GYNAECOMASTIA APPEARED THREE DAYS AFTER STARTING METHIMAZOLE

We reported that in a 29-year-old male patient with hyperthyroidism, bilateral breast swelling appeared in three days after starting methimazole and gradually aggravated. Several days later, a small amount of transparent liquid could be squeezed out from bilateral mammary glands. Breast ultrasound confirmed gynaecomastia. The level of testosterone, estradiol and luteinizing hormone increased. After the patient continued taking methimazole for a while, gynaecomastia relieved. Testosterone, luteinizing hormone and thyroid functions restored to normal. The possible mechanisms included increased levels of serum total cholesterol and relatively decreased T3 after initiating methimazole.

Distinct soil microbial communities under Ageratina adenophora invasions

Ageratina adenophora is one of the most hazardous invasive weeds in China. It can form a single species community quickly and cause extensive ecological harm. The belowground microbial community can participate in nutrient transformation in soil and plays an important role in the invasiveness of exotic plant species. We selected sampling sites with different invasion levels of A. adenophora. The soil property and soil biogeochemical activity were measured in both bulk and rhizosphere soil under the aggressive weed A. adenophora and under adjacent native plants. The composition of bacterial communities was investigated using high-throughput 16S rRNA gene sequencing. We found that the rhizosphere habitat selectively accumulated Sphingomonas and Steroidobacter and reduced the abundance of Gaiella and Gp6 regardless of plant host. The presence of A. adenophora caused a switch in microbial composition from Aeromicrobium and Marmoricola to Reyranella and Bradyrhizobium in the bulk soil, and from Gp4, Pirellula, Lysobacter and Aridibacterrae to Reyranella and Streptomyces in the rhizosphere soil. We also revealed specific microbes that closely related with N-cycling processes. In addition, soil pH was the main factor affecting microbial communities in both bulk and rhizosphere soil. Our study confirmed that the rhizosphere environment imposed homogenous microbial communities. The invasion of A. adenophora selected specialized bacterial communities in soils and specific microbes that potentially mediated soil nutrition cycling. Our findings provide ecological explanation to explain how the underground microbes help A. adenophora invasive.

Probing the Gluonic Structure of the Deuteron with J/ψ Photoproduction in d+Au Ultraperipheral Collisions

Understanding gluon density distributions and how they are modified in nuclei are among the most important goals in nuclear physics. In recent years, diffractive vector meson production measured in ultraperipheral collisions (UPCs) at heavy-ion colliders has provided a new tool for probing the gluon density. In this Letter, we report the first measurement of J/ψ photoproduction off the deuteron in UPCs at the center-of-mass energy sqrt[s_{NN}]=200  GeV in d+Au collisions. The differential cross section as a function of momentum transfer -t is measured. In addition, data with a neutron tagged in the deuteron-going zero-degree calorimeter is investigated for the first time, which is found to be consistent with the expectation of incoherent diffractive scattering at low momentum transfer. Theoretical predictions based on the color glass condensate saturation model and the leading twist approximation nuclear shadowing model are compared with the data quantitatively. A better agreement with the saturation model has been observed. With the current measurement, the results are found to be directly sensitive to the gluon density distribution of the deuteron and the deuteron breakup process, which provides insights into the nuclear gluonic structure.

[Effects of exosomes from human adipose-derived mesenchymal stem cells on pulmonary vascular endothelial cells injury in septic mice and its mechanism]

Objective: To investigate the effects of exosomes from human adipose-derived mesenchymal stem cells (ADSCs) on pulmonary vascular endothelial cells (PMVECs) injury in septic mice and its mechanism. Methods: The experimental research method was adopted. The primary ADSCs were isolated and cultured from the discarded fresh adipose tissue of 3 patients (female, 10-25 years old), who were admitted to the First Affiliated Hospital of Air Force Medical University undergoing abdominal surgery, and the cell morphology was observed by inverted phase contrast microscope on the 5th day. The expressions of CD29, CD34, CD44, CD45, CD73, and CD90 of ADSCs in the third passage were detected by flow cytometry. The third to the fifth passage of ADSCs were collected, and their exosomes from the cell supernatant were obtained by differential ultracentrifugation, and the shape, particle size, and the protein expressions of CD9, CD63, tumor susceptibility gene 101 (TSG101), and β-actin of exosomes were detected, respectively, by transmission electron microscopy, nano-particle tracking analysis and Western blotting. Twenty-four adult male BALB/c mice were adopted and were divided into normal control group, caecal ligation perforation (CLP) alone group, and CLP+ADSC-exosome group with each group of 8 according to random number table (the same grouping method below) and were treated accordingly. At 24 h after operation, tumor necrosis factor (TNF-α) and interleukin 1β (IL-1β) levels of mice serum were detected by enzyme-linked immunosorbent assay, and lung tissue morphology of mice was detected by hematoxylin-eosin and myeloperoxidase staining, and the expression of 8-hydroxy-deoxyguanosine (8-OHdG) of mouse lung cells was detected by immunofluorescence method. Primary PMVECs were obtained from 1-month-old C57 mice regardless gender by tissue block method. The expression of CD31 of PMVECs was detected by immunofluorescence and flow cytometry. The third passage of PMVECs was co-cultured with ADSCs derived exosomes for 12 h, and the phagocytosis of exosomes by PMVECs was detected by PKH26 kit. The third passage of PMVECs were adopted and were divided into blank control group, macrophage supernatant alone group, and macrophage supernatant+ADSC-exosome group, with 3 wells in each group, which were treated accordingly. After 24 h, the content of reactive oxygen species in cells was detected by flow cytometry, the expression of 8-OHdG in cells was detected by immunofluorescence, and Transwell assay was used to determine the permeability of cell monolayer. The number of samples in above were all 3. Data were statistically analyzed with one-way analysis of variance and least significant difference t test. Results: The primary ADSCs were isolated and cultured to day 5, growing densely in a spindle shape with a typical swirl-like. The percentages of CD29, CD44, CD73 and CD90 positive cells of ADSCs in the third passage were all >90%, and the percentages of CD34 and CD45 positive cells were <5%. Exosomes derived from ADSCs of the third to fifth passages showed a typical double-cavity disc-like structure with an average particle size of 103 nm, and the protein expressions of CD9, CD63 and TSG101 of exosomes were positive, while the protein expression of β-actin of exosomes was negative. At 24 h after operation, compared with those in normal control group, both the levels of TNF-α and IL-1β of mice serum in CLP alone group were significantly increased (with t values of 28.76 and 29.69, respectively, P<0.01); compared with those in CLP alone group, both the content of TNF-α and IL-1β of mice serum in CLP+ADSC-exosome group was significantly decreased (with t values of 9.90 and 4.76, respectively, P<0.05 or P<0.01). At 24 h after surgery, the pulmonary tissue structure of mice in normal control group was clear and complete without inflammatory cell infiltration; compared with those in normal control group, the pulmonary tissue edema and inflammatory cell infiltration of mice in CLP alone group were more obvious; compared with those in CLP alone group, the pulmonary tissue edema and inflammatory cell infiltration of mice in CLP+ADSC-exosome group were significantly reduced. At 24 h after operation, endothelial cells in lung tissues of mice in 3 groups showed positive expression of CD31; compared with that in normal control group, the fluorescence intensity of 8-OHdG positive cells of the lung tissues of mice in CLP alone group was significantly increased, and compared with that in CLP alone group, the fluorescence intensity of 8-OHdG positive cells in the lung tissues of mice in CLP+ADSC-exosome group was significantly decreased. The PMVECs in the 3rd passage showed CD31 positive expression by immunofluorescence, and the result of flow cytometry showed that CD31 positive cells accounted for 99.5%. At 12 h after co-culture, ADSC-derived exosomes were successfully phagocytose by PMVECs and entered its cytoplasm. At 12 h after culture of the third passage of PMVECs, compared with that in blank control group, the fluorescence intensity of reactive oxygen species of PMVECs in macrophage supernatant alone group was significantly increased (t=15.73, P<0.01); compared with that in macrophage supernatant alone group, the fluorescence intensity of reactive oxygen species of PMVECs in macrophage supernatant+ADSC-exosome group was significantly decreased (t=4.72, P<0.01). At 12 h after culture of the third passage of PMVECs, and the 8-OHdG positive fluorescence intensity of PMVECs in macrophage supernatant alone group was significantly increased; and compared with that in blank control group, the 8-OHdG positive fluorescence intensity of PMVECs in macrophage+ADSC-exosome supernatant group was between blank control group and macrophage supernatant alone group. At 12 h after culture of the third passage PMVECs, compared with that in blank control group, the permeability of PMVECs monolayer in macrophage supernatant alone group was significantly increased (t=6.34, P<0.01); compared with that in macrophage supernatant alone group, the permeability of PMVECs monolayer cells in macrophage supernatant+ADSC-exosome group was significantly decreased (t=2.93, P<0.05). Conclusions: Exosomes derived from ADSCs can ameliorate oxidative damage in mouse lung tissue, decrease the level of reactive oxygen species, 8-OHdG expression, and permeability of PMVECs induced by macrophage supernatant.

