HIV Infection Does Not Increase 10-Week Mortality of Chinese Cryptococcal Meningitis Patients

The role of HIV infection in precipitating different clinical features in cryptococcal meningitis (CM) patients remains controversial. One hundred twelve CM patients living with HIV/AIDS (CM+HIV+ patients) and 112 CM patients living without HIV/AIDS (CM+HIV- patients) were enrolled after propensity score matching. Demographic characteristics, symptoms, routine blood tests, and biochemical and cerebrospinal fluid (CSF) profiles were compared between the two groups. Kaplan-Meier analysis and Cox proportional hazards model was used to assess 10-week mortality. CM+HIV+ patients frequently occurred in young (mean age 40.3 ± 10.5) and male (89.3%) populations who also experienced leukopenia, neutropenia, lymphocytopenia, thrombocytopenia, and hypoalbuminemia, less headaches (66.9%), and higher cryptococcemia (23.2%) (all p < .050); they also had higher glucose (2.6 ± 1.1 mmol/L), increased smear positivity (78.8%), and decreased white blood cells [8.0 (2.0-28.0) × 10⁶/L] in initial CSF assay (all p < .050). The 10-week cumulative survival rate was 84.6% for CM+HIV+ patients and 88.5% for CM+HIV- patients (p = .345). Age <35.0 years (hazard ratio (HR) 3.0 (1.0-8.9), p = .046), intracranial pressure (ICP) >250.0 mmH₂O (HR: 4.8 (1.1-21.6), p = .041), and treatment lacking amphotericin B [HR: 6.5 (1.9-21.4), p = .003] were independent risk factors for 10-week mortality in CM+HIV+ patients. There are significant clinical differences in CM patients living with or without HIV/AIDS. However, the 10-week survival rate was similar between the two groups. Younger population, high ICP, and treatment lacking amphotericin B were independent risk factors for 10-week mortality of Chinese CM+HIV+ patients.

γ-Glutamyltransferase Elevations Are Frequent in Patients With COVID-19: A Clinical Epidemiologic Study

A newly identified coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), which causes the infectious coronavirus disease 2019 (COVID‐19), emerged in December 2019 in Wuhan, Hubei Province, China, and now poses a major threat to global public health. Previous studies have observed highly variable alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in patients with COVID‐19. However, circulating levels of the cholangiocyte injury biomarker gamma‐glutamyltransferase (GGT) have yet to be reported in the existing COVID‐19 case studies. Herein, we describe the relationship between GGT levels and clinical and biochemical characteristics of patients with COVID‐19. Our study is a retrospective case series of 98 consecutive hospitalized patients with confirmed COVID‐19 at Wenzhou Central Hospital in Wenzhou, China, from January 17 to February 5, 2020. Clinical data were collected using a standardized case report form. Diagnosis of COVID‐19 was assessed by symptomatology, reverse‐transcription polymerase chain reaction (RT‐PCR), and computed tomography scan. The medical records of patients were analyzed by the research team. Of the 98 patients evaluated, elevated GGT levels were observed in 32.7%; increased C‐reactive protein (CRP) and elevated ALT and AST levels were observed in 22.5%, 13.3%, and 20.4%, respectively; and elevated alkaline phosphatase (ALP) and triglycerides (TGs) were found in 2% and 21.4%, respectively. Initially, in the 82 patients without chronic liver disease and alcohol history, age older than 40 years (P = 0.027); male sex (P = 0.0145); elevated CRP (P = 0.0366), ALT (P < 0.0001), and ALP (P = 0.0003); and increased TGs (P = 0.0002) were found to be associated with elevated GGT levels. Elevated GGT (P = 0.0086) and CRP (P = 0.0162) levels had a longer length of hospital stay. Conclusion: A sizable number of patients with COVID‐19 infection have elevated serum GGT levels. This elevation supports involvement of the liver in persons with COVID‐19.

