Quality of life in first episode psychosis: a cluster analytic approach

PURPOSE

Quality of life is increasingly recognised as an important outcome for young people with first episode psychosis (FEP). The first aim was to determine whether distinct homogenous subgroups of young people with FEP could be delineated based on profiles on quality of life domains (Physical Health, Psychological, Social relationships and Environmental). The second aim was to examine the discriminant validity of these subgroups with respect to demographic, functioning and clinical features of FEP.

METHOD

Quality of life, demographic characteristics, clinical characteristics, cognition and functioning were assessed in 145 people with FEP. Cluster analysis using Ward's methods and Squared Euclidean Distance with a k-means verification were employed to identify subgroups with homogenous quality of life profiles. The clusters were externally validated using multinomial logistic regressions.

RESULTS

Three distinct quality of life profiles were identified: one with good quality of life across all domains (30%), one with poor quality of life particularly in Psychological and Social relationships domains (28%), and one 'intermediate' group with comparatively low Psychological quality of life (42%). Depression, semantic verbal fluency, social inclusion and social/occupational functioning showed associations with group membership.

CONCLUSION

Our results suggest the potential of maintaining relatively good quality of life despite the experience of FEP. Future research on interventions to improve quality of life may consider the potential of addressing depression, social inclusion and social/occupational functioning.

Size, weight, and power breakthrough in nonmechanical beam and line-of-sight steering with geo-phase optics

Thin-film geo-phase optics have the potential to dramatically reduce size, weight, and power for large-aperture optical components as well as provide nonmechanical functionality. Topics are presented in manner of increasing conceptual and system complexity to convey the different levels and aspects of system performance improvements. An 8^'' aperture, lightweight geo-phase lens is presented followed by discussions on both mechanical and nonmechanical beam steering embodiments. Laser damage thresholds for the thin-film geo-phase prisms are reported. Highly efficient and spectrally broadband nonmechanical line-of-sight steering is also demonstrated. Lastly, novel fabrication techniques, to the best of our knowledge, and the associated reduced fabrication cost implications are presented.

[An optimized protocol of meniscus cell extraction for single-cell RNA sequencing]

OBJECTIVE

To optimize the protocol of meniscus cell extraction to enhance the efficiency of cell suspension preparation and maintain a high cell viability for single-cell RNA sequencing.

METHODS

We compared the efficiency of the routine cell extraction methods (short-time digestion and long-time digestion) and the optimized protocol for obtaining meniscus cell suspensions by evaluating the cell number obtained and the cell viability. Single-cell RNA sequencing datasets were analyzed to evaluate the stability of the cell suspension prepared using the optimized protocol. The reliability of the optimized protocol was assessed by comparing the single-cell RNA sequencing dataset obtained by the optimized protocol with published single-cell RNA sequencing datasets of the meniscus.

RESULTS

The optimized protocol harvested a greater number of cells (over 1×10⁵) than the routine protocols. The cell suspension prepared with the optimized protocol showed a cell viability higher than 80%, the highest among the 3 methods. Analysis of single-cell RNA sequencing datasets showed that the ratio of the mitochondrial genes was below 20% in over 80% of the cells. CD34⁺ cells, MCAM⁺ cells and COL1A1⁺ cells were identified in the datasets. Comparison with the publish datasets showed that the optimized protocol was capable of harvesting COL3A1⁺, COL1A1⁺, MYLK⁺, BMP2⁺, CD93⁺ and CDK1⁺ cells.

CONCLUSION

Single-cell suspension prepared from the meniscus can be stably obtained using the optimized protocol for single-cell RNA sequencing using the 10× Genomics platform.

Prediction of spinal anesthesia-induced hypotension during elective cesarean section: a systematic review of prospective observational studies

BACKGROUND

Spinal anesthesia is the standard for elective cesarean section but spinal anesthesia-induced hypotension remains an important problem. Accurate prediction of hypotension could enhance clinical decision-making, alter management, and facilitate early intervention. We performed a systematic review of predictors of spinal anesthesia-induced hypotension and their predictive value during cesarean section.

METHODS

PubMed, Embase, Cochrane Library, Google Scholar and Web of Science databases were searched for prospective observational studies assessing the diagnostic accuracy of predictors of spinal anesthesia-induced hypotension in elective cesarean section. The quality of studies was assessed and predictors were grouped in domains based on the type of predictor.

