2.Unveiling the Complex World of Extracellular Vesicles: Novel Characterization Techniques and Manufacturing Considerations
James J. LAI ; John J. HILL ; Casey Y. HUANG ; Gino C. LEE ; Karol W. MAI ; Maggie Y. SHEN ; Simon K. WANG
Chonnam Medical Journal 2024;60(1):1-12
		                        		
		                        			
		                        			 Extracellular vesicles (EVs) function as potent mediators of intercellular communication for many in vivo processes, contributing to both health and disease related conditions. Given their biological origins and diverse functionality from correspondingly unique “cargo” compositions, both endogenous and modified EVs are garnering attention as promising therapeutic modalities and vehicles for targeted therapeutic delivery applications. Their diversity in composition, however, has revealed a significant need for more comprehensive analytical-based characterization methods, and manufacturing processes that are consistent and scalable. In this review, we explore the dynamic landscape of EV research and development efforts, ranging from novel isolation approaches, to their analytical assessment through novel characterization techniques, and to their production by industrial-scale manufacturing process considerations. Expanding the horizon of these topics to EVs for in-human applications, we underscore the need for stringent development and adherence to Good Manufacturing Practice (GMP) guidelines. Wherein, the intricate interplay of raw materials, production in bioreactors, and isolation practices, along with analytical assessments compliant with the Minimal Information for Studies of Extracellular Vesicles (MISEV) guidelines, in conjunction with reference standard materials, collectively pave the way for standardized and consistent GMP production processes. 
		                        		
		                        		
		                        		
		                        	
3.Application and evaluation of artificial intelligence TPS-assisted cytologic screening system in urine exfoliative cytology.
L ZHU ; M L JIN ; S R HE ; H M XU ; J W HUANG ; L F KONG ; D H LI ; J X HU ; X Y WANG ; Y W JIN ; H HE ; X Y WANG ; Y Y SONG ; X Q WANG ; Z M YANG ; A X HU
Chinese Journal of Pathology 2023;52(12):1223-1229
		                        		
		                        			
		                        			Objective: To explore the application of manual screening collaborated with the Artificial Intelligence TPS-Assisted Cytologic Screening System in urinary exfoliative cytology and its clinical values. Methods: A total of 3 033 urine exfoliated cytology samples were collected at the Henan People's Hospital, Capital Medical University, Beijing, China. Liquid-based thin-layer cytology was prepared. The slides were manually read under the microscope and digitally presented using a scanner. The intelligent identification and analysis were carried out using an artificial intelligence TPS assisted screening system. The Paris Report Classification System of Urinary Exfoliated Cytology 2022 was used as the evaluation standard. Atypical urothelial cells and even higher grade lesions were considered as positive when evaluating the recognition sensitivity, specificity, and diagnostic accuracy of artificial intelligence-assisted screening systems and human-machine collaborative cytologic screening methods in urine exfoliative cytology. Among the collected cases, there were also 1 100 pathological tissue controls. Results: The accuracy, sensitivity and specificity of the AI-assisted cytologic screening system were 77.18%, 90.79% and 69.49%; those of human-machine coordination method were 92.89%, 99.63% and 89.09%, respectively. Compared with the histopathological results, the accuracy, sensitivity and specificity of manual reading were 79.82%, 74.20% and 95.80%, respectively, while those of AI-assisted cytologic screening system were 93.45%, 93.73% and 92.66%, respectively. The accuracy, sensitivity and specificity of human-machine coordination method were 95.36%, 95.21% and 95.80%, respectively. Both cytological and histological controls showed that human-machine coordination review method had higher diagnostic accuracy and sensitivity, and lower false negative rates. Conclusions: The artificial intelligence TPS assisted cytologic screening system has achieved acceptable accuracy in urine exfoliation cytologic screening. The combination of manual screening and artificial intelligence TPS assisted screening system can effectively improve the sensitivity and accuracy of cytologic screening and reduce the risk of misdiagnosis.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Artificial Intelligence
		                        			;
		                        		
