THU0036 FIRST-IN-HUMAN TRIAL OF BCMA-CD19 COMPOUND CAR IN THE TREATMENT OF AUTOANTIBODY MEDIATED DISORDERS

Background:

Donor-specific anti-HLA antibodies (DSAs) are antibodies in the recipient directed against donor class I/II HLA antigens. The existence of DSAs before allogenic hematopoietic stem cell transplantation (AHSCT) are known to cause primary graft failure. Currently there’s no established method of DSA desensitization due to the long half-life of plasma cells.

Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease involving in multiple organ systems mediated by numerous autoantibodies. Recent results have shown that depletion of B cells by CD19 CAR-T cells effectively reversed some manifestations in two SLE mouse models. However, plasma cells could be spared with single CD19 CAR-T cells, and peripheral circulating anti-DNA IgG and IgM autoantibodies remain elevated or increased in treated mice.

Objectives:

We present the efficacy of BCMA-CD19 compound CAR (cCAR), which target on antibody- producing “root”, both B cells and plasma cells in preclinical study and in our first-in-human phase 1 clinical trial.

Methods:

We constructed a BCMA-CD19 cCAR composed of a complete BCMA-CAR fused to a complete CD19 CAR, separated by a self-cleaving P2A peptide. We assessed the functional activity of cCAR in co-culture assay with multiple cell lines. We also verified cCAR efficacy with two mouse models, injected with either BCMA-expressing MM.1S cells or CD19-expressing REH cells. In our phase 1 clinical trial, we enrolled patients with hematologic malignancies with antibody mediated disorders.

Results:

BCMA-CD19 cCAR exhibited robust cytotoxic activity against the K562 cells engineered to express either CD19 or BCMA in co-culture assays, indicating the ability of each complete CAR domain to specifically lyse target cells. In mouse model study, cCAR-T cells were able to eliminate tumor cells in mice injected with MM.1S cells and REH cells, indicating that both BCMA and CD19 are specifically and equally lysing B cells and plasma cells in vivo, making BCMA-CD19 cCAR a candidate for clinical use.

In our first-in-human clinical trial, the first case is a 48-year-old female patient having resistant B-ALL with high DSA titers. She exhibited complete remission of B-ALL at day 14 post-CAR T treatment. MFI of DSA dropped from 7800 to 1400 at 8 weeks post cCAR treatment, the reduction percentage was approximately 80% (Figure 1). The patient had no CRS, and no neurotoxicity was observed.

Figure 1.

1. A) MFI of DSA and other HLA antibodies before and at different time points after cCAR T infusion. B) the percent reduction post-transfusion of cCAR T cells at different time points.

The second case is a 41-year-old female patient having a refractory diffuse large B cell lymphoma with bone marrow (BM) involvement. Furthermore, she has a 20 years of SLE, with manifestation of fever dependent of corticosteroids. On day 28 after cCAR treatment, PET/CT scan showed CR, and BM turned negative. In addition, she is independent of steroids, has no fever and other manifestations, C3/C4 are within normal ranges, and all the ANA dropped significantly, especially the nuclear type ANA, which turned from> 1:1000 to be negative at day 64. She had Grade 1 CRS but with no neurotoxicity observed. The absence of B cells and plasma cells persisted more than 5 months post CAR therapy.

Conclusion:

Our first in human clinical trial on BCMA-CD19 cCAR demonstrated profound efficacy in reducing DSA levels in an AHSCT candidate and ANA titer in a SLE patient. There was strong clinical evidence of depletion of antibody-producing roots, B-cells and plasma cells in both patients. Our results further suggested that BCMA-CD19 cCAR has the potential to benefit patients receiving solid organ transplants or those with other antibody-mediated diseases.

Figure 2.

Reduction of different type of ANA titer at different time points.

Acknowledgments:

patients and their families

Disclosure of Interests:

Fang liu: None declared, Hongyu Zhang: None declared, Xiao Wang: None declared, Jia Feng: None declared, Yuanzhen cao Employee of: Employee of iCell Gene Therapeutics LLC, Yi Su: None declared, Masayuki Wada Employee of: employee of iCell Gene Therapeutics LLC, Yu Ma Employee of: employee of iCAR Bio Therapeutics Ltd, Yupo Ma Shareholder of: shareholder of iCell Gene Therapeutics LLC

AGC protein kinase AGC1-4 mediates seed size in Arabidopsis

AGC1-4 kinase plays a crucial role in the regulation of seeds by mediating cell proliferation and embryo development in Arabidopsis. Seed size is a crucial factor to influence final seed yield in plants. However, the molecular mechanisms that set final seed size still need to be investigated. Here, we identified a novel AGC protein kinase AGC1-4, which encodes a serine-threonine kinase, belongs to the AGC VIIIa subfamily. The seeds of agc1-4 mutant were significantly larger than that in the wild type. Overexpression of the AGC1-4 gene reduced seed size. Regulation of AGC1-4 seed size is dependent on embryonic cell number. To further determine AGC1-4 functions in seed size, we analyzed AGC1-4 phosphoproteins using label-free quantitative phosphoproteomics coupled to the transcriptome of agc1-4 using RNA sequencing (RNA-seq). The RNA-seq analysis showed 1611 differentially expressed genes (DEGs), which cover a wide range of functions, such as cell cycle and embryo development. The 262 unique phosphoproteins were detected by phosphoproteomics analysis. The differentially phosphorylated proteins were involved in cell cycle and post-embryo development. Overlay of the RNA-seq and phosphoproteomics results demonstrated AGC1-4 as an important factor that influences seed size by mediating cell proliferation and embryo development. The results in this study provide novel data on the serine-threonine kinase AGC1-4 mediating seed size in Arabidopsis.

A melt-electrowritten filter for capture and culture of circulating colon cancer cells

Metastasis is the major cause of death in cancer patients accounting for about 90% of the mortality. The detection and analysis of the hallmark of metastasis, circulating tumor cells (CTCs), have significant impact in cancer biology and clinical practice. However, the scarcity of CTCs in blood, particularly in that of colorectal cancer patients, is a serious bottleneck in the development of CTC-based precision medicine. Herein, the melt electrowriting (MEW) technology was used for reproductive fabrication of a biocompatible antibody-presenting polycaprolactone filter with tailored porous structure. It is demonstrated, for the first time, that such filter can be used not only to catch cancer cells spiked in whole blood but also to culture the cancer cells directly on site. Specifically, HT29 colon cancer cells can be captured with an efficiency of 85%, and when spiked into 4 mL of whole blood, 47% were captured on one Ø12mm filter. Furthermore, repeated capture and culture experiments have shown that as few as 20 HT29 colon cancer cells spiked into 4 mL of whole blood can be captured on the filter and within 2 weeks be expanded on site to become tumor bodies that are visible to the untrained eye. This filter allows for downstream analysis, such as flow cytometry, immunocytochemistry, Western blotting, and rt-qPCR. This technology represents a simple and cost-effective platform that potentially enables fast and efficient culture of rare CTCs from patients' blood. This provides non-invasive alternatives for solid biopsy tumor materials for treatment screening, with great potential to realize precision medicine for cancer treatment.

