AB0042 THREE HEMATOLOGIC/IMMUNE SYSTEM-SPECIFIC EXPRESSED GENES ARE CONSIDERED AS THE POTENTIAL BIOMARKERS FOR THE DIAGNOSIS OF EARLY RHEUMATOID ARTHRITIS THROUGH BIOINFORMATICS ANALYSIS

Background:

Rheumatoid arthritis (RA) is a common chronic autoimmune connective tissue disease that mainly involves the joints. The incidence of RA is 5 to 10 per 1000 people[1]. Early diagnosis and treatment of RA can effectively prevent disease progression, joint damage, and other complications in 90% of patients[2]. At present, serum biomarkers used in the diagnosis of established RA are rheumatoid factor and anti-cyclic citrullinated peptide antibody[3]. However, early RA especially serum RF and anti-CCP antibody-negative is difficult to diagnose due to the lack of effective biomarkers. Therefore, it is vital to identify new and effective biomarkers for the early diagnosis and treatment of RA.

Objectives:

This study aimed to identify new biomarkers and mechanisms for RA disease progression at the transcriptome level through a combination of microarray and bioinformatics analyses.

Methods:

Microarray datasets for synovial tissue in RA or osteoarthritis (OA) were downloaded from the Gene Expression Omnibus (GEO) database, and differentially expressed genes (DEGs) were identified by R software. Tissue/organ-specific genes were recognized by BioGPS. Enrichment analyses were performed and protein-protein interaction (PPI) networks were constructed to understand the functions and enriched pathways of DEGs and to identify hub genes. Cytoscape was used to construct the co-expressed network and competitive endogenous RNA (ceRNA) networks. Biomarkers with high diagnostic value for the early diagnosis of RA were validated by GEO datasets. The ggpubr package was used to perform statistical analyses with Student’s t-test.

Results:

A total of 275 DEGs were identified between 16 RA samples and 10 OA samples from the datasets GSE77298 and GSE82107. Among these DEGs, 71 tissue/organ-specific expressed genes were recognized. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis indicated that DEGs are mostly enriched in immune response, immune-related biological process, immune system, and cytokine signal pathways. Fifteen hub genes and gene cluster modules were identified by Cytoscape. Eight haematologic/immune system-specific expressed hub genes were verified by GEO datasets. GZMA, PRC1, and TTK may be biomarkers for diagnosis of early RA through combined the analysis of the verification results and the receiver operating characteristic (ROC) curve. NEAT1-miR-212-3p/miR-132-3p/miR-129-5p-TTK, XIST-miR-25-3p/miR-129-5p-GZMA, and TTK_hsa_circ_0077158- miR-212-3p/miR-132-3p/miR-129-5p-TTK might be potential RNA regulatory pathways to regulate the disease progression of early RA.

Conclusion:

This work identified three haematologic/immune system-specific expressed genes, namely, GZMA, PRC1, and TTK, as potential biomarkers for the early diagnosis and treatment of RA and provided insight into the mechanisms of disease development in RA at the transcriptome level. In addition, we proposed that NEAT1-miR-212-3p/miR-132-3p/miR-129-5p-TTK, XIST-miR-25-3p/miR-129-5p-GZMA, and TTK_hsa_circ_0077158-miR-212-3p/miR-132-3p/miR-129-5p-TTK are potential RNA regulatory pathways that control disease progression in early RA.

References:

[1]Smolen JS, Aletaha D, McInnes IB: Rheumatoid arthritis.Lancet 2016, 388:2023-2038.

[2]Aletaha D, Smolen JS: Diagnosis and Management of Rheumatoid Arthritis: A Review.Jama 2018, 320:1360-1372.

[3]Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO, 3rd, Birnbaum NS, Burmester GR, Bykerk VP, Cohen MD, et al: 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative.Arthritis Rheum 2010, 62:2569-2581.

