Analysis of synthetic electron cyclotron emission from the high field side of HL-2M tokamak plasmas

A synthetic electron cyclotron emission (ECE) diagnostic is used to interpret ECE signals from preset plasma equilibrium profiles, including magnetic field, electron density, and electron temperature. According to the simulation results, the electron temperature (T_e) profile covering the harmonic overlap region can be obtained by receiving ECE signals at the high field side (HFS) of the HL-2M plasma. The third harmonic ECE at the low field side (LFS) cannot pass through the second harmonic resonance layer at the HFS unless the optical thickness (τ) of the second harmonic becomes gray (τ ≤ 2). In addition, the impact of the relativistic frequency down-shift has been evaluated and corrected. The measurable range of the HFS ECE has been calculated by scanning different parameters (electron density, temperature, and magnetic field). Higher plasma parameters allow a wider radial range of electron temperature measurements. The minimum inner measurable position can reach R = 120 cm (r/a = -0.89) when the product of core temperature (T_e0) and density (n_e0) is greater than 35 × 10¹⁹ keV m^-3, which is extended by more than 30 cm inward compared with that of the LFS measurement. The HFS ECE will greatly improve the diagnostic ability of ECE systems on the HL-2M tokamak.

O-057 The pregnant outcome after laparoscopy treatment for subtle distal fallopian tube abnormalities in infertile population: a prospective cohort study

Study question

What is the the pregnancy outcome after laparoscopy treatment for subtle distal fallopian tube abnormalities and the factors related with natural pregnancy.

Summary answer

The natural pregnancy rate is 46.58% after laparoscopy and patients' age, duration time of infertility and concurrent number of abnormalities are related with natural pregnancy.

What is known already

Subtle distal fallopian tube abnormalities are a group of diseases that are characterized by subtle variations in tubal anatomy including fimbrial agglutination, tubal diverticula, accessory ostium, fimbrial phimosis, and accessory fallopian tube. The prevalence of subtle distal fallopian tube abnormalities is high in infertile women.This group of diseases is highly related to endometriosis, especially its early stage, and may indicate fimbrial abnormalities in endometriosis.

Study design, size, duration

This was a prospective cohort study conducted in the Reproductive Medicine Center of an university-affiliated teaching hospital from January 2017 to December 2018.

Participants/materials, setting, methods

234 patients with subtle distal fallopian tube abnormalities were included. Laparoscopies were performed by four senior reproductive surgeons who were familiar with the diagnostic criteria and surgery treatment for subtle abnormalities. The fallopian tube abnormalities were corrected and endometriosis was treated by either electrical ablation for peritoneal lesions or endometrioma excision.The participants were followed up by phone every 12 months for pregnancy outcome until 36 months after surgery.

Main results and the role of chance

167 patients conceived after surgery(clinical pregnancy rate 71.37%). 109 patients conceived naturally (natural pregnancy rate 46.58%) and 59 patients conceived after in IVF（One case conceived naturally after live birth after IVF, four cases conceived naturally twice) . The average time for natural conception after surgery is 8.36±7.47 months. 51.4% of natural pregnancy occurred within 6 months and 79.8% occurred within 12 months.Among the 109 naturally conceived patients, there were 94 cases of live birth, 13 cases of natural abortion (natural abortion rate 11.92%) and 2 cases of ectopic pregnancy (ectopic pregnancy rate 1.83%). No preterm birth, multiple pregnancy or birth defects were reported in this group.The patient age(HR = 0.917,95%CI 0.870-0.917,P=0.001), duration of infertility(HR = 0.846,95%CI 0.740-0.966,P=0.014) and concurrent number of subtle abnormalities (HR = 0.636,95%CI 0.416-0.970,P=0.036) are the factors associated with natural pregnancy. The type of subtle abnormalities, type of infertility, body mess index, concurrent endometriosis, uterine cavity abnormalities and myoma are not related with natural pregnancy.

Limitations, reasons for caution

Not all kinds of subtle distal abnormalities are included such as paratubal cyst is excluded from the study. Not all the patients had the test of ovarian reserve such as AMH, antral follicle count and FSH level, so we couldn’t evaluate the relationship between ovarian reserve and natural pregnancy.