Construction of nano receptors for ubiquitin and ubiquitinated proteins based on the region-specific interactions between ubiquitin and polydopamine

Ubiquitination is a prevalent post-translational modification that controls a multitude of important biological processes. Due to the low abundance of ubiquitinated proteins, highly efficient separation and enrichment approaches are required...

Study on the regulation mechanism of lipopolysaccharide on oxidative stress and lipid metabolism of bovine mammary epithelial cells

The long-term feeding of a high-concentrate diet (the concentrate ratio is greater than 60 %) leads to mammary gland inflammatory response in ruminants and decreased quality in dairy cows and affects the robust development of the dairy industry. The main reason is closely related to elevated lipopolysaccharide (LPS) in the body. In this experiment, a bovine mammary epithelial cell line (MAC-T) was used as a model, and LPS at different concentrations (0 ng/ml, 1 ng/ml, 10 ng/ml, 100 ng/ml, 1000 ng/ml, 10000 ng/ml) was added to the cells. The cell survival rate, oxidative stress indicators, total lipid droplet area, triglyceride content and key genes regulating lipid metabolism were detected by 3-(4,5)-dimethylthiahiazo(-z-y1)-3,5-di-phenytetrazoliumromide (MTT), assay kit, microscope observation and RT-PCR methods to explore the regulatory mechanism of mammary health and milk fat synthesis. The results showed that compared with those of the control group, the survival rates of cells were significantly decreased after 9 h of stimulation with 1000 ng/ml and 10000 ng/ml LPS (P<0.01). The contents of superoxide dismutase (SOD), catalase (CAT) and total antioxidant capacity (T-AOC) in cells were significantly decreased (P<0.05). Compared with that of the control group, the content of malondialdehyde (MDA) in cells was significantly increased (P<0.05) after stimulation with 10000 ng/ml LPS for 9 h. After 9 h of stimulation with 100 ng/ml, 1000 ng/ml and 10000 ng/ml LPS, the total lipid drop area and triglyceride (TG) content of MAC-T cells were significantly decreased (P<0.05). The expression levels of fatty acid synthesis-related genes Acetyl-CoA carboxylase (ACC) and Stearoyl-CoA desaturase 1 (SCD-1) were significantly decreased after 9 h of stimulation with 100 ng/ml, 1000 ng/ml and 10000 ng/ml LPS (P<0.05), while the expression levels of Fatty Acid synthetase (FAS) were significantly decreased after stimulation with 1000 ng/ml and 10000 ng/ml LPS (P<0.05). TG synthesis by the related gene Diacylglycerol acyltransferase-1 (DGAT1) was significantly lower than that of the control group after stimulation with 1000 ng/ml and 10000 ng/ml LPS for 9 h (P<0.05), and Diacylglycerol acyltransferase-2 (DGAT2) also showed a significant decrease after 10000 ng/ml LPS stimulation (P<0.05). In conclusion, adding different concentrations of LPS to MAC-T cells not only led to a decrease in cell activity, resulting in oxidative damage, but also affected fatty acid and TG synthesis, which may ultimately be closely related to the decrease in milk fat synthesis.

[Clinical characteristics, surgical treatment and prognosis of rolandic and perirolandic drug-resistant epilepsies]

Objective: To explore the clinical characteristics, treatment strategies and prognosis of rolandic and perirolandic drug-resistant epilepsies (DREs). Methods: The clinical data of 53 patients diagnosed with rolandic or perirolandic DRE who were admitted to Epilepsy Center, Sanbo Brain Hospital of Capital Medical University from January 2008 to January 2019 were retrospectively analyzed. The patients were divided into resective therapy group and non-resective therapy group [bipolar electrocoagulation on cortex, stereotactic electroencephalography (SEEG)-guided radiofrequency thermocoagulation, and vagus nerve stimulation]. The outcomes of epilepsy and post-surgical limb function were compared and analyzed. Results: A total of 53 patients were included, aged from 3 to 45 years old [(19±11) years], with 33 males and 20 females. Thirty patients received resective therapy and 23 patients received non-resective therapy. The curative effect of the resective therapy group was significantly better than that of the non-resective therapy group. The rate of Engel Ⅰ in resective therapy group was higher than that of non-resective group [83.3% (25/30) vs 39.1% (9/23), P=0.011). Compared with the non-resective group, the incidence of muscle strength decline in the resective group was higher both at 1 week [73.3% (22/30) vs 21.7% (5/23), P=0.006] and 3 months [30% (9/30) vs 0, P=0.016] after surgery. Conclusions: During the diagnosis and treatment, the multimodal method is conducive to the qualitative and localized diagnosis of the rolandic or perirolandic epilepsy, while SEEG has important value in the diagnosis, functional localization and treatment of the disease. Resective therapy is still the most effective method to terminate epilepsy, but it has a higher risk of post-surgical dysfunction.

Survey of risk factors in coronary heart disease: novel recruitment strategy and preliminary results

Introduction

SURF CHD (Survey of Risk Factors in Coronary Heart Disease) is a clinical audit on secondary prevention among CHD patients aiming to simplify recording and assessment of risk factors and medication. The second wave of the study (SURF CHD II) uses a novel recruitment strategy that provides a wider and more representative picture of CHD secondary prevention.

Methods

The survey is conducted during outpatient visits and collects data on demographics, risk factor history and measurements, and medications. The novel recruitment strategy is based on the network of European Association of Preventive Cardiology (EAPC). National Cardiovascular disease Prevention Coordinators (NCPC) appointed by the EAPC were invited; national cardiac societies (NCS) were invited in countries without NCPCs; and interested clinicians may also participate. SURF researchers discussed tailor-made approaches to implement the audit with national representatives.

Results

48 NCPCs, 11 NCS and 9 individual contacts were invited. 95 centres in 31 countries are participating and have enrolled 6966 participants in 5 regions: 109 in Eastern Mediterranean, 5170 in Europe, 108 in Americas, 1563 in South East Asia and 16 in Western Pacific. 24.4% of participants were female and mean age was 63.8±18 years. 75.3% of the study population had BMI≥25kg/m2 and 20.0% were smokers. Blood pressure &lt;140/90mmHg was recorded in 61.8% of participants, 26.4% had LDL &lt;1.8 mmol/l and 40,1% had HbA1c&lt;7%. South East Asia recorded the lowest prevalence of BMI≥25kg/m2 and LDL levels. Lowest use of statins was recorded in Europe and of angiotensin-converting enzyme inhibitors in Americas.

Conclusions

The novel recruitment strategy proved to be practicable. Preliminary results indicate regional variations in risk factors and secondary prevention. SURF will continue to collaborate with NCPCs and NCS to achieve a broader insight on CHD secondary prevention with a simplified tool.

Key messages

Cardiovascular risk factor prevalence in coronary patients is high and presents regional variations. SURF is a simplified clinical auditing tool useful to assess risk factor recording and management. Centre enrolment for the study based on the network of a renowned association of cardiology is practicable and helps to provide a wide picture of secondary prevention of coronary heart disease.