RESULTS

Thirty-eight studies (n=3086 patients) were included. In most studies, patients received 500-1000 mL crystalloid preload or 500-2000 mL crystalloid coload. Vasopressors for post-spinal hypotension were boluses of ephedrine 5-15 mg and/or phenylephrine 25-100 µg in most studies. The hypotension rate varied from 29% to 80% based on the definition. For analysis, >30 predictors were classified into seven domains: demographic characteristics, baseline hemodynamic variables, baseline sympathovagal balance, postural stress testing, peripheral perfusion indices, blood volume and fluid responsiveness indices, and genetic polymorphism.

CONCLUSIONS

Environmental and individual factors increased outcome variability, which restricted the value of the autonomic nervous system and peripheral perfusion indices for prediction of spinal anesthesia-induced hypotension. Supine stress tests may reflect parturients' cardiovascular tolerance during hemodynamic fluctuations and may optimize the predictive value of static state predictors. Future research for predicting spinal anesthesia-induced hypotension should focus on composite and dynamic parameters during the supine stress tests.

Retrospective Planning Study of Patients with Superior Sulcus Tumours Comparing Pencil Beam Scanning Protons to Volumetric-Modulated Arc Therapy

AIMS

Twenty per cent of patients with non-small cell lung cancer present with stage III locally advanced disease. Precision radiotherapy with pencil beam scanning (PBS) protons may improve outcomes. However, stage III is a heterogeneous group and accounting for complex tumour motion is challenging. As yet, it remains unclear as to whom will benefit. In our retrospective planning study, we explored if patients with superior sulcus tumours (SSTs) are a select cohort who might benefit from this treatment.

MATERIALS AND METHODS

Patients with SSTs treated with radical radiotherapy using four-dimensional planning computed tomography between 2010 and 2015 were identified. Tumour motion was assessed and excluded if greater than 5 mm. Photon volumetric-modulated arc therapy (VMAT) and PBS proton single-field optimisation plans, with and without inhomogeneity corrections, were generated retrospectively. Robustness analysis was assessed for VMAT and PBS plans involving: (i) 5 mm geometric uncertainty, with an additional 3.5% range uncertainty for proton plans; (ii) verification plans at maximal inhalation and exhalation. Comparative dosimetric and robustness analyses were carried out.

RESULTS

Ten patients were suitable. The mean clinical target volume D95 was 98.1% ± 0.4 (97.5-98.8) and 98.4% ± 0.2 (98.1-98.9) for PBS and VMAT plans, respectively. All normal tissue tolerances were achieved. The same four PBS and VMAT plans failed robustness assessment. Inhomogeneity corrections minimally impacted proton plan robustness and made it worse in one case. The most important factor affecting target coverage and robustness was the clinical target volume entering the spinal canal. Proton plans significantly reduced the mean lung dose (by 21.9%), lung V5, V10, V20 (by 47.9%, 36.4%, 12.1%, respectively), mean heart dose (by 21.4%) and thoracic vertebra dose (by 29.2%) (P < 0.05).

CONCLUSIONS

In this planning study, robust PBS plans were achievable in carefully selected patients. Considerable dose reductions to the lung, heart and thoracic vertebra were possible without compromising target coverage. Sparing these lymphopenia-related organs may be particularly important in this era of immunotherapy.

miR-326 inhibits the cell proliferation and cancer stem cell-like property of cervical cancer in vitro and oncogenesis in vivo via targeting TCF4

Background

Cervical cancer ranks as one of the most prevalent female malignancies globally, and its treatment with new targets has been the focus of current research. The present study set out to investigate the function of microRNA-326 (miR-326) in vitro and in vivo and to verify the direct targeting of transcription factor 4 (TCF4) by miR-326.

Methods

The detection of messenger RNA (mRNA) expressing miR-326 and TCF4 in cervical cancer cell lines and tumor samples was conducted using quantitative real-time polymerase chain (qRT-PCR). A dual-luciferase reporter assay was carried out to detect the target relationship of miR-326 with TCF4. A Cell Counting Kit-8 (CCK-8) assay was employed to detect the effect of miR-326 on CasKi cell viability. Flow cytometry and western blotting were employed to examine the effects of miR-326 on cancer stem cell (CSC)-like property. Tumor weight was measured in orthotopic xenograft mouse models. Immunohistochemistry was employed to analyze the protein expression levels of Ki-67, proliferating cell nuclear antigen (PCNA), CD44, and SRY-box 4 (SOX4).