Evidence of anomalous conventional and spontaneous exchange bias, high coercivity in Fe doped NiCr2O4 spinel

NiCr2-xFexO4 (x = 0 and 0.2) polycrystalline ceramics have been synthesized successfully through a simple co-precipitation technique to study the evolution of structural and magnetic properties by doping Fe. X-ray diffraction (XRD) reveals that the high-temperature cubic phase (space group Fd3[combining macron]m) observed at 320 K in bulk NiCr2O4 is stabilized at room temperature by decreasing the particle size to nanometer in x = 0 as well as after incorporating 20 at% Fe in the NiCr2O4 lattice. The cation distribution obtained from X-ray absorption fine structure (XAFS) analysis illustrates that while in x = 0, Ni2+ and Cr3+ ions occupy the tetrahedral (A) and octahedral (B) sites, respectively, x = 0.2, Fe3+ and Cr3+ ions occupy the A and B sites, respectively, and Ni2+ ions are distributed among the A and B sites. This transformation from the normal to mixed spinel structure strongly affects the magnetic properties. While the paramagnetic to long-range ferrimagnetic ordering temperature TC is enhanced from 71 to 192 K, significantly large coercive field (HC) of ∼29 kOe is observed for x = 0.2 as compared to the HC ∼13 kOe for x = 0. Moreover, unusually large conventional and spontaneous exchange bias fields of ∼26 and ∼2.6 kOe are observed for x = 0.2, which is absent for x = 0. The presence of anomalous exchange bias field is ascribed to the unidirectional exchange anisotropy between the two magnetic sublattices at A and B sites. The training effect of the exchange bias field is discussed using a phenomenological model, which considers the contribution from irreversible uncompensated spins that modify the exchange anisotropy at the interface between A and B magnetic sublattices. In addition, diffuse neutron scattering (DNS) with XYZ analysis is employed for both compositions to clearly illustrate the low-temperature peculiar magnetic phase transitions such as spin spiral transition, TS and spin lock-in transition, Tl. The DNS demonstrates that while Tl decreases from 10 K to 7 K with the incorporation of Fe in the NiCr2O4 lattice, TS significantly increases from 28 K to 50 K.

[The consideration about study design and implementation of vaccine clinic trials]

The safety of prophylactic vaccine is one of the key points both in clinical trials and evaluation. Based on the review practice of vaccine registration clinical trials in recent years, we puts forward a series of thoughts and suggestions on the common problems of safety study on vaccine, including the hypothesis of safety study, the consideration of inclusion/exclusion criteria and suspension/termination criteria for study; the routine requirements of safety study and some special issue such as medical laboratory test index, vaccine virus shedding and safety of adjuvant, and further clarifies the requirements of safety observation on sequential enrollment; also emphasized the scientific judgment of causality and the quality of safety monitoring. It can be used for reference by vaccine researchers and to explore appropriate solutions to promote vaccine research & development and risk control in China.

CTXA hip: the effect of partial volume correction on volumetric bone mineral density data for cortical and trabecular bone

This study compares the results of computed tomography X-ray absorptiometry (CTXA) hip volumetric BMD (vBMD) analyses of cortical and trabecular bone with and without partial volume correction. For cortical bone in some circumstances, corrected cortical volumes were negative and corrected vBMD was very high. For trabecular bone, the correction effects are smaller. CTXA volumetric data should be interpreted with caution.

PURPOSE

Previous studies have reported concerns about the reliability of CTXA hip cortical vBMD measurements generated using partial volume (PV) correction (the "default" analysis, with cortical PV correction). To date, no studies have examined the results of the alternative ("new") analysis (with trabecular PV correction). This study presents in vivo and phantom data comparing the corrected and uncorrected data for cortical and trabecular bone respectively.

METHODS

We used the commercial QCTPro CTXA software to analyze CT scans of 129 elderly Chinese men and women and an anthropomorphic European Proximal Femur phantom (EPFP) and accessed data for two alternative scan analyses using the database dump utility. The CTXA software gives the user two methods of performing the PV correction: (1) a default analysis in which only cortical bone results are corrected; (2) a new analysis in which only trabecular bone results are corrected. Both methods are based on a numerical recalculation of vBMD values without any change in volume of interest (VOI) placement.

RESULT

In vivo, the results of the two analyses for integral bone were the same while cortical and trabecular results were different. PV correction of cortical bone led to a decrease of cortical volume for all four VOIs: total hip (TH), femoral neck (FN), trochanter (TR), and intertrochanter (IT) volumes were reduced on average by 7.8 cm³, 0.9 cm³, 2.5 cm³, and 4.3 cm³ respectively. For TR, where cortex was thinnest, average corrected cortical volume was negative (- 0.4± 1.3 cm³). Corrected cortical vBMD values were much larger than uncorrected ones for TH, FN, and IT. Scatter plots of corrected cortical vBMD against cortical bone thickness showed that elevated results correlated with thinner cortices. When trabecular bone was corrected for the PV effect, trabecular volumes of TH, FN, TR, and IT were reduced on average by 7.9 cm³, 0.8 cm³, 2.6 cm³, and 4.4 cm³ respectively, while vBMD measurements were increased correspondingly. The trabecular volume and vBMD measurements of the two datasets both had highly positive correlations. For the EPFP, the PV-corrected FN data deviated from the nominal phantom value, but was closer for the TR and IT VOIs. Both corrected and uncorrected data overestimated trabecular vBMD, with the corrected results showing greater deviation from nominal values.

CONCLUSION

The default and new CTXA analyses for volumetric data generate different results, both for cortical and trabecular bone. For cortical bone, the uncorrected results are subject to partial volume effects but the correction method of the default analysis overcorrects the effect leading to in part unreasonable results for cortical bone volume and BMD. For trabecular bone, the correction effects are smaller. CTXA volumetric data should be interpreted with caution.

[The consideration about safety data analysis and expression in instructions of vaccine clinic trials]

The safety of prophylactic vaccine is one of the key points both in clinical trials and evaluation. Based on the review practice of vaccine registration clinical trials in recent years, we summarized the common problems in safety analysis and report and accordingly puts forward a series of thoughts and suggestions, including discussing the role of statistics in safety analysis, putting forward the framework of safety analysis and report involved analysis content, analysis index and analysis dimension, in which attention is paid to the severity analysis; emphasizing the initiative analysis on risk signal and encouraging the evidence-based initiative safety evaluation. At the same time, this paper discusses the basic principles of the presentation of safety data in the package inserts, as well as the comprehensive consideration of the safety data of each phase of the trial and different subjects. It can be used for reference by sponsor to promote vaccine clinical research and evaluation in China.

Infectious diseases and antimicrobial prescribing: Online spaced education for junior doctors

BACKGROUND

Inappropriate antimicrobial prescribing may harm patients and drive antimicrobial resistance. Junior doctors' knowledge of infectious diseases and antimicrobial prescribing is inadequate. Online spaced case-based learning can improve knowledge.

OBJECTIVE

To develop infectious diseases and antimicrobial prescribing course content for online spaced education and assess its effectiveness and feasibility for junior doctors.

METHODS

Infectious diseases and antimicrobial course content was developed for an online spaced education platform (Qstream Inc., Burlington, MA). Junior doctors (postgraduate years 1-3) at two tertiary teaching hospitals in Sydney participated in the study. Course content was provided with Qstream at one hospital and at the other hospital via two face-to-face (FTF) tutorials from August to October 2017. Knowledge and self-confidence were compared before and after training within and between both cohorts.

