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Hepatocellular carcinoma (HCC) is one of the most common malignancies in the world and is associated with high mortality. Ionizing radiation (IR)‐based therapy causes DNA damage, exerting a curative effect; however, DNA damage repair signaling pathways lead to HCC resistance to IR‐based therapy. RAD21 is a component of the cohesion complex, crucial for chromosome segregation and DNA damage repair, while it is still unclear whether RAD21 is implicated in DNA damage and influences IR sensitivity in HCC. The current research explores the effect and upstream regulatory mechanism of RAD21 on IR sensitivity in HCC. In the present study, RAD21 mRNA and protein expression were increased within HCC tissue samples, particularly within IR‐insensitive HCC tissues. The overexpression of RAD21 partially attenuated the roles of IR in HCC by promoting the viability and suppressing the apoptosis of HCC cells. RAD21 overexpression reduced the culture medium 8‐hydroxy‐2‐deoxyguanosine concentration and decreased the protein levels of γH2AX and ATM, suggesting that RAD21 overexpression attenuated IR treatment‐induced DNA damage to HCC cells. miR‐320b targeted RAD21 3ʹ‐UTR to inhibit RAD21 expression. In HCC tissues, particularly in IR‐insensitive HCC tissues, miR‐320b expression was significantly downregulated. miR‐320b inhibition also attenuated IR treatment‐induced DNA damage to HCC cells; more importantly, RAD21 silencing significantly attenuated the effects of miR‐320b inhibition on IR treatment‐induced DNA damage, suggesting that miR‐320b plays a role through targeting RAD21. In conclusion, an miR‐320b/RAD21 axis modulating HCC sensitivity to IR treatment through acting on IR‐induced DNA damage was demonstrated. The miR‐320b/RAD21 axis could be a novel therapeutic target for further study of HCC sensitivity to IR treatment. RAD21 expression is upregulated within HCC tissues and IR‐insensitive HCC tissue samples. RAD21 overexpression could attenuate IR treatment‐caused DNA damage to HCC cells, therefore reducing HCC cell sensitivity to IR treatment. miR‐320b contributes to HCC cell IR sensitivity through targeting RAD21.

Algal–bacterial granular sludge technology is a new type of wastewater treatment and resource regeneration process, which has received widespread attention due to its excellent nitrogen and phosphorus removal performance, and energy-saving and emission reduction effects. Although algal–bacterial granular sludge technology has achieved an ideal nutrient removal ability, some pol-lutants in wastewater might affect the symbiotic relationship between algae and bacteria. This study investigated the impact of coexisting Pb(II) on the symbiosis of algal–bacterial granular sludge. It was found that 2.5–10.0 mg/L of Pb(II) exposure increased the relative abundance of Pro-teobacteria. In addition, more protein in extracellular polymeric substances (EPS-PN) was secreted at 2.5 mg/L of Pb(II) exposure while EPS-PN content reduced at a rate of 5.0–10.0 mg/L of Pb(II). Under different concentrations of Pb(II), the damage degree of algal–bacterial granular sludge was exacerbated, evidenced by increased malondialdehyde (MDA) content. To cope with these adverse circumstances, the antioxidant enzyme activity of both super-oxide dismutase (SOD) and peroxidase dismutase (CAT) was boosted. With the help of these adaptive strategies, the symbiosis of algal–bacterial granular sludge was stable. Moreover, the performance of algal–bacterial granular sludge in treating COD, ammonia-N and phosphate-P was kept at above 95%. This study approved that a Pb(II) concentration less than 10.0 mg/L had little effect on the performance of algal–bacterial granular sludge in wastewater treatment. It is hoped that this study can provide useful information for an improved engineering feasibility of algal–bacterial granular sludge process.

The ubiquitous presence of phenolic compounds in effluents poses a risk to aquatic organisms and human health. This study investigates the responses of the emerging algal-bacterial granular sludge process in treating phenolic wastewater. The results showed that phenol at 1, 10, and 100 mg/L had little effect on ammonia-N, chemical oxygen demand (COD), and phosphate-P removal. At the highest phenol concentration of 100 mg/L, the average removal rates of ammonia-N, COD, and phosphate-P were 94.8%, 72.9%, and 83.7%, respectively. The presence of phenol led to a decline in chlorophyll content of the algal-bacterial granular sludge, concurrently resulting in an increase in the abundance of microbial diversity. Algal-bacterial granular sludge exhibited mechanisms such as elevated extracellular polymeric substances (EPSs), superoxide dismutase (SOD), and catalase (CAT) production, which may aid in coping with oxidative stress from phenols. This research underscores the algal-bacterial granular sludge’s potential for treating phenolic wastewater, thereby advancing knowledge in the field of phenol degradation with this innovative technology.