Assessment of Hypokalemia and Clinical Characteristics in Patients With Coronavirus Disease 2019 in Wenzhou, China

IMPORTANCE

Severe acute respiratory syndrome coronavirus 2 has caused a global outbreak of coronavirus disease 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 binds angiotensin-converting enzyme 2 of the rennin-angiotensin system, resulting in hypokalemia.

OBJECTIVE

To investigate the prevalence, causes, and clinical implications of hypokalemia, including its possible association with treatment outcomes, among patients with COVID-19.

DESIGN, SETTING, AND PARTICIPANTS

This cohort study was conducted at Wenzhou Central Hospital and Sixth People's Hospital of Wenzhou, Wenzhou, China, from January 11, 2020, to February 15, 2020. Participants included patients who received a diagnosis of COVID-19 according to the criteria issued by the Chinese Health Bureau and were admitted to the hospital. The patients were classified as having severe hypokalemia (plasma potassium <3 mmol/L), hypokalemia (plasma potassium 3-3.5 mmol/L), and normokalemia (plasma potassium >3.5 mmol/L). The clinical features, therapy, and outcomes were compared between the 3 groups. Data analysis was conducted in March 2020.

INTERVENTIONS

The patients were given general support and antiviral therapy. Their epidemiological and clinical features were collected.

MAIN OUTCOMES AND MEASURES

The prevalence of hypokalemia and response to treatment with potassium supplements were measured by analyzing plasma and urine potassium levels.

RESULTS

One hundred seventy-five patients (87 female patients [50%]; mean [SD] age, 45 [14] years) were classified as having severe hypokalemia (31 patients [18%]), hypokalemia (64 patients [37%]), and normokalemia (80 patients [46%]). Patients with severe hypokalemia had statistically significantly higher body temperature (mean [SD], 37.6 °C [0.9 °C]) than the patients with hypokalemia (mean [SD], 37.2 °C [0.7 °C]; difference, 0.4 °C; 95% CI, 0.2-0.6 °C; P = .02) and the patients with normokalemia (mean [SD], 37.1 °C [0.8 °C]; difference, 0.5 °C; 95% CI, 0.3-0.7 °C; P = .005). Patients with higher levels of hypokalemia also had higher creatine kinase levels (severe hypokalemia, mean [SD], 200 [257] U/L [median, 113 U/L; interquartile range {IQR}, 61-242 U/L]; hypokalemia, mean [SD], 97 [85] U/L; and normokalemia, mean [SD], 82 [57] U/L), higher creatine kinase-MB fraction (severe hypokalemia, mean [SD], 32 [39] U/L [median, 14 U/L; IQR, 11-36 U/L]; hypokalemia, mean [SD], 18 [15] U/L; and normokalemia, mean [SD], 15 [8] U/L), higher lactate dehydrogenase levels (mean [SD], severe hypokalemia, 256 [88] U/L; hypokalemia, 212 [59] U/L; and normokalemia, 199 [61] U/L), and higher C-reactive protein levels (severe hypokalemia, mean [SD], 29 [23] mg/L; hypokalemia, mean [SD], 18 [20] mg/L [median, 12, mg/L; IQR, 4-25 mg/L]; and normokalemia, mean [SD], 15 [18] mg/L [median, 6 U/L; IQR, 3-17 U/L]). Of 40 severely and critically ill patients, 34 (85%) had hypokalemia. Patients with severe hypokalemia were given potassium at a dose of 40 mEq per day, for a total mean (SD) of 453 (53) mEq potassium chloride, during the hospital stay. The patients responded well to potassium supplements as they recovered.

CONCLUSIONS AND RELEVANCE

The correction of hypokalemia is challenging because of continuous renal potassium loss resulting from the degradation of angiotensin-converting enzyme 2. The high prevalence of hypokalemia among patients with COVID-19 suggests the presence of disordered rennin-angiotensin system activity, which increases as a result of reduced counteractivity of angiotensin-converting enzyme 2, which is bound by severe acute respiratory syndrome coronavirus 2.

