Short communication: A decrease in diameter of milk fat globules accompanies milk fat depression induced by conjugated linoleic acid supplementation in lactating dairy cows

Milk fat is secreted from the mammary gland in the form of milk fat globules (MFG). Although milk fat depression has been studied since the beginning of the last century, the extent to which this phenomenon alters MFG synthesis is not fully understood. The aim of this study was to evaluate the effect of conjugated linoleic acid (CLA) on the size and distribution of MFG during milk fat depression in dairy cows. Twelve Holstein cows in mid lactation (145 ± 31 d in milk, 583 ± 34.6 kg of body weight, and 27.2 ± 2.4 kg of milk/d) were randomly assigned to a control diet or control plus Ca-protected CLA at 15 g/kg of dry matter for a 6-d period. The average diameter and particle size distribution of MFG were measured using a Mastersizer 3000 laser particle size analyzer (Malvern Instruments Ltd., Malvern, UK). Feeding CLA did not affect dry matter intake (16.2 ± 0.4 kg/d), milk production (28.4 ± 0.4 kg/d), milk protein, or lactose, but it decreased milk fat content (3.46 vs. 2.52%). In addition, surface area-related mean diameter of fat globules in cows fed CLA was lower compared with controls (3.02 vs. 3.45 μm). The percentage of large fat globules decreased and that of small fat globules increased in response to CLA. Overall, the data suggest that the milk fat depression induced by CLA is accompanied by a decrease in average diameter of MFG.

[Effects of Prrx2 gene silencing on the proliferation of breast cancer and its molecular mechanisms]

Objective: The aim of this study was to investigate the effects of silencing Paired related homoeobox 2 (Prrx2) expression on the proliferation of breast cancer and its molecular mechanisms. Methods: Short hairpin RNA knockdown of Prrx2 was used to examine cellular effects of Prrx2. The level of Prrx2 was verified by Western blot. MTT assay was used to analyze the proliferation of breast cancer cells in vitro. To investigate the effect of Prrx2 depletion on tumor growth in vivo, a nude mouse xenograft model was performed. Results: The expression of Prrx2 decreased 91.2% in MDA-MB-231 cells and 88.7% in MCF-7 cells after transfection with interfering vectors (P<0.05). MTT assay showed that the proliferation of cells in silenced Prrx2 expression group was significantly inhibited compared with the control group (P<0.05). Nude mice transplanted tumors showed that the growth of transplanted tumors was slow after silencing Prrx2 expression, and the weight of the tumors of silenced Prrx2 expression group were smaller than those of the control group ((160.2±26.3)mg vs (365.4±19.7)mg, P<0.05). Western blot showed that silencing Prrx2 expression inhibited the expression of β-catenin in breast cancer cell nucleus and down-regulated the activity of Wnt/β-catenin signaling pathway. Conclusions: Silencing Prrx2 expression can effectively inhibit the proliferation and growth of breast cancer, suggesting that Prrx2 may become a new target for the treatment of breast cancer.

Application Prospects of Virtual Autopsy in Forensic Pathological Investigations on COVID-19

Abstract

Autopsy of patients who died of infectious diseases is of significance for public health management. Few forensic autopsies have been performed since the outbreak of the corona virus disease 2019 （COVID-19） due to some limitations, thus forensic pathological examination failed to contribute to the prevention and treatment of infectious diseases. Virtual autopsy has unique advantages in the forensic examination of patients who died of infectious diseases. Accumulated virtual autopsy image data are of great value to the study of the pathological mechanism and diagnosis of COVID-19. This article reviews the relationship between imaging changes and pathology of the COVID-19 as well as the application of virtual autopsy in autopsy of patients who died of infectious diseases, in order to provide reference for performing virtual autopsy in the outbreak of COVID-19.

[Value of the simplified JSTH score criteria in the early diagnosis of sepsis-associated disseminated intravascular coagulation]

Objective: To evaluate the early diagnostic value of various indicators in the simplified JSTH score criteria for sepsis-associated disseminated intravascular coagulation (DIC). Methods: A retrospective study was conducted. Patients admitted to Intensive Care Unit (ICU) of the Second Affiliated Hospital of Kunming Medical University from January in 2017 to December in 2018 were enrolled. Totally of 365 patients were recruited, with 224 males and 132 females. The simplified JSTH score criteria was used to diagnose DIC. The patients were divided into sepsis with DIC group and sepsis without DIC group according to the diagnostic criteria of sepsis. Platelet (PLT), fibrin degradation products (FDPs), prothrombin time (PT), antithrombin (AT), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores, sequential organ failure assessment (SOFA) scores and the simplified JSTH scores were recorded on the first ICU day. Correlation analyses were conducted.Receiver operating characteristic (ROC) curves for diagnosis of DIC with each indicator were drawn to evaluate the diagnostic efficiency and predictive ability of 28-day mortality. Results: According to the simplified JSTH score, 143 cases of sepsis complicated with DIC were diagnosed. There were significant differences in PLT, FDP, AT, PT, APACHE Ⅱ score, SOFA score, 28-day mortality rate between the two groups (all P<0.01). It was shown by Pearson correlation analysis that the criteria has the best correlation with APACHEⅡ score and SOFA score (r=0.496 and 0.612, both P<0.01). The correlation between PLT and APACHE Ⅱ score or SOFA score was the best (r=-0.440 or-0.568, both P<0.01). It was shown by ROC curve that area under ROC curve (AUC) of PLT was 0.933, and the sensitivity and specificity was 93.0% and 85.0%, respectively. The 28-day mortality was predicted by using the indicators in the criteria. The AUG of AT was 0.813, and both the sensitivity (81.6%) and specificity (73.6%) were the highest. Conclusions: The simplified JSTH score criteria can be used for early diagnosis of sepsis-associated DIC and it is positively correlated with the severity of the disease. The correlation between PLT and the severity of disease is the best, and early diagnosis efficiency of PLT is the strongest. AT has a good predictive value for 28-day mortality.