[Mage-D1 binding to activated p75NTR positively regulates mineralization of rat ectomesenchymal stem cells in vitro]

OBJECTIVE

To detect the binding of Mage-D1 with activated p75NTR and explore their role in regulating mineralization of ectomesenchymal stem cells (EMSCs).

METHODS

EMSCs were isolated from the tooth germs of embryonic SD rats (19.5 days of gestation) by tissue explant culture and were identified for surface markers using flow cytometry. The cultured cells were divided into blank control group, 100 ng/mL nerve growth factor (NGF) stimulation group, and lentivirus-mediated Mage-D1 interference (SH-Mage-D1) group. Proximity ligation assay was used to detect the binding of Mage-D1 with activated p75NTR in the EMSCs, and the binding strength was compared among the 3 groups. Alizarin red staining and ALP staining were used to observe mineralization of the induced cells. The expressions of ALP, Runx2, OCN, BSP, OPN, Msx1 and Dlx1 at both the mRNA and protein levels were detected using RT-PCR and Western blotting.

RESULTS

The isolated EMSCs expressed high levels of cell surface markers CD44, CD90, CD29, CD146, and CD105 with a low expression of CD45. The results of proximity ligation assay showed that the binding of Mage-D1 with activated p75NTR in the cells increased over time, and the binding strength was significantly greater in NFG-treated cells than in the cells in the other two groups (P < 0.05). Alizarin red staining and ALP staining of the induced cells showed that the changes in the mineralization nodules were consistent with those of ALP activity. The cells treated with 100 ng/mL NGF exhibited significantly increased expressions of ALP, Runx2, OCN, BSP, OPN, Col1, Msx1 and Dlx1 as compared with the cells in the other two groups (P < 0.05).

CONCLUSION

Mage-D1 directly binds to activated p75NTR in embryonic rat EMSCs to positively regulate the mineralization of the EMSCs.

Clinical benefits of TNF-α inhibitors in Chinese adult patients with NLRP3-associated autoinflammatory disease

BACKGROUND

Nucleotide-binding oligomerization domain-like receptor family, pyrin domain containing 3 (NLRP3)-associated autoinflammatory disease (NLRP3-AID) is a rare, heterogeneous disease entity associated with mutations in NLRP3. Biologic therapy for NLRP3-AID yields diverse results.

OBJECTIVES

We aimed to evaluate the clinical features and outcomes of Chinese adult patients with NLRP3-AID who were treated with tumour necrosis factor (TNF)-α inhibitors.

METHODS

Five patients with NLRP3-AID were diagnosed and treated with TNF-α inhibitors at Peking Union Medical College Hospital between 2017 and 2020 and were followed up for 6 to 12 months. All patients were systematically studied for treatment outcomes, including clinical manifestations and inflammatory markers.

RESULTS

All five adult NLRP3-AID patients were Chinese Han, and four patients were males. The mean age at disease onset was 4.2 ± 4.1 years, and the mean time of diagnosis delay was 19.8 ± 6 years. All patients received TNF-α inhibitors with or without methotrexate/prednisone. During follow-up, all patients achieved remarkable clinical remission of skin lesions and polyarthritis and showed improvements in acute-phase reactants, inflammatory cytokines, patient visual analogue scale, physician global assessment and 36-item Short Form (SF-36).

CONCLUSIONS

Early diagnosis and effective therapy for NLRP3-AID are essential for avoiding irreversible organ damage. TNF-α inhibitors might serve as a therapeutic alternative for patients with NLRP3-AID who have unsatisfactory responses or no access to interleukin-1 inhibitors.

BGL3 inhibits papillary thyroid carcinoma progression via regulating PTEN stability

PURPOSE

BGL3, a novel long non-coding RNA (lncRNA) that plays a crucial role in several human malignancies. However, the clinical significance and biological function of BGL3 in papillary thyroid carcinoma (PTC) have not been explored. Herein, we aimed to investigate the role of BGL3 in human PTC.

METHODS

A total of 85 pairs of PTC and normal tissues were collected for clinicopathological analysis. Expression of BGL3 was determined by quantitative real-time polymerase chain reaction (qRT-PCR). The effects of BGL3 on PTC cells ware determined by CCK-8, colony formation, EdU and wound healing assays. The molecular mechanism underlying BGL3 was tested by ChIP, Co-IP, RNA pull-down and luciferase reporter assays. In vivo experiments were conducted using xenografts in nude mice.

RESULTS

BGL3 was significantly decreased in PTC tissues compared to adjacent normal thyroid tissues, and it was transcriptionally repressed by oncogene Myc. Low BGL3 is positively related to larger tumor size, lymph node metastasis, later TNM stage and poor prognosis. Overexpression of BGL3 inhibited PTC cell proliferation and migration in vitro, and reduced tumor size and lung metastasis nodules in vivo. BGL3 was mainly located in the cytoplasm, in which interacted with PTEN and recruited OTUD3, enhancing the de-ubiquitination effect of OTUD3 on PTEN, resulting in increasing PTEN protein stability and inactivating carcinogenic PI3K/AKT signaling.

CONCLUSIONS

Our data underscore the critical tumor-inhibiting role of BGL3 in PTC via post-translational regulation of PTEN protein stability, which may serve as a novel therapeutic target and prognostic biomarker in human PTC.

Mental health response to COVID-19 in China and impact on psychiatrists

The COVID-19 outbreak has raised numerous challenges for mental health service system in China. The pandemic has many affects on clinical, research and teaching, due to the strict quarantine in china. Fight the COVID-19 became the most important thing in work. We outlined major mental health needs during COVID-19 outbreak from the exiting studies and challenges for mental health professionals, and how to manage these challenges in China. To reduce the risk of negative psychological outcomes associated with the COVID-19 pandemic, the Central Health Authority of China and different national academic societies have integrated mental health crisis interventions into the general deployment of disease prevention and treatment. The NHCC developed a mental health triage strategy to provide four levels of psychological crisis interventions. More than 20 specific guidelines and expert consensus for mental health services for the COVID-19 outbreak were disseminated by the end of February 2020 to provide timely guidance for frontline health care professionals. External mental health expert teams in other provinces were also established to provide emergency mental health services in Hubei province, China. In addition, widespread adoption of online public education, psychological counseling, and hotline services have been set up for those in need. Although the COVID-19 pandemic has been under control in China, we should take a proactive lead to share its protocol of emergency mental health services with other countries affected by the COVID-19 pandemic. Also international cooperation is urgely needed to control the COVID-19 pandemic worldwide. Large-scale epidemiological surveys should be conducted to examine the prevalence of mental health problems associated with the COVID-19 pandemic to inform the development of appropriate mental health services in future.

P–547 Single-cell RNA sequencing identifies molecular regulations associated with poor maturation performance on rescue in vitro matured oocytes

Study question

What is the transcriptome signature associated with rescuein vitro matured (rIVM) oocytes?

Summary answer

GATA–1/CREB1/WNT signaling axis was repressed in rIVM oocytes of poor quality.

What is known already

rIVM aims to produce mature oocytes (MII) for in vitro fertilization (IVF) through IVM of immature oocytes collected from stimulated ovaries. It is less popular due to limited success rate in infertility treatment. Genetic aberrations, cellular stress, and the absence of cumulus cell support in oocytes could account for the failure of rIVM.

Study design, size, duration

We applied single-cell RNA sequencing (scRNA-seq) to capture the transcriptomes of human in vivo (IVO) oocytes (n = 10) from 7 donors and rIVM oocytes (n = 10) from 10 donors, followed by studying the maternal age effect and ovarian responses on rIVM oocyte transcriptomes.

Participants/materials, setting, methods

Human oocytes were collected from donors aged 28–41 years with a body mass index of &lt; 30. RNA extraction, cDNA generation, library construction and sequencing were performed in one preparation. scRNA-seq data were then processed and analyzed. Selected genes in therIVM vs. IVO comparison were validated by quantitative real-time PCR.