Luminescence Tuning of Layered Rare-Earth Hydroxides (LRHs, R = Tb, Y) Composites with 3-Hydroxy-2-naphthoic Acid and Application to the Fluorescent Detection of Al3

Tunable luminescence (quenching or blue shift) of HNA/OS-LRH composites (HNA is 3-hydroxy-2-naphthoic acid; OS is the anionic surfactant of 1-octanesulfonic acid sodium; LRHs are layered rare-earth hydroxides, R = Tb³⁺, Y³⁺) in the solid state and delaminated state is reported, which is utilized as an effective fluorescent probe for detecting metal ions. HNA/OS species are intercalated into LRH layers to generate composites of HNA _xOS_{1- x}-LTbH ( x = 0.10, 0.15, 0.20 , 0.25) and HNA _yOS_{1- y}-LYH ( y = 0.05, 0.10, 0.15, 0.20, 0.25, 0.30). In the solid state, LYH composites exhibit green emissions (from 493 to 504 nm) with a large blue shift in comparison to the 542 nm emission of free HNA^- anions, while in the delaminated state in formamide (FM), the composites display blue emission (480 nm) relative to the green emission (512 nm) of an HNA soltuion in FM. However, LTbH composites display coquenched luminescence in both the solid state and delaminated state. Also, HNA_0.25OS_0.75-1:1-LYH, HNA_0.25OS_0.75-1:2-LYH, and HNA_0.05OS_0.95-1:1-LYH (1:1 and 1:2 are HNA:NaOH molar ratios) show significantly elongated fluorescence lifetimes of 15.35, 14.37, and 12.72 ns, respectively, in comparison with free HNA-Na (6.44 ns), and their quantum yields of 23.40%, 21.97%, and 22.31%, respectively, are much larger than that of free HNA-Na (4.86%). The LTbH composite (HNA_0.25OS_0.75-1:1-LTbH) has also a relatively higher quantum yield of 12.46%. The HNA_0.25OS_0.75-1:1-LYH colloid exhibits excellent recognition selectivity for Al³⁺ over other metal ions (Mg²⁺, Co²⁺, Ni²⁺, Cu²⁺, Zn²⁺, Pb²⁺, Cd²⁺, and Hg²⁺) with distinct fluorescence sensitization. It shows an intense change in its fluorescence emission when it is bound to Al³⁺ ions, giving a lower detection limit of 6.32 × 10^-6 M. This is novel research on the fluorescence chemosensing of LRH composites.

Layered rare-earth hydroxide (LRH, R = Tb, Y) composites with fluorescein: delamination, tunable luminescence and application in chemosensoring for detecting Fe(iii) ions

We demonstrate a novel example of tunable luminescence and the application of the delaminated FLN/OS-LRH composites (LRHs are layered rare-earth hydroxides, R = Tb, Y; FLN is the fluorescein named 2-(6-hydroxy-3-oxo-(3H)-xanthen-9-yl)benzoic acid; OS is the anionic surfactant 1-octane sulfonic acid sodium) in detecting Fe(iii) ions. The FLNxOS1-x species (x = 0.02, 0.05, 0.10, and 0.20) are intercalated into the LTbyY1-yH layers (y = 1, 0.9, 0.7, 0.5, 0.3, 0.1 and 0) by ion exchange reactions to yield the composites FLNxOS1-x-LTbyY1-yH. In the solid state, the LYH composites display green emission (564 nm) arising from the organic FLN, while in LTbH composites, the luminescence of the Tb3+ in the layers (545 nm) and the FLN in the interlayers is co-quenched. In the delaminated state in formamide (FM), FLNxOS1-x-LTbH composites display green to yellowish-green luminescence (540-574 nm) following the increasing FLN/OS ratio; while the FLN0.02OS0.98-LTbyY1-yH composites show green emission at ∼540 nm. The fluorescence lifetimes of the composites (4.22-4.63 ns) are comparable to the free FLN-Na, and the quantum yields (31.62-78.70%) of the composites especially that (78.70%) of the FLN0.02OS0.98-LYH are much higher than that (28.40%) of free FLN-Na. The recognition ability of the FLN0.02OS0.98-LYH composite for metal cations is researched. The delaminated FLN0.02OS0.98-LYH colloidal suspension exhibits high selectivity for Fe3+ over other ions (Mg2+, Al3+, Ni2+, Co2+, Cu2+, Zn2+, Mn2+, Pb2+, and Cd2+) with fluorescence quenching, which can work as a kind of turn-off fluorescence sensor for the detection of Fe3+. The detection limit of Fe3+ is determined to be 2.58 × 10-8 M and the quenching constant (Ksv) is 1.70 × 103 M-1. This is the first work on LRH materials working as a chemosensor for recognising metal cations. It provides a new approach for the design of LRH materials to be applied in fluorescence chemosensing.