[Clinical and imaging characteristics of 110 patients with infectious sacroiliitis]

Objective: To investigate the clinical and imaging characteristics of infectious sacroiliitis. Methods: A total of 110 patients diagnosed with infectious sacroiliitis were retrospectively analyzed between 2008 and 2017.Clinical manifestations and therapeutic responses, laboratory tests such as HLA-B(27), erythrocyte sedimentation rate (ESR), C reactive protein (CRP), T cell spot test for tuberculosis infection(TB-SPOT), Brucella agglutination test ect., blood culture of pathogens, pathological findings as well as magnetic resonance imaging were all recorded and analyzed. Results: Among the 110 patients, the male to female ratio was 44 to 66 with an average age 15-58(29.4±10.8) years and the course of disease 0.3-60 (5.7±13.2) months. As to the pathogens, 71 cases were pyogenic, 24 cases with tuberculous sacroiliitis, and 15 cases were brucellosis infections. The majority of patients (97.3%) had unilateral sacroiliac joint involvement. Ten (9.1%) patients suffered infectious sacroiliac arthritis after delivery. Hip pain was the main clinical manifestation (83/110,75.5%) and fever as the second (77/110,70.0%). HLA-B(27) was positive in 11 patients (10.0%). Both ESR and CRP were elevated in the majority. There were 103 patients receiving sacroiliac joint puncture biopsy. Seven patients were diagnosed through blood culture or brucellosis agglutination test. Bone marrow edema and osteolytic lesions in magnetic resonance imaging (MRI) were more common in pyogenic or tuberculous sacroiliitis than in brucellosis infections. Conclusion: Infectious sacroiliitis should be differentiated from spondyloarthritis, which develops more in female patients, with short disease duration and fever, mostlynegative HLA-B(27). The majority patients present unilateral sacroiliitis. Active inflammatory lesions are usually beyond sacroiliac joints with osteolytic changes in MRI examinations.

[Chromosomal aberrations detection in chronic lymphocytic leukemia by conventional cytogenetics using DSP30 and IL-2]

Objective: To study the value of unmethylated cytosine guanine dinucleotide oligodeoxynucleotide (DSP30) and IL-2 in the conventional cytogenetic (CA) detection of the chromosomal aberrations in chronic lymphocytic leukemia (CLL) . Methods: Bone marrow or peripheral blood cells of CLL patients were cultured with DSP30 plus IL-2 for 72 h, following which R-banding analysis was conducted. Fluorescence in situ hybridization (FISH) was performed in 85 patients. CA results were compared with data obtained by FISH. Results: Among 89 CLL patients, the success rate of chromosome analysis was 94.38% (84/89) . Clonal aberrations were detected in 51 patients (51/84, 60.71%) . Of them, 27 (27/51, 52.94%) were complex karyotype. Among 85 CLL patients tested by FISH, chromosomal abnormalities were detected in 74 (74/85, 87.06%) patients, of which 2 (2/74) patients were complex karyotypes, accounting for 2.70%. Of the 85 CLL patients examined by FISH, 50 had abnormal karyotype analysis, 30 had normal karyotype, 5 failed to have chromosome analysis. Among them, 25 cases showed clonal aberrations by FISH assay but normal by CA, and 4 cases were normal by FISH but displayed aberrations in chromosome analysis, and totally 78 (91.76%) cases with abnormality detected by the combination of the two methods. The frequency of 13q- abnormality detected by FISH was significantly higher than that by CA analysis (69.41%vs 16.67%, P<0.001) , while the frequency of 11q-,+12 and 17p- detected by two methods showed no significant difference (P>0.05) . The detection rate of complex abnormalities in conventional karyotype analysis was higher than that in FISH (50.98%vs 2.70%) . In addition, 11 low-risk and 9 intermediate-risk patients according to FISH results showed complex karyotype by cytogenetics, and were classified into high-risk cytogenetic subgroup. Conclusion: DSP30 and IL-2 are effective in improving the detection rate of CA in CLL patients (60.71%) and CA is more effective to detect complex karyotype. However, FISH had a higher overall abnormality detection rate (87.06%) than CA, especially for 13q-. The combination of CA and FISH not only enhanced the detection rate of clonal aberrations to 91.76%, but also provided more precise prognosis stratification for CLL patients, thus to provide more information for clinical implication.

Gross examination report of a COVID-19 death autopsy

Abstract

[To evaluate the disk position of the temporomandibular joint using calcium suppressed spectral-based CT images in the patients with temporomandibular disorder]

Objective: To evaluate the application of calcium suppressed (CaSupp) spectral CT technique in evaluating disk position and measuring the thickness of the posterior band of temporomandibular joint (TMJ). Methods: The twenty-three temporomandibular disorder patients [mean age 23(12~62) years, male/female=14/9] were performed with oblique sagittal and coronal proton density weighted imaging (PDWI) and spectral CT scans from February to July, 2019 in Department of Radiology, Hainan Hospital of General Hospital of Chinese PLA, and 45 TMJ joints were evaluated. The subjects were classified into two groups according to the scanning modalities: MRI measurement group and CaSupp spectral-based CT group. The CaSupp technique were applied with the spectral-based CT images and CaSupp images were generated. The oblique sagittal and coronal CaSupp imaged were reformatted by perpendicular to the long axis of the condyle. The TMJ disk positions were evaluated on oblique sagittal and coronal images, and the maximal disk thickness were measured on the oblique sagittal images. Results: The joint position was basically consistent on MRI and CaSupp images for the 45 TMJ joints. The intra-class coefficient value was 0.843 (0.712, 0.914) for the measurement of the posterior band of the TMJ disk between MRI and CaSupp images. Bland-Altman presented that the [95.6% (43/45)] points with the difference located in the 95% agreement interval. Wilcoxon paired text demonstrated that there was no significant different for the thickness of the posterior band between MRI [2.57 (1.76, 3.65) mm] and CaSupp images [2.67 (1.74, 4.56) mm] (P=0.07). Conclusions: The CaSupp spectral-based CT could be used to evaluated the TMJ disk position and the thickness of the posterior band.