		                        			Urothelium/pathology*
		                        			;
		                        		
		                        			Cytodiagnosis
		                        			;
		                        		
		                        			Epithelial Cells/pathology*
		                        			;
		                        		
		                        			Sensitivity and Specificity
		                        			;
		                        		
		                        			Urologic Neoplasms/urine*
		                        			
		                        		
		                        	
4.Preliminary application of recombinase -aided amplification in detection of Clonorchis sinensis metacercariae in freshwater fish.
J CHEN ; Z WANG ; W HUANG ; J WANG ; L CHEN ; Y SUN ; L ZHAO ; Y ZHAO ; Y QIAN ; J DUAN ; Q ZHANG
Chinese Journal of Schistosomiasis Control 2023;35(5):458-463
		                        		
		                        			OBJECTIVE:
		                        			To evaluate the performance of recombinase-aided amplification (RAA) assay in detection of Clonorchis sinensis metacercariae in freshwater fish samples, so as to provide insights into standardization and field application of this assay.
		                        		
		                        			METHODS:
		                        			Wild freshwater fish samples were collected in the rivers of administrative villages where C. sinensis-infected residents lived in Jiangyan District, Xinghua County and Taixing County of Taizhou City, Jiangsu Province from June to September 2022. Genomic DNA was extracted from six freshwater fish specimens (5 g each) containing 0, 1, 2, 4, 8 and 16 C. sinensis metacercariae for fluorescent RAA assay, and the diagnostic sensitivity was evaluated. Fluorescent RAA assay was performed with genomic DNA from C. sinensis, Metorchis orientalis, Haplorchis pumilio and Centrocestus formosanus metacercariae as templates to evaluate its cross-reactions. In addition, the detection of fluorescent RAA assay and direct compression method for C. sinensis metacercariae was compared in field-collected freshwater fish samples.
		                        		
		                        			RESULTS:
		                        			Positive amplification was found in fresh-water fish specimens containing different numbers of C. sinensis metacercariae, and fluorescent RAA assay was effective to detect one C. sinensis metacercaria in 5 g freshwater fish specimens within 20 min. Fluorescent RAA assay tested negative for DNA from M. orientalis, H. pumilio and C. formosanus metacercariae. Fluorescent RAA assay and direct compression method showed 5.36% (93/1 735) and 2.88% (50/1 735) detection rates for C. sinensis metacercariae in 1 735 field-collected freshwater fish samples, with a statistically significant difference seen (χ2 = 478.150, P < 0.001). There was a significant difference in the detection of C. sinensis metacercariae in different species of freshwater fish by both the direct compression method (χ2 = 11.20, P < 0.05) and fluorescent RAA assay (χ2 = 20.26, P < 0.001), and the detection of C. sinensis metacercariae was higher in Pseudorasbora parva than in other fish species by both the direct compression method and fluorescent RAA assay (both P values < 0.05).
		                        		
		                        			CONCLUSIONS
		                        			Fluorescent RAA assay has a high sensitivity for detection of C. sinensis metacercariae in freshwater fish samples, and has no cross-reactions with M. orientalis, H. pumilio or C. formosanus metacercariae. Fluorescent RAA assay shows a higher accuracy for detection of C. sinensis infections in field-collected freshwater fish than the direct compression method.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Clonorchis sinensis/genetics*
		                        			;
		                        		
		                        			Metacercariae/genetics*
		                        			;
		                        		
		                        			Recombinases
		                        			;
		                        		
		                        			Fresh Water
		                        			;
		                        		
		                        			Fishes
		                        			;
		                        		
		                        			DNA
		                        			;
		                        		
		                        			Fish Diseases/diagnosis*
		                        			
		                        		
		                        	
5.Early Clinical Outcomes of Short versus Long Proximal Femoral Nail Anti-rotation (PFNA) in the Treatment of Intertrochanteric Fractures
Loh JLM ; Huang DME ; Lei J ; Yeo W ; Wong MK
Malaysian Orthopaedic Journal 2021;15(No.2):115-121
		                        		