Disclosure of Interests:

None declared

[Evaluation of infrahepatic inferior vena cava clamping in robot-assisted laparoscopic liver resection]

Objective: To evalutate the safety and efficacy of infrahepatic inferior vena cava clamping robot-assisted laparoscopic liver resection. Methods: All data about 24 patients with robotic liver resection at Hepatic Surgery Center,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology between February 2015 and December 2017 were collected and analyzed. These patients were divided into two groups based on different methods to decrease central venous pressure. Eight patients(6 males and 2 females,aged 49 years(range:50 to 56 years)) were applied with infrahepatic inferior vena cava clamping,and the other 16 matched cases (15 males and 1 female,aged 53 years(range:38 to 69 years)) were categorized into lowering central venous pressure group. Intraoperative blood loss,blood transfusion,intraoperative hemodynamic parameters,postoperative complications,and renal function were compared by t-test,non-parametric test,χ² test,or Fisher exact test. Results: There was significantly difference in the intraoperative blood loss between the infrahepatic vena cava clamping group and the lowering central venous group(200(220) ml (range:100 to 400 ml) vs. 750(800) ml (range:100 to 2 000 ml),Z=‒2.169,P=0.030). The clamping time of portal triad and infrahepatic inferior vena cava were 24 (18) minutes and 29 (20) minutes in the infrahepatic inferior vena cava clamping group, and portal triad clamping time was 23 (23) minutes in the low central venous group. There was no significant difference between the two groups (Z=‒0.323, P=0.747). There was no intraoperative blood transfusion in the infrahepatic inferior vena cava clamping group, and 5 cases in the low central venous group, with a transfusion volume of 1.5(1.5)U. The difference between the two groups was statistically significant (Z=‒3.353, P=0.001). However, the mean arterial pressure in the infrahepatic vena cava clamping group decreased from (88.6±4.9) mmHg to (67.4±3.8) mmHg(1 mmHg=0.133 kPa), which was lower than that of lowering central venous group (72.4±3.3) mmHg (t=2.315,P=0.003). And there were no significant differences related to postoperative complications rate or hepatic and renal function in both groups. Conclusion: The infrahepatic inferior vena cava technology is safe and feasible to decrease central venous pressure during robotic liver resections,which will not affect the recovery of hepatic and renal functions.

Persistence of pelvic spine polymorphism in a panmictic population of brook stickleback (Culaeainconstans) in Alberta, Canada

In the stickleback family (Gasterosteidae), divergence in pelvic morphology is typically associated with reproductive isolation and ecological niche specialization. In this study, we assessed whether reproductive isolation may be involved in the persistence of within-lake polymorphism in brook stickleback (Culaea inconstans (Kirtland, 1840)). We studied populations of brook stickleback in central Alberta, Canada, that are polymorphic for pelvic reduction (i.e., presence–absence of pelvic spines). We investigated the persistence of the pelvic polymorphisms over 40 generations in five lakes. We found that, of the five populations examined, the frequencies of pelvic phenotypes have remained unchanged in three populations, the polymorphism has persisted with significantly changed frequencies of pelvic phenotypes in one population, and the polymorphism has been lost in one population. Using 10 microsatellite loci, we observed low genetic divergence between individuals with and without pelvic spines in one lake, suggesting a lack of assortative mating among individuals with divergent pelvic phenotypes. This observation suggests that the pelvic polymorphism in brook stickleback persists due to balancing selection in the absence of reproductive isolation, although the selective forces were not evaluated. The significant changes in phenotypic frequencies in two populations are likely associated with environmental disturbances such as species introductions.

[Comparison of subgingival microbial profile of aggressive periodontitis, chronic periodontitis and periodontally healthy individuals]