Result

Downregulation of the mRNA expression levels of miR-326 was observed in cervical cancer cell lines and tumor tissue, while the levels of TCF4 were upregulated. The dual-luciferase reporter assay revealed binding of miR-326 to the three prime untranslated region (3'-UTR) of TCF4. In vitro assays demonstrated that miR-326 inhibited CasKi cell proliferation through regulating TCF4. miR-326 also suppressed the CSC-like property of CasKi cells by targeting TCF4. Furthermore, the protein expression levels of cyclin D1, β-catenin, and c-Myc were decreased when miR-326 was added to TCF4-transfected cells. In vivo assays demonstrated that miR-326 inhibited tumor weight, growth, and the protein expression levels of Ki-67, PCNA, CD44, SOX4, and β-catenin.

Conclusions

miR-326 acted in a tumor-suppressive manner through its regulation of TCF4, and has potential as a biomarker or therapeutic target for cervical cancer.

Integrated analysis of miRNAome and transcriptome reveals miRNA-mRNA network regulation in Vibrio alginolyticus infected thick shell mussel Mytilus coruscus

The thick shell mussel Mytilus coruscus has developed into a model species for studying the interaction between molluscs and environmental stimuli. Herein, integrated analysis of miRNAome and transcriptome was performed to reveal miRNA-mRNA network regulation in Vibrio alginolyticus infected M. coruscus. There have detected some histological abnormalities in digestive gland and gills of V. alginolyticus challenged mussels, ascertaining the effective irritation by the present bacterial strain. A total of 265 novel miRNAs were finally predicted, of which 26 were differentially expressed miRNAs (DEMs). Additionally, 667 differentially expressed genes (DEGs) were detected, which may be potentially associated with innate immune response to V. alginolyticus infection. A regulatory network linked to 22 important pathways and 16 DEMs and 34 OGs was constructed. Some traditional immune-related signaling pathways such as toll-like receptor signaling pathway (TLR) signaling pathway, transforming growth factor-beta (TGF-beta) signaling pathway, peroxisome, phagosome, lysosome, mammalian target of rapamyoin (mTOR) signaling pathway were linked to specific miRNAs and genes in this network. Further, interactional relationship between certain miRNAs and TLR pathway was dissected, which the results predicted that a number of TLRs and TLR-associated signaling genes including TLR1, TLR2, TLR4, TLR6, IRAK1, TRAF6, MAPK, and IL-17 were negatively regulated by novel_miR_11, novel_miR_145, novel_miR_196, novel_miR_5, novel_miR_163 and novel_miR_217 in the TLR pathway. Additionally, interactional relationship between novel_miR_145 and TLR2 was validated by laboratory experiment. The integrated analysis of mRNA and microRNA deep sequencing data exhibited a sophisticated miRNA-mRNA regulation network in M. coruscus in response to V. alginolyticus challenge, which shed a new light on the underlying mechanism of molluscan confronting bacterial infection.

The Relationship between Pre-Admission Waiting Time and the Surgical Outcomes after Hip Fracture Operation in the Elderly

OBJECTIVES

To investigate the association between pre-admission waiting time and postoperative complications, length of stay (LOS), and costs during hospitalization.

METHOD

This was a single-center, observational study. The subjects of this study were elderly hip fracture patients who were admitted to the Department of Orthopedics, West China Hospital, Sichuan University, from December 2010 to June 14, 2017, and that underwent internal fixation or joint replacement surgery. The pre-admission waiting time was treated as a categorical variable according to median and first quartile values. Outcomes included postoperative complications (pneumonia and other complications [urinary tract infection, heart failure, non-A-grade healing]), LOS, and costs during hospitalization. LOS and costs during hospitalization were converted into binary outcomes based upon median values. Binary logistic regression analyses were used to analyze correlations between pre-admission waiting time and patient outcomes.

RESULTS

A total of 889 patients 60 years of age and older were enrolled in this study, of whom 65.47% were females and 34.53% were males. The proportion of patients with pre-admission waiting times less than 8 h, 8 - 24 h, and ≥ 24 h were 24.3%, 17.32%, and 58.38%, respectively. Postoperative pneumonia and other complications affected 12.04% and 6.30% of patients, respectively. Relative to patients with the pre-admission waiting times of less than 8 h, those with longer pre-admission waiting times exhibited a higher risk of postoperative pneumonia (8 - 24 h: OR = 2.72,95% CI: 1.29-5.74, p = 0.009; ≥ 24 h: OR = 2.76,95% CI: 1.48-5.14, p = 0.001). Patients with the pre-admission waiting time ≥ 24 h also exhibited a higher risk of the other complications (OR = 2.55, 95% CI: 1.53-4.26, p <0.001), a longer LOS (OR = 1.43, 95% CI:1.02-2.01, p = 0.036), and higher costs during hospitalization (OR = 1.51, 95% CI:1.05 - 2.17, p = 0.026) relative to patients with a waiting time less than 8 hours.