Distal myopathy with rimmed vacuoles: Spectrum of GNE gene mutations in seven Chinese patients

Distal myopathy with rimmed vacuoles (DMRV) is a rare, autosomal, recessive inherited disease caused by mutations in the GNE gene. DMRV is an adult-onset disorder characterized by progressive muscle atrophy and weakness, which initially involves the distal muscles with quadriceps sparing. To date, >150 GNE mutations have been reported in different populations from around the world. The present study investigated the clinical, pathological and genetic characteristics of seven unrelated DMRV patients from China. Genetic analysis in these patients revealed three novel mutations (c.455_456insC, p.P421L, and p.A287T) and five previously reported mutations (p.D207V, p.C44S, p.G576R, p.A669P, and p.D218G). In addition, the literature on DMRV was reviewed to provide an overview of the disease and broaden the mutational spectrum of the GNE gene in China.

Complication Follow-up With Ultrasonographic Analyses of 91 Cases With Donor Gallbladder Preservation in Living Donor Liver Transplantation of Left Lateral Sectionectomies

BACKGROUND

Preserving the donor's gallbladder during living donor liver transplantation (LDLT) is a better method for liver transplantation surgery, but not enough is known about gallbladder complications after the operation.

METHODS

We retrospectively investigated postsurgical donor gallbladder complications in clinical LDLT with gallbladder preservation. The feasibility of retaining the gallbladder during liver graft procurement is discussed. Ninety-one donors with retained gallbladder after LDLT with the hepatic left lateral sectionectomy (from June 2013 to October 2015) were retrospectively analyzed. Donors were followed for 12.6 to 40.7 months after surgery (median 26.1 months). Sonography was used to evaluate gallbladder characteristics before and after surgery.

RESULTS

Gallbladder function had recovered to almost normal 1 month after transplantation. Four donors (4.40%) experienced gallbladder enlargement that resolved after 3 days. Thickening of the gallbladder wall in 31 donors (34.07%) was restored within 2 to 75 days. Biliary sludge appeared in 9 donors (9.89%); 6 of them recovered within 3 to 34 days. Three (3.30%) and 1 donor (1.10%) suffered gallstone and gallbladder polyps, respectively, which persisted until the last follow-up.

CONCLUSION

The rate of postoperative complications of the gallbladder in donors was relative low. Preserving the gallbladder in liver transplantation donors during liver graft procurement is feasible and safe.

Variability in the time to initiation of CPR in continuously monitored pediatric ICUs

AIM

To study the influence of patient characteristics and unit ergonomics and human factors on the time to initiation of CPR.

METHODS

A single center study of children, 0 to 21 years old, admitted to an ICU who experienced cardiopulmonary arrest (CPA) requiring >1 min of chest compressions. Time of CPA was determined by analysis of continuous ECG, plethysmography, arterial blood pressure, and end-tidal CO₂ (EtCO₂) waveforms. Initiation of CPR was identified by the onset of cyclic artifact in the ECG waveform. Patient characteristics and unit ergonomics and human factors were examined including CPA cause, identification on the High-Risk Checklist (HRC), existing monitoring, ICU type, time of day, nursing shift change, and outcome.