The rapid expansion of global urbanization and industrialization has significantly increased the discharge of municipal wastewater, leading to issues of carbon emissions and energy consumption when using traditional biological treatment processes. This study proposes an innovative process that couples iron coagulation with microalgal–bacterial granular sludge (MBGS), with optimization and regulation based on operational conditions. The study found that the coagulation performance achieved optimal levels at an iron concentration of 25 mg/L and an anionic polyacrylamide concentration of 1 mg/L, which could remove approximately 61% of the organics and over 90% of phosphorus from raw wastewater. By relying on heterotrophic microorganisms, such as Proteobacteria, Bacteroidota, and Chloroflexi, along with the synergistic interaction between algae and bacteria, the subsequent MBGS process could further effectively remove organics over the day-night cycles. Moreover, the addition of inorganic carbon sources of NaHCO3 increased the abundance of denitrification-related genes, reduced the accumulation of nitrite within MBGS, and led to effective total nitrogen removal. These results indicate that the iron coagulation–MBGS coupling process can efficiently treat municipal wastewater, offering potential for environment-sustainable pollutant removal with reduced energy consumption. These findings provide valuable insights for the practical engineering application of MBGS in wastewater treatment systems aiming for carbon-neutral wastewater treatment.

Background Accurate delineation of clinical target volume of tumor bed (CTV-TB) is important but it is also challenging due to surgical effects and soft tissue contrast. Recently a few auto-segmentation methods were developed to improve the process. However, those methods had comparatively low segmentation accuracy. In this study the prior information was introduced to aid auto-segmentation of CTV-TB based on a deep-learning model. Methods To aid the delineation of CTV-TB, the tumor contour on preoperative CT was transformed onto postoperative CT via deformable image registration. Both original and transformed tumor contours were used for prior information in training an auto-segmentation model. Then, the CTV-TB contour on postoperative CT was predicted by the model. 110 pairs of preoperative and postoperative CT images were used with a 5-fold cross-validation strategy. The predicted contour was compared with the clinically approved contour for accuracy evaluation using dice similarity coefficient (DSC) and Hausdorff distance. Results The average DSC of the deep-learning model with prior information was improved than the one without prior information (0.808 vs. 0.734, P  < 0.05). The average DSC of the deep-learning model with prior information was higher than that of the traditional method (0.808 vs. 0.622, P  < 0.05). Conclusions The introduction of prior information in deep-learning model can improve segmentation accuracy of CTV-TB. The proposed method provided an effective way to automatically delineate CTV-TB in postoperative breast cancer radiotherapy.

Small cell carcinoma of the bladder (SCCB) is a rare, highly malignant neuroendocrine tumor. This study attempted to analyze tumor characteristics, treatments and clinical outcomes in China. We conducted a retrospective analysis of patients diagnosed with non-metastatic SCCB at multi-institutions between January 2007 and January 2022. The Kaplan-Meier method was used to calculate survival. A total of 20 patients were included. 10 had localized disease (T1-2N0), and 10 had locally advanced disease (≥ T3 or N+). 13 received local treatment (partial cystectomy or transurethral resection of the bladder tumor) and 7 received radical treatment (radical cystectomy or radiotherapy). A total of 18 patients (90%) received chemotherapy (CT), either neoadjuvant CT ( n  = 5) or adjuvant CT ( n  = 13). The median OS for the receiving local treatment was 65.3 months (95% CI 0 to 138 months) and the corresponding 1-year, 2-year, and 3-year OS was 77%, 54%, and 54%, respectively. The median OS for the receiving radical treatment was not reached and the corresponding 1-year, 2-year, and 3-year OS was 100%, 100%, and 75%, respectively. The median PFS for receiving local treatment was 13.8 months (95% CI 9.3 to 18.3 months) and the corresponding 1-year, 2-year, and 3-year PFS was 46%, 31%, and 31%, respectively. The median PFS for the receiving radical treatment was not reached and the corresponding 1-year, 2-year, and 3-year PFS was 83%, 56%, and 56%, respectively. This study reported the largest cohort of non-metastatic SCCB among Chinese population. Given its metastatic potential, CT remained an essential part of the treatment. The survival outcomes of radical cystectomy and RT in non-metastatic SCCB were encouraging.

The microalgal-bacterial granular sludge (MBGS) process is expected to meet the future requirements of municipal wastewater treatment technology for decontamination, energy consumption, carbon emission and resource recovery. However, little research on the performance of the MBGS process in outdoor treatment was reported. This study investigated the performance of the MBGS system in treating municipal wastewater under natural alternate day and night conditions in late autumn. The results showed that the average removal efficiencies of Chemical oxygen demand (COD), NH4+-N and PO43−-P on daytime before cooling (stage I, day 1−4) could reach 59.9% ± 6.8%, 78.1% ± 7.9% and 61.5% ± 4.5%, respectively, while the corresponding average removal efficiencies at night were 47.6% ± 8.0%, 56.5% ± 17.9% and 74.2% ± 7.6%, respectively. Due to the dramatic changes in environmental temperature and light intensity, the microbial biomass and system stability was affected with fluctuation in COD and PO43−-P removal. In addition, the relative abundance of filamentous microorganisms (i.e., Clostridia and Anaerolineae) decreased, while Chlorella maintained a dominant position in the eukaryotic community (i.e., relative abundance > 99%). This study can provide a theoretical basis and technical support for the further engineering application of the MBGS process.

