AB0642 CLINICAL CHARACTERISTICS AND FACTORS ASSOCIATED WITH BONE EROSION IN GOUT PATIENTS WITH TOPHI

Background:

Bone erosion is a frequent complication of gout patients with tophi and can lead to joint damage, deformity and musculoskeletal disability. Few studies have focused on clinical characteristics and factors associated with bone erosion in gout patients with tophi.

Objectives:

The aim of this study was to describe clinical characteristics of bone erosion in gout patients with tophi.

Methods:

Bone erosion was detected by X-ray. Gout patients with tophi were divided into bone erosion group and non bone erosion group. The clinical characteristics were recorded. Comparison of clinical characteristics and risk factors for bone erosion were analyzed between two groups. Multivariate logistic regression analysis was conducted.

Results:

A total of 171 gout patients with tophi were enrolled, 121 patients with bone erosion and 50 patients without bone erosion. Bone erosion group were older, with prolonged duration with gout and tophi, higher levels of serum creatinine, lower levels of glomerular filtration rate (GFR), C-reactive protein and BMI. In univariate regression analysis, age, gout duration, tophi duration, GFR were associated with bone erosion. In multivariable logistic regression analysis, tophi duration was independently associated with bone erosion.

Conclusion:

Gout patients with bone erosion present different clinical characteristics compared with those without bone erosion. Tophi duration was strongly associated with bone erosion in patients with gout.

Table 1.

Comparison of clinical characteristics between bone erosion patients and non bone erosion patients.

Non Bone erosionBone erosionP ValueN(male)50(47)121(118)0.255Age(year)45.82±14.1553.74±14.880.002BMI (kg/m2)26.01±4.5824.18±4.720.027WBC(109/mL)9.73±3.4011.37±13.260.404PLT(109/mL)329.86±96.22328.31±124.020.938HGB(g/L)86.58±63.78102.75±51.160.201ALT(U/L)37.74 ±26.5634.26±35.260.561sUA(umol/L)540.16±121.79539.00±121.460.962sCr(umol/L)111.47±25.26135.77±52.43<0.001GFR(ml/min/1.73m2)74.01±27.9456.68±22.840.003ESR(mm/h)61.78±37.3253.08±36.700.181CRP(mg/L)60.00±58.2636.45±42.620.014Gout duration (year)9.22±5.4612.63±7.590.001Tophi duration(year)3.77±3.226.64±4.810.001Hypertension, n17520.277Diabetes, n9120.143Smoking history, n20550.513Drinking history, n14370.737Ulceration, n10350.228

Disclosure of Interests:

None declared.

AB0645 CLINCAL CHARACTERISTICS OF GOUT PATIENTS WITH RENAL CYSTS

Background:

Gout is a crystal-related arthropathy caused by monosodium urate deposition, which is a common and treatable form of inflammatory arthritis and becoming more prevalent[1]. A few studies have found that gout patients have an increased prevalence of simple renal cysts[2, 3]. The relationship between gout and renal cysts is still insufficient.

Objectives:

Compare the difference between gout with renal cyst and without renal cyst.

Methods:

We retrospectively collected data on 200 gout patients. The data includes age, gender, uric acid, creatinine, glomerular filtration rate, 24-hour urine collection, and whether they have kidney stones, renal cysts, coronary heart disease, hypertension, and diabetes. Chi-square and exact Fisher’s tests were utilized, while continuous variables were assessed by Student’s t-test. A P value of less than 0.05 was considered statistically significant.

Results:

Of the 200 gout patients, 56 have kidney cysts(28%). In gout patients who had a renal cyst, were significantly older than patients without renal cysts (59.14 vs. 46.87, P = 0.000), more number of people suffering from coronary heart disease (7 vs. 5, P = 0.016). The glomerular filtration rate was lower (58.5 vs. 71.6, P = 0.000), with lower urinary creatinine, uric acid, and urinary potassium.

Conclusion:

Gout patients with and without simple renal cysts have significant differences in age, hypertension, cardiovascular disease, GFR, serum creatinine, urine creatinine, and urine potassium.