RESULTS

The median time from CPA to initiation of CPR was 50.5 s (IQR 26.5 to 127.5) in 36 CPAs. Forty-seven percent of patients experienced time from CPA to initiation of CPR of >1 min. There was no difference in CPA cause, ICU type, time of day, or nursing shift change.

CONCLUSION

Nearly half of pediatric patients who experienced CPA in an ICU setting did not meet AHA guidelines for early initiation of CPR. This is an opportunity to study the recognition phase of CPA using continuous monitoring data with the aim of improving the understanding of and factors contributing to delays in initiation of CPR.

A Comprehensive Evaluation of Xpert MTB/RIF Assay With Bronchoalveolar Lavage Fluid as a Single Test or Combined With Conventional Assays for Diagnosis of Pulmonary Tuberculosis in China: A Two-Center Prospective Study

Introduction: The Xpert MTB/RIF is recommended by the World Health Organization as a first line rapid test for the diagnosis of pulmonary tuberculosis (TB); however, China does not routinely use this test, partially due to the lack of a sufficient number of systematic evaluations of this assay in local patients. The aims of this study were to comprehensively assess the diagnostic performance of Xpert MTB/RIF, either alone or in combination with conventional assays for the diagnosis of pulmonary TB in adult Chinese patients. Methods: Xpert MTB/RIF tests were performed in 190 adult patients with suspected pulmonary TB, using bronchoalveolar lavage fluid (BALF) as test specimens. In parallel, conventional tests were carried out using the same BALF samples. Using two different reference standards, the performance of Xpert MTB/RIF, conventional assays and their combinations were evaluated. Results: Using mycobacterial culture as the reference comparator, Xpert MTB/RIF was found to be superior to smear-microscopy in detecting Mycobacterium tuberculosis. When final diagnosis, based on clinical criteria, was employed as the reference standard, Xpert MTB/RIF showed an even higher accuracy of 72.1%, supported by a sensitivity of 61.1% and specificity of 96.6%. Xpert MTB/RIF also demonstrated a powerful capability to identify pulmonary TB cases undetected by culture or smear-microscopy. Combining smear-microscopy and Xpert MTB/RIF was found to be the most accurate early predictor for pulmonary TB. Rifampicin resistance reported by Xpert MTB/RIF slightly deviated from that by phenotypic antibiotic susceptibility testing and requires further study with a larger sample size. Conclusion: This two-center prospective study highlights the value of Xpert MTB/RIF with BALF in diagnosing pulmonary TB in adult Chinese patients. These findings might contribute to the optimization of current diagnostic algorithms for pulmonary TB in China.

Abstract PD4-06: First-line ribociclib + letrozole in hormone receptor-positive, HER2-negative advanced breast cancer: Efficacy by baseline circulating tumor DNA alterations in MONALEESA-2

Background: The addition of first-line ribociclib (RIB; cyclin-dependent kinase 4/6 inhibitor) to letrozole (LET) significantly improved progression-free survival (PFS) compared with placebo (PBO) + LET in patients (pts) with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2–) advanced breast cancer (ABC) in the Phase III MONALEESA-2 study. Identifying biomarkers that predict response to treatment remains a key challenge in pts with HR+ ABC. Here we analyze results from MONALEESA-2 by molecular alterations detected in circulating tumor DNA (ctDNA) at baseline, including PIK3CA mutations and other alterations considered to be important in HR+ ABC.

Methods: Postmenopausal women (N=668) with HR+, HER2– ABC who had not received any prior therapy for ABC were randomized 1:1 to RIB (600 mg/day; 3-weeks-on/1-week-off) + LET (2.5 mg/day; continuous) or PBO + LET. The primary endpoint was PFS. Biomarker analysis of the ctDNA mutation profile was an exploratory endpoint. Plasma samples for ctDNA analysis were collected at baseline and end of treatment. ctDNA was analyzed using next-generation sequencing with a targeted panel of ˜550 genes.