Objective: To compare the subgingival microbiota of subjects from patients with aggressive periodontitis (AgP), chronic periodontitis (CP) and periodontally healthy (PH) individuals, respectively. Methods: Volunteers were recruited from the Nangjing Stomatological Hospital, Medical School of Nanjing University during December 2013 to December 2014. Ten individuals were included in each of three groups. Preliminary estimation of sampling sites was chosen based on the X-ray and intraoral examination. Then the subgingival plaque samples were collected, the periodontal clinical indices were recorded, genes were extracted and amplified by PCR, and subsequently a DNA library was constructed for 16S rDNA sequencing. The library that can be successfully constructed and sequenced includes: 18 samples from 8 AgP group patients, 31 samples from 10 CP group patients and 10 samples from 8 PH group volunteers. Finally, we analyzed and compared the α-diversity, β-diversity and microbial compositions of samples in each group. Pearson correlation analysis was adopted to evaluate the correlation between the relative abundance of microorganisms and the probing depth (PD). Results: The α-diversity of subgingival flora in AgP group was significantly lower than that in PH group and CP group, respectively (P<0.05). On the phylum level, the abundance of Bacteroides [(36.8±7.4)%] and Spirochetes [(16.0±5.4)%] in AgP group and the abundance of Bacteroides [(37.2±6.3)%] and Spirochetes [(11.8±3.6)%] in CP group were significantly higher than those in PH group [(27.5±11.2)%, (5.2±4.4)%, respectively, P<0.05]. While the relative abundance of Actinomycetes and Proteobacteria [(4.2±3.3)%, (12.9±5.1)%, respectively] in AgP group and that of CP group [(6.1±2.6)%, (12.1±4.0)%, respectively] were significantly higher than PH group [(19.3±13.1)%, (23.0±10.1)%, respectively, P<0.01). The abundance of Spirochetes and Tenericutes in AgP group [(16.0±5.4)%, (1.7±1.2)%, respectively] were significantly higher than that in CP group [(11.8±3.6)%, (0.7±0.6)%, respectively, P<0.05]. At the genus level, Corynebacterium, Actinomycete, Saccharibacteria_norank, Selenomonas and Oribacterium in the subgingival flora of AgP group were significantly lower than that of CP group, while the relative abundance of Actinomycetes, Lentimicrobiaceae_norank, Defluvitaleaceae_UCG_011, Family_XI_unclassified were significantly higher than that of CP group (P<0.05). Principal coordinate analysis showed that samples of each group clustered separately from each other. Linear discriminant analysis revealed that the bacteria enriched in AgP group included Spirochetes, while in CP group included Bacteroidaceae. The result of correlation analysis showed that the abundance of the following genera in AgP group were positively correlated with PD: Treponema_2, Defluitaleaceaeae_UCG_011, Mycoplasma, Catonella, Fretibacterium (r=0.525-0.750, P<0.05). While the relative abundance of Comamonadaceae_unclassified, Streptococcus, Capnocytophaga, Neisseria, Prevotella, Peptococcus, Ralstonia, Bergenia and Actinomycetes were negatively associated with PD (r=-0.617--0.490, P<0.05). In the CP group, the abundance of Dialister, Family_XI_unclassified, Catonella, Peptococcus, Pelospora and Rikenella_RC9_gut group were positively correlated with PD (r=0.430-0.533, P<0.05). Conclusions: There is a clear difference between the subgingival flora of periodontal patients and that of PH individuals. Besides, subgingival flora of AgP and CP are also different, suggesting that these could be two different diseases.

The structure of ScC2 (X̃2A1): A combined Fourier transform microwave/millimeter-wave spectroscopic and computational study

Pure rotational spectra of Sc¹³C₂ (X̃²A₁) and Sc¹²C¹³C (X̃²A') have been measured using Fourier transform microwave/millimeter-wave methods. These molecules were synthesized in a DC discharge from the reaction of scandium vapor, produced via laser ablation, with ¹³CH₄ or ¹³CH₄/¹²CH₄, diluted in argon. The N_Ka,Kc = 1_0,1 → 0_0,0, 2_0,2 → 1_0,1, 3_0,3 → 2_0,2, and 4_0,4 → 3_0,3 transitions in the frequency range of 14 GHz-61 GHz were observed for both species, each exhibiting hyperfine splittings due to the nuclear spins of ¹³C (I = 1/2) and/or Sc (I = 7/2). These data have been analyzed with an asymmetric top Hamiltonian, and rotational, spin-rotation, and hyperfine parameters have been determined for Sc¹³C₂ and Sc¹²C¹³C. In addition, a quartic force field was calculated for ScC₂ and its isotopologues using a highly accurate coupled cluster-based composite method, incorporating complete basis set extrapolation, scalar relativistic corrections, outer core and inner core electron correlation, and higher-order valence correlation effects. The agreement between experimental and computed rotational constants, including the effective constant (B + C), is ∼0.5% for all three isotopologues. This remarkable agreement suggests promise in predicting rotational spectra of new transition metal-carbon bearing molecules. In combination with previous work on Sc¹²C₂, an accurate structure for ScC₂ has been established using combined experimental (B, C) and theoretical (A) rotational constants. The radical is cyclic (or T-shaped) with r_(Sc-C) = 2.048(2) Å, r_(C-C) = 1.272(2) Å, and ∠_(C-Sc-C) = 36.2(1)°. The experimental and theoretical results also suggest that ScC₂ contains a C₂ ^- moiety and is largely ionic.