[Prognostic evaluation of nutritional indicators in patients with limited-stage small cell lung cancer]

Objective: To explore the effect of nutritional status pre-and during chemoradiotherapy on the prognosis of patients with limited- stage small cell lung cancer (LS-SCLC). Methods: We retrospectively collected medical records of 172 LS-SCLC patients undergoing concurrent chemoradiotherapy in our hospital from 2000 to 2014, with 126 males and 46 females. The data of complete blood count and hepatic and renal function were collected before initial treatment, before radiotherapy, 4 weeks during radiotherapy, and 1 month after complete of treatment. The prognostic nutritional index(PNI)was calculated. Kaplan-Meier method was used to calculate the survival rate. Log-rank test was performed used to compare the survival differences between groups. Multivariate prognostic analysis was performed using Cox regression model. Results: The median overall survival (OS) was 21 months, with median progression-free survival (PFS) of 11 months. At the beginning of treatment, patients with pre-treatment PNI ≥ 53 had significantly superior OS (median 37 vs 15 months, P=0.001) and PFS (median 16 vs 10 months, P=0.017). Patients with pre-treatment hemoglobin ≥140 g/L and <140 g/L had an median OS of 32 months and 17 months (P=0.019), and median PFS of 16 months and 9 months (P=0.040), respectively. During chemoradiation, patients with elevated hemoglobin had similar median OS compared with those had decreased hemoglobin (27 vs 18 months, P=0.063, but superior median PFS (15 vs 9 months, P=0.017). Multivariate analysis revealed that prophylactic cranial irradiation, pre-treatment hemoglobin ≥140 g/L, and pretreatment PNI ≥53 were independent predictors of OS and PFS in patients with LS-SCLC. Conclusion: Pre-treatment nutritional status and the changes of nutritional status during chemoradiotherapy is significantly associated with the prognosis of patients with limited-stage small cell lung cancer. The patients with better pre-treatment nutritional status have a better prognosis.

Fasudil reduces β-amyloid levels and neuronal apoptosis in APP/PS1 transgenic mice via inhibition of the Nogo-A/NgR/RhoA signaling axis

Recent studies have shown that Nogo-A and the Nogo-A receptor affect β-amyloid metabolism and the downstream Rho GTP enzyme signaling pathway, which may affect the levels of β-amyloid and tau. Nogo-A may play a key role in the pathogenesis of Alzheimer's disease. However, the underlying molecular mechanisms of Fasudil treatment in Alzheimer's disease are not yet clear. Our results have found that Fasudil treatment for two months substantially ameliorated behavioral deficits, diminished β-amyloid plaque and tau protein pathology, and alleviated neuronal apoptosis in APP/PS1 transgenic mice. More importantly, two well-established markers for synaptic function, growth-associated protein 43 and synaptophysin, were upregulated after Fasudil treatment. Finally, the levels of Nogo-A, Nogo-A receptor complex NgR/p75NTR/LINGO-1 and the downstream Rho/Rho kinase signaling pathway were significantly reduced. These findings suggest that Fasudil exerts its neuroprotective function in Alzheimer's disease by inhibiting the Nogo-A/NgR1/RhoA signaling pathway.

[Rapamycin in the treatment of renal diseases associated with tuberous sclerosis complex]

Objective: To investigate the efficacy and safety of rapamycin in children with tuberous sclerosis complex (TSC) associated renal disease. Methods: A prospective self-control study was conducted. The clinical data of 92 children diagnosed with tuberous sclerosis complex associated kidney disease at the People's Liberation Army General Hospital from January 2011 to January 2019 were collected. The long-term rapamycin treatment for all patients initiated at 1 mg/(m(2)·d), which was gradually adjusted to reach a blood concentration of 5-10 μg/L. The changes of the maximum diameter of renal lesions in children after rapamycin treatment were observed and analyzed with Wilcoxon test. Results: Ninety-two children, including 52 males and 40 females, who met the criteria were analyzed. Sixty patients had only renal angiomyolipoma(RAML), while 24 patients had only multiple renal cysts(MRC), and 8 patients had both lesions. The age of TSC diagnosis was 16.0 (7.0, 42.0) months, and the age of initial treatment with rapamycin was 63.5 (21.0, 103.0) months. The follow-up lasted for 12.0 (4.0, 23.0) months. Sequencing of TSC1 and TSC2 genes was performed in 54 children with TSC, including 3 patients (6%) with mutations in TSC1 gene and 51 patients (94%) with mutations in TSC2 gene. The maximum RAML diameter before treatment was 7.0 (4.0, 9.0) mm. The best effect reached at 3 months of treatment, with the diameter of 4.0 (0,7.0) mm. The maximum diameters at 6 months, 1 year and 1-2 years were 5.0 (0,9.8) mm, 5.0 (1.5, 8.5) mm, 5.5 (3.0, 9.0) mm, respectively, and were significantly different from the baseline (Z=-2.404,-2.350,-2.750,P=0.016,0.019,0.006, respectively). The maximum diameter after 2-3 years, and ≥3 years were 5.0 (3.9,7.0) mm and 6.0 (1.0, 11.0) mm, without significant difference from the baseline (Z=-0.856,-0.102,P=0.393,0.919, respectively).The maximum diameters of MRC after 3 months, 6 months, 1 year,1-2 years, 2-3 years, and ≥3 years were 11.0 (5.0, 14.0) mm,3.0 (0.0,11.0) mm,5.0 (0,21.0) mm,0 (0,14.0) mm,0 (0,10.0) mm, and 0 (0,18.3) mm, respectively, but were not significantly different rom the baseline (7.0 (5.0, 15.7) mm)(Z=-0.944,-1.214,-1.035,-1.896,-1.603,-1.214,P=0.345,0.225,0.301,0.058,0.109,0.225, respectively).Twenty-nine patients (32%) had oral ulcers during the entire treatment period, and no serious adverse reactions were observed. Conclusions: Rapamycin could decrease the diameter of TSC-related RAML, but could not inhibit the growth of cysts. It is well tolerated in the treatment of renal diseases associated with tuberous sclerosis complex.

