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Additional file 1: Table S1. Summary of comorbidities in ≥ 5% patients in FAS. Table S2. Investigator-assessed efficacy of iruplinalkib in FAS. Figure S1. Waterfall plots of the subgroup BOR of target lesions by IRC in FAS. Figure S2. Waterfall plot of BOR by investigator in FAS. Figure S3. Swimmer plot of iruplinalkib exposure and response by investigator in FAS. Figure S4. Minimum plasma iruplinalkib concentration at each time point in the pharmacokinetics analysis set.

Additional file1: Table S1: Chinese and English search strategies. Table S2: Basic information included in the study. Figure S1: Evidence map for optimal transplantation route. Figure S2: Ranking results of optimal transplantation route. (A. The third week of acute phase + high dose transplantation. B. The fifth week of acute phase + high dose transplantation. C. The third week of acute phase + low dose transplantation. D. The fifth week of acute phase + low dose transplantation. E. The third week of subacute phase + high dose transplantation. F. The fifth week of subacute phase + high dose transplantation). Figure S3: Comparison-corrected funnel plots of optimal transplantation dose. Figure S4: Evidence map for optimal transplantation timing. Figure S5: Ranking results of optimal transplantation timing. (A. The third week of high dose + local transplantation. B. The fifth week of high dose + local transplantation. C. The third week of low dose + local transplantation. D. The fifth week of low dose + local transplantation. E. The third week of high dose + intravenous transplantation. F. The fifth week of high dose + intravenous transplantation). Figure S6: Comparison-corrected funnel plots of optimal transplantation dose.

Background: Carcinoma ex pleomorphic adenoma (CXPA), a very rare malignancy found mostly in the major salivary glands, has no established standardized treatment. Case presentation: This report describes a 67-year-old male with advanced CXPA who was effectively treated by anlotinib. Pleomorphic adenoma of the submandibular gland was first diagnosed in 1976 after a surgical resection of a mass underneath the jaw. The patient underwent re-excision 3 years later due to a recurrent pleomorphic adenoma. CXPA was first diagnosed in 2016 after a surgical removal of the left submandibular mass. A lung nodule was found on a chest CT scan in January 2018. Following a CT-guided lung biopsy that demonstrated findings consistent with pulmonary metastasis, the patient underwent local therapy (microwave ablation and radioactive seed implantation) but suffered a recurrence of disease approximately 6 months later. Anlotinib was administered orally at a dose of 12 mg daily on a 2 weeks on/1 week off schedule. A partial response was observed after two cycles of treatment. The disease remains in continued partial response after completion of his sixth cycle. Conclusion: This is the first report for anlotinib in treating CXPA. Further pre-clinical and clinical studies are needed to validate the efficacy and safety of anlotinib in the treatment of CXPA.

Shujie Song,* Ping Sui,* Minmin Li, Liangming Zhang, Dengjun SunDepartment of Medical Oncology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, People’s Republic of China*These authors contributed equally to this workBackground: Carcinoma ex pleomorphic adenoma (CXPA), a very rare malignancy found mostly in the major salivary glands, has no established standardized treatment.Case presentation: This report describes a 67-year-old male with advanced CXPA who was effectively treated by anlotinib. Pleomorphic adenoma of the submandibular gland was first diagnosed in 1976 after a surgical resection of a mass underneath the jaw. The patient underwent re-excision 3 years later due to a recurrent pleomorphic adenoma. CXPA was first diagnosed in 2016 after a surgical removal of the left submandibular mass. A lung nodule was found on a chest CT scan in January 2018. Following a CT-guided lung biopsy that demonstrated findings consistent with pulmonary metastasis, the patient underwent local therapy (microwave ablation and radioactive seed implantation) but suffered a recurrence of disease approximately 6 months later. Anlotinib was administered orally at a dose of 12 mg daily on a 2 weeks on/1 week off schedule. A partial response was observed after two cycles of treatment. The disease remains in continued partial response after completion of his sixth cycle.Conclusion: This is the first report for anlotinib in treating CXPA. Further pre-clinical and clinical studies are needed to validate the efficacy and safety of anlotinib in the treatment of CXPA.Keywords: pulmonary metastasis, chemotherapy, partial response, angiogenesis