Main results and the role of chance

The transcriptome profiles of rIVM/IVO showed distinctive differences. A total of 1559 differentially expressed genes (DEGs, genes with at least two-fold change and adjusted p &lt; 0.05) were found to be enriched in metabolic processes, biosynthesis, and oxidative phosphorylation. Among these DEGs, we identified a repression of WNT/β-catenin signaling in rIVM when compared with IVO oocytes. We found that estradiol level exhibited a significant age-independent correlation with the IVO mature oocyte ratio (MII ratio). rIVM oocytes with higher MII ratio showed over-represented cellular processes such as anti-apoptosis. To further identify targets that contribute to the poor outcomes of rIVM, we compared oocytes collected from young donors with high MII ratio versus donors of advanced maternal age and revealed CREB1was an important regulator in rIVM. Our study identified GATA–1/CREB1/WNT signaling was repressed in both rIVM condition and rIVM oocytes of low-quality.

Limitations, reasons for caution

In the rIVM oocytes of high- and low-quality comparison, the number of samples was limited after data filtering with stringent selection criteria. For the oocyte stage identification, we were unable to predict the presence of oocyte spindle so polar body extrusion was the only indicator.

Wider implications of the findings: This study showed that GATA–1/CREB1/WNT signaling and antioxidant actions were repressed in rIVM condition and was further downregulated in rIVM oocytes of low-quality, providing us the foundation of subsequent follow-up research on human subjects.

Trial registration number

Not applicable

P–134 Zygote morphokinetic parameters (ZMP) differs between fertilized and non-fertilized (in vitro maturation) oocytes

Study question

Is there any difference on the ZMP between the fertilized and the non-fertilized oocytes in an IVM cohort?

Summary answer

The zona pellucida (zp_g) , cytoplasm greyscale（cm_g),the cytoplasm size (cm_size), radius (cm_r) and deviation (cm_d) showed different patterns from the two groups.

What is known already

We developed a convolutional neural network (CNN) based algorithm that provides instant and bias-free analytical outcomes of oocyte morphological segmentation. The mature but not-fertilized oocytes tend to be static while the fertilized oocytes are more dynamic for preparing its following biological events.

Study design, size, duration

This was a case-control study on oocytes including 631 normal fertilized oocytes and 100 IVM oocytes from 01/08/2017 to 31/12/2019 conducted in the Prince of Wales Hospital, The Chinese University of Hong Kong.

Participants/materials, setting, methods

We used the convolutional neural network (CNN) algorithm to segment the ZMPs of the cytoplasm and zona pellucida of the oocytes. The ZMPs include cm_g, cm_size, cm_r, cm_d, zp_g, thickness of zona pellucida and the area of perivitelline space. For the ZMPs that did not change with time, we used t-test to test the significance and for the parameters changed with time we used dynamic warp timing and similarity test to find the difference.

Main results and the role of chance

The IVM group had a higher intensity of zp_g of 142.03 (128.52–158.70) compared with the fertilized group of 137.04 (121.69–154.37). The cm_g of IVM group was higher than fertilized group [122.55 (114.87–137.62) vs 119.37(108.88–132.87)]. The cm_size, cm_r and cm_d as parameters changed with time and showed a different pattern in two groups. The IVM group decreased the cm_size faster than the fertilized group but the fertilized group had a more dynamic change in the shape of cytoplasm (cm_d) during the development. The cm_r changed with the same pattern of cm_size provided evidence supporting the finding above.

Limitations, reasons for caution

The ZMPs in the IVM group was captured for 21 hours from the first polar body extrusion. Though the duration was similar to the one from fertilized to the first cleavage. The morphology change during that period may not represent the holistic one of IVM oocytes.

Wider implications of the findings: The IVM oocytes have different morphokinetic performance from fertilized oocytes. We used a novel method based on CNN to confirm the differences between the two groups showing that our algorithm was able to describe the morphokinetic changes in a quantitative way and corresponded with embryologist’s experience.

Trial registration number

The Hong Kong Obstetrical & Gynaecological Trust Fund

Optimal design of aeroacoustic airfoils with owl-inspired trailing-edge serrations

The trailing-edge serration that imitates the silent owl wing is used as a flow control method to suppress the aerodynamic noise generated from the rotating wind turbine blade. Recent studies have found that the addition of serrations could degrade the overall aerodynamic performance of the airfoil. To this end, an optimal design method for airfoils with the trailing-edge serration is developed. Combined with the modeling methods of aerodynamics for serrations, the fundamental parameters of serrations are integrated into the optimal design of wind turbine airfoils. Specifically, based on the existing multidisciplinary optimization method for airfoils, the aerodynamic prediction and evaluation module for the serrated airfoil was introduced to develop an aerodynamic-structural optimal design platform. In this way, a novel serrated airfoil equipped with high aerodynamic performance can be designed. Compared with the reference airfoil, the maximum lift-to-drag ratio and lift coefficient of the optimal serrated airfoil at the design point have been increased by 1.9% and 32.5%, while the aerodynamic noise could also be reduced. Finally, experiments were conducted in an anechoic chamber to verify the noise-reduction level of the optimal serrated airfoil, which sufficiently demonstrate the capability to improve the comprehensive performance of the airfoil using such a developed optimal scheme.

Effects of radiation on toxicity, complications, revision surgery and aesthetic outcomes in breast reconstruction: An argument about timing and techniques

BACKGROUND

Radiotherapy (RT) combined with breast reconstruction can reduce the risk of cancer recurrence and increase the survival rate. However, this approach seems to worsen aesthetic outcomes and increase complication rates. The impact of breast reconstruction timing and techniques on clinical outcomes, however, remains unclear. For this reason, we aimed to perform a more comprehensive analysis of a series of patients undergoing RT and breast reconstruction.

METHODS

Patients were divided into 4 groups according to the timing of reconstruction (before RT and after RT) and surgical technique (heterologous reconstruction and autologous reconstruction (AR)). The median time between RT and reconstruction, number of revision surgeries, incidence of complications, toxicity, aesthetics and associated clinical risk factors were used to assess the clinical outcomes. An objective system of skin toxicity evaluation was performed.

RESULTS

Ninety-five patients were included in this study. No significant differences in the median time between RT and reconstruction, incidence of complications, toxicity or aesthetics were noted between different timings or techniques of reconstruction. Patients undergoing AR needed more revision surgeries to complete reconstruction. However, the total number of surgical procedures was similar between the groups. In a comparison between the treated and untreated breasts by an objective system, RT produced an increase in erythema and pigmentation and a decrease in elasticity in the treated breast (p<0.05 for all parameters). On multivariate analysis, smoking was a significant predictor associated with complications.

CONCLUSIONS

Combined breast reconstruction and RT seem to be successful regardless of the order of treatment or the type of reconstruction.

Absent Cortical Venous Filling Is Associated with Aggravated Brain Edema in Acute Ischemic Stroke

BACKGROUND AND PURPOSE

Predicting malignant cerebral edema can help identify patients who may benefit from appropriate evidence-based interventions. We investigated whether absent cortical venous filling is associated with more pronounced early brain edema, which leads to malignant cerebral edema.

MATERIALS AND METHODS

Patients with acute ischemic stroke caused by large-vessel occlusion in the MCA territory who presented between July 2017 and September 2019 to our hospital were included. Collateral filling was rated using the modified Tan scale on CTA, and good collaterals were defined as a score of 2-3. The Cortical Vein Opacification Score (COVES) was calculated, and absent cortical venous filling was defined as a score of 0. Early brain edema was determined using net water uptake on baseline CT images. Malignant cerebral edema was defined as a midline shift of ≥5 mm on follow-up imaging or a massive cerebral swelling leading to decompressive hemicraniectomy or death. Multivariate linear and logistic regression models were performed to analyze data.