RESULTS

Participation in the course was higher in the Qstream cohort with 48/127 (37.8%) completing the course compared with 44/110 (40%) attending one or both FTF sessions, of whom 22/110 (20%) attended both. Improvement in mean knowledge score from 69.7% to 81.5% in the Qstream cohort was significantly greater than the FTF cohort's minimal improvement from 67.6% to 67.9% (95% CI 2.79-20.33; P=0.01). In the Qstream cohort mean confidence rating (0-10) improvement from 5.14 to 6.55 was greater than the FTF group improvement from 5.37 to 5.85 (95% CI 0.132-1.171; P=0.02). Qstream feedback was very positive.

CONCLUSIONS

Online spaced education in infectious diseases and antimicrobial prescribing was feasible, acceptable and effective for junior doctors. It has potential to reduce inappropriate antimicrobial prescribing and warrants further investigation.

Morphogenesis and vitality of seedlings of Ginkgo biloba in outdoor conditions

Ginkgo biloba L. is a relic tree that is preserved in natural conditions only in China. In the North-East Ukraine ginkgo is only in the process of introduction, but in certain places ginkgo trees are grown for decorative purposes which show high vitality. Therefore a relevant and promising task is the creation of industrial plantations of ginkgo for collection of its leaves. The objective of the study was morphological peculiarities of ginkgo plants and their vital condition depending on the calendar age of the seedlings at the stage when they were transplanted into the soil. For growing ginkgo, in our studies, a combined two-stage system was approbated, accor­ding to which seedlings were grown in greenhouses during 2–3 years, and then moved into soil outdoors. In our study, as planting material we used seedlings of ginkgo from a plant nursery (greenhouse) of Sumy National Agrarian University planted in 2014 and 2015. Seedlings were planted in the soil in early spring. Seedlings for growth completion were planted in rows with inter-row distance of 0.8 m and distance between the plants measuring 2.5–3.0 m. We studied the condition of the seedlings in two variants: variant 1 – three-year old seedlings obtained in the greenhouse were transplanted in spring 2018; variant 2 – two-year old seedlings obtained in greenhouse were transplanted in spring 2017. Comparative morphometric analysis and evaluation of vitality of these plants was performed in August 2019. Both groups of seedlings were five years old at the time of survey. For evaluation of morphometric structure of the ginkgo seedlings and their vital condition we used randomized selections of specimens in amount of up to 30 from plantations of variants 1 and 2. Analysis of the plants was conducted during the end of the vegetative period of 2019, when active growth of the plants stopped. Four main parameters of the plants were recorded: height, value of annual increment, diameter of the stem near the root neck and the number of leaves. Vital condition of the seedlings was evaluated on the basis of algorithm of vital analysis. Vitality of each seedling was evaluated by the coefficient of Q vitality, value of which was in interval from 0 to 1.0. Depending on the value of Q the seedlings were divided into five classes of vitality: 0–0.2 – cc (specimens of the lowest vitality), 0.2–0.4 – c (low vita­lity), 0.4–0.6 – b (average vitality), 0.6–0.8 – a (high vitality), 0.8–1.0 – aa (specimens with highest vitality). Comparative analysis of morphological peculiarities of the ginkgo seedlings revealed that two-year plants transplanted outdoors from the greenhouse had higher annual increment of the main stem, diameter of stem and number of leaves. Vital condition of such seedlings was the highest and was evaluated using Q index, which ranges between vitality of classes b to aa. This allows recommending a two-stage scheme of growing seedlings of ginkgo in North-East Ukraine. The optimum age for transplanting seedlings from greenhouses to open soil is two years.

Dietary mannan oligosaccharide ameliorates cyclic heat stress-induced damages on intestinal oxidative status and barrier integrity of broilers

This study investigated protective effects of mannan oligosaccharide (MOS) inclusion on growth performance, intestinal oxidative status, and barrier integrity of cyclic heat-stressed broilers. A total of 240 one-day-old chicks were allocated into 3 treatments of 10 replicates each. Control broilers reared at a thermoneutral temperature were fed a basal diet, whereas broilers in heat stress and MOS groups raised at a cyclic high temperature (32 to 33°C for 8 h/d) were given the basal diet supplemented with 0 or 250 mg/kg MOS, respectively. Compared with control group, heat stress decreased (P < 0.05) average daily gain and feed conversion ratio during grower, finisher, and entire periods, average daily feed intake during finisher and entire periods, and ileal superoxide dismutase activity at 42 D, whereas increased (P < 0.05) rectal temperature at 21 and 42 D and jejunal malondialdehyde content at 42 D. Dietary MOS increased (P < 0.05) average daily gain, average daily feed intake, and feed conversion ratio during finisher and entire periods, but decreased (P < 0.05) jejunal malondialdehyde concentration of heat-stressed broilers at 42 D. Heat stress decreased (P < 0.05) jejunal villus height (VH) and claudin-3 gene expression at 21 D, and VH and VH: crypt depth (CD) ratio in jejunum and ileum as well as mRNA abundances of jejunal mucin 2 and occludin, and ileal mucin 2, zonula occludens-1, and occludin, and claudin-3 at 42 D, whereas increased (P < 0.05) serum D-lactate acid content at 21 and 42 D, and serum diamine oxidase activity and jejunal CD at 42 D. The MOS supplementation increased (P < 0.05) jejunal VH at 21 D, VH and VH: CD of jejunum and ileum at 42 D, mRNA abundances of jejunal occludin and ileal mucin 2, zonula occludens-1, and occludin at 42 D, whereas reduced (P < 0.05) ileal CD at 42 D. These results suggested that MOS improved growth performance, and oxidative status and barrier integrity in the intestine of broilers under cyclic heat stress.

[Clinical characteristics and prognosis of high-risk neuroblastoma with bone marrow metastasis in children]

Objective: To analyze the clinical characteristics of newly treated high-risk group neuroblastoma (NB) patients with bone marrow metastasis and to explore the prognostic factors. Methods: The clinical features (sex, age, stage, risk group, pathological type, metastatic site, etc.) of 203 newly treated high-risk NB patients with bone marrow metastasis admitted to Hematology Oncology Center, Beijing Children's Hospital from January 2007 to December 2016 were analyzed retrospectively. There were 118 males (58.1%) and 85 females (41.9%). Kaplan-Meier method was used for survival analysis and Cox regression was used to analyze the prognostic factors. Results: The age at onset of the 203 patients was 41 months (9-147 months). The metastatic sites at diagnosis were as follows: bone in 195 cases (96.1%), distant lymph nodes in 104 cases (51.2%), skull and endomeninx in 61 cases (30.0%), orbit in 30 cases (14.8%), pleura in 16 cases (7.9%), liver in 13 cases(6.4%), canalis spinalis in 13 cases (6.4%), other sites in 11 cases (5.4%) and skin and soft tissue in 10 cases (4.9%). In all, 194 cases were enrolled for prognostic analysis. The follow-up time was 36 months (1 day-138 months) , and the 5-years event free survival (EFS) and overall survival (OS) were 36.1% and 39.7%, respectively. A total of 118 patients (60.8%) had events (first relapse or death) with the time to event occurrence was 15 months (1 day-72 months), whereas 112 patients (57.7%) died with the event occurrence to death time was 3 months (1 day-21 months). There was no significant difference in 5-years OS between radiotherapy group and non-radiotherapy group (42.3% vs. 38.3%, χ(2)=3.671, P=0.055). The 5-years OS in transplantation group was significantly better than the non-transplantation group (44.3% vs. 35.5%, χ(2)=8.878, P=0.003), and the radiotherapy combined transplantation group also had a better 5-years OS rate than the non-radiotherapy combined transplantation group (45.8% vs. 37.3%, χ(2)=5.945, P=0.015). Univariate survival analysis showed lactate dehydrogenase ≥ 1 500 U/L, the amplification of MYCN, the metastatic sites of orbit, canalis spinalis and pleura were associated with poor prognosis of newly diagnosed high-risk NB patients (χ(2)=21.064, 13.601, 3.998, 6.183, 15.307, all P<0.05). The amplification of MYCN and the metastatic sites of pleura were risk factors for prognosis of newly diagnosed high-risk NB patients by Cox regression models (HR=1.896,1.100, 95%CI: 1.113-3.231, 1.020-1.187, both P<0.05). Conclusions: The prognosis is unfavorable in high-risk group NB patients with BM metastasis. Radiotherapy combined with transplantation can further improve the prognosis of these patients. The amplification of MYCN and the metastatic sites of pleura were the poor prognostic factors for high-risk NB patients with bone marrow metastasis.

