Safety and efficacy of lenalidomide (Revlimid) in recurrent ovarian and primary peritoneal carcinoma

OBJECTIVES: To conduct a phase I trial to determine the safety and toxicity profile of a novel immunomodulatory drug, lenalidomide, in recurrent ovarian and primary peritoneal cancer. The secondary objective is to evaluate the efficacy profile and quality of life (QOL) parameters in patients receiving this treatment. METHODS: Patients with recurrent ovarian or peritoneal cancer who received standard staging surgery and at least one prior platinum-based chemotherapy regimen were treated with single-agent oral lenalidomide 25 mg daily for 21 days of a 28-day cycle. Toxicities were monitored by patient report, physical exam, and laboratories. Response was assessed by imaging, physical exam, and CA-125. Therapy was discontinued with disease progression and/or unacceptable toxicity. RESULTS: 20 patients with recurrent ovarian or peritoneal cancer were enrolled and received 70 completed 28-day cycles and 10 partial cycles of lenalidomide therapy. The majority of adverse events were grades 1-2, including fatigue (25/80 cycles), nausea/vomiting (23/80), constipation (13/80), abdominal pain (17/80), rash (12/80), neutropenia (12/80), and anemia (12/80). Grade 3 toxicities occurred in 12 of 80 cycles (14%) and no grade IV toxicities were observed. Eleven patients completed > or = 2 cycles and were evaluable for response. Nine achieved stable disease (SD) of at least 3 months, with four patients maintaining SD for > 6 months. The mean time to progression was 5.8 months (range 2-12 months). CONCLUSION: Overall, oral lenalidomide was well tolerated and may have some activity as a single agent in this heavily pre-treated population. Further studies combining lenalidomide with cytotoxic treatments may be warranted in this disease setting.     

Investigation of Friction and Wear Behavior of Cast Aluminum Alloy Piston Skirt with Graphite Coating Using a Designed Piston Skirt Test Apparatus

A piston skirt friction and wear apparatus that simulates the contact and the relative motion of piston and cylinder liner in a real engine has been designed and constructed. With this apparatus, the friction and wear behavior of a cast aluminum alloy piston with a graphite coating under different loads was studied, and the effectiveness of the apparatus was confirmed. The total wear of the piston skirt was higher under a higher load, and the upper part of the skirt surface (around the height of the piston pin) was worn more severely. The wear mechanisms were studied and, based on the test results and surface analyses, three main wear modes were believed to occur in the wear process of the piston skirt: abrasive, adhesive, and fatigue wear. The effects of skirt profile design, coating, and surface texturing on the friction and wear behavior of the piston skirt can be investigated well using the proposed apparatus, which can truly reflect actual working conditions and is useful to improve the tribological performances of piston skirts.     

Biological Characteristics of Infectious Laryngotracheitis Viruses Isolated in China

Infectious laryngotracheitis virus (ILTV) causes severe respiratory disease in chickens and results in huge economic losses in the poultry industry worldwide. To correlate the genomic difference with the replication and pathogenicity, phenotypes of three ILTVs isolated from chickens in China from 2016 to 2018 were sequenced by high-throughput sequencing. Based on the entire genome, the isolates GD2018 and SH2017 shared 99.9% nucleotide homology, while the isolate SH2016 shared 99.7% nucleotide homology with GD2018 and SH2017, respectively. Each virus genome contained 82 ORFs encoding 77 kinds of protein, 31 of which share the same amino acid sequence in the three viruses. GD2018 and SH2017 shared 57 proteins with the same amino acid sequence, while SH2016 shared 42 and 41 proteins with the amino acid sequences of GD2018 and SH2017, respectively. SH2016 propagated efficiently in allantoic fluid and on chorioallantoic membranes (CAMs) of SPF chicken embryo eggs, while GD2018 and SH2017 proliferated well only on CAMs. GD2018 propagated most efficiently on CAMs and LMH cells among three isolates. SH2016 caused serious clinical symptoms, while GD2018 and SH2017 caused mild and moderate clinical symptoms in chickens, although the sero of the chickens infected with those three isolates were all positive for anti-ILTV antibody at 14 and 21 days after challenge. Three ILTVs with high genetic homology showed significant differences in the replication in different culture systems and the pathogenicity of chickens, providing basic materials for studying the key determinants of pathogenicity of ILTV.     

Insights on Skin Quality and Clinical Practice Trends in Asia Pacific and a Practical Guide to Good Skin Quality from the Inside Out

ObjectiveWe sought to examine the current skin quality trends and gaps in clinical practice in the Asia Pacific region and develop a practical guide to improve skin quality.MethodsMedical practitioners from 11 countries in the Asia Pacific region completed an online survey on current trends in skin quality treatment. A panel of 12 leading experts convened for a virtual meeting to develop a practical guide for skin quality improvement.ResultsA total of 153 practitioners completed the survey. The four most common skin quality issues were uneven skin tone, skin surface unevenness, skin laxity, and sebaceous gland hyperactivity and enlarged pores. Most practitioners reported using a combination of treatment modalities for each skin quality issue. It was also observed that each treatment modality could be used to treat several skin quality issues. A multimodal approach targeting different interrelated issues across the tissue planes was recommended for balanced results. The panel developed a practical guide for the appropriate combinations and sequence of treatments, and created treatment protocols for specific skin quality outcome goals. The guide employed an “inside-out” approach, treating the deeper tissue planes prior to the superficial layers to achieve harmonious results.LimitationsFuture studies are needed to support the recommended treatment protocols for skin quality improvement.ConclusionThese findings provide valuable insights on current skin quality trends and gaps in clinical practice. The practical guide provides a framework for practitioners to customize their treatment plan according to each patient’s needs.     

原发性局灶节段性肾小球硬化预后相关因素的研究进展

近年来局灶节段性肾小球硬化（FSGS）发病率增加,且治疗困难,预后较差,是导致终末期肾疾病的主要原因之一。肾脏病学家试图探索某些指标来拟诊和预测预后,该文简述了原发性FSGS预后相关因素如蛋白尿程度、血肌酐水平、肾小管间质病变、病理类型、治疗方法、治疗反应、基因、足细胞及足细胞蛋白等的研究进展。     

3D打印技术应用于耳鼻咽喉科临床前瞻创新

目的 随着计算机技术不断进步、新型材料大量问世及制作成本下降,3D打印作为当今制造业前沿技术现已广泛应用于各种医疗过程尤其是外科专业,在耳鼻咽喉科领域目前主要应用于假体制造及植入、术前规划、模型重建和技能训练及教学等方面。通过定制个性化植入物及手术器械缩短手术时间、降低手术成本,通过术前规划及模型演练降低手术副损伤。近年来,组织工程学、活体组织器官的复合打印技术作为3D打印的潜在应用也得到了广泛的探索。论文主要讨论3D打印技术在耳鼻咽喉科领域的扩大应用及研究前景。