Results: Baseline ctDNA was successfully sequenced in 494 pts (RIB + LET: n=212; PBO + LET: n=215); 67 (14%) of 494 pts were removed from the analysis due to limited tumor DNA in circulation. 427 (86%) pts had ≥1 alteration, including 1,573 mutations, 513 short insertions/deletions, 166 amplifications, and 8 translocations. Alterations (frequency) were commonly observed in the following genes: PIK3CA (33%), TP53 (12%), ZNF703/FGFR1 (5%), and ESR1 (4%), and in genes involved in receptor tyrosine kinase (RTK) signaling (12%). RIB + LET treatment benefit was consistent in pts with wild-type (WT) and altered PIK3CA, and in pts with WT and altered TP53 (Table). RIB + LET improved PFS regardless of RTK or ZNF703/FGFR1 alterations. However, there was a weak trend for increased benefit in pts with WT vs altered RTK genes and in pts with WT vs altered ZNF703/FGFR1 genes. These results should be interpreted with caution due to the small number of pts with these alterations. There were too few ESR1 alterations for firm conclusions to be drawn.

 Events, n/NMedian PFS, months Gene(s)RIB + LETPBO + LETRIB + LETPBO + LETHazard ratio (95% confidence interval)PIK3CAWT54/14393/14229.614.70.44 (0.31–0.62)Altered40/6955/7319.212.70.53 (0.35–0.81)TP53WT72/180129/19427.614.70.44 (0.33–0.59)Altered22/3219/2110.25.50.43 (0.23–0.83)ZNF703/FGFR1WT88/202139/20524.814.60.47 (0.36–0.62)Altered6/109/1010.611.40.73 (0.23–2.29)RTKWT81/189128/18724.814.40.46 (0.35–0.61)Altered13/2320/2821.311.40.72 (0.34–1.53)

Conclusions: Consistent RIB + LET treatment benefit was observed compared with PBO + LET, irrespective of the status of baseline ctDNA biomarkers.

Citation Format: Hortobagyi GN, Stemmer S, Campone M, Sonke GS, Arteaga CL, Paluch-Shimon S, Petrakova K, Villanueva C, Nusch A, Grischke E-M, Chan A, Jakobsen E, Marschner N, Hart LL, Alba E, Ohnstand HO, Blau S, Yardley DA, Solovieff N, Su F, Germa C, Yap Y-S. First-line ribociclib + letrozole in hormone receptor-positive, HER2-negative advanced breast cancer: Efficacy by baseline circulating tumor DNA alterations in MONALEESA-2 [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD4-06.

Simvastatin Protects Heart from Pressure Overload Injury by Inhibiting Excessive Autophagy

Cardiac hypertrophy is an independent predictor of cardiovascular morbidity and mortality. To identify the mechanisms by which simvastatin inhibits cardiac hypertrophy induced by pressure overload, we determined effects of simvastatin on 14-3-3 protein expression and autophagic activity. Simvastatin was administered intragastrically to Sprague-Dawley (SD) rats before abdominal aortic banding (AAB). Neonatal rat cardiomyocytes (NRCs) were treated with simvastatin before angiotensin II (AngII) stimulation. 14-3-3, LC3, and p62 protein levels were determined by western blot. Autophagy was also measured by the double-labeled red fluorescent protein-green fluorescent protein autophagy reporter system. Simvastatin alleviated excessive autophagy, characterized by a high LC3II/LC3I ratio and low level of p62, and blunted cardiac hypertrophy while increasing 14-3-3 protein expression in rats that had undergone AAB. In addition, it increased 14-3-3 expression and inhibited excessive autophagy in NRCs exposed to AngII. Our study demonstrated that simvastatin may inhibit excessive autophagy, increase 14-3-3 expression, and finally exert beneficial effects on cardioprotection against pressure overload.