[Clinical and prognostic analysis of single-center multidisciplinary treatment for rhabdomyosarcoma in children]

Objective: To summarize the clinical characteristics, treatment response and prognostic factors of rhabdomyosarcoma (RMS) in children. Methods: The clinical characteristics such as age at diagnosis, primary tumor site, tumor size, pathological type, clinical stage, and risk grouping of 213 RMS patients (140 males and 73 females) treated in Hematology Oncology Center of Beijing Children's Hospital, Capital Medical University, from May 2006 to June 2018 were analyzed retrospectively. The clinical characteristics, overall survival (OS), event free survival (EFS) and prognostic factors of children treated with the Beijing Children's Hospital-Rhabdomyosarcoma (BCH-RMS) regimen were analyzed. Survival data were analyzed by Kaplan-Meier survival analysis, and single factor analysis was performed by Log-Rank test. Results: The diagnostic age of 213 cases was 48.0 months (ranged 3.0-187.5 months), of which 136 cases (63.8%) were younger than 10 years old. The head and neck region was the most common primary site of tumor (30%, 64 cases), followed by the genitourinary tract (26.8%, 57 cases). Among pathological subtypes, embryonal RMS accounted for 71.4% (152 cases), while alveolar RMS and anaplastic RMS accounted for only 26.8% (57 cases) and 1.9% (4 cases), respectively. According to the Intergroup Rhabdomyosarcoma Study Group (IRS), IRS-Ⅲ and Ⅳ accounted for 85.0% (181 cases) of all RMS patients. In all patients, 9.4% (20 cases) patients were divided in to low-risk group, 52.1% (111 cases) patients in to intermediate -risk group, 25.8% (55 cases) patients in to high-risk group, and 12.7% (27 cases) patients in to the central nervous system invasion group, respectively. All patients with RMS received chemotherapy. The cycles of chemotherapy were 13.5 (ranged 5.0-18.0) for patients without event occurrence, while 14.2 (ranged 3.0-30.0) for patients with event occurrence. Among the 213 patients, 200 patients had surgical operation, of whom 103 patients underwent surgery before chemotherapy and 97 patients at the end of chemotherapy, 21 patients had secondary surgical resection. Radiotherapy was performed in 114 patients. The follow-up time was 23.0 months (ranged 0.5-151.0 months) . There were 98 patients with relapsed or progressed disease and 67 patients with death. The median time to progression was 10 months, of which 67 (68.4%) relapse occurred within 1 year and no recurrence occurred after follow-up for more than 5 years. The 3-year EFS and 5-year EFS were (52±4) % and (48±4) %, while the 3-year OS and 5-year OS were (65±4) % and (64±4) % by survival analysis. The 5-year OS of the low-risk, intermediate-risk, the high-risk were 100%, (74±5) %, (48±8) %, and the 2-year OS of the central nervous system invasion group was (36±11) % (χ(2)=33.52, P<0.01). The 5-year EFS of the low-risk, intermediate-risk, the high-risk were (93±6) %, (51±5) %, (36±7) % and the 2-year EFS of the central nervous system invasion group was (31±10) % (χ(2)=24.73, P<0.01) . Survival factor analysis suggested that the OS of children was correlated with age(χ(2)=4.16, P=0.038), tumor TNM stage (χ(2)=22.02, P=0.001), IRS group (χ(2)=4.49, P<0.01) and the risk group (χ(2)=33.52, P<0.01). Conclusions: This study showed that the median age of newly diagnosed RMS patients was 4 years. The head and neck and the genitourinary tract were the most common primary origin of RMS. The OS was low in single-center RMS children. The median time to recurrence was 10 months, and recurrence was rare 3 years later.

1183Beta-Adrenoceptor activation increases cardiac galectin-3 levels via the hippo signaling pathway

Background

Galectin-3 (Gal-3) is a clinical biomarker for risk of cardiovascular disease and a disease mediator forming a therapeutic target. However, the mechanism(s) that regulate cardiac expression of Gal-3 remains unknown. Activation of the sympatho-β-adrenergic system is a hallmark of heart disease, but the relationship of βAR activation and cardiac content of Gal-3 remains unknown.

Purpose

To determine the role of βAR activation in regulating cardiac Gal-3 level and the responsible mechanism focusing on the Hippo signalling pathway.

Methods

Wild-type and Gal-3 gene deleted (Gal3-KO) mice were used. To test the role of the Hippo pathway, we used transgenic (TG) mouse strains with cardiac overexpression of mammalian-20-like sterile kinase 1 (Mst1, mammalian orthology of Drosophila Hippo kinase) either in wild-type form (TG-Mst1) or dominative-negative kinase dead mutant form (TG-dnMst1). Effects of β-antagonist (isoprenaline, ISO) and antagonists were determined. We measured phosphorylation (Ser127) of YAP as a transcription co-regulator acting as the main signal output of the Hippo pathway.

Results

In wild-type mice, treatment with ISO led to a time- and dose-dependent increase in cardiac expression of Gal-3 (Fig. A) accompanied by elevated circulating Gal-3 levels (Fig. B). ISO treatment stimulated cardiac expression of Mst1 and YAP hyper-phosphorylation (i.e. inactivation, Fig. C), indicating activation of the Hippo signalling. These effects of ISO were inhibited by β-blockers (propranolol, Prop; carvedilol, Carv; Fig. D,E). Relative to non-TG controls, ISO-induced expression of Gal-3 was inhibited by 75% in TG-dnMst1 mice (inactivated Mst1), but exaggerated by 7-fold in TG-Mst1 mice (activated Mst1). Mst1-TG mice had a 45-fold increase in Gal-3 content, YAP hyper-phosphorylation and enhanced pro-fibrotic signaling. In Mst1-TG mice, whilst blood Gal-3 level was unchanged, treatment with ISO (6 mg, 2 days) evoked a marked increase in cardiac and blood Gal-3 levels. Using rat cardiomyoblasts, we showed that ISO-mediated Mst1 expression and YAP phosphorylation were PKA-dependent and that siRNA-mediated YAP knockdown led to Gal-3 upregulation. The role of Gal-3 in mediating ISO-induced cardiomyopathy was examined by treating wild-type and Gal3-KO mice with ISO (30 mg/kg, 7 days). ISO-treated wild-type mice had 8-fold increase in cardiac Gal-3, ventricular dysfunction, fibrosis, hypertrophy and activated inflammatory or fibrotic signalling. All these changes, except hypertrophy, were abolished by Gal3-KO.

beta-AR regulates galectin-3

Conclusion

βAR stimulation increases cardiac expression of Gal-3 through activation of the Hippo signalling pathway. This is accompanied by elevated circulating Gal-3 level. βAR antagonists inhibited βAR-Mst1 (Hippo) signalling and cardiac Gal-3 expression, actions likely contributing to the overall efficacy of β-blockers.

