying results. Objective: To systematically review the prevalence of dermoscopic structures in BCC and its subtypes. Methods: Databases and reference lists were searched for relevant trials according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were assessed for the relative proportion of BCC dermoscopic features. Random-effects models were used to estimate summary effect sizes. Results: Included were 31 studies consisting of 5950 BCCs. The most common dermoscopic features seen in BCC were arborizing vessels (59%), shiny white structures (49%), and large blue-grey ovoid nests (34%). Arborizing vessels, ulceration, and blue-grey ovoid nests and globules were most common in nodular BCC;short-fine telangiectasia, multiple small erosions, and leaf-like, spoke wheel and concentric structures in superficial BCC;porcelain white areas and arborizing vessels in morpheaform BCC;and arborizing vessels and ulceration in infiltrative BCC. Limitations: Studies had significant heterogeneity. Studies reporting BCC histopathologic subtypes did not provide clinical data on pigmentation of lesions. Conclusion: In addition to arborizing vessels, shiny white structures are a common feature of BCC. A constellation of dermoscopic features may aid in differentiating between BCC histopathologic subtypes.

关键词： Primary mediastinal B cell lymphoma   MACOP-B   Rituximab   Radiotherapy   Checkpoint inhibitor  

摘要： Primary mediastinal B cell lymphoma is a rare entity and often should be promptly treated as a hematological emergency: The initial treatment decision is crucial for the management of this disease. An observational retrospective study was conducted with the aim to improve information on treatment and outcomes of primary mediastinal B cell lymphoma in real practice. After 12 cycles of MACOP-B regimen (methotrexate, doxorubicin, cyclophosphamide, vincristine, , and prednisone) with or without rituximab, 120 patients out of 151 (79.5%) achieved a complete response and 12 (7.9%) a partial response leading to a global response of 87.4%. The 21-year overall survival is 82.6%;progression-free and disease-free survivals are 69.3% and 86.4%, respectively. Regarding the role of radiotherapy (RT), patients with a negative PET scan after MACOP-B did not undergo RT: One out of these 48 (2.1%) showed a relapse at 11 months. All relapsed/refractory patients who achieved a response with checkpoint inhibitors are still in continuous complete response with a median follow-up of 14 months. Data that we have gathered over a 30-year experience in the treatment of primary mediastinal B cell lymphoma patients clearly indicate that a third-generation chemotherapy regimen such as MACOP-B is feasible and easily deliverable on an outpatient basis. Regarding the unmet medical need of relapsed/refractory patients, new encouraging results occurred with the advent of the checkpoint inhibitors.

关键词： non-viral delivery   Solupore   CAR T   CRISPR   CD19 CAR   TRAC  

摘要： Background aims: Next-generation immune cell therapy products will require complex modifications using engineering technologies that can maintain high levels of cell functionality. Non-viral engineering methods have the potential to address limitations associated with viral vectors. However, while electroporation is the most widely used non-viral modality, concerns about its effects on cell functionality have led to the exploration of alternative approaches. Here the authors have examined the suitability of the Solupore non-viral delivery system for engineering primary human T cells for cell therapy applications. Methods: The Solupore system was used to deliver messenger RNA (mRNA) and clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) guide RNA ribonucleoprotein (RNP) cargos to T cells, and efficiency was measured by flow cytometry. Cell perturbation was assessed by immune gene expression profiling, including an electroporation comparator. In vitro and in vivo cytotoxicity of chimeric antigen receptor (CAR) T cells generated using the Solupore system was evaluated using a realtime cellular impedance assay and a Raji-luciferase mouse tumor model, respectively. Results: Efficient transfection was demonstrated through delivery of mRNA and CRISPR CAS9 RNP cargos individually, simultaneously and sequentially using the Solupore system while consistently maintaining high levels of cell viability. Gene expression profiling revealed minimal alteration in immune gene expression, demonstrating the low level of perturbation experienced by the cells during this transfection process. By contrast, electroporation resulted in substantial changes in immune gene expression in T cells. CART cells generated using the Solupore system exhibited efficient cytotoxicity against target cancer cells in vitro and in vivo. Conclusions: The Solupore system is a non-viral means of simply, rapidly and efficiently delivering cargos to primary huma