References:

[1]N. Dalbeth, T.R. Merriman, L.K. Stamp, Gout, Lancet 388(10055) (2016) 2039-2052.

[2]E.M. Hasegawa, R. Fuller, M.C. Chammas, F.M. de Mello, C. Goldenstein-Schainberg, Increased prevalence of simple renal cysts in patients with gout, Rheumatol Int 33(2) (2013) 413-6.

[3]Y. Han, M. Zhang, J. Lu, L. Zhang, J. Han, F. Zhao, H. Chen, Y. Bao, W. Jia, Hyperuricemia and overexcretion of uric acid increase the risk of simple renal cysts in type 2 diabetes, Sci Rep 7(1) (2017) 3802.

Table 1.

Clinical characteristics of gout patients

Renal cyst(n=56)Without Renal cyst(n=144)PDisease duration, (month)98.7(±64.1)91.2(±67.0)0.468Age, (year)59.14(±14.3)46.78(±15.9)0.000Gender, n(F/M)7/4911/1330.281Smoking history, n(%)18(32.1%)47(32.6%)0.946Drinking history, n(%)10(17.9%)32(22.2%)0.496Hypertension, n(%)31(55.3%)49(34.0%)0.006Diabetes, n(%)9(16.1%)15(10.4%)0.269CVDs, n(%)7(12.5%)5(3.4%)0.016Nephrolithiasis, n(%)14(25%)43(29.9%)0.494UA, (μmol/L)494.8(±158.0)544.3(±121.0)0.037Serum creatinine, (μmol/L)139.4(±57.2)116.5(±35.45)0.007GFR, (ml/L)58.5(±22.5)71.6(±22.3)0.000FEUA, (%)7.0(±3.2)6.0(±3.2)0.052Urine creatinine, (μmol/L)4687.09(±1832.9)5565.2(±2599.8)0.008Urine Uric acid, (μmol/L)1204.9(±772.0)1542.1(±1048.5)0.030Urine sodium, (mmol)132.1(±68.7)131.2(±76.6)0.939Urine potassium, (mmol)25.6(±12.5)31.8(±14.2)0.005

Disclosure of Interests:

None declared.

[Prognosis and related risk factors of acute respiratory distress syndrome in elder patients]

Objective: To study the risk factors associated with the hospital survival rate of elder patients with acute respiratory distress syndrome (ARDS) in Medical/Respiratory Intensive Care Units (MICUs/RICUs) by evaluating the prognosis, and therefore to provide insight into patient treatment strategy. Methods: Twenty MICUs/RICUs of 19 general hospitals in mainland China participated in the multicenter prospective cohort study carried out from Mar 1^st, 2016 to Feb 28^th, 2018. Patients who met the criteria of Berlin ARDS and older than 65 years were recruited. Baseline data, risk factors of ARDS, ventilator setup and prognosis data were collected from all patients. Univariant and multivariant regression analysis were conducted to analyze the factors associated with the prognosis. Results: 170 elder ARDS patients (age≥65 years) met the Berlin ARDS criteria, among whom 8.8% (15/170), 42.9% (73/170) and 48.2% (82/170) patients had mild, moderate and severe ARDS, respectively. The most common predisposing factor for elder ARDS was pneumonia, which was present in 134 patients (78.8%). 37.6% (64/170) patients were treated with noninvasive mechanical ventilation (NIV), but 43.8% (28/64) cases experienced treatment failure. 76.5% (130/170) patients were treated with invasive mechanical ventilation. All patients 80 years or older were given invasive mechanical ventilation. 51.8% (88/170) cases had complications of non-pulmonary organ failure. 61.8% (105/170) patients deceased during hospital stay. Multivariant logistic analysis showed that the independent risk factors for hospital survival rate in elder patients with ARDS were SOFA score (P=0.030, RR=0.725, 95% CI 0.543-0.969), oxygen index after 24 hours of ARDS diagnosis (P=0.030, RR=0.196, 95% CI 0.045-0.853), accumulated fluid balance within 7 days after diagnosis of ARDS (P=0.026, RR=1.000, 95% CI 1.000-1.000) and shock (P=0.034, RR=0.140, 95% CI 0.023-0.863). Conclusion: Among 20 ICUs, the high mortality rate of elder patients with ARDS was correlated with higher 24 hour SOFA score, lower 24 hour oxygen index after ARDS diagnosis, more positive fluid balance within 7 days and concomitant shock. The conservative fluid strategy within 7 days of ARDS diagnosis may benefit the elder ARDS patients.