CONCLUSION

Pre-admission waiting time was associated with postoperative complications, LOS, and hospitalization costs among older Chinese patients undergoing surgery to treat hip fractures.

Hydroxychloroquine based chemical drug for combination therapy with 5-Fu for inhibiting the pathway of Akt/mTOR in autophagy process on colon cancer

Abstract: In order to improve the effect of hydroxychloroquine (HCQ) on the selectivity in anti-tumour therapy, the α-linolenic acid conjugated hydroxychloroquine (AHQ) was designed, which was aiming to enhance anti-tumor...

Hippocampal adult-born granule cells drive network activity in a mouse model of chronic temporal lobe epilepsy

Temporal lobe epilepsy (TLE) is characterized by recurrent seizures driven by synchronous neuronal activity. The reorganization of the dentate gyrus (DG) in TLE may create pathological conduction pathways for synchronous discharges in the temporal lobe, though critical microcircuit-level detail is missing from this pathophysiological intuition. In particular, the relative contribution of adult-born (abGC) and mature (mGC) granule cells to epileptiform network events remains unknown. We assess dynamics of abGCs and mGCs during interictal epileptiform discharges (IEDs) in mice with TLE as well as sharp-wave ripples (SPW-Rs) in healthy mice, and find that abGCs and mGCs are desynchronized and differentially recruited by IEDs compared to SPW-Rs. We introduce a neural topic model to explain these observations, and find that epileptic DG networks organize into disjoint, cell-type specific pathological ensembles in which abGCs play an outsized role. Our results characterize identified GC subpopulation dynamics in TLE, and reveal a specific contribution of abGCs to IEDs.

Gen-editing to model Short QT syndrome type 5 using human-induced pluripotent stem cell-derived cardiomyocytes

Aims

Short QT syndrome (SQTS), a disorder associated with characteristic electrocardiogram QT-segment abbreviation, predisposes afflicted patients to sudden cardiac death. Despite some progress in assessing the organ level pathophysiology and genetic changes of the disorder, the understanding of the human cellular phenotype and discovering of an optimal therapy has lagged due to a lack of appropriate human cellular models of the disorder. The aim of this study was to establish a cellular model of SQTS type 5 using human-induced pluripotent stem cell–derived cardiomyocytes (hiPSC-CMs) and gene-edited cell line using CRISPR/CAS9.

Methods and results

This study recruited one patient with short QT syndrome type 5 carrying a mutation in CACNb2 gene as well as one healthy control subject. We generated hiPSCs from their skin fibroblasts, and differentiated hiPSCs into cardiomyocytes (hiPSC-CMs) for physiological. Isogenic control hiPSC-CMs generated by the CRISPR/CAS9 technique were also used for the study.

The hiPSC-CMs from the patient showed a reduced calcium current (ICa-L) density and shortened action potential duration (APD) compared with healthy control hiPSC-CMs and isogenic hiPSC-CMs. Furthermore, they demonstrated abnormal rhythmic activities. Carbachol increased the arrhythmic events in SQTS significantly but not in healthy and isogenic control cells. Gene and protein expression profiling showed a decreased CACNb2 expression in SQTS cells. Quinidine prolonged the APD and abolished arrhythmic activity.

Conclusions

Patient-specific hiPSC-CMs are able to recapitulate single-cell phenotype features of SQTS type 5 and provide novel opportunities to further elucidate the cellular disease mechanism and test drug effects.

Funding Acknowledgement

Type of funding source: None

Molecular Characterization of a Novel Shell Matrix Protein With PDZ Domain From Mytilus coruscus

Mollusk shells are products of biomineralization and possess excellent mechanical properties, and shell matrix proteins (SMPs) have important functions in shell formation. A novel SMP with a PDZ domain (PDZ-domain-containing-protein-1, PDCP-1) was identified from the shell matrices of Mytilus coruscus. In this study, the gene expression, function, and location of PDCP-1 were analyzed. PDCP-1 was characterized as an ∼70 kDa protein with a PDZ (postsynaptic density/discs large/zonula occludes) domain and a ZM (ZASP-like motif) domain. The PDCP-1 gene has a high expression level and specific location in the foot, mantle and adductor muscle. Recombinantly expressed PDCP-1 (rPDCP-1) altered the morphology of calcite crystals, the polymorph of calcite crystals, binding with both calcite and aragonite crystals, and inhibition of the crystallization rate of calcite crystals. In addition, anti-rPDCP-1 antibody was prepared, and immunohistochemistry and immunofluorescence analyses revealed the specific location of PDCP-1 in the mantle, the adductor muscle, and the aragonite (nacre and myostracum) layer of the shell, suggesting multiple functions of PDCP-1 in biomineralization, muscle-shell attachment, and muscle attraction. Furthermore, pull-down analysis revealed 19 protein partners of PDCP-1 from the shell matrices, which accordingly provided a possible interaction network of PDCP-1 in the shell. These results expand the understanding of the functions of PDZ-domain-containing proteins (PDCPs) in biomineralization and the supramolecular chemistry that contributes to shell formation.