[Preliminary application of endoscopic titanium clip localization combined with three-dimensional CT reconstruction in the determination of resection margin of gastric central cancer under laparoscopy]

Objective: To evaluate the accuracy of endoscopic titanium clip localization combined with CT three-dimensional reconstruction for the control of incision margin in early gastric cancer under laparoscopy. Methods: A prospective analysis was made for gastric cancer whose lesions were located in the middle of the stomach and T stage was 1 to 2 from October 2017 to January 2019 at Department of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People's Hospital. Totally 25 patients were eventually enrolled in the study. There were 17 males and 8 females aging of (63.6± 7.2) years (range: 48 to 77 years). All cases were treated with titanium clip localization under endoscope combined with CT three-dimensional (3D) reconstruction to construct a virtual panorama of gastric cavity and lesions, and to design surgical margins. Laparoscopic surgical resection was performed according to the surgical margins designed before operation. The distance from the gastric angle to the origin of the minor curvature of the incisional margin, the distance from the gastric angle to the the center of lesion and the distance of the upper incision margin were measured under three-dimensional CT reconstruction and under actual specimen. Paired t test was used to compare the three distances measured by two methods. Results: The measured distances from the gastric angle to the center of the lesion and the proximal incisional margin under 3D reconstruction CT were according to the measured values of actual specimens ((2.67±1.38) cm vs. (2.83±1.56) cm, t=1.51, P=0.14; (5.23±0.60) cm vs. 5 cm, t=1.93, P=0.07); the measured distances from the gastric angle to the origin of the minor curvature of the incisional margin under CT 3D reconstruction were different with the measured values of solid specimens ((5.94±0.94) cm vs. (6.37±0.90) cm, t=3.52, P=0.00). Conclusion: The method of titanium clip localization combined with CT 3D reconstruction can provide a feasible laparoscopic localization method and incision edge solution for T1 to 2 gastric central cancer.

[Introduction to Guidelines for Salt Reduction in Chinese Food Industry]

Excessive salt intake is an important risk factor of diseases such as hypertension, stroke, and stomach cancer. China is one of countries with high salt intake in the world. Recently, the intake of sodium from pre-packaged foods in China has been increasing, and the situation of salt control is rigorous. Based on the summary of the domestic and international experience of salt reduction, the "Guidelines for Salt Reduction in Chinese Food Industry" presents the basic principles, targets at different stages within various categories, technical routes, steps and measures, and social environment co-construction of salt reduction in Chinese food industry. This article focuses on the background, basis, process, key content and promotion of the guideline. The implementation of this guideline will contribute to the vigorous advancement of salt reduction action in Chinese food industry.

[Surgical treatment of port-site metastases after laparoscopic radical resection of gastric cancer]

Objective: To investigate the feasibility of surgical treatment of port-site metastasis after laparoscopic radical resection of gastric cancer. Methods: The clinical and follow-up data of five patients with port-site metastases after laparoscopic radical resection of gastric cancer at Zhejiang Provincial People's Hospital between January 2014 and January 2018 were retrospectively analyzed. Results: Port-site metastases occurred within 6 months after gastrointestinal tumor resection in three patients, 10 months after the operation in one patient, and 30 months after the operation in one patient, respectively. Metastasis to the abdominal cavity or distant metastasis was excluded before the surgical treatment of the port-site metastases, and all patients recovered well after the operation. No incisional infection or hernia occurred. By December 2018, two patients died (they survived for 13 and 24 months, respectively) and three patients survived. The follow-up duration ranged from 7 to 19 months. Conclusions: Surgical resection of port-site metastases is not difficult due to their superficial location. Surgical treatment can improve the prognosis of patients without abdominal or distant metastasis/recurrence.

[Research progress of the surrogate of protection of pneumococcal conjugate vaccine]

There are many limitations in evaluating vaccine efficacy by comparing the incidence of clinical endpoint events (such as morbidity, bacterial colonization) between the vaccine group and the control group. Therefore, the researchers put forward the concept of Surrogate of protection to predict vaccine protection with immunological indicators. In 2012, WHO put forward the immunological substitution endpoint of pneumococcal vaccine, using 0. 35 μg/ml as the protective antibody level of pneumococcal vaccine. But subsequent studies have found that using this threshold to assess all vaccine serotypes may not be accurate.

Adaptive velocity-dependent proportional-integral controller for high-speed atomic force microscopy

High-speed atomic force microscopy (AFM) has been rapidly developed in recent years. To reduce the oscillation of the scanner, a single-tone sinusoidal wave is widely used as a scanning wave rather than a triangular wave in high-speed AFM. However, the sinusoidal wave is nonlinear, resulting in a nonconstant relative linear velocity between the sample and the tip while scanning in the x-direction. If a traditional proportional-integral controller is still used as a feedback controller in the z-direction, the control errors will be enormous. Therefore, the paper proposes a new adaptive velocity-dependent proportional-integral controller. The relationship between the proportional-integral parameters and the linear velocity is achieved by fitting the experimental results. The adaptive and traditional controllers are compared against each other in some examples. The experiments demonstrate that the adaptive controller decreases the control errors in the z-direction to a half, which provides more precise AFM images. LAY DESCRIPTION: Typically, the scanner follows a triangular waveform in fast axis (x-axis), and follows a very slow ramp signal in the slow axis (y-axis) of conventional AFM. This scanning mode can be called raster scan. However, the triangular waveform contains high-order Fourier harmonics, vibrating the scanner and distorting the image easily. In high-speed AFM, the effect of the high-order Fourier harmonics will be more severe. The above problems can be solved by replacing triangular waves with single-tone sinusoidal waveform. Therefore, the sinusoidal-raster scan and nonraster scan based on the sinusoidal waveform are widely used in high-speed atomic force microscopy. However, the nonlinearly scan path will cause a variable relative linear velocity between the sample and the tip. If a standard proportional-integral controller is still used as a feedback controller in Z direction, the control errors will be large, and this difference will be evident at high-speed scanning. Thus, the paper proposes a new adaptive velocity-dependent proportional-integral controller to solve this problem. Experiments show that the control errors obtained by using the adaptive controller is about a half of that without using it. These illustrate that the proposed method can improve the image quality of the AFM at both low and high scan speeds.