Elliptic Flow of Electrons from Beauty-Hadron Decays in Pb-Pb Collisions at sqrt[s_{NN}]=5.02 TeV

The elliptic flow of electrons from beauty hadron decays at midrapidity (|y|<0.8) is measured in Pb-Pb collisions at sqrt[s_{NN}]=5.02  TeV with the ALICE detector at the LHC. The azimuthal distribution of the particles produced in the collisions can be parametrized with a Fourier expansion, in which the second harmonic coefficient represents the elliptic flow, v_{2}. The v_{2} coefficient of electrons from beauty hadron decays is measured for the first time in the transverse momentum (p_{T}) range 1.3-6  GeV/c in the centrality class 30%-50%. The measurement of electrons from beauty-hadron decays exploits their larger mean proper decay length cτ≈500  μm compared to that of charm hadrons and most of the other background sources. The v_{2} of electrons from beauty hadron decays at midrapidity is found to be positive with a significance of 3.75  σ. The results provide insights into the degree of thermalization of beauty quarks in the medium. A model assuming full thermalization of beauty quarks is strongly disfavored by the measurement at high p_{T}, but is in agreement with the results at low p_{T}. Transport models including substantial interactions of beauty quarks with an expanding strongly interacting medium describe the measurement within uncertainties.

Hsa_circRNA_101036 acts as tumor-suppressor in oral squamous cell carcinoma cells via inducing endoplasmic reticulum stress

OBJECTIVE

Endoplasmic reticulum (ER) stress has an effect on cancer cell proliferation and survival. TMTC1 has been reported to be involved in cell proliferation and inflammation, and development of ER. Hsa_circRNA_101036 is an exon circRNA formed by splicing of TMTC1 mRNA precursor. This study intends to explore the effect of hsa_circRNA_101036 on the malignant behavior of oral squamous cell carcinoma through endoplasmic reticulum stress.

MATERIALS AND METHODS

We firstly evaluated the levels of Hsa_circRNA_101036 in human oral mucous fibroblasts (hOMF), and in several OSCC cell lines, including FaDu, OECM1, SAS, HSC3. Then, we studied the effects of overexpression of Hsa_circRNA_101036 on the cell proliferation, apoptosis, invasion, migration, and cytokine release in OSCC cells. Finally, we evaluated the levels of CHOP that are critical in ER and the ROS levels in OSCC cells.

RESULTS

We found that compared with hOMF, a significantly lower mRNA expression of Hsa_circRNA_101036 was found in OECM1 and HSC3 cells. In OECM1 and HSC3 cells, with overexpression of Hsa_circRNA_101036, a significant decrease in cell proliferation, apoptosis, invasion, migration, and cytokine release was found. A significantly increased ROS, as well as increased protein level of CHOP, P38 and Bcl-2, was found in cells with Hsa_circRNA_101036 overexpression.

CONCLUSIONS

This study indicated that Hsa_circRNA_101036 may acts as a tumor suppressor in OSCC via regulating the ER in cancer cells.

Microsatellite markers reveal polymorphisms at the 3′ untranslated region of the SLC11A1 gene in Zhongdian Yellow cattle (Bos taurus)