Recombinant transgelin-like protein 1 from Mytilus shell induces formation of CaCO3 polymorphic crystals in vitro

Transgelin is an actin cross-linking/gelling protein of the calponin family, which is associated with actin stress fibres, cell motility, adhesion and the maintenance of cell morphology. Transgelin-like proteins (TLPs) have also been identified as shell matrix proteins (SMPs) in several mollusc species; however, the functions of TLPs in biomineralization remain unknown. Transgelin-like protein 1 (TLP-1) was previously identified from the shell of Mytilus coruscus as a novel 19 kDa SMP with a calponin homology (CH) domain. To understand the role of TLP-1 in shell formation, the expression level and localization of the TLP-1 gene in biomineralization-related tissues were determined in this study. Furthermore, recombinant TLP-1 was expressed in a prokaryotic expression system with codon optimization, and an anti-rTLP-1 antibody was prepared based on the expressed recombinant TLP-1 (rTLP-1) protein. In vitro, rTLP-1 induced the formation of CaCO3 polymorphic crystals with distinct morphologies and inhibited crystallization rate and crystal interactions. Immunohistochemical, immunofluorescence, and pull-down analyses using the anti-rTLP-1 antibody revealed the specific locations of TLP-1 in biomineralization-related tissues and shell myostracum layer, and suggested the existence of a possible TLP-1 interaction network in the shell matrix. Our results are beneficial for understanding the functions of TLP-1, particularly through its CH domain, during shell mineralization.

Research on CRISPR/system in major cancers and its potential in cancer treatments

Cancer is a serious public health problem in the world and the prevention and control of cancer has become one of the health strategies of governments around the world. According to the data of the International Agency for Research on Cancer (IARC), about 8 million people die of cancer every year in the world. With the continuous progress of medical technology, there are many methods to treat cancer at present. However, many treatment methods have achieved different therapeutic effects, some of them have obvious toxic and side effects. Therefore, it is necessary to study simpler and more effective new therapies for alleviating pain and prolonging lifetime of patients. In this view, we focus on the application progress of CRISPR system in some major cancers and its potential in cancer treatments.

Application of Various Delivery Methods for CRISPR/dCas9

As gene-editing technology has become more and more popular in the life sciences, CRISPR has brought good news to scientific researchers because of its efficiency, convenience, and wide application. Its wide application has also promoted the development of basic scientific research, agriculture, basic medicine, and clinical treatment. However, how the CRISPR/dCas9 system is effectively delivered to the target organs or cells is still unknown. This paper briefly introduces the CRISPR/dCas9 system and then lists some common delivery methods and their characteristics.

SAT0140 SAFETY OF TOFACITINIB THERAPY IN HBSAG CARRIERS WITH RHEUMATOID ARTHRITIS: A PROSPECTIVE STUDY

Background:

Targeted synthetic DMARDs (ts-DMARDs) are becoming more available and affordable in developing countries, where the prevalence of hepatitis B virus (HBV) infection is still an important public health issue. The safety of ts-DMARDs therapy in terms of the reactivation of hepatitis B virus (HBV) infection need more concern. Rare data from a prospective study focus on the use of ts-DMARDs in patients with concurrent rheumatoid arthritis (RA) and HBV infection were available by now.

Objectives:

To evaluate the influence of tofacitinib on reactivation of HBV infection in HBsAg carriers with RA.

Methods:

In this 52 weeks observation, HBsAg carriers with active RA (DAS28>5.1) despite failed combined treatment with MTX and other non-biological DMARDs were enrolled. Patients must have normal liver function prior to study. All patients received therapy with tofacitinib (5mg twice daily) and concomitant MTX (10-12.5mg/w). Entecavir was prescribed preventively for patients who had a baseline HBV load >2000 copy/ml (group 1), and Lamivudin for patients with HBV load ≤ 2000 copy/ml (group 2). Liver enzymes (AST/ALT) and HBV viral load were monitored every 4 weeks. Increased viral load and abnormal liver function were managed according to expert opinion.