Particulate matter adheres to human hair exposed to severe aerial pollution: consequences for certain hair surface properties

BACKGROUND

The deposit and adherence of particulate matter (PM) from aerial pollution onto the surface of human hair is a poorly studied phenomenon.

OBJECTIVES

(i) To reproduce in vitro the deposit of known PM on standardized hair swatches in a closed box, (ii) to compare in vitro data with those obtained under 'real-life' conditions of severe aerial pollution and (iii) to assess the changes of the hair surface properties, potentially caused by the adherence of airborne PM onto the hair.

METHODS

In vitro: a PM was sprayed onto untreated or sebum-coated hair swatches. Real-life conditions: other swatches were exposed to a severely polluted environment, for 24 to 72 h, in Baoding (PR China). In both cases, swatches were examined using scanning electron microscopy. The shine, the frictional properties and the level of metals were measured and compared to those same properties for the unexposed swatches.

RESULTS

This work clearly indicates that, under real-life conditions, a large number of PM of various sizes are deposited onto the hair surface. This phenomenon is increased by the presence of sebum and longer exposure times. The in vitro level of PM deposited onto the hair surface is comparable to the in vivo level. The presence of sebum seems to favour the deposit of larger PM. The shine of the exposed swatches is significantly decreased, whereas their respective friction coefficients are significantly increased. Both the presence of sebum and length of exposure time increased the amount of analysed metals present on the exposed hair surface (Al, Fe, Cu, Ba and Zn).

CONCLUSION

This work indicates that a very high amount (e.g. billions) of PM can be deposited on a full head of hair for subjects living in a severely aerially polluted environment. This process can be reproduced in vitro. In real-life, pollution has a strong impact on hair surface properties, leading to a modification of the visual aspect (loss of shine) and the alteration of hair surface (increase in friction force). This work may be used to pave the way for prevention and cleansing studies in the field of hair care.

Tetrahydroxystilbene Glycoside Improves Microvascular Endothelial Dysfunction and Ameliorates Obesity-Associated Hypertension in Obese ZDF Rats Via Inhibition of Endothelial Autophagy

Aims: Obesity is a major risk for hypertension. Endothelial dysfunction contributes to increased peripheral vascular resistance and subsequent hypertension. Autophagy regulates endothelial function, however, whether autophagy is related to hypertension in obesity remains largely unclear. We wished to ascertain: (i) the role of autophagy in obesity-induced hypertension and the underlying mechanisms; (ii) if tetrahydroxystilbene glycoside (TSG) influences endothelial dysfunction and obesity-associated hypertension. Methods: (TSG-treated) male Zucker diabetic fatty (ZDF) rats and cultured human umbilical vein endothelial cells (HUVECs) were used. Blood pressure was measured non-invasively with a tail-cuff system. Westernblotting was performed to determine the expression of autophagy-associated proteins. Autophagy flux was assessed by transfection HUVECs with the Ad-mGFP–RFP–LC3. Results: Compared with their lean counterparts, obese ZDF rats exhibited hypertension and endothelial dysfunction, along with impaired Akt/mTOR signaling and upregulated expression of autophagy-associated proteins beclin1, microtubule-associated protein 1 light chain 3 II/I, autophagy protein (ATG)5 and ATG7. Two-week TSG administration restored blood pressure and endothelial function, reactivated Akt/mTOR pathway and decreased endothelial autophagy in ZDF rats. Rapamycin pretreatment blocked the hypotensive effect of TSG in ZDF rats. Suppression of Akt/mTOR expression with siRNA significantly blunted the anti-autophagic effect of TSG in HUVECs as evidenced by abnormal autophagic flux and increased expression of autophagy-associated proteins. Conclusion: Endothelial dysfunction in ZDF rats is partially attributable to excessive autophagy. TSG improves endothelial function and exerts hypotensive effects via regulation of endothelial autophagy.