RESULTS

A total of 163 patients were included. Net water uptake was significantly higher in patients with absent than in those with favorable cortical venous filling (8.1% versus 4.2%; P < .001). In the multivariable regression analysis, absent cortical venous filling (β = 2.04; 95% CI, 0.75-3.32; P = .002) was significantly and independently associated with higher net water uptake. Absent cortical venous filling (OR, 14.68; 95% CI, 4.03-53.45; P < .001) and higher net water uptake (OR, 1.29; 95% CI, 1.05-1.58; P = .016) were significantly associated with increased likelihood of malignant cerebral edema.

CONCLUSIONS

Patients with absent cortical venous filling were associated with an increased early brain edema and a higher risk of malignant cerebral edema. These patients may be targeted for optimized adjuvant antiedematous treatment.

[Association between parental education level and left ventricular hypertrophy in childhood]

Objective: To examine the relationship between parental education level and left ventricular hypertrophy (LVH) in children. Methods: The data comes from the baseline survey of the Huantai Childhood Cardiovascular Health Cohort Study (HCCH) conducted in Huantai County, Zibo City, Shandong Province. A convenient cluster sampling method was used to select a primary school in Huantai County, Zibo City, Shandong Province as a survey point. A cross-sectional survey was conducted from November 2017 to January 2018. A total of 1 316 children aged 6-11 years with complete data were included. LVH was defined as left ventricular mass index ≥ sex-and age-specific 90th percentile values of this population. Education levels of both parents were divided into junior high school or lower, high school, university or higher, respectively. Logistic regression models were used to analyze the association between parental education level and LVH in children. Results: The age of 1 316 participants was (8.9±1.5) years old. Among them, there were 703 boys (53.4%).After adjusting for gender, age, intake of vegetables and fruits, intake of carbonated drinks, physical activity, sleep time, screen time, overweight or obesity, and occasional hypertension, the logistic regression model results show that compared with those children whose parents' education level is junior high school or below, paternal or maternal education level of college or higher was associated with odds of LVH (father: OR=0.53, 95%CI: 0.33-0.87; mother: OR=0.52, 95%CI: 0.32-0.87; father/mother: OR=0.54,95%CI: 0.32-0.91). Conclusion: Parental education level is inversely associated with LVH in childhood. The probability of LVH in childhood decreases with the increase of parental education levels.

Tai Chi postural training for dyskinesia rehabilitation: a study protocol for a randomised controlled trial in convalescent ischaemic stroke patients

INTRODUCTION

Acute ischaemic stroke (AIS) is not only seriously damaging to the physical and mental health of patients, but also has become a major social public health problem. Effective dyskinesia rehabilitation treatment in convalescence is of great significance for AIS patients' prognosis and quality of life. Tai Chi (TC) shows great potential in improving motor function. This trial aims to evaluate the clinical efficacy of modified TC postural training (TPT), and to explore the related central-peripheral neurotransmitter mechanisms.

METHODS/DESIGN

The proposed study will be a multicentre randomised controlled trial. The trial will randomise 120 eligible AIS patients in a 1:1 ratio to receive TPT or Bobath rehabilitation training. Each training session will last 40 min and will be implemented once a day and five times per week (from Monday to Friday) in a duration of 4 weeks. After finishing the 4-week treatment, another 3-month follow-up period will be seen. Root mean square generated from the surface electromyogram (sEMG) will be the primary outcome. Other sEMG time-domain parameters and frequency-domain parameters and clinical scales assessment will be the secondary outcomes. Peripheral blood samples will be collected at baseline and at the end of 4-week treatment, which will be used to explore the related therapeutic mechanisms. Intention-to-treat analysis and per-protocol analysis will both be implemented in this trial.

ETHICS AND DISSEMINATION

The study has been approved by Ethics Committee of Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, being granted approval numbers DZMEC-KY-2020-22. The research results will be disseminated through (open access) peer-reviewed publications and presentations at conferences.

TRIAL REGISTRATION NUMBER

ChiCTR2000032999.

Survey of risk factors in coronary heart disease (SURF CHD) II: rationale, methods for a novel recruitment strategy and preliminary results

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): European Association of Preventive Cardiology

Introduction

SURF CHD (Survey of Risk Factors in Coronary Heart Disease) is a clinical audit on risk factors and secondary prevention among CHD patients. The first wave of the study showed usefulness of the tool and poor control of risk factors, however the centres were identified by personal contacts. A more formal recruitment strategy was required to increase representativeness in the second wave of the study (SURF CHD II). Purpose: SURF CHD II aims to simplify recording and assessment of risk factor management and medication in CHD patients, while using a novel recruitment strategy that improves representativeness of results and provides a wider picture of secondary prevention of CHD. Methods: The survey is conducted electronically during routine outpatient visits. Data on demographics, risk factors, laboratory and physical measurements and medications is collected and summarized. The novel recruitment strategy is based on the pre-existing network of a renowned association of preventive cardiology, which designates a National Cardiovascular disease Prevention Coordinator (NCPC) for several countries. NCPCs were invited to participate in the clinical audit; selected national cardiac societies were invited to pilot recruitment in countries without a designated NCPC; and clinicians that independently showed interest in SURF were welcome to participate too. The SURF team and interested country representatives held meetings to discuss a tailor-made approach for the implementation of the audit in each country. Results: A total of 48 NCPCs, 11 national cardiac societies and 9 individual contacts were invited to SURF. In 18 meetings with country representatives, enrolment of centres adapting to the countries’ characteristics were discussed. To date, 95 centres in 31 countries have agreed to participate and have enrolled 6145 participants: 88 in Eastern Mediterranean, 4786 in Europe, 108 in the Americas, 1069 in South East Asia and 13 in Western Pacific. 80.11% of the centres are public and 96.73% are located in urban areas. 25.21% of participants were female and mean age was 63.82 ± 18 years. 75.99% of the study population were overweight or obese and 16.6% were smokers. Blood pressure lower than &lt;140/90mmHg was reported in 61.05% of participants, 20.58% had LDL &lt;1.8 mmol/l and 39.58% had  HbA1c &lt; 7%. 27.15% of participants attended cardiac rehabilitation. South East Asia recorded the lowest prevalence of overweight and obesity and LDL levels. Lowest use of statins was recorded in Europe (78.94%), and of angiotensin-converting enzyme inhibitors in the Americas (14.18%). Conclusions: The recruitment strategy based on the preventive cardiology association’s network is successful. Preliminary results indicate regional variations in risk factors and secondary prevention. SURF will continue to collaborate with NCPCs national cardiac societies to promote the survey and achieve a broader insight on secondary prevention of CHD with a simplified tool.

MiR-645 promotes proliferation and migration of non-small cell lung cancer cells by targeting TP53I11

OBJECTIVE

To research the expression and biological function of micro ribonucleic acid (miR)-645 in non-small cell lung cancer (NSCLC), and to further explore the regulatory relationship between miR-645 and tumor protein p53 inducible protein 11 (TP53I11).

PATIENTS AND METHODS

A total of 41 tissue samples were collected from NSCLC patients, and RNAs were extracted from these tissues and reversely transcribed. Then, the expression level of miR-645 in the 41 tissue samples of patients, as well as that in NSCLC cells and human bronchial mucosal epithelial cells, was detected by quantitative Reverse Transcription-Polymerase Chain Reaction (qRT-PCR). In vitro functional assays [methyl thiazolyl tetrazolium (MTT) assay, colony formation assay and transwell assay] were conducted to explore the effects of miR-645 on the proliferation and migration abilities of NSCLC cells. Finally, the downstream target genes of miR-645 were predicted by bioinformatics, screened via qRT-PCR and Western blotting experiments, and verified through Dual-Luciferase reporter gene assay.

RESULTS

QRT-PCR results showed that the miR-645 expression was upregulated in the tissue samples of 35 out of 41 NSCC cases. Besides, the miR-645 expression was upregulated in NSCC cells compared with that in human bronchial mucosal epithelial cells. After interfering with miR-645 expression, in vitro functional assay (MTT assay, colony formation assay and transwell assay) results revealed that the cell proliferation, migration, and invasion were inhibited. According to the results of qRT-PCR and Western blotting, after knocking down the expression of miR-645 in NSCLC cells, the expression of TP53I11 was upregulated, and the results of Dual-Luciferase reporter gene assay confirmed that miR-645 could directly bind to TP53I11.