Results:

Thirteen patients (10 female) were recruited. Nine patients had a baseline viral load >2000 copy/ml (group 1, with preventive Entecavir), and the other 4 patients had a viral load ≤ 2000 copy/ml (group 2, with preventive Lamivudin). Two patients from group 1 discontinued tofacitinib at week 12 due to ineffectiveness, and both continued taking Entecavir for another 3 months after the discontinuation of tofacitinib.

No reactivation of hepatitis B was observed in patients from group 1. One patients (female, 54 years old) from group 2 underwent a mild increase of both ALT and AST (67 and 56 IU/L, respectively) at week 16. An elevated viral load (4.9e6 copies/ml, baseline 1.4e3) and a HBV YMDD mutant was also found. The tofacitinib treatment continued. After prescription of Adefovir (combined with the pre-existing Lamivudin), both liver enzyme and viral load decreased to normal range in 8 weeks and remained normal throughout the study.

Conclusion:

An aggressive Tofacitinib + MTX therapy may be a safe option for HBsAg carriers with cs-DMARDs refractory RA. More active and effective prophylaxis strategy may be recommended to reduce the risk of HBV reactivation during the treatment.

References:

[1]Chen YM, Huang WN, Wu YD, et al. Reactivation of hepatitis B virus infection in patients with rheumatoid arthritis receiving tofacitinib: a real-world study. Ann Rheum Dis 2018; 77:780-2.

Disclosure of Interests: :

None declared

AB0727 WORK OUTCOMES AND ASSOCIATED FACTORS IN ANKYLOSING SPONDYLITIS PATIENTS IN CHINA

Background:

Poorer work productivity due to pain and functional impairment is commonly seen in ankylosing spondylitis (AS) patients, which may contribute to huge social economic burden. However, data about work outcomes and associated factors in Chinese AS patients were barely reported.

Objectives:

To assess work outcomes and identify factors associated with poor work productivity in patients with AS in China.

Methods:

A cross-sectional study was conducted in China. Adult patients (aged ≥ 18 years) fulfilled the 1984 New York modified criteria of AS were enrolled from rheumatology center from Jan 2017 to Aug 2017. All participants completed questionnaires about socio-demographic characteristics, disease characteristics, quality of life and the Work productivity and activity impairment questionnaire in AS (WPAI:SpA) to accesses the impact of chronic health conditions on job performance and productivity. Factors associated with work outcomes were evaluated.

Results:

A total of 91 patients with AS were included: 87.8% males, 78.02% employed, mean age and disease duration of 30 and 10 years respectively. The mean (SD) activity impairment of all patients was 48.57% (22.02%). For patients with employed work, mean (SD) absenteeism, presenteeism and work productivity loss were 10.22% (19.44%), 43.86% (22.48%) and 47.92% (25.81%) respectively. In multivariable analysis, activity impairment was associated with Bath Ankylosing Spondylitis Functional Index (BASFI) (P<0.01) and Ankylosing Spondylitis Quality of Life (ASQoL) (P<0.01). Absenteeism was associated with disease duration (P=0.03). Presenteeism was associated with disease duration (P=0.04), BASFI (P<0.01) and ASQoL (P<0.01). Work productivity loss was associated with BASFI (P<0.01) and ASQoL (P<0.01).

Conclusion:

Longer disease duration, reduced physical function and poorer quality of life are associated with reduced work productivity in Chinese AS patients.

References:

[1]Boonen A, van der Heijde D, Landewe R, Spoorenberg A, Schouten H, Rutten-van Molken M, et al. Work status and productivity costs due to ankylosing spondylitis: comparison of three European countries. Annals of the rheumatic diseases. 2002;61(5):429-37.

[2]Martindale J, Shukla R, Goodacre J. The impact of ankylosing spondylitis/axial spondyloarthritis on work productivity. Best Pract Res Clin Rheumatol. 2015;29(3):512-23.

[3]Castillo-Ortiz JD, Ramiro S, Landewe R, van der Heijde D, Dougados M, van den Bosch F, et al. Work Outcome in Patients With Ankylosing Spondylitis: Results From a 12-Year Followup of an International Study. Arthritis Care Res (Hoboken). 2016;68(4):544-52.

[4]Sag S, Nas K, Sag MS, Tekeoglu I, Kamanli A. Relationship of work disability between the disease activity, depression and quality of life in patients with ankylosing spondylitis. J Back Musculoskelet Rehabil. 2018;31(3):499-505.