Inoculation of exogenous lactic acid bacteria exerted a limited influence on the silage fermentation and bacterial community compositions of reed canary grass straw on the Qinghai-Tibetan Plateau

AIMS

This study evaluated the effects of exogenous lactic acid bacteria (LAB) on silage fermentation and bacterial community of reed canary grass (RCG) straw.

METHODS AND RESULTS

The leaf, stem and whole crop of RCG straw were separately ensiled in small bag silos, without (control) or with inoculation of two exogenous LAB (LP, Lactobacillus plantarum; LB, Lactobacillus buchneri), and stored at ambient temperature of <20°C. Inoculation of exogenous LAB decreased (P < 0·05) bacterial alpha diversity and shifted (P < 0·05) bacterial community compositions, but did not change (P> 0·05) the relative abundance of Lactobacillus. Particularly, inoculation of LB increased (P < 0·05) acetic acid and propionic acid contents, decreased (P < 0·05) butyric acid (BA) and ammonia-N contents, separated (P < 0·05) the bacterial community in silage. However, the exogenous LAB inoculated silages were characterized by main distribution of yeasts, presence of undesirable bacterial genera such as Clostridium and high levels of BA and ammonia-N.

CONCLUSION

Inoculation of exogenous LAB exerted a limited influence on the silage fermentation and bacterial community compositions of RCG straw on the Qinghai-Tibetan Plateau.

SIGNIFICANCE AND IMPACT OF THE STUDY

Commercial LAB inoculants are not always efficient on enhancing silage quality and stability. Thus, an alternative additive for inhibiting undesirable microbes during storage is important to improve RCG silage quality on the Qinghai-Tibetan Plateau.

Control of protein function through oxidation and reduction of persulfidated states

Irreversible oxidation of Cys residues to sulfinic/sulfonic forms typically impairs protein function. We found that persulfidation (CysSSH) protects Cys from irreversible oxidative loss of function by the formation of CysSSO_1-3H derivatives that can subsequently be reduced back to native thiols. Reductive reactivation of oxidized persulfides by the thioredoxin system was demonstrated in albumin, Prx2, and PTP1B. In cells, this mechanism protects and regulates key proteins of signaling pathways, including Prx2, PTEN, PTP1B, HSP90, and KEAP1. Using quantitative mass spectrometry, we show that (i) CysSSH and CysSSO₃H species are abundant in mouse liver and enzymatically regulated by the glutathione and thioredoxin systems and (ii) deletion of the thioredoxin-related protein TRP14 in mice altered CysSSH levels on a subset of proteins, predicting a role for TRP14 in persulfide signaling. Furthermore, selenium supplementation, polysulfide treatment, or knockdown of TRP14 mediated cellular responses to EGF, suggesting a role for TrxR1/TRP14-regulated oxidative persulfidation in growth factor responsiveness.