Acknowledgement/Funding

NHMRC of Australia; Nature Science Fund of China

Long-term decomposed straw return positively affects the soil microbial community

AIMS

In order to understand the response of soil microbial communities to the long-term of decomposed straw return, the modifications of soil microbial community structure and composition induced by more than 10 years of fresh and decomposed straw return was investigated and the key environmental factors were analysed.

METHODS AND RESULTS

Phospholipid fatty acid analysis and high-through sequencing technique were applied to analyse the structure and composition of the soil microbial communities. Compared with fresh straw, returning decomposed straw increased the relative abundance of bacteria and fungi by 1·9 and 7·7% at a rate of ~3750 kg ha^-1 , and increased by 23·1 and 5·7%, at a rate of ~7500 kg ha^-1 respectively. The relative abundance of the bacteria related to soil nitrification increased, but the ones related to soil denitrification decreased with decomposed straw return, which led to higher total nitrogen contents in soils. Moreover, returning decomposed straw reduced pathogenic fungal populations (genus of Alternara), which had significantly positive correlation with soil electric conductivity. It indicated that the long-term of decomposed straw return might have lower risk of soil-borne disease mainly for the reasonable soil salinity.

CONCLUSIONS

Long-term of decomposed straw return could provide suitable nutrient and salinity for healthier development of soil microbial community, both in abundance and structure, compared with fresh straw return.

SIGNIFICANCE AND IMPACT OF THE STUDY

The results of the study helps to better understand how the microbial community modifications induced by decomposed straw return benefit on soil health. The obtained key factors impacting soil microbial community variations is meaningful in soil health management under conditions of straw return.

Tau positron emission tomography imaging in C9orf72 repeat expansion carriers

BACKGROUND AND PURPOSE

AV-1451 (18 F-AV-1451, flortaucipir) positron emission tomography was performed in C9orf72 expansion carriers to assess tau accumulation and disease manifestation.

METHODS

Nine clinically characterized C9orf72 expansion carriers and 18 age- and gender- matched cognitively normal individuals were psychometrically evaluated and underwent tau positron emission tomography imaging. The regional AV-1451 standard uptake value ratios from multiple brain regions were analyzed. Spearman correlation was performed to relate the AV-1451 standard uptake value ratio to clinical, psychometric and cerebrospinal fluid measures.

RESULTS

C9orf72 expansion carriers had increased AV-1451 binding in the entorhinal cortex compared to controls. Primary age-related tauopathy was observed postmortem in one patient. AV-1451 uptake did not correlate with clinical severity, disease duration, psychometric performance or cerebrospinal fluid markers.

CONCLUSION

C9orf72 expansion carriers exhibited increased AV-1451 uptake in entorhinal cortex compared to cognitively normal controls, suggesting a propensity for primary age-related tauopathy. However, AV-1451 accumulation was not associated with psychometric performance in our cohort.

[Case report and diagnosis of Noonan syndrome with multiple lentigines with deafness as its main clinical feature]

Summary Noonan syndrome with multiple lentigines（NSML） is a disorder with syndromic hearing loss. Abnormalities of other systems in NSML have received increasing attention, but hearing loss is rarely concerned. And due to the incomplete phenotype, some patients with NSML maybe missed or maybe confused with other syndromic deafness such as Waardenburg syndrome. Our study will familiarize more otolaryngologists with Leopard syndrome. A 5-year-old boy with bilateral sensorineural hearing loss and numerous symmetrically distributed dark brown macules that had good effect of cochlear implantation was collected in this study. And his father had bilateral sensorineural hearing loss and numerous symmetrically distributed dark brown macules. Waardenburg syndrome was initially diagnosed by clinical phenotype and its molecular etiology was confirmed by gene diagnosis. Waardenburg syndrome-related deafness genes and 131 known deafness genes were not identified by second-generation sequencing. Whole-exon sequencing was performed for 4 individuals in the family and the results were confirmed by Sanger sequencing. This study confirmed the diagnosis by identifying a disease-causing mutation in the PTPN11 gene, which was a heterozygous missense mutation at p. Tyr279Cys（c. 836A>G）. The mutation co-segregated with hearing loss in the family. Our results demonstrated that hearing loss in this family was caused by heterozygous mutations in PTPN11. These cases will familiarize more otolaryngologists with NSML, and they emphasize the importance of considering NSML as a possible cause of hearing problems.

Record Purcell factors in ultracompact hybrid plasmonic ring resonators

For integrated optical devices and traveling-wave resonators, realistic use of the superior wave-matter interaction offered by plasmonics is impeded by ohmic loss, which increases rapidly with mode volume reduction. In this work, we report composite hybrid plasmonic waveguides (CHPWs) that are not only capable of guiding subwavelength optical mode with long-range propagation but also unrestricted by stringent requirements in structural, material, or modal symmetry. In these asymmetric CHPWs, the versatility afforded by coupling dissimilar plasmonic modes provides improved fabrication tolerance and more degrees of device design optimization. Experimental realization of CHPWs demonstrates propagation loss and mode area of 0.03 dB/μm and 0.002 μm2, corresponding to the smallest combination among long-range plasmonic structures reported to date. CHPW ring resonators with 2.5-μm radius were realized with record Purcell factor compared with existing plasmonic and dielectric resonators of similar radii.

Clinical characteristics and treatments of patients with alpha-fetoprotein producing gastric carcinoma

Alpha-fetoprotein (AFP) is a well-known tumor marker of hepatic carcinoma and yolk sac tumor. Alpha-fetoprotein producing gastric carcinoma (AFPGC) is a rare type of gastric cancer with high malignancy and poor prognosis, which make it different from other types of gastric cancer. This rare gastric cancer patient subgroup is likely frequently misdiagnosed which may be related to lack of knowledge of the disease. The purpose of this article is to summarize the mechanism of AFP positive gastric cancer, classification, biological behavior and treatment, in order to assist clinical practitioners to detect AFPGC earlier and treat it better. Previous studies have showed that AFPGC has a complex pathophysiology mechanism. AFPGC is more aggressive and characterized by stronger proliferation, neovascularization, lymphatic invasion and distant metastasis. Furthermore, so far there has been no standard treatment for patients with AFPGC. Nevertheless, our present study summarizes some effective treatments based on previous research outcome. In conclusion, the present study demonstrates that the importance of detecting AFP routinely in serum and tissues in gastric cancer cases, which will greatly improve the diagnosis rate of AFPGC, and in regards to treatment, surgery, chemotherapy, targeted therapy and interventional treatment may have positive impacts on AFPGC treatment outcome. However, further study with a larger sample is required to confirm the reliability and validity of these methods.

