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Dendritic cell (DC)-based vaccination is a promising approach for active-specific immunotherapy, but is currently of limited efficacy. The safety and effectiveness of a DC vaccine (DCV) loaded with glioblastoma stem cell-like (GSC) antigens was assessed in glioblastoma multiforme (GBM) patients. In this double-blind, placebo-controlled phase II clinical trial, 43 GBM patients were randomized after surgery at a 1:1 ratio to receive either DCV (n = 22) or normal saline placebo (n = 21). Overall survival (OS) and progression-free survival (PFS) were analysed. Participants were stratified into different molecular subgroups based on the mutation (MT) status of isocitrate dehydrogenase (IDH1/2) and telomerase reverse transcriptase (TERT). Plasma cytokine levels, tumor-infiltrating lymphocyte numbers and immune co-inhibitory molecules PD-L1 and B7-H4 were also assessed. Multivariate Cox regression analysis revealed that DCV treatment significantly prolonged OS (p = 0.02) after adjusting for IDH1 and TERT promoter MT and B7-H4 expression, primary vs recurrent GBM. Among IDH1 TERT patients, DCV treatment significantly prolonged OS (p < 0.01) and PFS (p = 0.03) and increased plasma levels of cytokines CCL22 and IFN-γ compared with placebo. Patients with low B7-H4 expression showed significantly prolonged OS (p = 0.02) after DCV treatment. Therefore, IDH1TERT and low B7-H4 expression identified subgroups of GBM patients more responsive to GSC DCV-based specific active-immunotherapy.

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A Pilot Studyhe transjugular intrahepatic portosystemic shunt (TIPS) is used for management of refractory acute variceal hemorrhage and intractable ascites in late-stage liver diseases with portal hypertension. 1 In addition to monitoring the clinical status, it is important to monitor TIPS hemodynamic function objectively. 2,3 Although the portosystemic pressure gradient (PPG) and hepatic venous pressure gradient are still considered the reference standards for diagnosis and monitoring of portal hypertension, they Jing Gao, MD, Xiao Zheng, MS, Yuan-Yi Zheng, MD, Guo-Qing Zuo, MD, Hai-Tao Ran, MD, Yong Ho Auh, MD, Levi Waldron, PhD, Tiffany Chan, MS, Zhi-Gang Wang, MD Received July 6, 2015, Objectives-To assess the feasibility of splenic shear wave elastography in monitoring transjugular intrahepatic portosystemic shunt (TIPS) function.Methods-We measured splenic shear wave velocity (SWV), main portal vein velocity (PVV), and splenic vein velocity (SVV) in 33 patients 1 day before and 3 days to 12 months after TIPS placement. We also measured PVV, SVV, and SWV in 10 of 33 patients with TIPS dysfunction 1 day before and 3 to 6 days after TIPS revision. Analyses included differences in portosystemic pressure gradient (PPG), PVV, SVV, and mean SWV before and after TIPS procedures; comparison of median SWV before and after TIPS procedures; differences in PVV, SVV, and SWV before and at different times up to 12 months after TIPS placement; accuracy of PVV, SVV, and SWV in determining TIPS dysfunction; and correlation between PPG and SWV.Results-During 12 months of follow-up, 23 of 33 patients had functioning TIPS, and 10 had TIPS dysfunction. The median SWV was significantly different before and after primary TIPS placement (3.60 versus 3.05 m/s; P = .005), as well as before and after revision (3.73 versus 3.06 m/s; P = .003). The PPG, PVV, and SVV were also significantly different before and after TIPS placement and revision (P < .001). The PPG and SWV decreased, whereas PVV and SVV increased, after successful TIPS procedures. A positive correlation was observed between PPG and SWV (r = 0.70; P < .001), and a negative correlation was observed between PPG and PVV and SVV (r = -0.65; P < .001). The areas under the receiver operating characteristic curve for PVV, SVV, and SWV in determining TIPS dysfunction were 0.82, 0.84, and 0.81, respectively.Conclusions-Splenic SWV is compatible with splenoportal venous velocity in quantitatively monitoring TIPS function and determining TIPS dysfunction.

Background:Virtual touch tissue quantification (VTTQ) provides numerical measurements (shear wave velocity (SWV) values) of tissue stiffness.Objectives:The purpose of this study was to describe the SWV values of the kidney by VTTQ and to examine the clinical usefulness of this procedure in the evaluation of elasticity changes in the kidneys of patients with chronic kidney disease (CKD).Patients and Methods:Sixty-five patients with CKD and seventy healthy participants were included in this study. A total of 270 kidneys were examined by VTTQ. The kidney elasticity was expressed as shear wave velocity. The SWV values, blood serum creatinine (Scr)/BUN and pathological findings were analyzed and compared between patients with CKD and healthy participants.Results:In patients with CKD and healthy participants, the SWV values both gradually decreased from the renal cortex to the medulla and renal sinus The SWV value of the renal cortex in patients with CKD was less than that of healthy participants (P < 0.05), and the SWV value of the renal cortex in patients with renal insufficiency was significantly less than in those with normal renal function (2.46 ± 0.15 vs. 3.45 ± 0.26 m/s, P < 0.05). The best cutoff value for predicting renal insufficiency (Scr > 1.24 mg/dL or/and BUN > 21 mg/DL) was a SWV value of the renal cortex of less than 1.92 m/s with a sensitivity of 84.4% (95% CI: 67.2-94.7%) and a specificity of 96.8% (95% CI: 83.3-99.9%) (P < 0.001).Conclusion:VTTQ can sensitively detect the elasticity changes in patients with CKD, and it can effectively predict renal insufficiency. This technology provides a valuable tool for the assessment of CKD.

To analyze the topological properties of Beijing public transport network, until July 2010, we have collected 1165 bus lines and 9618 bus stops of Beijing City (14 districts and 2 counties) as the sample data to build up a directed and weighted complex network model based on neighboring stops by applying the complex network theory. In this model, bus stops are considered as nodes of the complex network, while bus lines connecting two neighboring stops as edges. Consequently, the network has the topological properties of a complex network and meanwhile the nodes (bus stops) have clear geographic coordinates. The complexity of Beijing public transport is then verified through analyzing the topological properties of node degree, node strength, strength distribution, average shortest path, clustering coefficient in the complex network. We find that the distributions of node degrees and node strengths are extremely uneven and the cumulative strength distributions of the top 5% and 10% nodes reach 22.43% and 43.02% respectively. The results also show that the node strength, ordinal number and cumulative strength distribution of the nodes all follow the power-law distribution, showing the network characteristics of scale-free and small world. Some "key nodes" play an important role in network connection. We find two kinds of "key nodes" by using high carrying pressure node analysis and extract regional central analysis. These rules provide new references for optimizing the urban transport network, managing traffic congestion and planning and developing the traffic.