Runoff variation characteristics, association with large-scale circulation and dominant causes in the Heihe River Basin, Northwest China

The water resources in arid and semi-arid regions are critical to providing reliable sources of water for food production and ecosystem functioning. In this study, continuous wavelet transform and wavelet coherence were used to analyse the runoff periodicity and relationship with climate indices, respectively. Additionally, the double mass curve (DMCD), the slope changing ratio of cumulative quantity (SCRCQ) and the Choudhury-Yang equation (Budyko-CY) methods for different potential evapotranspiration data (E₀(E₀-20 cm, E₀-PM, E₀-H)) were used to separate the impacts of climate changes and anthropogenic activities on runoff variations. The results demonstrated that the flow regimes in high and low flow seasons were not obvious shifts, and that after implementation of the Ecological Water Diversion Project (EWDP), ecosystems were gradually restored in the downstream portion of the Heihe River Basin (DHRB). Periodicities of 1-7 years and 1-5.8 years were detected in Yingluoxia and Zhengyixia, respectively. Additionally, on a 1-148.2 month timescale, the monthly runoff with AO, NAO, PDO, and AMO had significant resonance periodicity and a 1-48 month Spearman's lag correlation. On the annual and high-flow, climate changes dominant determinant to an increase of runoff for the DMCD and Budyko-CY in period 2, SCRCQ and Budyko-CY in period 3 for different E₀ in the upstream (UHRB). In the midstream (MHRB) region, anthropogenic activities played a dominant role in deducing the runoff by the SCRCQ and Budyko-CY methods for different E₀ values in period 3. During the low-flow season, the impact of human activities in the UHRB and climate changes in the MHRB was significant for period 2 and 3. Therefore, the impacts of climate change and human activities on runoff changes caused by the introduction of different E₀ on different timescales should be fully considered in the future.

[Surveillance and sociological factors of schistosomiasis among mobile populations in Haining City]

OBJECTIVE

To investigate the correlation between the source of Schistosoma japonicum infections and sociological factors among mobile populations in Haining City, so as to provide insights into the management of schistosomiasis among mobile populations in Haining City.

METHODS

A total of 12 villages were randomly sampled from 8 townships and 4 subdistricts in Haining City. The mobile populations from schistosomiasis-endemic areas were detected for S. japonicum infections using serological tests. In addition, the awareness of schistosomiasis prevention and control knowledge was investigated using a questionnaire survey.

RESULTS

A total of 1 019 mobile populations were investigated in 12 villages from Haining City, and 23 sero-positives were found, with a positive rate of 2.26%; however, no egg-positives were detected. Logistic regression analysis showed that the mobile populations with original occupations of aquaculture and husbandry were more likely to be sero-positive. The mobile populations had an overall low awareness rate of schistosomiasis prevention and control knowledge, and a higher rate was seen in sero-positive than in sero-negatives.

CONCLUSIONS

The mobile populations with original occupations of aquaculture and husbandry were the key for the surveillance of source of S. japonicum infections. The health education should be intensified to improve the awareness of schistosomiasis prevention and control knowledge among mobile populations.

The impact of SLE on health-related quality of life assessed with SF-36: a systemic review and meta-analysis

OBJECTIVE

To evaluate the impact of systemic lupus erythematosus (SLE) on health-related quality of life (HRQoL) assessed with SF-36 and explore factors associated with HRQoL in SLE patients.

METHODS

A random-effect meta-analysis was performed to calculate extracted data. Sensitivity and subgroup analyses were performed to distinguish sources of heterogeneity.

RESULTS

A total of 36 articles were finally included in this meta-analysis, including 6510 patients. The pooled mean scores of SF-36 physical component summary and mental component summary were 46.10 (95% confidence interval (CI): 43.09-49.10) and 50.37 (95% CI: 47.78-52.87), respectively. Spearman's correlation analysis found that mean age, proportion of female participants, and publication decades were negatively associated with some of the SF-36 domains. Sample size and SLEDAI were positively associated with some of the SF-36 domains. Patients with SLE have lower HRQoL in comparison to the general population.

CONCLUSIONS

SLE has a significant impact on HRQoL, which proves that the necessity of improving HRQoL in SLE patients cannot be ignored. Measuring HRQoL should be considered as an indispensable part of the overall evaluation of health conditions of SLE patients.