[Optical properties of computer aided design and computer aided manufactured materials for veneer restorations]

Objective: To investigate the translucency parameters (TP) and the color parameters of computer-aided design and computer-aided manufacturing (CAD/CAM) materials for veneer restorations in order to guide clinical practice. Methods: Eleven groups of CAD/CAM materials (A2 shade) were included in this study: IPS e.max CAD HT/LT, IPS Empress CAD HT/LT, Lava(TM) Ultimate HT/LT, VITA SUPRINITY HT/T, VITA ENAMIC HT/T, VITABLOCS Mark Ⅱ, and were named as Group A, B, C, D, E, F, G, H, I, J, K. Each material was designed and milled to disk-shaped specimens (10.0 mm×8.0 mm×0.7 mm) (n=6). The specimens were polished with silicon carbide paper and the thickness of specimens were adjusted into (0.60±0.03) mm. The color parameters of specimens were individually measured with the colorimeter against black and white ceramic tiles background to obtain the TP values. The color parameters of the specimens against the composite resin background were also measured and the color differences (ΔE values) between specimens and the A2 shade tab were calculated. Results: One-way ANOVA showed that the translucency parameters of the 11 groups of materials were statistically significant (F=253.69, P<0.05). The ΔE values of CAD/CAM material groups ranged from 1.78 to 4.12 (ΔE values<5.5). Conclusions: The microstructure of CAD/CAM materials and the types of material translucency influence the optical properties. The CAD/CAM materials in this experiment have achieved color matching with the A2 shade tab.

[Perianal swabs surveillance cultures of Carbapenem-resistant Enterobacteriaceae(CRE) can be hints for CRE bloodstream infection in patients with hematological diseases]

目的

探讨血液病患者肛周皮肤拭子细菌培养检出耐碳青霉烯类肠杆菌（CRE）对CRE血流感染的预警价值，寻找CRE血流感染的危险因素。

方法

对2016年1月至2017年12月进行肛周皮肤拭子细菌培养的血液病患者分离出CRE的耐药率、患者后期CRE血流感染发生情况及危险因素进行回顾性分析。

结果

2 914例血液病患者进行了肛周皮肤拭子细菌培养，74例检出CRE，其中后期发生CRE血流感染者13例（17.6%）。共分离出CRE 87株（相同患者相同部位去重），包括肺炎克雷伯菌31株、大肠埃希菌43株、阴沟肠杆菌8株、其他肠杆菌科细菌6株。分离出CRE菌株对哌拉西林/他唑巴坦、亚胺培南、美罗培南、阿米卡星、左氧氟沙星、替加环素的耐药率分别为91.9%、74.4%、98.8%、17.6%、74.4%和8.0%。13例发生CRE血流感染患者肛周皮肤拭子与血液中分离株对碳青霉烯类、氨基糖苷类、喹诺酮类及替加环素耐药程度一致率较高。粒细胞缺乏（粒缺）、存在消化道症状、肛周感染持续时间为肛周皮肤CRE阳性患者发生CRE血流感染的独立危险因素（OR值分别为1.10、1.13和1.23，P值分别为0.029、0.005、0.016）。

结论

对血液病患者进行肛周皮肤拭子细菌培养可为后期CRE血流感染提供预警，并可为其提供抗菌药物选择参考；粒缺、伴消化道症状以及肛周感染持续时间长可作为CRE血流感染患者早期识别因素。

Abstract P3-13-09: Increased mortality with repeat lumpectomy alone after ipsilateral breast tumor recurrence: A propensity-adjusted, population-based SEER analysis

Background: The benefit of repeat lumpectomy for ipsilateral breast tumor recurrence (IBTR) after breast conserving surgery (BCS) is currently inconclusive. This issue has become even more important as small and isolated recurrent tumors were frequently diagnosed.

Methods: IBTR patients with definitive surgery were identified in the Surveillance, Epidemiology, and End Results registry between 1973 and 2013. The effect of different IBTR surgeries on overall and cancer-specific mortality was assessed using risk-adjusted Cox proportional hazard regression modeling and stratified propensity score matching analysis (PSMA).

Results: Based on the selection criteria, 5098 patients were recruited. Of those, 4048 (79.4%) women underwent mastectomy and 1050 (20.1%) underwent repeat lumpectomy after IBTR. Patients who received repeat lumpectomy had lower grade (23.7% vs 15% for well-differentiated) and smaller recurrent tumor (47% vs 36.2% for ≤ 1 cm) but earlier recurrence (23.9% vs 11.2% for interval times &lt; 48 months) than those who underwent mastectomy. A minority of each group (24.7% of those undergoing repeat lumpectomy and 3% of the mastectomy group) underwent RT after surgery. In multivariable Cox regression analysis, repeat lumpectomy was associated with increased overall mortality (Hazard ratio (HR) = 1.58, 95% CI = 1.353 to 1.844, P &lt; 0.001) and cancer-specific mortality (HR = 1.721, 95% CI = 1.345 to 2.202, P&lt; 0.001). Similar HRs were derived from the PSMA cohort. However, we found no significant difference in overall mortality for women who underwent repeat lumpectomy followed by RT compared with that for those who underwent mastectomy (P= 0.411). Moreover, IBTR patients with small tumors (≤ 1 cm) who underwent repeat lumpectomy with RT rather than without had similar overall and cancer-specific survival rates to those who underwent mastectomy (P= 0.189 and P= 0.604, respectively).

Conclusions: Our investigation suggests that compared with mastectomy, repeat lumpectomy for IBTR is associated with higher overall and cancer-specific mortality under real-world observational conditions. Furthermore, repeat lumpectomy with RT is equivalent to mastectomy with respect to overall mortality and may influence treatment decision making for patients with small IBTR.

Citation Format: Su Y, Guo R, Xue J, Chi Y, Wu J. Increased mortality with repeat lumpectomy alone after ipsilateral breast tumor recurrence: A propensity-adjusted, population-based SEER analysis [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 P3-13-09.

[Regression analysis of cerebral blood perfusion and cognitive function in patients with mild cognitive impairment and Alzheimer's disease]

Objective: To analyze the relationships between cerebral blood perfusion and impairments of cognitive function in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Methods: A total of 21 patients with AD, 18 patients with MCI and 21 healthy adults as control group (NC group) matched in age, gender and education were recruited between November 2016 and November 2017 from Northern Jiangsu People's Hospital. All cases were performed routine head MRI, arterial spin labeling (ASL). Cognitive function evaluation including simple mental state scale (MMSE) and improved Addenbrooke's cognitive examination revised (ACE-R) of patients were also assessed. The difference between cerebral blood perfusion signals and cognitive impairment of the three groups were analyzed. Results: The subtest scores of attention and orientation, memory, language fluency, language and visual space of ACE-R scores were significantly reduced (P<0.001,uncorrected) for AD when compared with MCI. Using REST1.8 software to perform single factor ANOVA, and adjusted for P<0.05. The AD group showed a decrease in total cerebral perfusion compared to the NC group, a decrease and in the frontotemporal lobe compared to MCI group; compared with the normal group, MCI group also showed decreased perfusion in frontotemporal cortex. Pearson correlation analysis was performed on the cerebral blood flow and ACE-R scores in the AD group and the MCI group,the decrease degree of CBF in multiple brain regions was positively correlated with the total score of ACE-R's total scores, and the subtest score of ACE-R including attention and orientation, memory, language fluency, language and visual space also showed positive correlation. Conclusion: ASL technology can detect the changes of cerebral blood flow metabolism in AD and MCI patients, and reveal association relationships between brain function damage and cerebral blood flow metabolism in AD and MCI patients.