Solute carrier family 11-member A1 (SLC11A1) gene encodes natural macrophage resistance-associated protein which regulates activity of macrophages against intracellular pathogens. The objective of this study was to study the polymorphism in the microsatellites present at 3′ untranslated region (UTR) of the SLC11A1 gene in 113 Zhongdian Yellow cattle (Bos taurus). Using DNA bi-directional sequencing, we detected seven alleles (GT10–16) for the first microsatellite (MS1), five alleles (GT12–16) for MS2, and four alleles (GT4–7) for MS3. MS3 is studied for the first time and revealed four novel variants (alleles GT4–7). Alleles GT12 (45.1%), GT13 (59.3%), and GT5 (85.4%) were the most frequent alleles at MS1, MS2, and MS3, respectively, Genotypes G12/12, G13/13, and G5/5 had the highest frequency 0.239, 0.540, and 0.743 at MS1, MS2, and MS3, respectively. Haplotypic data revealed that GT12/GT13 was the most frequent haplotype observed followed by GT12/14 haplotype. Three nucleotide variations were observed in MS1 and MS2. Comparative analysis of GT12/GT12 and GT13/GT13 genotype with other bovine genotypes showed significant difference (P > 0.05). Our results suggest that the homozygous genotypes GT12/GT12 and GT13/GT13 in Zhongdian Yellow cattle might be related to disease resistance. The findings reported in this study would be helpful in cattle breeding programs.

Massively Multiplexed Electrohydrodynamic Tip Streaming from a Thin Disc

We report an experimental study on the multiple tip streaming enabled by an externally wetted thin disc in electric fields. The electrohydrodynamic stress acting on the liquid-air interface triggers an interfacial instability that develops into multiple radial liquid ligaments at the rim of the disc. The scaling law suggests that the wave number is inversely proportional to the square of the peak electric field at the rim, which is determined by the combined thickness of the disc and the attached liquid layer. The thin disc edge effectively intensifies the electric field, which in turn leads to spacing between ligaments as short as 30  μm for ethanol, generating over 1000 cone jets for a 1 cm diam thin disc.

Clinical, molecular, metabolic, and immune features associated with oxidative phosphorylation in melanoma brain metastases

Background

Recently, we showed that melanoma brain metastases (MBMs) are characterized by increased utilization of the oxidative phosphorylation (OXPHOS) metabolic pathway compared to melanoma extracranial metastases (ECMs). MBM growth was inhibited by a potent direct OXPHOS inhibitor, but observed toxicities support the need to identify alternative therapeutic strategies. Thus, we explored the features associated with OXPHOS to improve our understanding of the pathogenesis and potential therapeutic vulnerabilities of MBMs.

Methods

We applied an OXPHOS gene signature to our cohort of surgically resected MBMs that had undergone RNA-sequencing (RNA-seq) (n = 88). Clustering by curated gene sets identified MBMs with significant enrichment (High-OXPHOS; n = 21) and depletion (Low-OXPHOS; n = 25) of OXPHOS genes. Clinical data, RNA-seq analysis, and immunohistochemistry were utilized to identify significant clinical, molecular, metabolic, and immune associations with OXPHOS in MBMs. Preclinical models were used to further compare melanomas with High- and Low-OXPHOS and for functional validation.

Results

High-OXPHOS MBMs were associated with shorter survival from craniotomy compared to Low-OXPHOS MBMs. High-OXPHOS MBMs exhibited an increase in glutamine metabolism, and treatment with the glutaminase inhibitor CB839 improved survival in mice with MAPKi-resistant, High-OXPHOS intracranial xenografts. High-OXPHOS MBMs also exhibited a transcriptional signature of deficient immune activation, which was reversed in B16-F10 intracranial tumors with metformin treatment, an OXPHOS inhibitor.

Conclusions

OXPHOS is associated with distinct clinical, molecular, metabolic, and immune phenotypes in MBMs. These associations suggest rational therapeutic strategies for further testing to improve outcomes in MBM patients.