[5]Goh Y, Kwan YH, Leung YY, Fong W, Cheung PP. A cross-sectional study on factors associated with poor work outcomes in patients with axial spondyloarthritis in Singapore. Int J Rheum Dis. 2019;22(11):2001-8.

Disclosure of Interests:

None declared

THU0385 SAFETY OF TOFACITINIB THERAPY IN HBSAG CARRIERS WITH ANKYLOSING SPONDYLITIS: A PROSPECTIVE STUDY

Background:

Targeted synthetic DMARDs (ts-DMARDs) are becoming more available and affordable in developing countries, where the prevalence of hepatitis B virus (HBV) infection is still an important public health issue. The safety of ts-DMARDs therapy in terms of the reactivation of hepatitis B virus (HBV) infection need more concern. Rare data from a prospective study focus on the use of ts-DMARDs in patients with concurrent ankylosing spondylitis (AS) and HBV infection were available by now.

Objectives:

To evaluate the influence of tofacitinib on reactivation of HBV infection in HBsAg carriers with AS.

Methods:

In this 52 weeks observation, HBsAg carriers with active AS (BASDAI ≥ 4) despite failed treatment with at least two NSAIDs and sulfasalazine (for patients with persistent peripheral arthritis) were studied. Patients must be positive for HBsAg and have a normal liver function prior to study.

All patients received therapy with tofacitinib (5mg twice daily). Entecavir were prescribed preventively regardless of individual viral load. Pre-existing NSAIDs and sulfasalazine were allowed. Liver enzymes (AST/ALT) and HBV viral load were monitored every 4 weeks. Increased viral load and abnormal liver function were managed according to expert opinion.

Results:

Eleven patients (9 male) were recruited. Eight patients had a baseline viral load >2000 copy/ml (group 1), and the other 3 patients had a viral load ≤ 2000 copy/ml (group 2). Two patients from group 1 discontinued tofacitinib at week 12 due to ineffectiveness, and both continued taking Entecavir for another 3 months after the discontinuation of tofacitinib.

One patients (male, 26 years old) from group 1 underwent a mild increase of both ALT and AST (67 and 56 IU/L, respectively) at week 16, but no elevated viral load (2.1e3 copies/ml, baseline 2.8e3) or a HBV YMDD mutant was found. The tofacitinib treatment continued. After prescription of polyene phosphatidyl choline, the liver enzyme of this patient decreased to normal range in 4 weeks and remained normal throughout the study.

No reactivation of hepatitis B was observed in patients from group 2.

Conclusion:

Tofacitinib treatment may be a safe and effective option for HBsAg carriers with AS refractory to traditional treatment. Prophylaxis strategy with effective anti-viral drugs is recommended.

References:

[1]Chen YM, Huang WN, Wu YD, et al. Reactivation of hepatitis B virus infection in patients with rheumatoid arthritis receiving tofacitinib: a real-world study. Ann Rheum Dis 2018; 77:780-2.

Disclosure of Interests:

None declared

AB1301-HPR COMORBIDITIES AND FACTORS INFLUENCING RECURRENT GOUT ATTACK IN PATIENTS WITH GOUT: A CROSS-SECTIONAL STUDY

Background:

Gout attack is characterized by painful arthritis, loss of function and reduced quality of life. Frequent gout attacks can exert negative an influence on gout management [1].

Objectives:

The objective was to identify the comorbidities of gout, to compare gender difference and to identify independent factors of multiple gout attacks.

Methods:

A cross-sectional study was performed to collect demographic, clinical variables, self-reported comorbidities, and relevant testing. Group comparison and correlation of serum uric acid (sUA) levels with other variables was performed. Univariate and multivariate logistic regression was used to detect independent risk factors of sUA.

Results:

653 gout patients were enrolled, including 553 (84.7%) males. The mean age was 48.3±15.8 years old, with a disease duration of 8.0±6.4 years. 170 (26.0%) patients had hypertension, and 57 (8.7%) had hyperlipidemia. Elevated total cholesterol (TC) was observed in 173 (26.5%) cases. 42 (37.1%) cases presented with increased triglycerides (TG) and 270 (41.3%) had increased low-density lipoprotein (LDL-C). Abnormalities including nephrolithiasis (29.4%), hydronephrosis (3.2%), and gallstones (11.9%) were detected in the patients who underwent ultrasound examination. Although female patients had a longer disease duration, they had lower levels of sUA, creatine and C-reactive protein (CRP). A positive correlation with sUA was found in TG and CRP (P<0.05) in female patients, which was not observed in males. Only gout duration (OR=1.406,P<0.001), sUA (OR=1.006,P<0.001) and LDL-C (OR=0.530,P=0.006) were independent factors of gout attack (>20 times).