Wider implications of the findings

This is the largest clinical study that investigated the pregnancy outcome of subtle fallopian tube abnormalities in the infertile population.Laparoscopy surgery is an effective treatment for infertility patients with subtle distal fallopian tube abnormalities, especially for the young, short duration time of infertility and ≤2 types of subtle abnormalities.

Trial registration number

ChiCTR2000029095

POS0218 DECREASED miR-122-5p IN NEUTROPHIL-DERIVED EXOSOMES ATTENUATED IMMUNOREGULATORY FUNCTION ON MACROPHAGES BY TARGETING IRF5 EXPRESSION IN BEHCET’S DISEASE

Background

Behçet’s disease (BD) is a chronic systemic vasculitis characterized by the overactivation of neutrophils and macrophages. Exosomes are membrane-derived vesicles that mediate intercellular communications and neutrophil-derived exosomes account for the major portion of serum exosomes in BD. However, the role of neutrophil-derived exosomes in BD remains unknown.

Objectives

1) To investigate the production of exosomes by BD neutrophils; 2) To elucidate the regulation of macrophage by BD neutrophil-derived exosomes; 3) To explore the mechanism of immunoregulatory functions of BD neutrophil-derived exosomes.

Methods

BD and healthy control (HC) neutrophil-derived exosomes were extracted and quantified. Human monocyte-derived macrophages (HMDM) were stimulated with BD and HC neutrophil-derived exosomes, and TNF-α and IL-6 production were examined. Differently expressed miRNAs in BD neutrophil-derived exosomes were analyzed using miRNA sequencing. LPS-induced HMDM were treated with miRNA mimics or inhibitors, and TNF-α and IL-6 production were detected. miRNA was overexpressed in macrophages, and RNA sequencing was performed to analyze regulating pathways. Dual-luciferase assays were performed to confirm miRNA-mRNA interaction.

Results

BD neutrophils produced a significantly lower level of exosomes than HC ones. Both BD and HC neutrophil-derived exosomes suppressed TNF-α and IL-6 production by macrophages, but to a lesser extent by BD neutrophil-derived exosomes. Six downregulated miRNAs were presented in BD neutrophil-derived exosomes, including miR-122-5p. miR-122-5p mimics inhibited IL-6 and TNF-α production while miR-122-5p inhibitor promoted IL-6 and TNF-α production by HMDMs. Overexpression of miR-122-5p attenuated TLR4 and IFN-β signaling. miR-122-5p directly targeted 3’UTR of IRF5, the TF regulating TLR4 pathway and autocrine of IFN-β, and downregulated IRF5 expression confirmed by dual luciferase assay. Knocking down IRF5 dampened IL-6 and TNF-α production in HMDMs.

Figure 1.

(A) Decreased production of BD neutrophil-derived exosomes. (B) Reduced suppression of macrophage activation by BD neutrophil-derived exosomes. (C) Differentially expressed miRNAs (downregulated) in BD neutrophil-derived exosomes. (D) miR-122-5p suppressed TLR4 and JAK-STAT signaling in HMDM. (E) miR-122-5p inhibited activation of HMDM. (F) miR-122-5p inhibited IRF5 expression in HMDM.

Conclusion

Our findings suggested the reduced production and immunoregulatory function of BD neutrophil-derived exosomes, mediated by lower levels of miR-122-5p in neutrophil-derived exosomes. Impaired BD neutrophil-derived exosomes might be implicated in the overactivation of macrophages in BD.

References

[1]Kolonics, Ferenc et al. Cells vol. 9,12 2718. 18 Dec. 2020,

Disclosure of Interests

None declared

POS0471 INDUCED ANTIBODIES DIRECTED TO THE ANGIOTENSIN RECEPTOR TYPE 1 PROVOKE SKIN AND LUNG INFLAMMATION AND DERMAL FIBROSIS AND ACT SPECIES OVERARCHING

Background

Antibodies directed to the angiotensin receptor type 1 (AT1R) were found to be increased in patients with SSc ad they predict mortality and SSc complications (1, 2). In vitro studies suggested an involvement in the pathogenesis of systemic sclerosis (SSc).

Objectives

Here, we aim to determine the contribution and functions of AT1R autoantibodies (Abs) in vivo and in vitro as well as their capacity to recognize AT1R from different species.