[Application value of urinary IGFBP7 and TIMP-2 in acute kidney injury with decompensated hepatitis B virus-related liver cirrhosis]

Objective: To investigate the application value of new urinary biomarkers insulin-like growth factor binding protein 7 (IGFBP7) and tissue matrix metalloproteinase inhibitor-2 (TIMP-2) in acute kidney injury with decompensated hepatitis B virus-related liver cirrhosis. Methods: 45 newly hospitalized cases with decompensated hepatitis B virus-related liver cirrhosis were selected. Among them, 19 cases were combined with AKI on admission (cirrhosis-AKI group), 26 cases without AKI (cirrhosis-non-AKI group), and 12 healthy cases (normal control group). First-morning urine samples were collected and IGFBP7 and TIMP-2 were detected by enzyme-linked immunosorbent assay (ELISA). Urinary IGFBP7 and serum creatinine (SCr) were dynamically monitored after hospitalization in cirrhosis-non-AKI group. Normally distributed measurement data were compared by t-test, and non-normally distributed measurement data were compared by rank sum test. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the diagnostic accuracy of the indicators. Results: Urinary IGFBP7, IGFBP7 with TIMP-2 (IGFBP7×TIMP-2) in cirrhosis-AKI group (n = 19) were equally higher than that of the cirrhosis-non-AKI group (P < 0.05). Urinary IGFBP7, TIMP-2 and IGFBP7×TIMP-2 in cirrhosis-AKI group or cirrhosis-non-AKI group were significantly higher than those of the normal control group (P < 0.01). The AUC of urinary IGFBP7 and urinary IGFBP7×TIMP-2 for diagnosis of AKI were 0.703 (95% CI 0.547-0.860) and 0.700 (95% CI 0.541-0.859), respectively. In the liver cirrhosis-non-AKI group (n = 26), 5 cases of AKI were newly diagnosed according to the changes in SCr during hospitalization (progressive group). Urinary IGFBP7 was significantly increased 2 days before the diagnosis of AKI. The concentration of urinary IGFBP7 at admission in the progressive group (n = 5) was higher than that of the non-progressive group (n = 21) (P < 0.05). Conclusion: Urinary IGFBP7 and TIMP-2 concentrations were significantly increased in patients with decompensated hepatitis B virus-related liver cirrhosis. When AKI occurred, urinary IGFBP7 and IGFBP7×TIMP-2 was further increased. Urinary IGFBP7 is valuable for early AKI diagnosis, and may play a role in predicting AKI occurrence.

Measurement of the Low-Energy Antideuteron Inelastic Cross Section

In this Letter, we report the first measurement of the inelastic cross section for antideuteron-nucleus interactions at low particle momenta, covering a range of 0.3≤p<4  GeV/c. The measurement is carried out using p-Pb collisions at a center-of-mass energy per nucleon-nucleon pair of sqrt[s_{NN}]=5.02  TeV, recorded with the ALICE detector at the CERN LHC and utilizing the detector material as an absorber for antideuterons and antiprotons. The extracted raw primary antiparticle-to-particle ratios are compared to the results from detailed ALICE simulations based on the geant4 toolkit for the propagation of (anti)particles through the detector material. The analysis of the raw primary (anti)proton spectra serves as a benchmark for this study, since their hadronic interaction cross sections are well constrained experimentally. The first measurement of the inelastic cross section for antideuteron-nucleus interactions averaged over the ALICE detector material with atomic mass numbers ⟨A⟩=17.4 and 31.8 is obtained. The measured inelastic cross section points to a possible excess with respect to the Glauber model parametrization used in geant4 in the lowest momentum interval of 0.3≤p<0.47  GeV/c up to a factor 2.1. This result is relevant for the understanding of antimatter propagation and the contributions to antinuclei production from cosmic ray interactions within the interstellar medium. In addition, the momentum range covered by this measurement is of particular importance to evaluate signal predictions for indirect dark-matter searches.

An emergency strategy for intensive care unit during COVID-19 outbreak in Chongqing, China

OBJECTIVE

Since December 2019, a novel coronavirus disease 2019 (COVID-19) broke out in Wuhan, China, which has rapidly spread from China to at least 200 countries abroad. COVID-19 was issued a global outbreak and pandemic by the World Health Organization with more than 3 million confirmed cases by May 31, 2020. So far more than ten thousand severe and critically ill patients and hospital-related infection with COVID-19 have been reported with more than four thousand deaths in China. There is a great challenge for intensive care units (ICUs) in hospitals.

PATIENTS AND METHODS

The comment mainly focused on admission and discharge criteria, therapy protocol, prevention and control strategies for ICU during COVID-19 outbreak. The emergency strategy for ICU will be helpful for prevention and control of COVID-19 and treatment of critically ill patients with COVID-19.