Wound Age Estimation by Neutrophil Migration Distance

Abstract

Objective To explore the application of neutrophil migration distance for wound age estimation of skeletal muscles in rats, and to provide methodological basis for follow-up study in future. Methods The skeletal muscle contusion model was established in rats, and the control group and the 2, 4, 6 h post-traumatic groups were set. The law of response of neutrophils that participated in the inflammation after injury was detected by immunohistochemical staining, and the relationship between neutrophil migration distance and injury time was detected by TissueFAXS PLUS software. Results The skeletal muscle was obviously infiltrated with neutrophils 2-6 h after injury. The positive rate of neutrophil was （28.75±0.94）% at 2 h post-traumatic, and reached the peak （45.50±3.63）% at 4 h post-traumatic, then decreased to （31.92±1.56）% at 6 h post-traumatic. The neutrophil migration distances increased with the progress of inflammation, and reached （124.80±12.32） μm, （229.03±21.45） μm and （335.04±16.75） μm at 2 h, 4 h and 6 h, respectively. Conclusion There is a relationship of neutrophil infiltrated number and migration distance and wound age within the 2-6 h after skeletal muscle injury, which could be used for the inference of skeletal muscle wound age.

Continuously wavelength-tunable blueshifting soliton generated in gas-filled photonic crystal fibers

We experimentally report the generation of wavelength-tunable blueshifting soliton in the visible spectral region through a gas-filled single-ring photonic crystal fiber (SR-PCF). In particular, in a He-filled SR-PCF, we observed a sharp narrow-band spectral peak at the first resonant spectral region of the SR-PCF, which results from phase-matched nonlinear processes. To the best of our knowledge, this is the first time investigating the influence of the core-cladding resonance on the blueshifting soliton. In addition, when Ar gas was filled into the SR-PCF, some interference fringes on the blueshifting soliton were observed at high pulse-energy levels due to plasma-induced pulse fission. These two experimental observations are confirmed by numerical simulations. Furthermore, through properly adjusting input pulse energy, we found that the blueshifting soliton can obtain a high conversion efficiency (∼84%) and its wavelength can be tuned over hundreds of nanometers (∼240  nm).

Evaluation of glucocorticoid treatment on different pathological types of primary nephrotic syndrome

This study aimed to assess the distribution of pathotypes in primary nephrotic syndrome (PNS) and their relationship with glucocorticoid treatment efficacy. The study included 120 patients who were treated in the nephrology, internal medicine and pediatrics wards of The Second Affiliated Hospital of Qiqihar Medical University between March 2014 and October 2017 and who underwent renal biopsy to confirm PNS. The patients with PNS were divided into a child group (40 cases, aged 0~17 years) and an adult group (80 cases, aged over 18 years). We evaluated the correlation of the curative effect of glucocorticoid with age, pathological type, renal tubulointerstitial damage retinol binding protein and total urine protein. The main pathological types of PNS were glomerular minor lesion (GML) and mesangial proliferative nephritis (MPGN). The glucocorticoid treatment had an improved effect on children compared to adults, and also the effect decreased with age. The pathotypes of PNS were correlated with hormone resistance: tubulointerstitial lesions were associated with glucocorticoid resistance which was also associated with the degree of tubular damage. In both adults and children the retinol binding protein (RBP) urinary levels were positively associated with the degree of renal tubular injury. In conclusion, age, pathological type, renal tubulointerstitial damage, and RBP urinary level were related to the therapeutic effect of glucocorticoid treatment in adults and children with PNS.

[Effects of calcium supplementation during the pregnancy and early infancy stage on the body mass index and gut microbiota in the infants]

Objective: To investigate the effects of calcium supplementation during the pregnancy and early infancy stage on body mass index (BMI) and gut microbiota in the infants. Methods: A total of 1 752 healthy pregnant women and their infants (breast feeding) in two maternal and child health care hospitals of Beijing were chosen as the subjects in this study from May to October 2016. Questionnaires were used to obtain the general information and supplementation of calcium and vitamin D in mothers and their infants. The body length and weight of infants at birth and 6 months were recorded to calculate the BMI. The random number table method was used to randomly select 40 infants from each group for gut microbiota analysis (If less than 40 infants were all included in this study, 23 infants in the pregnancy and early infancy would be all treated with calcium supplements. There were 6 infants who was not added calcium during the pregnancy but added in the early infancy). Then it was compared that the effects of calcium supplementation during the pregnancy and early infancy on the BMI and gut microbiota composition of infants were determined at birth and 6 months. Results: Compared to the group with no calcium supplementation during the pregnancy ((12.76±1.23), (17.68±0.76)kg/m(2)), the BMI of infants at birth and 6 months in the group with calcium supplementation during the pregnancy ((13.51±0.47), (17.91±0.23)kg/m(2)) were significantly higher(P<0.05). In the group with maternal calcium supplementation, the BMI at 6 months ((18.63±0.52)kg/m(2)), BMI increment ((5.71±0.54)kg/m(2)) and the content of lactobacillus (21.04%±3.68%) in the only calcium supplementation subgroup in the early infancy were higher than those in only vitamin D supplementation subgroup ((17.69±0.89) kg/m(2), (4.17±1.01) kg/m(2) and 12.28%±3.86%) (P<0.05). In the group without maternal calcium supplementation, the content of lactobacillus (20.15%±4.87%) in the only calcium supplementation subgroup were also higher than those in only vitamin D supplementation subgroup (14.64%±3.71%) (P<0.05). Conclusion: Appropriate calcium supplementation during the pregnancy is good for the growth and development of the fetus. Calcium supplementation in the early infancy could increase the BMI of infants, and promote the growth of intestinal lactobacillus.

[A cohort study on the association between dynamics of thyroid volume and the changes of physical growth as well as the comparison of different thyroid volume indexes in school-aged children]

Objectives: To investigate the association between the dynamics of thyroid volume and the changes of physical growth in school-aged children as well as to compare the applicability of different thyroid volume indexes, so as to explore more reliable methods for the assessment of thyroid volume. Methods: In October 2012, a multi-stage cluster sampling method was used to select a primary school in Minhang district of Shanghai, Haimen city of Jiangsu province and Yuhuan city of Zhejiang province, respectively. In these areas, a total number of 784 students aged 8-10 years were enrolled in the cohort. Demographic data was collected, while height and weight were measured, with BMI and body surface area (BSA) were calculated. Thyroid volume was examined by B-ultrasonography. Height volume index (HVI), weight and height volume index (WHVI), BMI volume index (BMIV) and BSA volume index (BSAV) were all applied to correct the thyroid volume. All students were followed up, one year later. Results: A total of 769 students with complete data on thyroid volume and physical growth were enrolled, including 378 boys (49.16%) and 391 girls (50.84%). Thyroid volume showed an increase with age, while growth of thyroid volume reduced with the increase of age (P<0.001). The thyroid volume showed a correlation with the changes of physical growth. The growth of height appeared as the dominant influencing factor for thyroid volume growth in those aged 8 and 10 years (P<0.05), while the growth of weight, BMI and BSA were all influencing factors for thyroid volume on students aged 9 years (P<0.05). Conclusions: Thyroid volume in school-aged children was a factor not only associated with age but also with physical growth which had not been considered in the currently used criteria. The inclusion of items as iodine intake, age, physical growth into the thyroid volume indexes seemed to be more reliable, in practice. For the assessment of goiter, HVI for students aged 8 and 10 years and BMIV for students aged 9 years might serve as better indicators.