Effects of Modified Palygorskite Supplementation on Egg Quality and Mineral Element Content, and Intestinal Integrity and Barrier Function of Laying Hens

This study was conducted to investigate effects of modified palygorskite (MPal) supplementation on the laying performance, egg quality and mineral element content, immunity, oxidative status, and intestinal integrity and barrier function of laying hens. A total of 360 52-week-old Hyline Brown hens were randomly assigned into four dietary treatments for a 7-week feeding trial. The birds were fed a basal diet supplemented with 0 (control group), 0.25, 0.5, and 1 g/kg MPal, respectively. The supplementation of MPal did not alter laying performance and egg quality among groups. Compared with the control group, MPal inclusion decreased lead (Pb) content in yolks at 49 days, and either 0.5- or 1-g/kg MPal supplementation decreased Pb accumulation in yolks at 25 days and manganese (Mn) accumulation in yolks at 25 and 49 days. The contents of jejunal secretory immunoglobulin A (SIgA), ileal SIgA, and immunoglobulin G were decreased by the dietary 0.5-g/kg MPal supplementation. The supplementation of MPal also decreased malondialdehyde content in jejunum and ileum, and decreased serum diamine oxidase activity of the laying hens at 25 and 49 days. The inclusion of 0.5 and 1 g/kg MPal enhanced villus height in jejunum and ileum, and also increased the ratio of villus height to crypt depth in ileum. In conclusion, MPal supplementation decreased Pb and Mn contents in yolks, and exhibited beneficial effects on the intestinal immunity, oxidative status, and intestinal integrity and barrier function of laying hens and its optimal dosage was 0.5 g/kg.

[The relationship between the changes of serum NGF, HO-1, IL-1 beta and cognitive function in patients with severe OSAHS after comprehensive treatment]

Objective:To explore the relationship between the levels of serum nerve growth factor(NGF), hemeoxygenase 1(HO-1),interleukin-1 beta (IL-1β) and cognitive function in OSAHS patients. Method:the levels of serum NGF, HO-1 and IL-1β concentrations in 60 severe OSAHS patients were measured before and after treatment, and the Montreal cognitive score (MoCA), AHI and the LSaO₂ were also recorded. Result:①OSAHS patients have serum NGF decreased and serum HO-1, IL-1β increased.②In severe OSAHS patients the AHI was negatively correlated with NGF (r=－0.648), positively correlated with HO-1 (r=0.695), and positively correlated with IL-1β(r=0.616).③The MoCA value was positively correlated with NGF (r=0.663), negatively correlated with HO-1 (r=－0.614), and negatively correlated with IL-1β(r=－0.346).④After half a year of follow-up, the AHI and Serum HO-1 and IL-1β were significantly decreased, while the MoCA values and serum NGF were significantly increased after treatment. Conclusion:①Severe OSAHS patients have cognitive impairment.②The changes of serum NGF, HO-1 and IL-1β may be related to the changes of cognitive function in OSAHS patients. ③Comprehensive treatment can improve the patient's LSaO₂,reduce AHI, and improve the cognitive function.④Regular monitoring the concentration of serum NGF, HO-1, and IL-1β may be helpful to assess the patient's condition and recovery.

Cost-effectiveness of osteoporosis screening strategies for hip fracture prevention in older Chinese people: a decision tree modeling study in the Mr. OS and Ms. OS cohort in Hong Kong

Despite the high costs of hip fracture, many governments provide limited support for osteoporosis screening. We demonstrated that osteoporosis screening by dual-energy X-ray absorptiometry (DXA) with or without pre-screening by Fracture Risk Assessment Tool (FRAX) or calcaneal ultrasound are more cost-effective than no screening in Chinese people aged 65 or over in Hong Kong.

INTRODUCTION

To examine the cost-effective potential osteoporosis screening strategies for hip fracture prevention in Hong Kong.

METHODS

Decision tree models were constructed to evaluate the cost per quality-adjusted life years (QALYs) of the different osteoporosis screening strategies followed by subsequent 5-year treatment with alendronate compared to no screening (but treat if a hip fracture occurs). The multiple osteoporosis screening strategies were composed of alternative tests and initiation age groups were evaluated with a 10-year horizon, and treatment were assigned if central dual-energy X-ray absorptiometry (DXA) T-score (at either the hip or spine) is - 2.5 or less. Strategies included DXA for all people and pre-screening with the Fracture Risk Assessment Tool (FRAX) at specific thresholds or by calcaneal quantitative ultrasonography (QUS) before taking DXA examination. All the model inputs were based on the Mr. OS and Ms. OS Hong Kong cohort; data are obtained from the Social Welfare Department or the published literature.

RESULTS

All of the screening strategies, including the universal screening with DXA and the pre-screening with FRAX or QUS before DXA, were consistently more cost-effective than no screening for people aged 65 years old or over. One-way sensitivity analysis with a more optimistic assumption on treatment adherence or inclusion of other major osteoporotic fractures did not change the results materially. Probabilistic sensitivity analyses showed a dominant role of pre-screening with FRAX followed by subsequent osteoporosis drug treatment in people aged 70 years old or over in Hong Kong.

CONCLUSIONS

Osteoporosis screening strategies based on DXA with or without pre-screening are more cost-effective compared to no screening for Chinese people aged 65 or over in Hong Kong.

QTL mapping in diploid potato by using selfed progenies of the cross S. tuberosum × S. chacoense

Usually, mapping studies in potato are performed with segregating populations from crosses between highly heterozygous diploid or tetraploid parents. These studies are hampered by a high level of genetic background noise due to the numerous segregating alleles, with a maximum of eight per locus. In the present study, we aimed to increase the mapping efficiency by using progenies from diploid inbred populations in which at most two alleles segregate. Selfed progenies were generated from a cross between S. tuberosum (D2; a highly heterozygous diploid) and S. chacoense (DS; a homozygous diploid clone) containing the self-incompatibility overcoming S locus inhibitor (Sli-gene). The Sli-gene enables self-pollination and the generation of selfed progenies. One F2 population was used to map several quality traits, such as tuber shape, flesh and skin color. Quantitative trait loci were identified for almost all traits under investigation. The identified loci partially coincided with known mapped loci and partially identified new loci. Nine F3 populations were used to validate the QTLs and monitor the overall increase in the homozygosity level.

The role of previous falls in major osteoporotic fracture prediction in conjunction with FRAX in older Chinese men and women: the Mr. OS and Ms. OS cohort study in Hong Kong

Falls are a major concern in terms of fracture risk. Although awareness rising for the absence of falls in the FRAX algorithm, our study only identified the independent predictive role of previous recurrent falls and their better conjunction use with FRAX for major osteoporotic fracture prediction in older Chinese men.

Comparison of gefitinib and platinum-based chemotherapy and only platinum-based chemotherapy to treat lung adenocarcinoma

To study the curative effects and safety for patients who adopt both gefitinib and platinum-based chemotherapy or only platinum-based chemotherapy in the treatment of lung adenocarcinoma, 80 EGFR mutation-positive lung adenocarcinoma patients in stage IIIB/IV were divided into two groups. Half of them received both gefitinib and standard chemotherapy (group A), and the others (group B) received only standard chemotherapy. Overall response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and the related toxicities of both groups were recorded in order to take certain nursing measures for a variety of toxicities. Next, statistical methods were used to analyze the curative effects and safety of the two treatments. The results showed that ORR, DCR and median progression-free (mPFS) survival of the two groups of patients showed no statistical difference (P >0.05). However, group A (18.56 months) had a longer median overall survival (mOS) than group B (14.87 months), which was of statistical significance (P less than 0.05). Nausea and loss of appetite were common mild adverse reactions, and anemia and leukocytopenia were moderate common adverse reactions. The difference between these two groups of patients regarding adverse reactions was not statistically significant (P>0.05). In conclusion, the two treatments have similar safety, but lung adenocarcinoma patients with drug resistance during stage IIIB/IV after using first-line gefitinib therapy have lower survival benefits than patients who take both gefitinib and platinum-based chemotherapy.