CONCLUSIONS

MiR-645 expression is upregulated in NSCLC tissues and cells, and the proliferation and migration of NSCLC cells are promoted by targeted regulation on the TP53I11 expression.

Neuroprotective effect of miR-204-5p downregulation against isoflurane-induced learning and memory impairment via targeting EphB2 and inhibiting neuroinflammation

BACKGROUND

Isoflurane, one of the most commonly used inhalational anesthetics, is usually used in surgery patients and often causes long-term learning and memory impairment. The aim of this study was to explore the role of microRNA-204-5p (miR-204-5p) in isoflurane-induced learning and memory impairment in rats.

METHODS

The Morris Water Maze (MWM) test was used to estimate the spatial learning and memory abilities of laboratory rats. Enzyme-linked immunosorbent assay (ELISA) was used to determine interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) concentrations in the hippocampal tissues. The expression level of miR-204-5p was determined by using quantitative reverse transcription polymerase chain reaction (qRT-PCR). The potential target genes of miR-204-5p were predicted and verified by the TargetScan and dual-luciferase reporter assay, respectively.

RESULTS

Isoflurane-induced rats showed significantly higher neurological function scores, higher escape latency and shorter time spent in the original quadrant. Isoflurane could significantly induce neuroinflammation, and the expression of miR-204-5p was increased in the hippocampal tissue of rats exposed to isoflurane. Moreover, downregulation of miR-204-5p attenuated the effect of isoflurane treatment on the escape latency and the time in the original quadrant, and inflammatory cytokines level was downregulated by inhibiting the expression of miR-204-5p. EphB2 was verified as a direct target gene of miR-204-5p.

CONCLUSION

Downregulated miR-204-5p exerts protective effects against isoflurane-induced learning and memory impairment via targeting EphB2 and inhibiting neuroinflammation. MiR-204-5p could serve as a potential therapeutic target for the lightening of cognitive dysfunction induced by isoflurane.

Long-term results of a randomized partial irradiation trial compared to whole breast irradiation in the early stage and low-risk breast cancer patients after conservative surgery

PURPOSE

To report long-term results of a randomized trial comparing accelerated partial breast irradiation (APBI) to whole-breast irradiation (WBI) in terms of efficacy, toxicity, and cosmesis.

METHODS AND MATERIALS

WBI group was treated with 3D conformal external irradiation, 2 Gy daily/fraction, 5 fractions/week, to a total dose of 50 Gy. APBI group was treated with 3D conformal external irradiation 3.75 Gy/fraction, twice a day, 5 fractions/week, to a total dose of 37.5 Gy in the APBI group. Patients were followed up every 6 months up to 5 years and yearly thereafter. During follow-up visits, the clinician evaluated chronic toxicity and scored cosmetic results with a four-scale system.

RESULTS

After a median follow-up of 10.3 years, 43 patients in each group (84%) are alive without disease. One patient died after disease progression in the APBI arm, and there was no death in the WBI arm. The rest of the patients died from another disease different than breast cancer, similarly between groups. There was greater fibrosis in the APBI group (9 patients grade 1 and one grade 2) compared to WBI (3 patients grade 1 and one grade 2); p = 0.18. Regarding cosmesis, in APBI group, 19 and 21 (43.2 and 47%) patients had excellent or good results, similar to the WBI group with 18 patients (40.9%) in each cosmesis outcome. The WBI group did not have any patient with poor cosmesis but the APBI had 3 (6.8%; p = 0.24).

CONCLUSION

After a follow-up of 10 years, there were no differences in efficacy between the 2 treatment arms. Despite slight greater toxicity in the APBI group, the cosmesis was similar and satisfactory in both groups.

Prospects for beyond the Standard Model physics searches at the Deep Underground Neutrino Experiment: DUNE Collaboration

The Deep Underground Neutrino Experiment (DUNE) will be a powerful tool for a variety of physics topics. The high-intensity proton beams provide a large neutrino flux, sampled by a near detector system consisting of a combination of capable precision detectors, and by the massive far detector system located deep underground. This configuration sets up DUNE as a machine for discovery, as it enables opportunities not only to perform precision neutrino measurements that may uncover deviations from the present three-flavor mixing paradigm, but also to discover new particles and unveil new interactions and symmetries beyond those predicted in the Standard Model (SM). Of the many potential beyond the Standard Model (BSM) topics DUNE will probe, this paper presents a selection of studies quantifying DUNE's sensitivities to sterile neutrino mixing, heavy neutral leptons, non-standard interactions, CPT symmetry violation, Lorentz invariance violation, neutrino trident production, dark matter from both beam induced and cosmogenic sources, baryon number violation, and other new physics topics that complement those at high-energy colliders and significantly extend the present reach.

Pollution Load Capacity Calculation Study Based on Multi-objective System in Trans-boundary Area, Plain River Network

In this paper, a new method for pollution load control was proposed to solve the transboundary pollution problem in plain river network. The spatial distribution of load capacity, considering both multiple management requirements and local hydrodynamic features, has been studied in three steps: (1) the multiple objectives calculation system featured by multiple constraints has been proposed considering water quality requirements for different kinds of objectives. (2) the corresponding 1-d and 0-d models for load capacity calculation, considering the complex hydrodynamic characteristic, have been established separately. (3) based on the multi-objective calculation system, the load capacity satisfying the multiple objectives in different administrative units could be calculated. The results indicated that pollution load capacity of the whole transboundary area in Taihu basin is 151806 t/y for chemical oxygen demand, 15,099 t/y for ammonia nitrogen and 3394 t/y for total phosphorus, respectively. Then the rationality of the result has been analyzed and the load capacity calculated has been proved reasonable.

MiR-526b suppresses cell proliferation, cell invasion and epithelial-mesenchymal transition in breast cancer by targeting Twist1

OBJECTIVE

The aberrant expression of microRNAs (miRNAs) acts as crucial regulators in the tumorigenesis of breast cancer (BC). The aim of the study is to investigate the functional effects of miR-526b expression in breast cancer progression.

PATIENTS AND METHODS

The expression level of miR-526b in breast cancer tissues and cell lines was detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Cell proliferation, migration, and invasion capacity was detected by CCK-8 cell proliferation, colony formation, and transwell invasion assays after up-regulating or down-regulating miR-526b expression in breast cancer cells. Bioinformatics analysis and Dual-Luciferase reporter gene assays were used to demonstrate that Twist1 was a target of miR-526b. Western blot analysis was also performed.

RESULTS

We showed that miR-526b expression was significantly downregulated in breast cancer tissues compared to adjacent normal tissues. Lower miR-526b expression was associated with lymph node metastasis in breast cancer patients. Function assays showed that upregulation of miR-526b expression suppressed cell proliferation, cell colony formation, and cell invasion ability in breast cancer. Furthermore, the upregulation of miR-526b suppressed EMT makers Vimentin expression but increased the E-cadherin expression. Mechanically, we showed that miR-526b inhibited cell EMT process by targeting Twist1 expression.

CONCLUSIONS

Thus, our evidence indicated that miR-526b may serve as a potential target of breast cancer treatment.

MiR-20a acted as a ceRNA of lncRNA PTENPL and promoted bladder cancer cell proliferation and migration by regulating PDCD4

OBJECTIVE

Bladder cancer is the most frequent tumor of the urinary system. Despite variety of new treatment options, bladder cancer remains a main global medical problem. Our purpose was to explore the potential molecular and therapeutic targets of bladder cancer diagnosis.

PATIENTS AND METHODS

The qRT-PCR was used to assess the expression of miR-20a in tissues and cell lines. Counting Cell Kit-8 (CCK-8) assay was carried out to evaluate cell proliferation. Cell migration was calculated using the transwell assay.