Correlative analysis of miR-34b and p53 with pathological characteristics of NSCLC

The expression of miR-34b and p53 in non-small cell lung cancer (NSCLC) was investigated to explore its relationship with clinical pathology of NSCLC. Reverse transcription-quantitative PCR (RT-qPCR) method was used to quantitatively analyze miR-34b and p53 in cancer tissue and adjacent paraneoplastic (PTLC) tissue in 54 cases of NSCLC. The relationship between gene expression and clinical pathological data was analyzed. The expression of miR-34b in tumor tissues of NSCLC patients was significantly downregulated in comparison with PTLC. The expression level of miR-34b was negatively correlated with lymph node metastasis. It was positively correlated with the degree of differentiation and negatively correlated with the pathological stage (P<0.05). There was no significant association in the expression of miR-34b with age, sex, histological type, and gross classification (all P>0.05). The expression of p53 in the tumor tissue of NSCLC patients was significantly reduced in comparison with PTLC, and its expression was negatively correlated with the pathological stage, lymph node metastasis, and was positively correlated with the degree of differentiation. The expression of p53 in adenocarcinoma was generally higher than that of squamous cell carcinoma and large cell carcinoma. The expression of p53 in central type cancer was significantly higher than that in peripheral type (P<0.05). The expression of miR-34b and p53 was positively correlated in NSCLC tissues (r=0.797, P<0.001). The high expression of miR-34b and p53 is closely related to the clinical stage and pathological grade of NSCLC. miR-34b and p53 may serve as important tumor markers for NSCLC.

Abstract P4-07-11: Investigating the activity of ESR1 allosteric compounds in ER+ breast cancer

Breast cancer (BCa) is the most frequently diagnosed cancer in women worldwide. Approximately 80% of breast cancer is estrogen receptor positive (ER+) with 74% demonstrating high expression of estrogen receptor alpha (). Thus, current endocrine therapies such as selective estrogen receptor degraders (i.e.- Fulvestrant) or selective estrogen receptor modulators (i.e-Tamoxifen) are involved modulation of ER signaling. However, most patients develop resistance to these drugs, and disease progression is common resulting in metastatic disease. Therefore, targeting alternative sites on the surface of has been proposed as an effective therapy to directly block its activity. In the present study, we investigated putative AF2 compounds that can bind to AF2 allosteric sites and inhibit complex formation and transcription of targetgenes. In the present study, we characterized a series of allosteric compounds using breast cancer cellular assays. MCF7 parental cells were treated with a series of putative allosteric compounds in a seven day CTG cell proliferation assay, and the compound ERX-11 was found to exhibit anti-proliferative activity. Genomic RNA was isolated after overnight treatment with ERX-11 to investigate compounds treatment on the expression of key ER pathway transcription factors via real time PCR. The degradation effect on nuclear ER and cytoplasmic ER after treatment with ERX-11 were assessed via western blots. We successfully characterized a series of putative allosteric compounds with ERX-11 being the only compound that exhibited anti-proliferative activity in both MCF7 parental and LSZ resistant cells. ERX-11 inhibited the activation of ER transcription gene and degradation of nuclear ER. These findings show promising effects of ERX-11 to block the AF2 sites on the binding domain of ERα with potential therapeutics for ER+ breast cancer.

Citation Format: Uwimana A, Tiong Yip CL, Das R, Cheng Q, Meredith E, Gaither AL. Investigating the activity of ESR1 allosteric compounds in ER+ breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-07-11.

[Research and application of three-dimensional printed template in endodontics]

With the progress of technology, three-dimensional (3D) printing technology has become more and more widely used in stomatology. 3D printed template has played an irreplaceable role in oral implantation; at the same time, 3D printed template, which has been successfully applied to the calcified root canal negotiation, endodontic treatment of dental invaginatus, apical surgery and autotransplantation, has also provided a new concept and treatment mode for the diagnosis and therapy of endodontic diseases. This review, summarized the research and application of 3D printed template from the perspective of the treatment of endodontic deseases.

