Exosomes serve as tumour markers for personalized diagnostics owing to their important role in cancer metastasis

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License CC BY-NC 4.0 ( http://creativecommons.org/licenses/by-nc/4.0/ ), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.Exosomes, membrane vesicles of 40-100 nm in diameter, are derived from endosomes in various cells. The bioactive molecules specifically packed into exosomes can be horizontally transferred into recipient cells changing their biological properties, by which tumour cells continuously modify their surrounding microenvironment and distant target cells favouring cancer metastasis. It has been suspected for a long time that exosomes participate in the whole process of tumour metastasis. Although there is much unknown and many controversies in the role of cancer exosome, the major contribution of tumour-associated exosomes to different steps of cancer metastasis are demonstrated in this review. Mainly because these exosomes are easily accessible and capable of representing their parental cells, exosomes draw much attention as a promising biomarker for tumour screening, diagnosis and prognosis. Currently, researchers have found numerous biomarkers in exosomes with great potential to be utilized in personalized medicine. In this article, we summarize the roles of biomarkers, which are validated by clinical samples. Even though many conundrums remain, such as exosome extraction, large multicentre validation of biomarkers and data interpretation, exosomes are certain to be used in clinical practice in the near future as the field rapidly expands.Peer reviewedFinal Published versio

Artificial disc and vertebra system: a novel motion preservation device for cervical spinal disease after vertebral corpectomy

OBJECTIVE: To determine the range of motion and stability of the human cadaveric cervical spine after the implantation of a novel artificial disc and vertebra system by comparing an intact group and a fusion group. METHODS: Biomechanical tests were conducted on 18 human cadaveric cervical specimens. The range of motion and the stability index range of motion were measured to study the function and stability of the artificial disc and vertebra system of the intact group compared with the fusion group. RESULTS: In all cases, the artificial disc and vertebra system maintained intervertebral motion and reestablished vertebral height at the operative level. After its implantation, there was no significant difference in the range of motion (ROM) of C3-7 in all directions in the non-fusion group compared with the intact group (p>;0.05), but significant differences were detected in flexion, extension and axial rotation compared with the fusion group (

Derivation and validation of a prognostic model for predicting in-hospital mortality in patients admitted with COVID-19 in Wuhan, China:the PLANS (platelet lymphocyte age neutrophil sex) model

Background Previous published prognostic models for COVID-19 patients have been suggested to be prone to bias due to unrepresentativeness of patient population, lack of external validation, inappropriate statistical analyses, or poor reporting. A high-quality and easy-to-use prognostic model to predict in-hospital mortality for COVID-19 patients could support physicians to make better clinical decisions. Methods Fine-Gray models were used to derive a prognostic model to predict in-hospital mortality (treating discharged alive from hospital as the competing event) in COVID-19 patients using two retrospective cohorts (n = 1008) in Wuhan, China from January 1 to February 10, 2020. The proposed model was internally evaluated by bootstrap approach and externally evaluated in an external cohort (n = 1031). Results The derivation cohort was a case-mix of mild-to-severe hospitalized COVID-19 patients (43.6% females, median age 55). The final model (PLANS), including five predictor variables of platelet count, lymphocyte count, age, neutrophil count, and sex, had an excellent predictive performance (optimism-adjusted C-index: 0.85, 95% CI: 0.83 to 0.87; averaged calibration slope: 0.95, 95% CI: 0.82 to 1.08). Internal validation showed little overfitting. External validation using an independent cohort (47.8% female, median age 63) demonstrated excellent predictive performance (C-index: 0.87, 95% CI: 0.85 to 0.89; calibration slope: 1.02, 95% CI: 0.92 to 1.12). The averaged predicted cumulative incidence curves were close to the observed cumulative incidence curves in patients with different risk profiles. Conclusions The PLANS model based on five routinely collected predictors would assist clinicians in better triaging patients and allocating healthcare resources to reduce COVID-19 fatality

Neoadjuvant chemoimmunotherapy achieved a pathologic complete response in stage IIIA lung adenocarcinoma harboring RET fusion: a case report