Objective: To conduct a meta-analysis of all association studies on two of the collagen 1 alpha 1 (COL1A1) gene polymorphisms, the -1997G/T (rs1107946) and the -1663indelT (rs2412298) polymorphisms and osteoporosis/BMD and fracture. Methods: PubMed/Medline and Web of Knowledge were searched for relevant association studies published in English. Pooled OR and its corresponding 95% CI or pooled MD and its corresponding 95% CI was calculated with the Cochrane Review Manager (Revman, version 5.2) using a random-effect or a fixed effect model. Results: No significant association between the -1997G/T polymorphism and Lumbar Spine (LS) and Femoral Neck (FN) BMD except for the Caucasian subpopulation wherein subjects with the T allele of the -1997G/T polymorphism was associated with significantly higher LS BMD. Our analysis did reveal that women, especially postmenopausal or perimenopausal women with the GG genotype, had significantly higher Total Hip (TH) BMD than those with the GT. Additionally, our meta-analysis did not show significant association between the -1997G/T polymorphism and risk of fracture, between the -1663indelT polymorphism and LS BMD in postmenopausal or perimenopausal women, or between the -1663indelT polymorphism and the risk of fracture. Conclusions: Our results suggested the possibility of the COL1A1 -1997G/T and the -1663indelT polymorphisms individually playing very little role in osteoporosis and fracture, although more studies are needed especially for the analysis of association between these two polymorphisms and fracture. Haplotype studies may become one important future direction of study to further elucidate whether and how various COL1A1 polymorphisms affect bone health, osteoporosis and fracture.

Background: Mutations in the epidermal growth factor receptor gene (EGFR) are found in around half of Asian patients with non-small cell lung cancer (NSCLC). For this reason, EGFR tyrosine kinase inhibitors (TKI) are often prescribed depending on the EGFR status. Two common EGFR mutations, a deletion in exon 19 and L858R in exon 21, demonstrate a positive response to gefitinib, the first approved EGFR TKI. However, T790M and an insertion in EGFR exon 21 are resistant to EGFR TKI treatment. The relationships between the EGFR mutation type and response to the target drug have not been fully investigated. Case presentation: We describe a 66-year-old Chinese male diagnosed with stage IV lung adenocarcinoma based on evidence from a computed tomography (CT) scan and histological features of a biopsy taken during fiberoptic bronchoscopy surgery. Molecular analysis of EGFR exons 19 and 21 revealed the presence of only one mutation in exon 19: L747P (2239-2240 TT>CC). The patient requested gefitinib treatment for 2 weeks but his response was poor. A CT scan revealed that the number and relative volume of the liver metastases had increased after treatment. Conclusion: L747P (2239-2240 TT>CC) in exon 19 is a rare EGFR mutation that appears to lead to gefitinib resistance and might accelerate liver metastases.

The aim of this study was to provide an effective procedure for immunohistochemistry (IHC) investigations of bone specimens. Samples from rat femoral and human vertebral bone were processed with a detailed and effective IHC protocol summarized here. First, a novel antigen retrieval (AR) method of hyaluronidase combined pepsin predigestion (H+P) was established and the optimal concentration and pH value for AR of bone specimens were determined. Second, the newly developed method was compared with existing AR methods (boiling in sodium citrate, hyaluronidase predigestion (H) and pepsin predigestion (P), with PBS only as the negative control) using two chromogenic detection systems (horseradish peroxidase (HRP) and alkaline phosphatase (AP)) to evaluate their efficacy in obtaining the best IHC results for bone samples. Considering the drawbacks of significant shrinking and detachment from slide for heat retrieval methods and the only moderate immunolabeling for H and P, H+P was the optimal AR method for IHC of bone specimens with the advantages of both good morphological preservation and strong immunoreactivity. Moreover, AP-mediated chromogenic detection was superior to HRP-labeled chromogenic detection due to significantly less nonspecific staining. In conclusion, we presented an effective and practical IHC protocol for bone specimens characterized by H+P predigestion combined with APmediated chromogenic detection. Finally, a detailed troubleshooting guide was provided for common mistakes that occur during IHC processing of the bone tissue samples.

Induced pluripotent stem cells (iPSCs) are of great clinical interest for they are derived from one’s own somatic cells and have the potential of committed differentiation without immunological rejection after autografting. However, the use of viral and other modified vectors may still cause tumorigenesis due to chromosome insertion mutation, leading to limited practical use. iPSCs generated by reprogramming proteins overcome the potential safety risk and complicated manipulation procedures, thus they own better application prospective, yet some technical difficulties need to be studied and resolved, for instance, low reprogramming efficiency, unclear transduction, and reprogramming mechanism. In this paper, we summarize the current progress of proteins reprogramming technology for generation of iPSCs and discuss the promising efficiency-improved reprogramming methods by proteins plus other kinds of chemical compounds.