CONCLUSIONS

Progress in the management of ICU is crucial for a decrease in the mortality of critically ill patients with COVID-19 with the clinical evidence and experience updated.

AB0693 TIM-3-EXPRESSING NEUTROPHILS AS A NOVEL INDICATOR TO ASSESS DISEASE ACTIVITY AND SEVERITY IN ANKYLOSING SPONDYLITIS

Background:

Ankylosing spondylitis (AS) is a type of chronic inflammatory disease that compromises the axial skeleton and sacroiliac joints. Many studies have shown that neutrophils play an important roles in the inflammatory process of AS. However, the immunomodulatory roles and mechanisms of neutrophils in AS are poorly understood. T-cell immunoglobulin and mucin domain-containing protein 3 (Tim-3) has been reported as an important regulatory molecule, expressed and regulated on different innate immune cells, plays a pivotal role in several autoimmunity diseases. Recent study indicates that Tim3 is also expressed on neutrophils. However, the frequency and roles of Tim3-expressing neutrophils in AS was not clear.

Objectives:

In this study, we investigated the expression of Tim3 on neutrophils in AS patients and analyzed the correlation between the level of Tim3-expressing neutrophils and the disease activity of AS.

Methods:

AS Patients were recruited from Guangdong Second Provincial General Hospital (n=49). Age/sex-matched volunteers as Healthy controls (HC) (n=39). The medical history, clinical manifestations, physical examination, laboratory measurements were recorded. The expression of costimulatory molecules including programmed death 1 (PD-1), Tim-3 on neutrophils were determined by flow cytometry. The frequencies of Tim3-expressing neutrophils in AS patients were further analyzed for their correlation with markers of inflammation ESR and CRP, disease activity and severity of AS.

Results:

The expression of Tim3 on neutrophils in patients with AS was increased compared to the HC (Figure 1A). The frequency of Tim3-expressing neutrophils in patients with AS showed an positive correlation with ESR, CRP and ASAS-endorsed disease activity score (ASDAS) (Figure 1B). Moreover, the frequency of Tim3-expressing neutrophils in active patients(ASDAS≥1.3) was increased as compare with the inactive patients (ASDAS<1.3) (Figure 1C).

Conclusion:

Increased Tim-3 expression on neutrophils may be a novel indicator to assess disease activity and severity in AS, which may serves as a negative feedback mechanism preventing potential tissue damage caused by excessive inflammatory responses in AS patients.

References:

[1]Han, G., Chen, G., Shen, B. & Li, Y., Tim-3: an activation marker and activation limiter of innate immune cells.FRONT IMMUNOL4449 (2013).

[2]Vega-Carrascal, I.et al., Galectin-9 signaling through TIM-3 is involved in neutrophil-mediated Gram-negative bacterial killing: an effect abrogated within the cystic fibrosis lung.J IMMUNOL1922418 (2014).

Figure 1.

(A)The expression of Tim3 on neutrophils in AS and HC.(B)The correction between Tim3-expressing neutrophils and ESR,CRP,ASDAS.(C) The expression of Tim3 on neutrophils in active and inactive patients.

Disclosure of Interests:

None declared

AB0047 T-CELL IMMUNOGLOBULIN AND MUCIN DOMAIN–CONTAINING PROTEIN 3 EXPRESSION IN REGULATORY T CELLS OF ANKYLOSING SPONDYLITIS PATIENTS AND THE CORRELATION WITH DISEASE ACTIVITY

Background:

Ankylosing spondylitis (AS) is a chronic inflammatory autoimmune disease. Regulatory T cells have been found in peripheral blood of AS patients. However, there is a controversy regarding the relative number and function of regulatory T cells in AS. T-cell immunoglobulin and mucin domain–containing protein 3 (Tim-3) is a negative immune regulator that participates in immune responses and widely expresses on a variety of immune cells. Many studies have shown that Tim-3 participates in tumors, infections, hematological system diseases and autoimmune diseases (such as systemic lupus erythematosus, rheumatoid arthritis, autoimmune hepatitis, etc). While there has not yet clinical trials with large samples to verify whether or not Tim-3 is involved in the incidence of AS and the relationship between the disease activity of AS and the expression of Tim-3 in regulatory T cells.