Neoadjuvant chemoimmunotherapy has demonstrated significant benefit for resectable non-small-cell lung cancer (NSCLC) excluding known EGFR/ALK genetic alterations. Recent evidence has shown that neoadjuvant chemoimmunotherapy could be clinically valuable in resectable localized driver gene-mutant NSCLC, though the data still lack robust support, especially for rare oncogenic mutations. Here, we report a patient with stage IIIA lung adenocarcinoma with a RET fusion gene and high expression of PD-L1 who underwent neoadjuvant chemoimmunotherapy and successfully attained a pathologic complete response. The patient has survived for 12 months with no recurrence or metastases after surgery. Our case suggests that this treatment strategy may be an alternative therapeutic option for resectable RET fusion-positive NSCLC patients

Comparative analysis of ecological carrying capacity at different scales in Xilingol League, Inner Mongolia

Coal is a vital resource in China. With limited coal and the deteriorating eco-environment, it is consensus to take the sustainable development road in coal power exploitation regions. Taking Xilingol League, Inner Mongolia as an example, based on the cascade framework constituted by the “Driver - Pressure - State - Impact - Response” (DPSIR) model, this paper aimed to analyze the ecological carrying capacity at the league (city) scale and at the banner (county) scale contrastively. It found that the overall change trend was a wide “V” type at the league (city) scale. Moreover, the ecological carrying capacity at the banner (county) scale showed that the north was superior to the central and south in 2005, 2011 and 2018. The principal component analysis (PCA) approach had been adopted to analyze the driving factors. Driving factors were economic development and coal and electricity development at the league (city) scale, as well as resource supply and urbanization development at the banner (county) scale. At the league (city) scale, the economic benefits of industrial development had improved people’s living standards, and part of the funds could be used in the investment in ecological restoration, thus improving the ecological carrying capacity; at the banner (county) scale, most counties were still coal-dependent areas, and the number of resources had a more significant impact on the ecological carrying capacity. This study provided ideas for sustainable development in energy exploitation regions at different scales

Transition-Layer Implantation for Improving Magnetoelectric Response in Co-fired Laminated Composite

Magnetoelectric (ME) laminated composites with strong ME coupling are becoming increasingly prevalent in the electron device field. In this paper, an enhancement of the ME coupling effect via transition-layer implantation for co-fired lead-free laminated composite (80Bi0.5Na0.5TiO3-20Bi0.5K0.5TiO3)/(Ni0.8Zn0.2)Fe2O4 (BNKT/NZFO) was demonstrated. A transition layer composed of particulate ME composite 0.5BNKT-0.5NZFO was introduced between the BNKT piezoelectric layer and the NZFO magnetostrictive layer, effectively connecting the two-phase interface and strengthening interface stress transfer. In particular, an optimal ME voltage coefficients (αME) of 144 mV/(cm·Oe) at 1 kHz and 1.05 V/(cm·Oe) at the resonant frequency in the composite was achieved, with a layer thickness ratio (BNKT:0.5BNKT-0.5NZFO:NZFO) of 3:1:6. The static elastic model was used to determine strong interface coupling. A large magnetodielectric (MD) response of 3.95% was found under a magnetic field excitation of 4 kOe. These results demonstrate that transition-layer implantation provides a new path to enhance the ME response in co-fired laminated composite, which can play an important role in developing magnetic field-tuned electronic devices

Numerical Simulation to Determine the Largest Confining Stress in Longitudinal Tests of Cable Bolts

Bolt support is an economic method of roadway support. However, due to the influence of mining disturbance, the stress of roadway-surrounding rock changes, thus resulting in varying degrees of confining pressure in the radial direction of bolt. In this manuscript, a numerical solution was proposed to determine the largest confining stress in longitudinal tests of cable tendons. FLAC3D was selected to simulate the longitudinal process of cable tendons. The structural pile element was selected to simulate the cable tendon. The loading behavior of the cable was controlled by the cohesive and the frictional behavior of the cable/grout surface. To confirm the credibility of this numerical solution, the loading behavior of a normal cable and an improved cable was simulated. Experimental longitudinal tests were selected to validate the numerical results, showing that there was a satisfactory agreement between numerical and experimental results. The loading behavior of normal cables and improved cables was numerically simulated. Under the same test conditions, when the improved cable was used, the confining medium can generate much higher confining stress compared with normal cable tendons. Consequently, higher confining stress can result in a larger loading capacity of cable tendons

Media 1: In vivo fast variable focus photoacoustic microscopy using an electrically tunable lens

Originally published in Optics Express on 25 August 2014 (oe-22-17-20130