Inhibition of heat stress-related apoptosis of chicken myocardial cells through inducing Hsp90 expression by aspirin administration in vivo

1. This experiment investigated the anti-apoptosis effects and the mechanism of aspirin action in the heat shock response of chicken myocardial cells in vivo, via changes in the heat stress (HS) protein Hsp90 and the rate of apoptosis. Broiler chickens were administered aspirin (1 mg/kg body weight) 2 h before exposure to HS, and then exposed to 40 ± 1°C for 0, 1, 2, 3, 5, 7, 10, 15 and 24 h. 2. The induction and consumption of the HS factor heat shock factor (HSF)-1, and reductions of HSF-2 and HSF-3 induced by HS led to a delay in Hsp90 expression. HSF-1, 2 and 3 regulation of hsp90 expression in turn inhibited the synthesis and activation of protein kinase β (Akt), which resulted in a significant increase in caspase-3 at 2 and 10 h, caspase-9 from 1 to 7 h (except at 5 h), and the heat-stressed apoptosis of the myocardial cells. 3. Administration of aspirin changed the expression patterns of HSF-1, 2 and 3 such that the expression of Hsp90 protein was significantly upregulated (by 2.3-4.1 times compared with that of the non-treated cells). The resultant increase in Akt expression and activation, compared with the HS group, inhibited caspase-3 and caspase-9 activities and reduced the myocardial cells apoptosis rate (by 2.14-2.56 times). 4. Aspirin administration could inhibit heat-stressed apoptosis of myocardial cells in vivo and may be closely associated with its promotion of HS response of chicken hearts, especially Hsp90 expression.

[Comparative analysis of methylation profiles in tissues of oral leukoplakia and oral squamous cell carcinoma]

Objective: To compare the methylation profiles in tissues of oral leukoplakia (OLK) and oral squamous cell carcinoma (OSCC) with healthy tissues of oral mucosa, in order to identify the role of DNA methylation played in tumorigenesis. Methods: DNA samples extracted from tissues of 4 healthy oral mucosa, 4 OSCC and 4 OLK collected from patients of the Department of Oral Medicine, Capital Medical University School of Stomatology were examined and compared using Methylation 450 Bead Chip. The genes associated with differentially methylated CpG sites were selected for gene ontology (GO) analysis and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment. Results: Multiple differentially methylated CpG sites were identified by using the above mentioned assay. Hypermethylation constitutes 86.18% (23 290/27 025) of methylation changes in OLK and hypomethylation accounts for 13.82% (3 734/27 025) of methylation changes. Both hypermethylated and hypomethylated CpG sites were markedly increased in OSCC tissue compared with OLK tissue. The majority of differentially methylated CpG sites were located outside CpG islands, with approximately one-fourth in CpG shores flanking the islands, which were considered highly important for gene regulation and tumorigenesis. Pathway analysis revealed that differentially methylated CpG sites in both OLK and OSCC patients shared the same pathway enrichments, most of which were correlated with carcinogenesis and cancer progression (e.g., DNA repair, cell cycle, and apoptosis). Conclusions: In the present study, methylation-associated alterations affect almost all pathways in the cellular network in both OLK and OSCC. OLK and OSCC shared similar methylation changes whether in pathways or genes, indicating that epigenetically they might have the same molecular basis for disease progression.

The Influence of Nitrile Gloves on the Setting Behavior of Polyvinyl Siloxane Putty Impression Materials

OBJECTIVE

The purpose of this study was to assess the gelation and polymerization time of three polyvinyl siloxane (PVS) putty materials and to determine if those times were affected by nitrile gloves under different conditions.

MATERIALS AND METHODS

Ten specimens (n=10) were obtained for each PVS putty material (Express STD, 3M ESPE; Extrude Xtra, Kerr and Exafast, GC) and tested under different conditions (gloves washed, gloves unwashed and hands contaminated). The gelation and polymerization time were measured using an oscillating rheometer and recorded for 400 s at 37°C to simulate the oral environment.

RESULTS

The mean gelation time of hand contaminated specimens was 157.50 minutes and was significantly slower than that by using nitrile washed gloves (mean=117.94, p=.004) and by using unwashed gloves (mean=99.46, p⟨0.001). Unwashed gloves had significantly quicker gelation times compared to washed gloves (p=.046). The gelation time was significantly delayed with Exafast compared to Extrude Xtra and Express STD across all the different types of glove conditions (p⟨0.043). No significant differences were observed between polymerization time with Exafast and Extrude Xtra Putty.

CONCLUSIONS

Extrude Xtra putty material had significantly better performance than GC Exafast and Express. Hand contaminated specimens were affected by the gelation/polymerization time.

Abstract P5-07-05: LOC283299 suppress the lymphnode metastatic cascade in breast cancer patients

Background

Long non-coding RNAs (lncRNAs) have been proved to play an essential role in cancer metastasis. The accuracy of intraoperative assessment of lymph nodes metastasis need to be improved. In this study, we aimed to define the lncRNA biomarker ectopic expressed in breast cancer patients' metastatic lymph nodes, and to explore the potential molecular mechanisms.

Experimental Design

RNA-seq analyses in 3 paired breast cancer patients' primary tumor and metastatic lymph node was used as training set to determine differentially expressed lncRNAs that may be associated with lymph node metastasis. The other 40 patients were analyzed as validation set to test the accuracy of lncRNAs identification by quantitative real-time PCR. The correlation between LOC283299 expression level and prognosis in other 282 breast cancer patients was confirmed. In parallel, in vitro and in vivo analyses were carried out to determine the potential mechanisms of LncRNA-dependent lymph node metastases and prognosis.

Results

RNA-seq analyses in the training set revealed significant correlation between high expression level of LOC283299 and lower lymph node metastasis potential in breast cancer patients. We further validated that the expression level of LOC283299 was significantly higher in tumor primary tissue than that in paired metastatic lymph node (P=0.0245), and higher LOC283299 expression level was markedly associated with good metastasis-free survival in breast cancer patients (P=0.04). In breast cancer cell lines, CRISPR-on overexpression of LOC283299 inhibited proliferation, migration, invasion, and metastases both in vivo and in vitro. shRNA knockdown LOC283299 promotes the ability of tumor proliferation and metastasis. The molecular mechanisms by which LOC283299 as metastasis-suppressing lncRNAs regulates recurrence and metastasis may involve regulation of epithelial to mesenchymal transition (EMT), cellular invasion and microenvironment in breast cancer cells.

Conclusion

Our study revealed a strong correlation between LOC283299 expression and lymph node metastases in breast cancers. High level of LOC283299 was associated with better metastasis-free survival. The changed metastasis phenotype may be mediated by the interaction of LOC283299 and breast cancer cells. Therefore, LOC283299 may represent a potential predictive biomarker for early lymph node metastasis in breast cancer.

Citation Format: Guo R, Xue J, Su Y, Xiu B, Ji W, Chi Y, Wu J. LOC283299 suppress the lymphnode metastatic cascade in breast cancer patients [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 P5-07-05.