Objectives:

The present study aimed to identify the Tim-3 expression in regulatory T cells in AS patients, and the association between Tim-3 and the disease activity of AS.

Methods:

There were 47 patients diagnosed as AS and 51 age- and sex-matched healthy controls (HCs) from Guangdong Second Provincial Central Hospital enrolled in the study. The clinical information of the AS patients was recorded in detail and the disease activity was calculated. The positive expression rates and medium fuorescence intensity (MFI) of Tim-3 in regulatory T cells were examined by fow cytometry. Statistical approaches were used to analyze the experimental data of patients and controls.

Results:

The Treg cells level was significantly decreased in AS patients compared to the healthy controls (5.14±0.27 vs 4.38±0.23, P = 0.032, Fig 1 A). Tim-3 expression in regulatory T cells was lower in AS patients than the HCs (63.29±2.39 vs 52.56±3.49, P = 0.013, Fig1 B). And Tim-3 MFI in regulatory T cells was significantly decreased too(1355.04±171.44 vs 859.19±105.11, P = 0.016, Fig1 C).

The Treg cells ratio negatively correlated with BASDAI (r=-0395, p=0.014) and BASFI (r=-0391, p=0.015) in AS patients. However, the Tim-3 expression in the Treg cells has no correlation with diseases activity in patients.

Conclusion:

According to the test results, we could confirm that regulatory T cells participate in the progression of AS, and it has negative relationship with disease activity. Tim-3 can express in Treg, but whether Tim-3 can be used as a potential target for AS treatment in future need further verified.

Disclosure of Interests:

None declared

Prognostic value of radiologically enlarged lymph nodes in node-negative colon cancer

AIM

Assessment of lymph node (LN) involvement is of crucial importance in the estimation of prognosis and choice of therapeutic options for patients with colon cancer. The relationship between the radiological size of LNs and prognosis in node-negative colon cancer remains uncertain. This study aims to investigate the prognostic impact of radiologically enlarged LNs on the survival of patients with node-negative colon cancer.

METHOD

This retrospective study recruited 395 patients with Stages I and II colon cancer diagnosed between January 2012 and March 2016. Preoperative computed tomography was reviewed for the maximum short-axis diameter of regional LNs, the optimal cutoff value of which was set to 8 mm. The prognostic relevance was analysed in Kaplan-Meier and multivariable Cox proportional hazard regressions.

RESULTS

Patients with tumour in the left colon, TNM Stage II and 12 or more retrieved LNs tended to have radiologically enlarged LNs. Our results suggest that 3-year recurrence-free survival (RFS) and overall survival (OS) were significantly worse in patients with enlarged LNs than those without (RFS 82.8% vs 92.4%, P = 0.026; OS 87.1% vs 95.2%, P = 0.017), which was also confirmed in multivariable analysis [RFS hazard ratio (HR) = 2.192, P = 0.018; OS HR = 3.305, P = 0.010]. Subgroup analysis revealed that in patients with Stage II disease or at least 12 retrieved LNs, radiologically enlarged LN remained an independent predictor of poor RFS and OS.

CONCLUSION

The presence of radiologically enlarged LNs in patients with node-negative colon cancer had an adverse prognosis.

Clinical and genetic analysis of idiopathic normophosphatemic tumoral calcinosis in 19 patients

PURPOSE

Tumoral calcinosis is a rare clinicopathological entity characterized by ectopic soft-tissue calcification, typically periarticular. Normophosphatemic tumoral calcinosis is seldom reported in East Asian populations, and the preoperative diagnosis is often elusive. This study was performed to characterize the clinical profile of normophosphatemic tumoral calcinosis and investigate the presence of the SAMD9 gene mutation.

METHODS

The clinical features, pathological examination findings, and outcomes of 19 subjects were retrospectively reviewed. All patients were analyzed for SAMD9 gene mutation using paraffin-embedded tumoral calcinosis specimens.