Abstract P2-08-16: Impact of germline BRCA mutation status on survival in women with metastatic triple negative breast cancer

Background: 15-20% of patients with triple negative breast cancer (TNBC) harbor deleterious germline (g) BRCA1/2 mutations. Recent data suggests that in metastatic TNBC (mTNBC) gBRCA1/2 mutations are associated with response to PARP inhibitors (PARPi) and platinum chemotherapy. However, diagnosis of mTNBC is associated with short overall survival (OS) with no available biomarkers that can identify mTNBC patients with better prognosis.

Aim: Utilizing data from a prospective registry, the objective of this study was to investigate whether presence of gBRCA1/2 mutation impacts overall survival for patients with mTNBC treated prior to clinical availability of PARPi.

Methods: 643 patients with stage I-IV TNBC were enrolled in an IRB approved multisite prospective registry between 2011 to 2018. Clinical, demographic, and treatment information was collected and patients were followed for recurrence and survival. 100/643 patients had metastatic breast cancer (de novo stage IV disease or metastatic recurrence). OS (from the time of diagnosis of metastatic disease to death from any cause) was estimated according to the Kaplan-Meier method and compared among groups by log-rank test.

Results: For the 100 mTNBC patients, the median age at diagnosis of metastatic disease was 55 years, 17% were African American, 20% had novo stage IV and 80% had relapsed disease. 84% had visceral disease, 12% had bone-only disease, and 4% had lymph node only disease. Metastatic treatment: 87% received chemotherapy, 7% received radiation only without chemotherapy and 6% did not receive any treatment. No patients received treatment with PARP inhibitor. Among de-novo stage IV patients, 35% (7/20) had breast surgery for removal of primary tumor during their course of metastatic treatment. For all 100 patients, 12% (n=12) had gBRCA mutation; 72% (n=72) had no gBRCA mutation; and 16% (n=16) had unknown BRCA mutation status. When compared with non-carriers, gBRCA carriers were younger at time of metastatic diagnosis (median age 49 vs. 57 years, p=0.02). There was no difference in prevalence of visceral disease, de-novo stage IV disease or median lines of metastatic chemotherapy among gBRCA carriers and non-carriers. At a median follow up of 31 months, median OS for all patients is 21 months (95% CI 13-23 months). Median OS is 18 months (95% CI 15-27 months) for non-carriers and has not yet been reached for gBRCA mutation carriers (p=0.023). 3-year estimated OS is 63% in gBRCA carriers compared to 28% in non-carriers (p=0.02). On multivariate Cox regression analysis, gBRCA carrier status was associated with reduced risk of death (HR=0.33; 95%CI [0.23-0.91], p=0.033)

Conclusions: gBRCA mutation associated mTNBC patients have a clinically significant improved OS at 3 years compared to mTNBC patients without BRCA mutations (3-year OS of 63% vs 28%). Further research is needed to understand tumor and host biological reasons for this observation. Outcomes of gBRCA mutation associated mTNBC are likely to be further improved with availability of PARPi. Given that patients with gBRCA mutation are at risk for second breast/ovarian cancers, these findings also underscore need for further research regarding the role of prophylactic surgeries mTNBC with gBRCA mutation.

Citation Format: Larson K, Wang YY, Finke K, O'Dea AP, Khan Q, Nye L, Heldstab J, Godwin AK, Kimler BF, Sharma P. Impact of germline BRCA mutation status on survival in women with metastatic triple negative breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-16.

[Plaque features in saphenous vein graft evaluated by virtual histology intravascular ultrasound]

Objective: To investigate the features of plaques of saphenous venous graft (SVG) with virtual histology intravascular ultrasound (VH-IVUS) in patients underwent coronary artery bypass graft surgery. Methods: From March 2016 to March 2018, a total of 45 patients ((64.4±7.9) years old, 88.9% male (40 cases)) with ischemic symptoms after coronary artery bypass graft surgery and with coronary artery angiography evidenced SVG stenosis greater than or equal to 50%, who received percutaneous coronary intervention in Tianjin chest hospital were continuously included in this study, and the clinical data were retrospectively analyzed. VH-IVUS was performed before PCI to analyze plaque composition. The patients were divided into no smoking group (21 cases) and smoking group (24 cases), no diabetes group (30 cases) and diabetes group (15 cases), normal very low density lipoprotein cholesterin (VLDL-C) group (24 cases) and elevated VLDL-C group (21 cases), stable angina pectoris group (5 cases) and acute coronary syndrome group (40 cases), plaque burden (PB) < 70% group (11 cases) and PB ≥ 70% group (34 cases), without thin-cap fibroatheroma group (35 cases) and thin-cap fibroatheroma group (10 cases), and plaque features were compared between different groups. Results: The graft age was (8.9±3.7) years.The stenosis degree of SVG lesions was 90 (90, 98) %. The minimum lumen diameter was 1.6 (1.5, 1.8) mm. The vessel cross-sectional area was (12.1±4.0) mm(2). The plaque area was 8.6 (5.7,12.0) mm(2). The minimum lumen area was 2.5 (2.1,3.3) mm(2). The plaque burden was (75.3±8.3)%. The fibrotic tissue (FI) ratio was (65.1±10.1)%, fibrofatty plaque (FF) ratio was 13.8 (5.4,25.3) %, necrotic core tissue (NC) ratio was 12.0 (5.4,24.0)%, and dense calcium tissue (DC) ratio was1.0 (0.2,3.8)% in SVG lesions. There were no significant differences in SVG plaque area, FI area,FF area,NC area,and DC area between no smoking group and smoking group, no diabetes group and diabetes group, and normal VLDL-C group and elevated VLDL-C group. SVG plaque volume was significantly higher in acute coronary syndrome group than in stable angina pectoris group (262.2 (148.5,401.2) mm(3) vs. 93.1 (50.6,155.9) mm(3),P=0.006), and plaque area (10.1 (6.6,13.3) mm(2) vs. 5.0 (3.6,6.9) mm(2), P<0.001), FI area(4.8 (3.2,6.8) mm(2) vs. 2.8 (1.9,3.0) mm(2), P<0.001),and FF area (1.15 (0.60, 2.07) mm(2) vs. 0.30 (0.10,0.90) mm(2), P=0.009) were significantly larger in PB ≥ 70% group than in PB < 70% group.The NC area (1.75(0.40,2.78) mm(2) vs. 0.60 (0.20,1.30) mm(2), P=0.030) and DC area (0.35 (0.10,0.50) mm(2) vs. 0.00 (0.00,0.10) mm(2), P=0.006) were significantly larger in thin-cap fibroatheroma group than that in without thin-cap fibroatheroma group. Spearman correlation analysis showed that the plaque area of SVG lesion was positively correlated with FF area (r=0.64, P<0.001) and NC area (r=0.43, P=0.003). PB was positively correlated with FF area (r=0.50, P<0.001) and NC area (r=0.33, P=0.028). Graft age was positively correlated with FF area (r=0.30, P=0.047). Conclusions: The main components of SVG plaque are fibrotic tissue, conversely, calcified tissue is rare in patients with SVG stenosis after coronary artery bypass graft surgery. Fibrofatty tissue is increased in the plaque in patients with PB ≥ 70%. The necrotic component is also increased in patients with thin-cap fibroatheroma. The fibrofatty component increases and the plaque tends to be unstable in proportion with increaing age of the graft in this patient cohort.