Methods

C57BL/6J mice were immunized with membrane-embedded human AT1R or empty membrane as control. Phenotypic properties of various organs were examined by immunohistochemistry, immunofluorescence, and TUNEL apoptosis assay. A monoclonal (m)AT1R Ab was generated based upon this mouse model by hybridoma technology and transferred into C57BL/6J mice. Mice deficient for CD4+ and CD8+ T cells, B cells and AT1Ra/b served as controls. In vitro, Abs responses towards AT1R were measured using rat cardiomyocytes, human epithelial cells, AT1R-transfected HEK293 cells and primary human monocytes.

Results

AT1R-immunized mice developed perivascular skin and lung inflammation, lymphocytic alveolitis, weak endothelial apoptosis and skin fibrosis, not present in controls or mice deficient for CD4+ T and B cells. The contribution of AT1R Abs to skin manifestations and interstitial lung disease was demonstrated by application of a mAT1R Ab, which induced skin and lung inflammation, not observed in the AT1Ra/b knockout mice. IgG from immunized mice containing AT1R Abs and/or the mAT1R Ab activated rat cardiomyocytes and human monocytes. Treatment of AT1R-transfected HEK293 cells with the mAT1R Ab enhanced AT1R signaling in the presence of the endogenous agonist Angiotensin II.

Conclusion

Our immunization strategy successfully induced AT1R Abs, contributing to inflammation and most likely to fibrosis via activation of AT1R. Therefore, AT1R Abs are valuable targets for future therapies in SSc and possibly other AT1R Ab-related diseases.

References

[1]Riemekasten, G. et al. Involvement of functional autoantibodies against vascular receptors in systemic sclerosis. Ann. Rheum. Dis. 70, 530–536 (2011).

[2]Becker, M. O. et al. Vascular receptor autoantibodies in pulmonary arterial hypertension associated with systemic sclerosis. Am. J. Respir. Crit. Care Med. 190, 808–817 (2014).

Figure 1.

AT1R immunization and induction of AT1R Abs in C57BL/6J mice induced lymphocytic alveolitis in bronchoalveolar fluid (A), interstitial lung disease (B) with increased inflammatory score (C)

Figure 2.

AT1R immunization and induction of AT1R Abs in C57BL/6J mice induced skin fibroses (A) as determined by collagen content (B) and skin thickness (C).

Acknowledgements

This manuscript was founded by the German Research Council RI1056/11-1-3 and the Excellence Cluster Precision Medicine in Inflammation and by the BMBF-founded Mesinflame project.

Disclosure of Interests

None declared.

[Equol and its enantiomers inhibited urethane-induced lung cancer in mice]

OBJECTIVE

To investigate the effects and mechanisms of equol and its enantiomers on urethane-induced lung cancer in mice.

METHODS

A total of 120 5-week-old male C57BL/6 mice were randomly divided into 8 groups: lung cancer tumor control group (CG), genistein control group (GCG), low dose racemic equol group (LEG), high dose racemic equol group (HEG), low dose R-equol group (LRE), high dose R-equol group (HRE), low dose S-equol group (LSE) and high dose S-equol group (HSE). Urethane was injected subcutaneously twice a week for 4 weeks to induce lung cancer and then the mice were fed for 4 months. The body weight and food intake of each group were measured and recorded weekly. After the mice were sacrificed, the blood, livers and lungs of the mice were collected. The incidence of lung cancer in each group was recorded. The concentration of serum superoxide dismutase (SOD), malondialdehyde (MDA) and 8-hydroxydeoxygunosine (8-OHdG) were detected by the corresponding kits. Western blotting was used to detect the expression of nuclear factor (erythroid-derived 2)-like 2 (Nrf2) in the livers. Between-group differences in body weight and food intake of the mice were compared using repeated measures ANOVA, and ANOVA for the differences between non-repeated measurements, with post hoc analysis using Tukey's method if there were between-group differences. Comparisons of categorical data were performed by chi-square test, and if there were differences between the groups, the Bonferroni method was used for pairwise comparison.

RESULTS

A total of 49 in the 120 mice developed lung cancer. The overall incidence of lung cancer was 40.8%. Compared with the control group, the incidence of lung cancers in each experimental group was lower, and the difference was statistically significant. The incidence of lung cancer in the high-dose experimental group was significantly lower than that in the low-dose experimental group. However, the incidence of lung cancer was similar in the three equol groups and the genistein group at the same dose. Compared with the control group, the high-dose experimental group had higher serum SOD concentration, lower MDA and 8-OHdG concentrations, and the differences were statistically significant. Western blotting analysis showed that the expression levels of Nrf2 protein in the experimental groups were higher than those in the control group except the low-dose racemic equol group, and the Nrf2 protein expression level in the high-dose equol groups was higher than that in the low-dose equol groups.