		                        			
		                        			Introduction: Both short and long PFNA are employed to
treat intertrochanteric fractures. Controversy exists in the
choice between the two nails as each implant has specific
characteristics and theoretical advantages. This retrospective
study seeks to examine the operative complication rates and
clinical outcomes of short versus long (Proximal Femoral
Nail Antirotation) PFNA in the treatment of intertrochanteric
fractures.
Materials and methods: Between July 2011 and February
2015, 155 patients underwent PFNA insertion. The decision
on whether to use a short or long PFNA nail, locked or
unlocked, was determined by the attending operating
surgeon. Visual Analogue Pain Score (VAS) Harris Hip
Scores (HHS), Short-form 36 Health Questionnaire (SF-36)
and Parker Mobility Scores (PMS) were collected at six
weeks, six months and one year post-operatively.
Results: A total of 137 (88.4%) patients were successfully
followed-up. Forty-two (30.7%) patients received a short
PFNA. The patients were similar in baseline characteristics
of age, gender, and comorbidities. Operative time was
significantly longer in the short PFNA group (62 ±17 mins)
versus the long PFNA group (56±17). While the patients in
both groups achieved improvement in all outcome measures,
there was no significant difference between the groups in
terms of HHS (61.0 ±16.0 vs 63.0 ±16.8, p=0.443), PMS
(2.3±1.5 vs 2.7±2.1, p=0.545) and VAS (1.7±2.9 vs 1.8 ±2.2
p=0.454). There were 3 (7.1%) and 7 (7.4%) complications
in the short versus long PFNA group, respectively.
Conclusion: Both short and long PFNA had similar clinical
outcomes and complication rates in the treatment of
intertrochanteric fractures in an Asian population.
		                        		
		                        		
		                        		
		                        	
6.MCC1019, a selective inhibitor of the Polo-box domain of Polo-like kinase 1 as novel, potent anticancer candidate.
Sara ABDELFATAH ; Angela BERG ; Qi HUANG ; Li Jun YANG ; Sami HAMDOUN ; Anette KLINGER ; Henry J GRETEN ; Edmond FLEISCHER ; Thorsten BERG ; Vincent K W WONG ; Thomas EFFERTH
Acta Pharmaceutica Sinica B 2019;9(5):1021-1034
		                        		
		                        			
		                        			Polo-like kinase (PLK1) has been identified as a potential target for cancer treatment. Although a number of small molecules have been investigated as PLK1 inhibitors, many of which showed limited selectivity. PLK1 harbors a regulatory domain, the Polo box domain (PBD), which has a key regulatory function for kinase activity and substrate recognition. We report on 3-bromomethyl-benzofuran-2-carboxylic acid ethyl ester (designated: MCC1019) as selective PLK1 inhibitor targeting PLK1 PBD. Cytotoxicity and fluorescence polarization-based screening were applied to a library of 1162 drug-like compounds to identify potential inhibitors of PLK1 PBD. The activity of compound MC1019 against the PLK1 PBD was confirmed using fluorescence polarization and microscale thermophoresis. This compound exerted specificity towards PLK1 over PLK2 and PLK3. MCC1019 showed cytotoxic activity in a panel of different cancer cell lines. Mechanistic investigations in A549 lung adenocarcinoma cells revealed that MCC1019 induced cell growth inhibition through inactivation of AKT signaling pathway, it also induced prolonged mitotic arrest-a phenomenon known as mitotic catastrophe, which is followed by immediate cell death apoptosis and necroptosis. MCC1019 significantly inhibited tumor growth in a murine lung cancer model without affecting body weight or vital organ size, and reduced the growth of metastatic lesions in the lung. We propose MCC1019 as promising anti-cancer drug candidate.
		                        		