Background The role of post-mastectomy radiotherapy (PMRT) in the treatment of patients with T1–2N1 breast cancer is controversial. This study’s purpose was to evaluate the risk of recurrence of T1–2N1 breast cancer and the efficacy of PMRT in low-, medium- and high-risk groups of patients. Methods Post-mastectomy patients with T1–2N1 breast cancer were restaged according to the American Joint Committee on Cancer Staging Manual, 8th edition (AJCC 8th ed.) staging system. Recurrence scores were generated using prognostic factors identified for loco-regional recurrence and distant metastasis in patients without PMRT, and three risk groups were identified. Rates of loco-regional recurrence and distant metastasis were calculated with a competing risk model and compared using Gray’s test. Disease-free survival and overall survival were calculated using the Kaplan-Meier method and compared using the log-rank test. The Cox proportional hazards regression model was used for the multivariate analysis. Results Data from 1986 patients (1521without PMRT; 465 with PMRT) were analyzed. Patients without PMRT were stratified into low-, intermediate- and high-risk groups by age, tumor location, AJCC 8th ed. stage, number of positive nodes and lympho-vascular invasion. The 5-year loco-regional recurrence rate and distant metastasis rates for the three risk groups were significant at 2.5, 5.4 and 16.2% ( p  <  0.001) respectively, and 4.9, 8.4 and 18.6% ( p  <  0.001) respectively. In the high-risk group, loco-regional recurrence ( p <   0.001), and distant metastasis ( p  = 0.044) were significantly reduced, and disease free survival ( p  = 0.004), and overall survival ( p  = 0.029) were significantly improved after PMRT. In the low- and intermediate-risk groups, PMRT had no significant effect on loco-regional recurrence ( p  = 0.268), distant metastasis ( p  = 0.252), disease free survival ( p  = 0.608) or overall survival ( p  = 0.986). Conclusion Our results showed no benefits of PMRT in the low-risk group, and thus, omitting PMRT radiotherapy in this population could be considered.

Background Peri-operative chemo-radiotherapyplayed important rolein locally advanced gastric cancer. Whether preoperative strategy can improve the long-term prognosis compared with postoperative treatment is unclear. The study purpose to compare oncologic outcomes in locally advanced gastric cancer patients treated with preoperative chemo-radiotherapy (pre-CRT) and postoperative chemo-radiotherapy (post-CRT). Methods From January 2009 to April 2019, 222 patients from 2 centers with stage T3/4 and/or N positive gastric cancer who received pre-CRT and post-CRT were included. After propensity score matching (PSM), comparisons of local regional control (LC), distant metastasis-free survival (DMFS), disease-free survival (DFS) and overall survival (OS) were performed using Kaplan-Meier analysis and log-rank test between pre- and post-CRT groups. Results The median follow-up period was 30 months. 120 matched cases were generated for analysis. Three-year LC, DMFS, DFS and OS for pre- vs. post-CRT groups were 93.8% vs. 97.2% ( p  = 0.244), 78.7% vs. 65.7% ( p  = 0.017), 74.9% vs. 65.3% ( p  = 0.042) and 74.4% vs. 61.2% ( p  = 0.055), respectively. Pre-CRT were significantly associated with DFS in uni- and multi-variate analysis. Conclusion Preoperative CRT showed advantages of oncologic outcome compared with postoperative CRT. Trial registration ClinicalTrial.gov NCT01291407 , NCT03427684 and NCT04062058 , date of registration: Feb 8, 2011.

Background During tumor progression, HER2 expression undergoes dynamic changes. Circulating tumor cells (CTCs) can be used to monitor HER2 expression in real-time and hold potential for clinical application. This study aimed to evaluate the consistency of HER2 expression between primary tumors and CTCs in patients with breast cancer (BC). Methods We used a previously established telomerase reverse transcriptase-based CTC detection method (TBCD) combined with anti-HER2 antibody to detect CTC and HER2-positive CTC (HER2 + CTC) in 4 ml of peripheral blood from patients with breast cancer prior to radiotherapy. The results indicated that the status of HER2 in CTC was inconsistent with the histological results. Results Discordance in HER2 status between primary tumor and CTC was observed in 32.6% of patients (kappa value = 0.325, p = 0.03). And among patients with histologically HER2-negative breast cancer, the detection rate of HER2 + CTC was 32.1% (9/28). Conclusions We found that the HER2 status of CTC in peripheral blood was inconsistent with the histological findings. Further research should explore the clinical significance of detecting HER2-positive CTCs, and it is desired that real-time HER2 status testing of CTCs could hold potential value for patients with breast cancer.