CONCLUSION

Racemic equol and its enantiomers mayinhibit lung carcinogenesis through antioxidant effects.

Treatment-related adverse events as predictive biomarkers of efficacy in patients with advanced neuroendocrine tumors treated with surufatinib: results from two phase III studies

Background

No validated biomarkers currently exist for predicting the efficacy outcomes in patients with neuroendocrine tumors (NETs) treated with antiangiogenic therapy. We aimed to evaluate the association between treatment-related adverse events (TRAEs) and efficacy outcomes of surufatinib in patients with advanced NET.

Patients and methods

We included patients with NET treated with surufatinib in two multicenter, randomized, double-blind, placebo-controlled, phase III trials (SANET-p and SANET-ep) in this study. The main exposure was the presence of any of the TRAEs including hypertension, proteinuria, and hemorrhage in the first 4 weeks of surufatinib treatment. The primary outcome of the study was investigator-assessed progression-free survival (PFS). PFS outcomes were estimated using the Kaplan–Meier method with the log-rank test. Hazard ratios (HRs) were calculated by using univariable and multivariable Cox proportional hazard regression models. Blinded independent image review committee (BIIRC) assessments and 4-week landmark analysis were also performed as supportive evaluations.

Results

During the study period, a total of 242 patients treated with surufatinib were included in the analysis, and 164 (68%) patients had at least one of hypertension, proteinuria, and hemorrhage in the first 4 weeks of treatment. The presence of TRAEs in the first 4 weeks was associated with prolonged median PFS [11.1 versus 9.2 months; HR 0.67, 95% confidence interval (CI) 0.47-0.97; P = 0.036]. In multivariable Cox regression analysis, the presence of TRAEs was also significantly associated with longer PFS (HR 0.65, 95% CI 0.44-0.97; P = 0.035). Similar results were obtained in the BIIRC assessments and 4-week landmark analysis.

Conclusions

Treatment-related hypertension, proteinuria, and hemorrhage could be potential biomarkers to predict antitumor efficacy of surufatinib in patients with advanced NET. Future prospective studies are needed to validate the findings.

Trial registration

ClinicalTrials.govNCT02589821; https://clinicaltrials.gov/ct2/show/NCT02589821 and ClinicalTrials.gov NCT02588170; https://clinicaltrials.gov/ct2/show/NCT02588170

•

Treatment-related hypertension, proteinuria, or hemorrhage is associated with longer survival in NETs.

•

The association is confirmed by the BIIRC assessments and 4-week landmark analysis.

•

TRAEs can be biomarkers to predict antitumor efficacy in patients with NET.

Sodium MRI at 7T for Early Response Evaluation of Intracranial Tumors following Stereotactic Radiotherapy Using the CyberKnife

BACKGROUND AND PURPOSE

Conventionally, early treatment response to stereotactic radiotherapy in intracranial tumors is often determined by structural MR imaging. Tissue sodium concentration is altered by cellular integrity and energy status in cells. In this study, we aimed to investigate the feasibility of sodium MR imaging at 7T for the preliminary evaluation of radiotherapeutic efficacy for intracranial tumors.

MATERIALS AND METHODS

Data were collected from 16 patients (12 men and 4 women, 24-75 years of age) with 22 intracranial tumors who were treated with stereotactic radiation therapy using CyberKnife at our institution between December 1, 2016, and August 15, 2019. Sodium MR imaging was performed at 7T before and 48 hours, 1 week, and 1 month after CyberKnife radiation therapy. Tissue sodium concentration (TSC) was calculated and analyzed based on manually labeled regions of tumors.