Uptake and transformation of steroid estrogens as emerging contaminants influence plant development

Steroid estrogens are emerging contaminants of concern due to their devastating effects on reproduction and development in animals and humans at very low concentrations. The increasing steroid estrogen in the environment all over the world contrasts very few studies for potential impacts on plant development as a result of estrogen uptake. This study evaluated the uptake, transformation and effects of estradiol (17β-E2) and ethinyl estradiol (EE2) (0.1-1000 μg L-1) on lettuce. Uptake increased in leaves and roots in a dose-dependent manner, and roots were the major organ in which most of the estrogen was deposited. The transformation of estrogens to major metabolite and their further reverse biotransformation in lettuce tissue was identified. At low concentrations (0.1 and 50 μg L-1) estrogens resulted in enhanced photosynthetic pigments, root growth and shoot biomass. Application of higher concentrations of estrogens (10 mg L-1) significantly reduced total root growth and development. This was accompanied by increased levels of hydrogen peroxide (H2O2), and malondialdehyde (MDA), and activities of antioxidant enzymes superoxide dismutase (SOD), peroxidase (POD), catalase (CAT) and ascorbate peroxidase (APX). Taken together, these findings suggest that at low concentrations estrogens may biostimulate growth and primary metabolism of lettuce, while at elevated levels they have adverse effects.

[Progress in research of influence of gene polymorphisms on immune response]

Genes play an important role in the immune system response, and different gene loci may result in different vaccine immune response rates. This review focuses on the correlation between gene polymorphisms and vaccine immune response in order to investigate the influence of gene polymorphisms on the immune response to vaccines. It discusses the effect of an individual's immune response after vaccination at genetic level and provides a scientific basis for individualized immune development strategies. It reveals that human leukocyte antigen genes, various cytokines and their receptor genes, and Toll-like receptor genes all affect the vaccine immune response.

[Risk stratification of type-specific human papillomavirus for cervical precancers: evidence from a cross-sectional study in Shenzhen]

Objective: To analyze the epidemiological genotype features of human papillomavirus (HPV) in cervical infection and their risks for cervical precancers among women in Shenzhen area. Methods: A total of 2 717 individuals ranging in age from 30~59 years were recruited in 18 community health centers of Shenzhen city from March 1 to June 15, 2015 by a cluster sampling method. The results of genotype of HPV, liquid-based cytology (LBC), colposcopy and pathology were analyzed. The clinical sensitivity and specificity as well as positive (PPV) and negative (NPV) predictive values of the combination of different HPV genotype in screening the cervical intraepithelial neoplasia (CIN) 2 and above were estimated. Results: The HPV infection rate in Shenzhen area was 15.9% (432/2 717). The most common HPV genotype was HPV52 (22.9%), followed by HPV16 (12.7%), HPV53 (10.0%), HPV51 (8.6%) and HPV58 (8.1%). Compared with HPV16/18 genotyping, HPV33/16 genotyping had a higher sensitivity (57.1% vs. 42.9%, P<0.05) and an analogous specificity (87.3% vs. 86.9%, P>0.05) in predicting CIN2+ . The sensitivity of combination of HPV33/16 genotyping and low grade squamous intraepithelial lesion (LSIL) positive tested by LBC in predicting CIN2+ was 75.0%, significantly higher than 64.3% of atypical squamous cells of undetermined significance (ASC-US) positive tested by LBC alone (P<0.05). The specificities of these two methods mentioned above in predicting CIN2+ were 83.5% and 89.2%, respectively, without statistical difference (P>0.05). Conclusions: Women infected by HPV have distinct risks for CIN2+ according to different high-risk HPV genotypes. The top five risks were HPV 33, 16, 58, 56, and 68. HPV-positive women triaged by LBC LSIL+ combined with HPV33/16 genotyping may be a potential strategy for cervical cancer screening in developed urban area.

