This randomized, phase 3 trial compared the effectiveness of roxadustat, an oral hypoxia-inducible factor prolyl hydroxylase inhibitor, with epoetin alfa in patients undergoing hemodialysis or ...peritoneal dialysis in China. Oral roxadustat was noninferior to parenteral epoetin alfa as therapy for anemia.
The long-term outcome of 1390 children with acute lymphoblastic leukemia (ALL), treated in two successive clinical trials (Taiwan Pediatric Oncology Group (TPOG)-ALL-97 and TPOG-ALL-2002) between ...1997 and 2007, is reported. The event-free survival improved significantly (P=0.0004) over this period, 69.3+/-1.9% in 1997-2001 to 77.4+/-1.7% in 2002-2007. A randomized trial in TPOG-97 testing L-asparaginase versus epidoxorubicin in combination with vincristine and prednisolone for remission induction in standard-risk (SR; low-risk) patients yielded similar outcomes. Another randomized trial, in TPOG-2002, showed that for SR patients, two reinduction courses did not improve long-term outcome over one course. Decreasing use of prophylactic cranial irradiation in the period 1997-2008 was not associated with increased rates of CNS relapse, prompting complete omission of prophylactic cranial irradiation from TPOG protocols, beginning in 2009. Decreased use of etoposide and cranial irradiation likely contributed to the low incidence of second cancers. High-risk B-lineage ALL, T-cell, CD10 negativity, t(9;22), infant, and higher leukocyte count were consistently adverse factors, whereas hyperdiploidy >50 was a consistently favorable factor. Higher leukocyte count and t(9;22) retained prognostic significance in both TPOG-97 and TPOG-2002 by multivariate analysis. Although long-term outcome in TPOG clinical trials is comparable with results being reported worldwide, the persistent strength of certain prognostic variables and the lower frequencies of favorable outcome predictors, such as ETV6-RUNX1 and hyperdiploidy >50, in Taiwanese children warrant renewed effort to cure a higher proportion of patients while preserving their quality of life.
Summary
Background
The role of Helicobacter pylori in the pathogenesis of peptic ulcer disease in patients with uraemia remains unclear.
Aim
To evaluate the long‐term effect of H. pylori eradication ...in these patients.
Methods
Uraemic and non‐uraemic patients with peptic ulcer were enrolled in this study. Patients having history of non‐steroidal anti‐inflammatory drugs use or cardiovascular disease that need aspirin use were excluded. After confirmation of H. pylori infection, they received a triple therapy and were followed up for 2 years.
Results
Between September 1999 and December 2005, 34 patients (41%) of the end‐stage renal disease H. pylori (+) group and 67 (84%) of the non‐uraemic patients with peptic ulcer disease (PU group) received anti‐H. pylori therapy. After triple therapy, 32 (94%) from the end‐stage renal disease group and 64 (96%) from the peptic ulcer group obtained successful eradication. During the 2‐year follow‐up, three patients in the end‐stage renal disease group were excluded because of the presence of cardiovascular disease and aspirin use in two cases and died of heart failure in one case; two patients in peptic ulcer group refused follow‐up. Finally, 29 uraemic and 62 non‐uraemic patients had achieved the follow‐up. Recurrence of peptic ulcer was more in the end‐stage renal disease group than in the peptic ulcer group with intention‐to‐treat analysis (eight of 32, 25% vs. two of 64, 3%, P = 0.001, OR: 10.0, 95% CI: 1.979–50.540) or per‐protocol analysis (eight of 29, 28% vs. two of 62, 3%, P < 0.001, OR: 11.4, 95% CI: 2.245–58.168).
Conclusions
Peptic ulcer recurrence after H. pylori eradication is higher in end‐stage renal disease patients with peptic ulcer than in peptic ulcer patients without renal disease. Factors aside from H. pylori play an important role in peptic ulcer recurrence in end‐stage renal disease patients.