RESULTS

Ultra-high-field sodium MR imaging clearly showed the intratumoral signal, which is significantly higher than that of normal tissue (t = 5.250, P <.001)., but the edema zone has some influence. The average TSC ratios of tumor to CSF in the 22 tumors, contralateral normal tissues, edema zones, frontal cortex, and frontal white matter were 0.66 (range, 0.23-1.5), 0.30 (range, 0.15-0.43), 0.58 (range, 0.25-1.21), 0.25 (range, 0.17-0.42), and 0.30 (range, 0.19-0.49), respectively. A total of 12 tumors in 8 patients were scanned at 48 hours, 1 week, and 1 month after treatment. The average TSC at 48 hours after treatment was 0.06 higher than that before treatment and began to decrease at 1 week. The TSC ratios of 10 continued to decline and 2 tumors increased at 1 month, respectively. Tumor volume decreased by 2.4%-99% after 3 months.

CONCLUSIONS

Changes in the TSC can be quantified by sodium MR imaging at 7T and used to detect radiobiologic alterations in intracranial tumors at early time points after CyberKnife radiation therapy.

The effects of tislelizumab plus chemotherapy as first-line treatment on health-related quality of life of patients with advanced squamous non-small cell lung cancer: Results from a phase 3 randomized clinical trial

BACKGROUND

This study assessed the effects of adding tislelizumab to first-line standard-of- care chemotherapy on the health-related quality of life (HRQoL) of patients with advanced squamous non-small cell lung cancer (sq-NSCLC).

PATIENTS AND METHODS

Patients in this open-label, multicenter, phase 3 RATIONALE 307 trial were randomized to one of the three arms: tislelizumab plus carboplatin and paclitaxel (Arm A), tislelizumab plus carboplatin and nab-paclitaxel (Arm B), or paclitaxel plus carboplatin (Arm C). HRQoL was measured using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and the EORTC Quality of Life Questionnaire Lung Cancer 13-item module (QLQ-LC13). Mean score change from baseline at Weeks 6 and 12 in the QLQ-C30's global health status/quality of life (GHS/QoL), fatigue, and physical functioning scores and QLQ-LC13 lung cancer specific subscales were examined. Time to deterioration was estimated for the GHS/QoL score.

RESULTS

A total of 355 sq-NSCLC patients received at least one dose of study drug and completed at least one HRQoL assessment. The GHS/QoL scores improved in Arms A and B relative to Arm C at Weeks 6 and 12. Arms A and B also experienced a reduction in most lung cancer-specific symptoms relative to Arm C. Time to deterioration of GHS/QoL was not reached by any of the three arms.

CONCLUSIONS

The addition of tislelizumab to platinum-based chemotherapy is associated with improvements in sq-NSCLC patients' HRQoL, especially in GHS/QoL and most importantly in lung cancer-specific symptoms including coughing, dyspnea, and hemoptysis.

The analysis of osteosarcopenia as a risk factor for fractures, mortality, and falls

Osteosarcopenia is defined as the concomitant occurrence of sarcopenia and osteoporosis/osteopenia. This study aimed to clarify whether osteosarcopenia implies a greater risk of fractures, mortality, and falls and to draw attention to osteosarcopenia.

INTRODUCTION

Osteosarcopenia, which is characterized by the co-existence of osteoporosis/osteopenia and sarcopenia, is one of the most challenging geriatric syndromes. However, the association between osteosarcopenia and the risk of falls, fractures, disability, and mortality is controversial.

METHODS

We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials, from their inception to March 18, 2021, for cohort studies on the relationship between osteosarcopenia and fractures, falls, and mortality. Two reviewers independently extracted data and assessed study quality. A pooled analysis was performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) using fixed or random-effects models.

RESULTS

Eight cohort studies including 19,836 participants showed that osteosarcopenia significantly increased the risk of fracture (OR 2.46, 95% CI 1.83-3.30, P_{heterogeneity} = 0.006, I² = 63.0%), three cohort studies involving 2601 participants indicated that osteosarcopenia significantly increased the risk of mortality (OR 1.66, 95% CI 1.23-2.26, P_{heterogeneity} = 0.214, I² = 35.2%), and three cohort studies involving 3144 participants indicated that osteosarcopenia significantly increased the risk of falls (OR 1.62, 95% CI 1.28-2.04, P_{heterogeneity} = 0.219, I² = 34.1%). No publication bias existed among the studies regarding the association between osteosarcopenia and fractures. The findings were robust according to the subgroup and sensitivity analyses.

CONCLUSIONS

This pooled analysis demonstrated that osteosarcopenia significantly increased the risk of fractures, falls, and mortality, thus highlighting its relevance in daily life. Therefore, we suggest that elderly persons should be aware of the risks associated with osteosarcopenia.