RESULTS

The expression of miR-20a increased and PDCD4 decreased in bladder cancer tissues compared with normal tissues. Overexpression of miR-20a promoted T24 cell proliferation and migration, while miR-20a inhibitor suppressed cell proliferation and migration. MiR-20a targeted PDCD4 to regulate its expression in T24 cells. MiR-20a is inversely related to PDCD4 and PTENPL in bladder cancer tissues. Upregulation of PDCD4 suppressed T24 cell proliferation and migration.

CONCLUSIONS

The PTENP1/miR-20a/PTEN axis was involved in the progression of bladder cancer. Our study investigated the function of miR-20a in bladder cancer and provided new insights into the treatment of bladder cancer.

Effects of subacute ruminal acidosis on colon epithelial morphological structure, permeability, and expression of key tight junction proteins in dairy goats

The hindgut epithelial barrier plays an important role in maintaining absorption and immune homeostasis in ruminants. However, little information is available on changes in colon epithelial barrier structure and function following grain-induced subacute ruminal acidosis (SARA). The objective of this study was to investigate the effects of grain-induced SARA on colon epithelial morphological structure, permeability, and gene expression involved in epithelial barrier function. Twelve mid-lactating (136 ± 2 d in milk; milk yield = 1.68 ± 0.15 kg/d) Saanen dairy goats with 62.13 ± 4.76 kg of body weight were randomly divided into either the control (CON) treatment (n = 6) or SARA treatment (n = 6). The CON goats were fed a basal diet with a nonfiber carbohydrates to neutral detergent fiber ratio of 1.15 for 60 d. The SARA goats were fed 4 diets with increasing nonfiber carbohydrates to neutral detergent fiber ratio at 1.15, 1.49, 2.12, and 2.66 to induce SARA, with each diet (referred to as period) being fed for 15 d, including 12 d for adaptation and 3 d for sampling. Continuous ruminal pH recordings were used to diagnose the severity of SARA. Additionally, colonic tissues were collected to evaluate the epithelial morphological structure, permeability, and expression of tight junction proteins using transmission electron microscopy, Ussing chamber, quantitative real-time PCR, and Western blotting. Profound disruption in the colonic epithelium was mainly manifested as the electron density of tight junctions decreased, intercellular space widened, and mitochondria swelled in SARA goats. Colon epithelial short-circuit current, tissue conductance, and the mucosal-to-serosal flux of fluorescein isothiocyanate-dextran 4 kDa were increased and potential difference was decreased in SARA goats compared with CON goats. Subacute ruminal acidosis increased mRNA and protein expression levels of CLDN1 and OCLN in the colonic epithelium. Overall, the data of the present study demonstrate that SARA can impair the barrier function of the colonic epithelium at both structural and functional levels, which is associated with severe epithelial structural damage and increased permeability and changes in the expression of tight junction proteins.

The Incidence and Disease Course of Perianal Crohn's Disease: A Danish Nationwide Cohort Study, 1997-2015

BACKGROUND AND AIMS

Perianal Crohn's disease [CD] places a considerable burden on patients' quality of life and is complex to treat. Despite its impact and high frequency, few studies have investigated the incidence and disease course of perianal CD. The aim of this study was to assess the incidence and disease course of perianal CD in adult patients throughout a 19-year period.

METHODS

The cohort comprised all individuals aged 18 years or older who were diagnosed with CD in Denmark between January 1, 1997, and December 31, 2015, according to the National Patient Registry [NPR].

RESULTS

A total of 1812 [19%] out of 9739 patients with CD were found to have perianal CD. Perianal fistulas were the most common manifestation, accounting for 943 [52%] cases. The incidence of perianal CD remained stable over time. Patients with perianal CD were found to have an increased risk of undergoing major abdominal surgery compared with patients without perianal CD (hazard ratio: 1.51, 95% confidence interval [CI]: 1.40 to 1.64, p <0.001) in a multivariate Cox regression analysis. The incidence rate ratios of anal and rectal cancer in perianal CD patients were 11.45 [95% CI: 4.70 to 27.91, p <0.001] and 2.29 [95% CI: 1.25 to 4.20, p = 0.006], respectively, as compared with non-IBD matched controls.

CONCLUSIONS

In this nationwide study, 19% of CD patients developed perianal disease. Patients with perianal CD were at increased risk of undergoing major surgery compared with non-perianal CD patients. The risk of anal and rectal cancer was increased in patients with perianal CD compared with non-IBD matched controls.

PODCAST

This article has an associated podcast which can be accessed at https://academic.oup.com/ecco-jcc/pages/podcast.

Uric Acid Variability and All-Cause Mortality: A Prospective Cohort Study in Northern China

OBJECTIVES

Uric acid(UA) is related with cardiovascular disease, but the association of UA variability with all-cause mortality is rarely known. This study aimed to investigate the relationship between UA variability and all-cause mortality in Kailuan cohort study in northern China.

DESIGN

Cohort study.

SETTING

Kailuan community hospitals in Tangshan, Hebei province, Northern China.

PARTICIPANTS

A total of 55717 participants from Kailuan Study were enrolled, and our study followed up biennially from 2006 to 2010.

MEASUREMENTS

Clinical records of the participants enrolled were analyzed. UA variation independent of mean (UAVIM) values were calculated and all the participants were quartile grouped into four groups as: Q1(UAVIM<0.68), Q2(0.68≤UAVIM<1.10), Q3(1.10≤UAVIM<1.67) and Q4(UAVIM≥1.67). The endpoint event was all-cause death. Cox regression model was performed to evaluate the hazard ratios(HRs) of all-cause mortality based on UAVIM groups.

RESULTS

During a median follow-up of 6.83 years, 2926 deaths occurred. The accumulated mortality rates were 4.6%, 4.8%, 5.4% and 6.1% in group Q1, Q2, Q3 and Q4 respectively. When adjusted potential confounders, the highest risk for all-cause mortality was in group Q4 and the adjusted HRs and 95% confidence intervals(CIs) of group Q2-Q4 for all-cause death were 1.044(0.937, 1.164), 1.182(1.064, 1.314) and 1.353(1.220, 1.501) compared with group Q1, respectively. Further analysis showed that the risk for all-cause death increased as UAVIM value increased. Sensitive analysis still showed the similar results when excluding participants with hyperuricemia or severe chronic kidney diseases. Sub-group analysis by age, gender, BMI or hypertension history also indicated analogous results.

CONCLUSION

Elevated UAVIM was related with increased all-cause mortality and UAVIM was an independent risk factor for all-cause mortality in the community cohort study.

Comparison of Nanomaterials with Other Unconventional Materials Used as Additives for Soil Improvement in the Context of Sustainable Development: A Review

Since the concept of sustainable development enjoys popular support in the 21st century, various kinds of unconventional materials were introduced for soil improvement in the past few decades to replace the traditional materials like concrete and lime. This paper compared nanomaterials with other three kinds of representative unconventional materials to demonstrate its superiority in soil treatment. The other three kinds of unconventional materials include microbially induced calcite precipitation (MICP), recycled tire and environmental fiber. Nanomaterial and MICP have a comprehensive effect on soil reinforcement, since they can improve shear strength, adjust permeability, resist liquefaction and purify the environment. Recycled tire and environmental fibers are granular materials that are mostly adopted to reinforce reconstituted soil. The reinforcement mechanisms and effects of these four kinds of unconventional materials are discussed in detail, and their price/performance ratios are calculated to make an evaluation about their market application prospects. It can be seen that nanomaterials have promising prospects. Colloidal silica, bentonite and laponite present a satisfactory effect on liquefaction mitigation for sandy foundation, and carbon nanotube has an aptitude for unconfined compressive strength improvement. Among the investigated nanomaterials, colloidal silica is the closest to scale market application. Despite the advantages of nanomaterials adopted as additives for soil improvement, they are known for unwanted interactions with different biological objects at the cell level. Nevertheless, research on nanomaterials that are adopted for soil improvement are very promising and can intensify the relationship between sustainable development and geotechnical engineering through innovative techniques.