Methotrexate (MTX), a folate antagonist, was developed for the treatment of malignancies, and is currently used in rheumatoid arthritis (RA) and other chronic inflammatory disorders. It has been ...proven in short-term and long-term prospective studies that low doses of MTX (0.75 mg/Kg/week) are effective in controlling the inflammatory manifestations of RA. Low-concentrations of MTX achieve apoptosis and clonal deletion of activated peripheral T cells. One of the mechanisms of the anti-inflammatory and immunosuppressive effects may be the production of reactive oxygen species (ROS). However, the drug resistance of MTX in malignancies remains poorly understood. Ornithine decarboxylase (ODC) plays an important role in diverse biological functions, including cell development, differentiation, transformation, growth and apoptosis. In our previous studies, ODC overexpression was shown to prevent TNFalpha-induced apoptosis via reducing ROS. Here, we also investigated one mechanism of MTX-induced apoptosis and of drug resistance as to the anti-apoptotic effects of ODC during MTX treatment. We found MTX could induce caspase-dependent apoptosis and promote ROS generation together with disrupting the mitochondrial membrane potential (DeltaPsim) of HL-60 and Jurkat T cells. Putrescine and ROS scavengers could reduce MTX-induced apoptosis, which leads to the loss of DeltaPsim, through reducing intracellular ROS. Overexpression of ODC in parental cells had the same effects as putrescine and the ROS scavengers. Moreover, ODC overexpression prevented the decline of Bcl-2 that maintains DeltaPsim, the cytochrome c release and activations of caspase 9 and 3 following MTX treatment. The results demonstrate that MTX-induced apoptosis is ROS-dependent and occurs along a mitochondria-mediated pathway. Overexpressed ODC cells are resistant to MTX-induced apoptosis by reducing intracellular ROS production.
Two photoalignment-based methods to achieve orientational control of optical diffractions by cholesteric liquid crystal (CLC) fingerprint gratings are proposed and demonstrated. A trace of methyl red ...in the CLC host can effectively induce surface alignment upon linearly polarized green exposure and enable optically rewritable alignment. An effective rotation of the photo-aligned CLC grating is attained by changing the surface alignment axis. Using axially symmetric photoalignment, electrically tunable radial and concentric gratings are also realized. 1D grating diffraction is produced by operating off-axis and can be rotated by mechanically moving the axially symmetric grating. Such optical gratings have great potential for practical use in vibration detection, multi-directional optical modulations, and beam steering.
This article reviews the technical applicability and the treatment performance of various advanced oxidation technologies (AOTs) for landfill leachate. A particular focus is given to ozonation, ...homogeneous systems without irradiation (Fe
2+/H
2O
2, O
3/H
2O
2) and homogeneous systems with irradiation (UV/O
3, UV/H
2O
2, UV/O
3/H
2O
2, photo-Fenton oxidation). Their advantages and limitations in application are evaluated. The formation of
OH radicals in enhancing oxidation reactions is also elaborated. Selected information such as the pH, the dose of oxidants required, the characteristics of leachate in terms of COD and NH
3-N concentration and treatment performance is presented. It is evident from a review of 167 papers (1976–2005) that none of the individual AOTs is universally applicable or highly effective for leachate treatment. Among the individual AOTs reviewed, ozonation and/or Fenton oxidation are the most frequently studied and widely applied for leachate treatment. Both treatments are effective for 40–89% of COD removal with its concentrations ranging from 560 to 8894
mg/L. By combining the Fenton oxidation and coagulation–flocculation process, about 69–90% of COD removal with its concentrations ranging from 417 to 7400
mg/L was achieved. An almost complete COD removal (98%) was attained by combining the activated sludge (AS) and the Fenton oxidation (COD: 7000
mg/L) and/or the AS and wet air oxidation (WAO) (COD: 4140
mg/L). In general, the selection of the most suitable AOT for leachate treatment depends on the leachate characteristics, technical applicability and potential constraints, effluent discharge standard, cost-effectiveness, regulatory requirements and long-term environmental impacts.