摘要： Aims Insulin degludec/aspart (IDegAsp) and insulin glargine U300 (IGlarU300) have recently emerged as popular new-generation insulin analogues. The aim of this real-life study was to investigate the patient profiles in which IGlarU300 and IDegAsp were preferred and the insulin combinations after which each of them were mostly used and also to analyse the effect of these two insulin analogues on blood glucose regulation and hypoglycaemia. Materials and Methods The retrospective study included 174 patients that were switched from basal insulin, basal-bolus insulin, or premixed insulin to IGlarU300 or IDegAsp due to uncontrolled blood glucose levels or history of hypoglycaemia. Hypoglycaemia, body weight, body mass index (BMI), fasting plasma glucose (FPG) and HbA1c levels over 3-month periods were evaluated for each patient. Results There were 84 and 90 patients in the IGlarU300 and IDegAsp groups, respectively. Body weight was similar in both groups. Baseline FPG and HbA1c levels in the IGlarU300 and IDegAsp groups were 9.0%, 175.5 mg/dL and 9.4%, 193.5 mg/dL, respectively. A significant decrease was found in FPG and HbA1c levels in both groups (138.5, 7.8 vs 141.5, 8.2;P < .001 for all). Moreover, a significant weight gain was observed in both groups (P < .05 for both). The prevalence of hypoglycaemia in both groups decreased significantly and consistently between months 1 and 9 (P < .001). At month 12, although this decrease continued in the IGlarU300 group (P = .013), no significant decrease was observed in the IDegAsp group (P = .057). Conclusion Both twice-daily IDegAsp +/- bolus insulin and IGlarU300 basal bolus insulin therapies are effective and safe treatment modalities.

关键词： anaplastic large cell lymphoma   anaplastic lymphoma kinase   CD30   central nervous system   primary central nervous system lymphoma   prognostic factors  

摘要： Simple Summary Primary anaplastic large cell lymphoma (ALCL) of the central nervous system (CNS) is a subtype of primary central nervous system lymphoma (PCNSL). ALCL is divided into anaplastic lymphoma kinase (ALK)-positive ALCL and ALK-negative ALCL, according to ALK expression. ALK-positive cancers tend to develop at a younger age and tend to have a better prognosis. Almost all past articles on primary ALCL of the CNS have been case reports and there have been no randomized trials or cohort studies on this subject. We thus performed a systematic review of primary ALCL of the CNS. According to the author's survey, 36 case reports have been published in English-language journals. In this paper, we have summarized the clinical features and prognostic factors for primary ALCL of the CNS based on previous studies. Primary anaplastic large cell lymphoma (ALCL) of the central nervous system (CNS) is a subtype of primary CNS lymphoma (PCNSL). There are very few comprehensive reports on this extremely rare tumor. Therefore, it is necessary to investigate the clinical features and prognostic factors for primary ALCL of the CNS. We performed a systematic review of the published literature. Past cases were comprehensively searched using PubMed, Cochrane Library, and Web of Science. Clinical information, such as age, sex, anaplastic lymphoma kinase (ALK) status, lesion sites, treatment methods, and survivorship were extracted. Thirty-nine cases with information on ALK status and treatment course were identified. The average observation period was 13 months, and the overall 2-year survival rate was 58%. Univariate analyses showed a statistically significantly better prognosis among patients < 40 years of age (p = 0.039, HR 0.32 (0.11-0.95)) and in relation to ALK positivity (p = 0.010, HR 0.24 (0.08-0.71) and methotrexate treatment (p = 0.003, HR 0.17 (0.05-0.56)). Because of the sparsity of cases, it is necessary to accumulate cases in order to perform more detailed analyses.

关键词： chemotherapy   human papilloma virus   oropharyngeal carcinoma   radiotherapy   Transoral Robotic Surgery  

摘要： Objectives To analyse the oncological outcomes following primary Transoral Robotic Surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC). Design Observational case series. Setting Tertiary centre;first TORS practice to commence in the UK. Participants All consecutive patients undergoing primary TORS with curative intent, with or without adjuvant treatment. Main outcome measures Descriptive analysis of patient and tumour pathology variables. Survival outcomes: Overall, Disease-Specific, Progression-Free and Locoregional control. Results The cohort comprised of 120 patients undergoing TORS with minimum 12-month follow-up data and the following characteristics: mean age 58 years, 91 males (76%), 78 tonsil (65%) and 34 base of tongue primaries (28%), 89% HPV-related OPSCC. The surgical pathology revealed 14 (12%) with positive margins, 19 (16%) had close margins <2mm and 31% with extranodal extension. The treatment was as follows: 39 (33%) treated with TORS alone, 50 (42%) received adjuvant radiotherapy and 31 (26%) received adjuvant radiotherapy with chemotherapy. There were 15 recurrences. Estimated survival for all patients at 3 years (95% CI): overall 85% (78-92), disease-specific 90% (85-96), progression-free 86% (79-92) and locoregional control 90% (84-96). The equivalent survival figures for the HPV-related cases alone were as follows: overall 88% (82-94), disease-specific 93% (87-98), progression-free 88% (81-95) and locoregional control 92% (87-98). Conclusions Whilst TORS has become a common practice in the management of OPSCC in the UK, these are the first reported oncological outcomes. For selected patients, TORS with or without adjuvant therapy is an appropriate treatment modality.