[Design of huantai childhood cardiovascular health cohort study]

Cardiovascular disease (CVD) has been an important public health issue in China. Recently, the prevalence of obesity, elevated blood pressure, hyperglycemia, dyslipidemia, and unhealthy lifestyles was high in Chinese children and adolescents, which might increase the risk of short-term target organ damage and adult CVD. Therefore, we selected one primary school in Huantai County, Zibo City between November 2017 and January 2018 to establish the Huantai Childhood Cardiovascular Health Cohort Study. The aim of this project was to investigate the effects of childhood exposures on short-term target organ damage and adult CVD, and to provide evidence to curb the epidemic of CVD in China from the source. A total of 1 515 children aged 6-11 years old were included at the baseline. In this paper, we will introduce the overall design of the survey, including participants, methods, quality control, basic characteristics of the participants, study limitations, and future directions, which might provide some useful implications for similar researches in the future.

[Atypical renal cysts: a clinicopathological and molecular analysis of six cases]

Objective: To investigate the clinicopathological characteristics and molecular genetics of atypical renal cysts. Methods: Six cases of atypical renal cysts were collected from Zhejiang Provincial People's Hospital, Hangzhou, China, between February 2014 and February 2019. The clinicopathological characteristics and disease progression were analyzed. The 3p deletion and trisomy of chromosomes 7 and 17 were detected using fluorescence in situ hybridization (FISH). Results: All of the 6 patients were male, aged 43-63 years (median: 52 years). Preoperative Bosniak classification showed 4 cases of grade Ⅱ, 1 case of grade Ⅰ and 1 of grade Ⅲ. Histologically, atypical renal cysts appeared as unilocular or multilocular cysts, lined by multilayered flattened or cuboidal-shaped clear or eosinophilic cells. They often showed short papillary projections, and lacked solid or nodular growth of the lesional cells within the wall or septa of the cysts. Histologically, these cysts could be classified into three categories: acquired cystic disease-associated renal cell carcinoma (ACKD-RCC)-like (3 cases), clear cell type (2 cases), and eosinophilic papillary type (1 case). Two cases of ACKD-RCC-like atypical renal cysts were accompanied by clear cell renal cell carcinomas. On immunohistochemical staining, ACKD-RCC-like atypical renal cysts were focally CK7+/AMACR+/CD57+, the clear-cell type atypical renal cysts were CK7+/CAⅨ+, and eosinophilic papillary type atypical renal cysts were CK7+/AMACR+. FISH analyses showed that one case of ACKD-RCC-like atypical renal cysts had trisomy 17 and one case of clear cell type had 3p deletion, while no signal abnormality was detected in the other cases. The six patients were followed up for 13 to 70 months (median: 27 months), and no evidence of renal cell carcinoma was noted. Conclusion: Atypical renal cysts are a group of lesions that are heterogeneous in clinical, histological and immunophenotypical and molecular genetic features. FISH analyses suggest that a subset of the cases may be precursors of currently known renal cell carcinomas. Extensively sampling and careful observation of the histological characteristics of the cyst wall are important for distinguishing atypical renal cysts from extensively cystic renal cell carcinomas.

[Association between elevated blood pressure and high carotid intima-media thickness in children according to different blood pressure references]

Objective: To analyze the association between elevated blood pressure (BP) and carotid intima-media thickness (cIMT) in children according to four BP references. Methods: Study population came from"Huantai Childhood Cardiovascular Health Cohort Study"in Huantai County, Zibo City, Shandong Province. A convenient cluster sampling method was used to conduct a cross-sectional survey on 1 515 children from November 2017 to January 2018 in a primary school. A total of 1 431 children aged 6-11 years old with complete data were included in this study. Data on demographic characteristics, BP and cIMT were collected through questionnaire survey, physical examination and ultrasound examination. High cIMT was defined as the level of cIMT ≥ age-and sex-specific 90^th percentile of this study population. Based on the Chinese Guideline reference, the Health Industry reference, the International reference and the U.S. reference, all participants were divided into three subgroups: the normal BP, high normal BP and, elevated BP. The multivariate logistic regression models were used to examine the association between BP status and high cIMT in children. Results: The age of children was (8.9±1.5) years, and boys accounted for 53.4% (n=682). The multivariate logistic regression models showed that after adjusting for relevant confounding factors, the risk of high cIMT in elevated BP group was increased compared with the normal BP group according to the four references (all P values<0.05) Conclusion: Elevated BP according to the four BP references is associated with high cIMT in children.

[Association of abdominal obesity in childhood with high carotid intima-media thickness]

Objective: To examine the association of abdominal obesity assessed by waist circumference (WC) with carotid intima-media thickness (cIMT) in children. Methods: The study participants were from the "Huantai Childhood Cardiovascular Health Cohort Study" conducted in Huantai County, Zibo City, Shandong Province. A convenient cluster sampling method was used to select a primary school in Huantai County to conduct the baseline survey from November 2017 to January 2018. A total of 1 515 children aged 6-11 years old were included. The first follow-up survey was conducted from November to December 2019, and a total of 981 children aged 8-13 years old were finally included after exclusion of those with high cIMT at baseline. Questionnaire survey, physical examination and ultrasonic examination were used to collect general demographic characteristics, WC and cIMT information. According to the status of WC at baseline, the participants were divided into normal WC group and abdominal obesity group. Covariance analysis was used to compare the cIMT levels of children between normal WC group and abdominal obesity group. Multivariable logistic regression models were used to evaluate the association between baseline abdominal obesity and high cIMT during the follow-up. Results: The age of 981 children was (8.5±1.5) years at the baseline. The follow-up age was (10.5±1.5) years, and 520 boys accounted for 53.0%. The cIMT of children in the abdominal obesity group was 0.54 mm, which was higher than that in the normal WC group (0.51 mm) (P<0.001). Similarly, the prevalence of high cIMT in children with abdominal obesity (23.9%) was higher than that of normal WC group (3.9%) (P<0.001). After adjusting for potential covariates at the baseline and during the follow-up period, compared with the normal WC group, abdominal obesity was significantly associated with high cIMT (OR=5.78, 95%CI:3.43-9.74). Conclusion: The abdominal obesity in children could increase the risk of high cIMT.

Defining heart disease risk for death in COVID-19 infection

BACKGROUND

Cardiovascular disease (CVD) was in common in coronavirus disease 2019 (COVID-19) patients and associated with unfavorable outcomes. We aimed to compare the clinical observations and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients with or without CVD.

METHODS

Patients with laboratory-confirmed SARS-CoV-2 infection were clinically evaluated at Wuhan Seventh People's Hospital, Wuhan, China, from 23 January to 14 March 2020. Demographic data, laboratory findings, comorbidities, treatments and outcomes were collected and analyzed in COVID-19 patients with and without CVD.

RESULTS

Among 596 patients with COVID-19, 215 (36.1%) of them with CVD. Compared with patients without CVD, these patients were significantly older (66 vs. 52 years) and had higher proportion of men (52.5% vs. 43.8%). Complications in the course of disease were more common in patients with CVD, included acute respiratory distress syndrome (22.8% vs. 8.1%), malignant arrhythmias (3.7% vs. 1.0%) including ventricular tachycardia/ventricular fibrillation, acute coagulopathy(7.9% vs. 1.8%) and acute kidney injury (11.6% vs. 3.4%). The rate of glucocorticoid therapy (36.7% vs. 25.5%), Vitamin C (23.3% vs. 11.8%), mechanical ventilation (21.9% vs. 7.6%), intensive care unit admission (12.6% vs. 3.7%) and mortality (16.7% vs. 4.7%) were higher in patients with CVD (both P < 0.05). The multivariable Cox regression models showed that older age (≥65 years old) (HR 3.165, 95% CI 1.722-5.817) and patients with CVD (HR 2.166, 95% CI 1.189-3.948) were independent risk factors for death.

CONCLUSIONS

CVD are independent risk factors for COVID-19 patients. COVID-19 patients with CVD were more severe and had higher mortality rate, early intervention and vigilance should be taken.