Summary
Evidence from our previous study suggested that the incidence of germ cell neoplasms in children and adolescents is increasing. The objectives of this analysis were to quantify this trend in ...patients aged 0–9 and 10–19 years (pre‐pubertal and adolescent groups, respectively) and compare rates in Taiwan according to geographic distribution. Germ cell neoplasm frequencies among 1267 patients aged 0–19 years spanning 1995–2009 were obtained from the population‐based Taiwan Cancer Registry. The incidence patterns according to sex, age, disease subgroup, and geographic distribution were analyzed. The incidence rates in the pre‐pubertal and adolescent groups were 10.58 and 16.06 per million person‐years, respectively. The overall rates increased significantly by 3.2% annually in the adolescent group during the 15‐year study period, and increased only among the males. In contrast, no change in trend was observed in the pre‐pubertal group. Subgroup analysis showed significant upward trends in the incidence rates of intracranial/intraspinal and testicular germ cell tumors (GCTs) in the adolescent males and extracranial/extragonadal GCTs in the pre‐pubertal boys. The most striking differences between the study population and white Americans were that the rates of testicular GCTs were 5‐fold higher and 4‐fold lower in the Taiwanese pre‐pubertal and adolescent groups, respectively. Significantly higher rates were found in Hualien and Chiayi Counties compared with the other areas of Taiwan. The upward trend of testicular GCTs in the adolescent males is consistent with findings from Western countries. The underlying causes that led to the high rate of testicular GCTs in the pre‐pubertal boys and significantly higher rates in specific counties warrant further investigation.
This work proposes an optically controllable beam-steering device, fabricated using cholesteric liquid crystals (CLCs) that are doped with azobenzene. The trans-cis photoisomerization of azobenzene ...changes the pitch of the CLC fingerprint structure and shifts the diffraction angle. The diffraction angle increases when the cell is irradiated with UV light, and restored when it is irradiated with green light. Combining the photoisomerization effect with electrical effect, the CLC beam-steering device provides a steering angle of approximately 19 degrees. The tuning is continuous and could be completed within a few seconds.
Viral infections are known to adversely affect pregnancy, but scant attention has been given to human papilloma virus (HPV) infection. We aimed to determine the molecular and histopathological ...features of placental HPV infection, in association with pregnancy complications including fetal growth restriction, pre-maturity, pre-eclampsia, and diabetes. Three hundred and thirty-nine placentae were selected based on the presence or absence of pregnancy complications. Five independent methods were used to identify HPV in the placenta, namely, immunohistochemistry for L1 viral capsid, in situ hybridization to high-risk HPV DNA, PCR, western blotting, and transmission electron microscopy. Pregnancy complications and uterine cervical smear screening results were correlated with placental HPV histopathology. In this study, which was deliberately biased towards complications, HPV was found in the decidua of 75% of placentae (253/339) and was statistically associated with histological acute chorioamnionitis (P<0.05). In 14% (35/253) of the HPV positive cases, HPV L1 immunoreactivity also occurred in the villous trophoblast where it was associated with a lymphohistiocytic villitis (HPV-LHV), and was exclusively of high-risk HPV type. HPV-LHV significantly associated with fetal growth restriction, preterm delivery, and pre-eclampsia (all P<0.05). All cases of pre-eclampsia (20/20) in our cohort had high-risk placental HPV. A further 55 cases (22%, 55/253) of HPV positive placentae had minimal villous trophoblast HPV L1 immunoreactivity, but a sclerosing pauci-immune villitis, statistically associated with diabetes (49.1%, 27/55, P<0.05). For women with placental HPV, 33% (69/207) had an HPV-related positive smear result before pregnancy compared with (9.4% 8/85) of women with HPV-negative placentae (P=0.0001). Our findings support further investigations to determine if vaccination of women and men will improve pregnancy outcomes.
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