[Preparation of chaperone-antigen peptide vaccine derived from human gastric cancer stem cells and its immune function]

Objective: To explore the method of extracting chaperone antigen peptide complexes from gastric cancer stem cells and its immune function. Methods: Gastric cancer stem cells and gastric cancer cells were screened by low temperature ultrasonic lysis. After salting out and dialysis, the lysate supernatant was processed with SDS-PAGE to analyze the expression of chaperone antigen peptide complexes, and then was separated and purified with CNBr-activated SepharoseTM 4B. Reverse high pressure liquid chromatography (HPLC), SDS-PAGE and Western blotting were used to analyze the purity and nature of the acquired albumen. Lymphocyte proliferation assay and lymphocytotoxicity assay were used to ditermine the immunological activity of the chaperone-antigen peptide complexes. Results: The chaperone antigen peptide complexes of gastric cancer stem cells were prepared and identified successfully, of which the main components were the antigen peptides of HSP60, HSP70, HSP90 and HSP110. 0.75 μg and 1.00 μg HSP70-antigen peptide and 1.00 μg HSP90-antigen peptide activated lymphocytes significantly. Their A(490) values were 0.26±0.03, 0.45±0.05 and 0.32±0.04, respectively, while the corresponding doses of HSP60-antigen peptide and HSP110-antigen peptide did not activate lymphocytes. The killing rates of 1.00 μg HSP70-antigen peptide and 1.00 μg HSP70 were (45.0±2.0)% and (16.0±2.0)%, respectively, showing a significant difference (P=0.012). Similarly, the killing rates of 1.00 μg HSP90-antigen peptide and 1.00 μg HSP90 were (36.0±5.0)% and (13.0±4.0)%, respectively, also showing a significant difference (P=0.048). Conclusions: The amount of chaperone antigen peptide complexes in gastric cancer cells is extremely low, but it is obviously increased in gastric cancer stem cells. After purification, the chaperone antigen peptide complexes with high purity can be prepared. The extracted chaperone antigen peptide complexes have stronger immunogenicity, and can be used to make tumor vaccine in vitro, which may have a good application value in the targeted therapy of gastric cancer.

Abstract 208: Excessive Autophagy Contributes to Microvascular Endothelial Dysfunction in Prehypertensive Spontaneously Hypertensive Rats

Autophagy exists in vascular endothelial cells, however, the exact role of autophagy in hypertensive-associated vascular endothelial dysfunction remains largely elusive. We assessed the hypothesis that autophagy is one of the mechanisms of endothelial dysfunction in normotensive spontaneously hypertensive rats (SHRs). Age-matched male SHRs and Wistar Kyoto rats (WKY) aged 4 weeks (young) and 12 weeks (adult) were randomized into 2 groups and treated daily for 2 weeks by a) gavage with vehicle alone (normal saline) or b) intraperitoneally injection of rapamycin (1 mg/kg/day), and the vascular function of their isolated aorta and mesenteric artery was assessed in vitro . Furthermore, human umbilical vein endothelial cells (HUVECs) were incubated serum-starved for 6 h to induce excessive cell autophagy, and then incubated with DMEM containing 10% FBS and a) treated with 10 nmol/L insulin-like growth factor 1 (IGF-1) for 12 h, b) treated with 100 nmol/L Rapamycin for 1 h for 37°C. Compared with WKY, young and adult SHRs showed endothelial dysfunction of the aorta and mesenteric artery, along with decreased phosphorylated (p)-Akt, p-mTOR, and autophagic marker protein p62 and increased LC3 II/I in microvascular but not aortic tissues. Treatment of young SHRs with the mTOR inhibitor rapamycin aggravated the endothelial autophagy and subsequent impaired endothelial function. Moreover, IGF-1 significantly activated Akt/mTOR signaling in HUVECs and reduced autophagic levels, while rapamycin inhibited p-mTOR and increased autophagic levels. In conclusion, mesenteric endothelial dysfunction in prehypertensive SHRs is at least partly attributable to excessive autophagy in vascular tissues, and is likely mediated by the underactive Akt/mTOR signaling pathway; however, autophagy appears not to be responsible for the macrovascular endothelial dysfunction.