RESULTS

Nineteen subjects were analyzed (7 males, 12 females). Their mean age at surgery, mean age at symptom onset, and median disease duration was 51.9 ± 17.3 (range 7-75) years, 49.1 ± 17.2 (range 7-74) years, and 1.3 (interquartile range 0.5-3.0) years, respectively. Lesions were located in the hand in 8 (42.1%) subjects; wrist in 5 (26.3%); shoulder in 2 (10.5%); and hip, knee, buttock, and scrotum in 1 (5.3%) subject each. The lesions in 17 (89.5%) subjects were located around the joints [small joints (hand and wrist) in 13 (68.4%) and large joints (shoulder, hip, and knee) in 4 (21.1%)]. Lesions occurred in the upper limbs in 15 (78.9%) subjects and in the lower limbs in 2 (10.5%). Multiple-lesion involvement (distal right index finger and middle finger) occurred in one (5.3%) subject. Symptoms included pain in 15 (78.9%) subjects, impaired mobility in 5 (26.3%), swelling in 5 (26.3%), numbness in 2 (10.5%), and an asymptomatic mass in 2 (10.5%). The serum inorganic phosphorus concentration was normal in all 19 subjects (mean 1.17 ± 0.15 mmol/L). The serum calcium concentration was normal in 18 subjects and low in 1. The serum alkaline phosphatase concentration was normal in all 19 subjects. Pathological examination indicated multiple nodules of calcified materials that manifested an amorphous or granular blue-purple crystal and were surrounded by proliferation of mononuclear or multinuclear macrophages, osteoclastic-like giant cells, fibroblasts, and chronic inflammatory cells. Notably, different phases of pathological manifestations were observed in the same microscopic field. During follow-up (0.5-65.0 months), no recurrence of tumoral calcinosis was observed in 18 (94.7%) subjects, but 1 subject developed in situ recurrence of an asymptomatic subcutaneous mass after 6 months postoperatively. Genetic analysis in all 19 subjects revealed no SAMD9 gene mutations.

CONCLUSIONS

Most subjects were females and developed calcinosis in adulthood. Small joints (hand and wrist) and the upper limbs were frequently involved. The presence of different phases of pathological features in the same subject suggests that about half of the study participants had been misdiagnosed with another condition (such as gout, osteoarthritis, etc.). Complete surgical excision led to cure without recurrence during follow-up in majority of the study participants.

Optimal cut-points of visceral adipose tissue areas for cardiometabolic risk factors in a Chinese population: a cross-sectional study

AIM

To determine the optimal cut-points of visceral adipose tissue (VAT) areas at different anatomic levels to discriminate participants with cardiometabolic risk factors in a Chinese middle-aged population.

METHODS

A total of 1744 individuals who underwent regular health checks in Nanjing BENQ Medical Center from January 2013 to December 2016 were included in this cross-sectional study. VAT areas were measured by abdominal quantitative computed tomography at the L2/3 intervertebral disk and umbilicus levels. Cardiometabolic risk factors including serum triglycerides, HDL cholesterol levels, plasma glucose and blood pressure were defined using IDF 2005 criteria for metabolic syndrome.

RESULTS

The cut-points for VAT area at the umbilicus level were 111 cm² for men and 96 cm² for women to identify people with one or more cardiometabolic risk factors. For VAT area at the L2/3 level, the optimal cut-points were 142 cm² for men and 115 cm² for women. A VAT area at the L2/3 level of ≥ 142 cm² for men or 115 cm² for women significantly increased the prevalence of hyperglycaemia [odds ratio (OR) 3.18, 95% confidence interval (CI) 2.45-4.13], hypertension (OR 2.81, 95% CI 2.27-3.49) and dyslipidaemia (OR 4.37, 95% CI 3.50-5.45) after adjusting age.

CONCLUSIONS

The optimal cut-points for VAT area at the umbilicus level and L2/3 level were 111 cm² and 142 cm² for men and 96 cm² and 115 cm² for women to identify participants with one or more cardiometabolic risk factors.