Conclusion:

Comorbidity screening involving dyslipidemia is often neglected in gout patients. Gout duration and sUA level are risk factors of multiple gout attacks.

References:

[1]Wang Y, Yan S, Li C et al. Risk Factors for Gout Developed From Hyperuricemia in China: A Five-Year Prospective Cohort Study.Rheumatol Int. 2013; 3: 705-10.

Table 1.

Comparisons of clinical and laboratory variables between male and female patients with gout

VariableMale (n=553)Female (n=100)pAge (years)47.7±15.951.3±14.50.040*BMI (kg/ m2)24.5 (22.0-27.0)23.3 (20.3-25.3)0.001*Gout duration (years)6.0 (3.0-11.0)9.5 (4.0-15.0)0.001*Gout attack times•≤5209 (37.5)33 (33.0)•6-1097 (17.5)22 (22.0)•11-2070 (12.7)22 (23.0)•>20177 (32.0)23 (23.0)ComorbidiesHypertension, n (%)138 (25.0)32 (32.0)0.140Coronary heart disease, n (%)57 (10.3)10 (10.0)0.926Fatty liver disease53 (9.6)4 (4.0)0.069Laboratory testing•ALT(U/L)25.0 (17.0-40.0)19.2 (14.6-29.0)0.003*•ALB(g/L)43.5±6.342.4±3.90.025*•TB (μmol/L)12.7 (9.0-17.3)14.5 (12.1-17.4)0.002*•BUN (mmol/L)4.85 (3.98-6.27)4.85 (3.91-4.82)0.588•Creatine (mmol/L)94.0 (81.4-108.1)73.8 (67.4-87.2)<0.001*•UA (μmol/L)528.4±141.1363.8±122.9<0.001*•Glucose (mmol/L)5.62±1.675.43±1.170.317•TC (mmol/L)5.05±1.155.09±1.100.726•TG (mmol/L)2.11±1.661.94±1.860.335•HDL-C (mmol/L)1.14±0.301.52±0.41<0.001*•LDL-C (mmol/L)3.25±0.973.39±0.920.182•ESR (mm/h)40.1±32.437.4±20.80.402•CRP (mg/L)28.0±40.310.5±18.6<0.001*

*p< 0.05; BMI: body mass index; sUA: serum uric acid; ALT: alanine aminotransferase; ALB: albumin; TB: Total bilirubin; BUN: blood urea nitrogen; UA: uric acid; TC: total cholesterol; TG: triglycerides; HDL-C: high-density lipoprotein; LDL-C: Low-density lipoprotein; ESR: erythrocyte sedimentation rate; CRP: C-reactive protein

Acknowledgments:

None.

Disclosure of Interests:

None declared

Characterization of a novel shell matrix protein with vWA domain from Mytilus coruscus

Mollusk shell is a product of biomineralization with excellent mechanical properties, and the shell matrix proteins (SMPs) have important functions in shell formation. A vWA domain-containing protein (VDCP) was identified from the shell of Mytilus coruscus as a novel shell matrix protein. The VDCP gene is expressed at a high level in specific locations in the mantle and adductor muscle. Recombinant VDCP (rVDCP) showed abilities to alter the morphology of both calcite and aragonite, induce the polymorph change of calcite, bind calcite, and decrease the crystallization rate of calcite. In addition, immunohistochemistry analyses revealed the specific location of VDCP in the mantle, the adductor muscle, and the myostracum layer of the shell. Furthermore, a pull-down analysis revealed eight protein interaction partners of VDCP in shell matrices and provided a possible protein-protein interaction network of VDCP in the shell.

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Parkes Weber syndrome is a rare congenital condition of the vascular system with severe symptoms and life-threatening complications. The challenge is to manage the arteriovenous malformations, and there is no consensus on optimal treatment. We report the case of an 18-year-old woman with Parkes Weber syndrome who was treated with ethanol combined with coil embolisation at an early stage. After two sessions of embolisation, a significant devascularisation was achieved. No sign of recurrence was observed two years after the initial procedure. The patient's symptoms and signs were greatly relieved during the follow-up period. This case raises awareness of Parkes Weber syndrome and highlights the importance of timely intervention, as well as offering a promising therapeutic option for this condition.