[Efficacy and safety of ombitasvir/paritaprevir/ritonavir and dasabuvir combined with ribavirin in Asian adult patients with chronic HCV genotype 1b infection and compensated cirrhosis]

Objective: To evaluate the efficacy and safety of ombitasvir/paritaprevir/ritonavir (OBV/PTV/r) 25/150/100 mg once daily and dasabuvir (DSV) 250 mg twice daily combined with ribavirin in adult patients of Mainland China with chronic HCV genotype 1b infection and compensated cirrhosis. Methods: An open-label, multicenter, phase 3 clinical trial study was conducted in mainland China, Taiwan, and South Korea. Adult patients with compensated cirrhosis (Metavir score =F4) who were newly diagnosed and treated for hepatitis C virus genotype 1b infection with ombitasvir/paritaprevir/ritonavir and dasabuvir combined with ribavirin for 12 weeks were included. Assessed SVR rate of patients obtained at 12 and 24 weeks after drug withdrawal. Efficacy and safety were evaluated in patients who received at least one time study drugs. Results: A total of 63 patients from mainland China were enrolled, 62 of whom (98.4%) had a baseline Child-Pugh score of 5 points. The overall rate of SVR12 and SVR24 in patients was 100% (95% CI: 94.3% to 100.0%). Most of the adverse events that occurred were mild. The incidence of common (≥10%) adverse events and laboratory abnormalities included elevated total bilirubin (36.5%), weakness (19.0%), elevated unconjugated bilirubin (19.0%) and conjugated bilirubin (17.5%), and anemia (14.3%). Three cases (4.8%) of patients experienced Grade ≥ 3 adverse events that were considered by the investigators to be unrelated to the study drug. None patients had adverse events leading to premature drug withdrawal. Conclusion: Mainland Chinese patients with chronic HCV genotype 1b infection and compensated cirrhosis who were treated with OBV/PTV/r plus DSV combined with RBV for 12 weeks achieved 100 % SVR at 12 and 24 weeks after drug withdrawal. Tolerability and safety were good, and majority of adverse events were mild.

[Application of MDCT and post-processing in children with tracheal foreign body]

Objective:To explore the clinical value of MDCT and post-processing in children with suspected foreign body in trachea.Method:Two hundred patients with suspected tracheal foreign body were treated with 64-slice spiral CT (MDCT) and simulated endoscopic imaging,then compared with seen in bronchoscopy; Compare the results of MDCT and post-processing with the coincidence of intraoperative findings.Result:One hundred and eighty-four cases of positive children were examined by MDCT postprocessing technique and bronchoscopy,179 cases were obstructed by exogenous foreign body,5 cases were phlegm thrombosis (endogenous foreign body) obstruction; 16 cases of children with no foreign body diagnosed by MDCT post-processing technique were also examined by bronchoscopy. The results showed that there was a foreign body in 1 case,and the foreign body was located in the pharyngeal cleft (watermelon spermoderm),and the remaining 15 cases had no foreign body. MDCT and post-treatment techniques for children with tracheal foreign body diagnosis of 99.4% sensitivity,specificity of 75%.There was no significant difference in the detection rate of foreign body between the two techniques of MDCT and post-processing technique and bronchoscopy (P>0.05). Examed by MDCT and postprocessing,we can understand the specific location and size of foreign body,nature,shape preoperatively.Conclusion:Although MDCT and post-processing techniques can not be used to treat tracheal foreign bodies,but the diagnostic rate of bronchial foreign bodies is comparable to that of bronchoscopy. We could apply MDCT examination and post processing before the bronchoscopy,for foreign body inhalation history is not clear,or suspected airway foreign body. We can improve the level of diagnosis and treatment through guiding the operation of bronchoscopy focus.

Cup-on-cup technique to manage severe protrusio acetabular defects

Previous studies have demonstrated that revision of total hip arthroplasty consumes considerably more resources than the primary procedure. Worse, patients who need revision procedures are more likely to have radiographic evidence of acetabular and femoral bone loss than those undergone primary total hip arthroplasty. Many techniques have been introduced to manage different conditions of acetabular deficiencies. We describe a rare case of a 67-year-old man with severe acetabular bone loss, which was caused by a long-term loose acetabular component and was successfully managed by cup-on-cup technique. We also discuss the similarities and differences between cup-on-cup and cup-in-cup techniques in the management of protrusio acetabular defects, with a case-based approach.