		                        		
		                        		
		                        	
7.The Association of Acquired T790M Mutation with Clinical Characteristics after Resistance to First-Line Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor in Lung Adenocarcinoma.
Yen Hsiang HUANG ; Kuo Hsuan HSU ; Jeng Sen TSENG ; Kun Chieh CHEN ; Chia Hung HSU ; Kang Yi SU ; Jeremy J W CHEN ; Huei Wen CHEN ; Sung Liang YU ; Tsung Ying YANG ; Gee Chen CHANG
Cancer Research and Treatment 2018;50(4):1294-1303
		                        		
		                        			
		                        			PURPOSE: The main objective of this study was to investigate the relationship among the clinical characteristics and the frequency of T790M mutation in advanced epidermal growth factor receptor (EGFR)–mutant lung adenocarcinoma patients with acquired resistance after firstline EGFR–tyrosine kinase inhibitor (TKI) treatment. MATERIALS AND METHODS: We enrolled EGFR-mutant stage IIIB-IV lung adenocarcinoma patients, who had progressed to prior EGFR-TKI therapy, and evaluated their rebiopsy EGFR mutation status. RESULTS: A total of 205 patients were enrolled for analysis. The overall T790M mutation rate of rebiopsy was 46.3%. The T790M mutation rates among patients with exon 19 deletion mutation, exon 21 L858R point mutation, and other mutations were 55.0%, 37.3%, and 27.3%, respectively. Baseline exon 19 deletion was associated with a significantly higher frequency of T790M mutation (adjusted odds ratio, 2.14; 95% confidence interval [CI], 1.20 to 3.83; p=0.010). In the exon 19 deletion subgroup, there was a greater prevalence of T790M mutation than other exon 19 deletion subtypes in patients with the Del E746-A750 mutation (61.6% vs. 40.6%; odds ratio, 2.35; 95% CI, 1.01 to 5.49; p=0.049). The progression-free survival (PFS) of first-line TKI treatment > 11 months was also associated with a higher T790M mutation rate (54.1% vs. 39.3%; adjusted odds ratio, 1.82; 95% CI, 1.02 to 3.25; p=0.044). Patients who underwent rebiopsy at metastatic sites had more chance to harbor T790M mutation (52.6% vs. 33.8%; adjusted odds ratio, 1.97; 95% CI, 1.06 to 3.67; p=0.032). CONCLUSION: PFS of first-line EGFR-TKI, rebiopsy site, EGFR exon 19 deletion and its subtype Del E746-A750 mutation are associated with the frequency of T790M mutation.
		                        		
		                        		
		                        		
		                        			Adenocarcinoma*
		                        			;
		                        		
		                        			Disease-Free Survival
		                        			;
		                        		
		                        			Epidermal Growth Factor*
		                        			;
		                        		
		                        			Exons
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Lung Neoplasms
		                        			;
		                        		
		                        			Lung*
		                        			;
		                        		
		                        			Mutation Rate
		                        			;
		                        		
		                        			Odds Ratio
		                        			;
		                        		
		                        			Phosphotransferases
		                        			;
		                        		
		                        			Point Mutation
		                        			;
		                        		
		                        			Prevalence
		                        			;
		                        		
		                        			Receptor, Epidermal Growth Factor*
		                        			;
		                        		
		                        			Sequence Deletion
		                        			
		                        		
		                        	
8.Exposure to bisphenol A during maternal pregnancy and the emotional and behavioral impact on their preschool children.
X CHEN ; H H BAO ; W K WU ; S Q YAN ; J SHENG ; Y Y XU ; C L GU ; K HUANG ; H CAO ; P Y SU ; F B TAO ; J H HAO
Chinese Journal of Epidemiology 2018;39(2):188-193
		                        		