关键词： convolutional neural networks (CNN)   unet   machine learning   semantic segmentation   demosponge behavior   classification   time series   deep learning   image analysis  

摘要： Biological data sets are increasingly becoming information-dense, making it effective to use a computer science-based analysis. We used convolution neural networks (CNN) and the specific CNN architecture Unet to study sponge behavior over time. We analyzed a large time series of hourly high-resolution still images of a marine sponge, Suberites concinnus (Demospongiae, Suberitidae) captured between 2012 and 2015 using the NEPTUNE seafloor cabled observatory, off the west coast of Vancouver Island, Canada. We applied semantic segmentation with the Unet architecture with some modifications, including adapting parts of the architecture to be more applicable to three-channel images (RGB). Some alterations that made this model successful were the use of a dice-loss coefficient, Adam optimizer and a dropout function after each convolutional layer which provided losses, accuracies and dice scores of up to 0.03, 0.98 and 0.97, respectively. The model was tested with five-fold cross-validation. This study is a first step towards analyzing trends in the behavior of a demosponge in an environment that experiences severe seasonal and inter-annual changes in climate. The end objective is to correlate changes in sponge size (activity) over seasons and years with environmental variables collected from the same observatory platform. Our work provides a roadmap for others who seek to cross the interdisciplinary boundaries between biology and computer science.

关键词： lacrimal gland   myoepithelial cells   muscarinic   purinergic   rat  

摘要： PURPOSE. The functional characteristics of receptors that regulate lacrimal gland myoepithelial cells are still somewhat unclear. To date, mainly muscarinic receptors have been of interest;however, further knowledge is needed regarding their expression and functional roles. For this purpose, primary cultures of rat lacrimal gland myoepithelial cells were established and examined functionally. METHODS. Rat lacrimal glands were excised, minced, and further digested, yielding mixtures of cells that were seeded in culturing flasks. After 4-6 weeks, primary monocultures of myoepithelial cells were established, verified by immunocytochemistry. The cells were stained for all muscarinic receptor subtypes (M1-M5) and examined functionally regarding intracellular [Ca2+] responses upon activation of muscarinic receptors. For methodological verification, purinergic functional responses were also studied. RESULTS. Expression of muscarinic receptor subtypes M2-M5 was detected, whereas expression of muscarinic M1 receptors could not be shown. Activation of muscarinic receptors by the non-selective muscarinic agonist methacholine (3 x 10(-11)-10(-3) M) did not cause a significant increase in intracellular [Ca2+]. However, activation of purinergic receptors by the non-selective purinergic agonist ATP (10-8-10-3 M) caused a concentration-dependent increase in intracellular [Ca2+] that could be blocked by the P2 antagonists PPADS and suramin. CONCLUSIONS. Primary cultures of rat lacrimal gland myoepithelial cells were established that displayed a heterogeneous expression of muscarinic receptors. Purinergic functional responses demonstrated a viable cell population. Upon treatment with methacholine, no significant increase in intracellular [Ca2+] could be detected, indicating that cholinergic activation of myoepithelial cells occurs via other intracellular messengers or is dependent on interaction with other cell types.

关键词： Autohaemotherapy   Gold therapy   Corneal wound healing   Human corneal epithelial cells  

摘要： Background: Wound healing disorders characterised by impaired or delayed reepithelialisation are a serious medical problem. In the present study, we show that gold-based blood serum therapy is a suitable therapeutic approach and shows a supportive effect in wound closure of human corneal epithelial cells (HCE) in primary in vitro experiments. Methods: For this purpose, blood from healthy individuals was incubated without (***) or with gold-microparticles (***) for 24 h. Prior to human epithelial cell stimulation (HCE), the gold particles were removed and the serum was diluted in DMEM (10 % or 30 %). Both groups of serum were compared after injury. HCE were cultured and injured (corneal in vitro wound model) and then stimulated with *** or ***. Results: Treatment with serum from a gold-based serum therapy (***) shows a supportive effect on wound healing in HCE cells in vitro. In addition, gold therapy supports the secretion of important cytokines normally associated with ocular surface wound healing (IL-1 beta, IL-6, TNF-alpha and TGF-beta) in HCE cells. Conclusions: Therapy with gold-based blood serum significantly promotes the secretion and expression of cytokines and growth factors in HCE cells in vitro. Further preclinical experiments are necessary to demonstrate the influence of this therapy on HCE cells for possible clinical application on the human ocular surface and to prove its function also in poorly healing corneal lesions. (C) 2021 Elsevier GmbH. All rights reserved.