		                        			
		                        			Objective: To explore the long-term effects of maternal pregnancy bisphenol A (BPA) exposure on emotional and behavioral problems appeared in their preschool children. Methods: The study sample was a subset of the China-Anhui Birth Cohort Study (C-ABCS). A unified questionnaire was used to collect basic information on both pregnant women and their children. Free BPA concentration in maternal serum was determined by high-performance liquid chromatographytandem mass spectrometry (HPLC-MS/MS). The parent-report version of the Strengths and Difficulties Questionnaire (SDQ) was used to estimate the emotional and behavioral problems in preschool children. A total of 1 713 pairs of mothers and children were included in this study. Association between BPA exposure during pregnancy and the emotional and behavioral problems in preschool children was evaluated with multinomial logistic regression model. Results: Prevalence rates in 1 713 preschool children appeared as: 6.48% of emotional problems, 8.11% for conduct problems, 8.35% for hyperactivity/inattention, 2.86% for peer problems, 11.38% for prosocial behaviors and 7.94% for total difficulties. Subjects were divided according to the degrees of exposure and the results showed as: low exposure group (≤0.120 ng/ml), medium exposure group (0.120
		                        		
		                        			Benzhydryl Compounds/toxicity*
		                        			;
		                        		
		                        			Child Behavior Disorders/etiology*
		                        			;
		                        		
		                        			Child, Preschool
		                        			;
		                        		
		                        			China/epidemiology*
		                        			;
		                        		
		                        			Cohort Studies
		                        			;
		                        		
		                        			Emotions/physiology*
		                        			;
		                        		
		                        			Environmental Exposure
		                        			;
		                        		
		                        			Environmental Pollutants
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Gas Chromatography-Mass Spectrometry
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Maternal Exposure
		                        			;
		                        		
		                        			Mothers
		                        			;
		                        		
		                        			Phenols/toxicity*
		                        			;
		                        		
		                        			Pregnancy
		                        			;
		                        		
		                        			Prenatal Exposure Delayed Effects
		                        			;
		                        		
		                        			Prevalence
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			Surveys and Questionnaires
		                        			;
		                        		
		                        			Tandem Mass Spectrometry
		                        			
		                        		
		                        	
9.Incidence of fall related injury in people aged 50 and above and risk factors in 8 provinces in China: a cross-sectional study.
Y F GUO ; W J MA ; Q J ZHANG ; M YU ; Y Z XIAO ; X L GUO ; Y L ZHU ; F LIU ; Y RUAN ; S Y SUN ; Z Z HUANG ; Y ZHENG ; F WU
Chinese Journal of Epidemiology 2018;39(3):258-263
		                        		
		                        			
		                        			Objective: To estimate the incidence and distribution characteristics of fall related injury in people aged ≥50 years in 8 provinces in China and related physiological, psychological and social risk factors. Methods: Cross-sectional data were collected from adults aged ≥50 years participating in the World Health Organization (WHO) study on global ageing and adult health (SAGE) round 1 in China. Two-level hierarchical logistic model was used to identify the related factors for fall-related injury. All the models were stratified by living area (urban/rural). Results: Estimated incidence of fall related injury (road traffic injury was not included) was 3.2%. Ageing and multiple chronic conditions (OR=2.55, 95%CI: 1.41-4.64) was significantly associated with the incidence of fall related injury in urban area. In rural area, depression (OR=4.33, 95% CI: 2.52-7.42) and multiple chronic conditions (OR=2.46, 95%CI: 1.37-4.41) were associated with the incidence of fall related injury. Conclusions: This study estimated the incidence of fall related injury in adults aged ≥50 years in 8 provinces in China. A significant association between multiple chronic conditions and fall related injury were found in both urban and rural residents. Targeted measures should be taken for the prevention and control of chronic diseases in elderly population.
		                        		
		                        		
		                        		
		                        			Accidental Falls/statistics & numerical data*
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Chronic Disease/epidemiology*
		                        			;
		                        		
		                        			Cross-Sectional Studies
		                        			;
		                        		
		                        			Depression/epidemiology*
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Incidence
		                        			;
		                        		
		                        			Logistic Models
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			Rural Population
		                        			;
		                        		
		                        			Wounds and Injuries/etiology*
		                        			
		                        		
		                        	
10.Stratified sampling survey of major human parasitic diseases in Henan province.
B L XU ; H W ZHANG ; Y DENG ; Z L CHEN ; W Q CHEN ; D L LU ; Y L ZHANG ; Y L ZHAO ; X M LIN ; Q HUANG ; C Y YANG ; Y LIU ; R M ZHOU ; P LI ; J S CHEN ; L J HE ; D QIAN
Chinese Journal of Epidemiology 2018;39(3):322-328
		                        		
		                        			
		                        			Objective: To understand the prevalence of major human parasitic diseases and related factors in Henan province. Methods: This stratified sampling survey was carried out according to the requirement of national survey protocol of major human parasitic diseases, 2014-2015. The prevalence of soil-transmitted helminths infection, taeniasis and intestinal protozoiasis were surveyed in 104 sites selected from 35 counties (districts) and the prevalence of clonorchiasis was surveyed in 62 sites selected from 37 townships. In each survey spot, 250 persons were surveyed. A total of 26 866 persons and 15 893 persons were surveyed. Modified Kato-Katz thick smear was used to detect the eggs of intestinal helminthes. Tube fecal culture was used to identify the species of hookworm. The Enterobius eggs were detected in children aged 3 to 6 years by using adhesive tape. The cyst and trophozoite of intestinal protozoa were examined with physiological saline direct smear method and iodine stain method. Results: The overall infestation rate of intestinal parasites was2.02% in Henan, and the worm infection rate was higher than protozoa infection rate. Fourteen kinds of intestinal parasites were found, including nematode (5 species), trematode (2 species), and protozoan (7 species). The infection rate of Enterobius vermicularis was highest, and Qinba Mountain ecological area had the highest infestation rate of intestinal parasites in 4 ecological areas of Henan. There was no significant difference in intestinal parasite infection rate between males and females (χ(2)=3.630, P=0.057), and the differences in intestinal parasite infection rate among different age groups had significance (χ(2)=124.783, P=0.000 1). The infection rate reached the peak in age group ≤9 years and the major parasite was Enterobius vermicularis. Furthermore the overall human infection rate of parasite showed a downward trend with the increase of educational level of the people (χ(2)=70.969, P=0.000 1), the differences had significance (χ(2)=120.118, P=0.000 1). For different populations, the infection rate of intestinal parasites was highest among preschool children. The infection of intestinal helminth was mainly mild, only 2 severe cases were detected. The infection rate of Clonorchis sinensis in urban residents was only 0.006%. Logistic regression analysis showed that being preschool children (χ(2)=15.765, P=0.000 1) and drinking well water (χ(2)=45.589, P=0.000 1) were the risk factors for intestinal parasite infection, and annual income per capita of farmers was the protective factor against intestinal parasite infection. The infection rates of protozoa and intestinal parasites decreased sharply compared with the results of previous two surveys, and the rate of intestinal helminth infection also dropped sharply compared with the second survey. The numbers of protozoa, helminth and intestinal parasites detected in this survey were all less than the numbers found in the previous two surveys. Conclusions: Compared the results of three surveys in Henan, the infection rate of protozoa and intestinal parasites showed a downward trend. The prevention and treatment of Enterobius vermicularis infection in children should be the key point of parasitic disease control in the future.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Child, Preschool
		                        			;
		                        		
		                        			Clonorchiasis/epidemiology*
		                        			;
		                        		
		                        			Farmers
		                        			;
		                        		
		                        			Feces/parasitology*
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Helminthiasis/epidemiology*
		                        			;
		                        		
		                        			Helminths
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Intestinal Diseases, Parasitic/parasitology*
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Prevalence
		                        			;
		                        		
		                        			Protective Factors
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			Rural Population
		                        			;
		                        		
		                        			Soil Microbiology
		                        			;
		                        		
		                        			Surveys and Questionnaires
		                        			;
		                        		
		                        			Taeniasis/epidemiology*
		                        			;
		                        		
		                        			Trematode Infections/parasitology*
		                        			;
		                        		
		                        			Urban Population
		                        			;
		                        		
		                        			Water Wells
		                        			
		                        		
		                        	
            

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