[The attentional bias of emotion in medical workers of emergency department in one hospital and it's relationship with mood state]

Objective: To study the characteristics of attentional bias to emotional stimulus in medical workers of emergency department and explore the relationship between the emotional Stroop effect and mood states, thus providing a reference to the assessment and intervention of emergency medical workers' mental health. Methods: Two kinds of emotional Stroop tasks with words and pictures and the Profile of Mood States (POMS) were administered to thirty-six medical workers of emergency department and thirty-six medical workers of other departments. Results: The reaction time to negative and positive words and pictures were all higher than the reaction time to neutral stimulus, thus showing the significant Stroop effect in medical workers. The Stroop effect to negative emotional stimulus in medical workers of emergency department was significantly smaller than that in medical workers of other departments, while the difference of Stroop effect to positive stimulus was not significant between the two groups. Correlation analyses revealed that the correlations between Stroop effect size to positive pictures and tension and angry of POMS were all negatively significant (r value was -0.314 and -0.330 respectively) , and the correlation between Stroop effect size to negative pictures and fatigue was negatively significant (r=-0.303) . Conclusions: There is a significant emotional Stroop effect in medical workers. Although the ability of anti-interference to emotional stimulus in medical workers of emergency department was better than medical workers of the other departments, the long-term avoidance to negative emotional stimulus was still has a negative effect on the mood states of individuals.

[An analysis of mental health status of female migrant workers in a city]

Objective: To investigate the mental health status of female migrant workers in a city. Methods: From August to December, 2016, cluster random sampling was used to select female migrant workers aged 16-60 years from 10 districts of this city, and Symptom Checklist-90 (SCL-90) and a questionnaire on general status were used. Results: Among these female migrant workers, the detection rates of obsessive-compulsion, hostility, and depression were 6.62%, 4.18%, and 4.10%, respectively. There was a significant difference in the detection rate of mental health issues between the female migrant workers from different districts, with different occupations, or with different education levels (P<0.05) . Districts, occupation, and education level were associated with mental health issues, after adjustment for age (P<0.05) . Conclusion: Although female migrant workers in this city have a high mental health level, the issues such as obsessive-compulsion, hostility, and depression should be taken seriously. Targeted mental health surveys and comprehensive interventions should be implemented to improve the mental health level of female migrant workers.

Pinopode score around the time of implantation is predictive of successful implantation following frozen embryo transfer in hormone replacement cycles

STUDY QUESTION

Is pinopode measurement of any prognostic value?

SUMMARY ANSWER

Pinopode expression was significantly associated with the occurrence of pregnancy after frozen embryo transfer.

WHAT IS KNOWN ALREADY

Pinopodes are expressed in the endometrium during the implantation period. Pinopode measurement has been proposed as a marker of endometrial receptivity.

STUDY DESIGN, SIZE, DURATION

A prospective cohort study was conducted at the Center of Reproductive Medicine, Sir Run Run Shaw Hospital, between 2014 and 2016, recruiting 172 women with infertility and undergoing frozen embryo transfer following IVF treatment. Among 172 participants, 46 women took part in the first study to quantify the daily changing pattern of pinopodes 3-7 days after the initiation of progesterone therapy in the hormone replacement cycles and the remaining 126 women with infertility participated in a study to examine the relationship between pinopode count and pregnancy outcome following frozen embryo transfer in hormone replacement cycles.

PARTICIPANTS/MATERIALS, SETTING, METHODS

The mean age of participants was 29 years old. All participants received an artificial hormone replacement protocol capable of supporting successful implantation. Endometrial biopsies from 46 women were obtained 3, 4, 5, 6 and 7 days after the initiation of progesterone therapy (P + 3, n = 6; P + 4, n = 6; P + 5, n = 11; P + 6, n = 13; P + 7, n = 10, respectively). Another 126 endometrial biopsies were obtained precisely 6 days after the initiation of progesterone. Scanning electron microscopy was used to capture the pinopode images, followed by use of the image J program to quantify the count and subtype of the pinopodes.

MAIN RESULTS AND THE ROLE OF CHANCE

We found that at least 60 microscopic fields were necessary to achieve a reproducible result. An intra-observer variability study showed good agreement between two measurements regarding the developing pinopode (DP) subtype (r = 0.95) and the fully developed pinopode (FDP) subtype (r = 0.86) but not for the regressing (RP) pinopode subtype (r = 0.39). The proportion of DP/total pinopodes (TP) declined rapidly form day P + 4 to a minimum on day P + 6. The percentage of FDP/TP increased rapidly from day P + 4 to reach a peak on day P + 6. On the other hand, the percentage of RP/TP reached a peak on day P + 7. Participants who conceived had a significantly (P = 0.011) higher percentage of FDP/TP on day P + 6 and significantly (P = 0.005) lower percentage of DP/TP on the same day compared with participants who did not become pregnant. Using a scoring system incorporating the percentages of DP and FDP, it was found that the pregnancy rate and the embryo implantation rate of women with a high pinopode score (82.3%; 63.0%) was significantly (P = 0.001; P = 0.046) higher than that of women with a low pinopode score (53.3%; 46.7%), respectively. There remains a possibility that the observations could have arisen due to chance.

LIMITATIONS, REASONS FOR CAUTION

This study examined pinopode count and subtype in the HRT cycles, and it is uncertain whether the same observations apply to in natural cycles.

WIDER IMPLICATIONS OF THE FNDINGS

Pinopodes have been questioned as a potential marker of endometrial receptivity for many years. Our results suggested that pinopode measurement may be of value in predicting pregnancy.

STUDY FUNDING/COMPETING INTEREST(S)

The study was supported by the grants from the general project of medicine and health in Zhejiang Province of China (2015KYA142; 2018KY106), the Key Research and Development Program of Zhejiang Province (2017C03022) and the National Natural Science Foundation of China (81701514).The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript. We have no competing interests to declare.

TRIAL REGISTRATION NUMBER

ISRCTN26300668.

[Analysis of clinicopathological characteristics of papillary thyroid carcinoma and BRAF V600E gene mutation]

Objective: To study the correlation between the BRAF V600E mutation and the clinicopathological features of papillary thyroid carcinoma(PTC), and to explore the application value of BRAF V600E mutation in PTC. Method: The BRAF V600E gene mutation was detected in 108 PTC cases and 30 control cases by qPCR. The results were statistically analyzed by using SPSS 21.0 software. Result: The BRAF V600E mutation was absent in the control group. The BRAF V600E mutation rate was 72.20% in 108 PTC cases. Compared with patients with wild type,the mean age of patients with the mutant BRAF V600E was significantly older(P<0.05). BRAF V600E mutations were associated with PTC tissue subtypes and central area lymph node metastasis(P<0.05). BRAF V600E mutations were not correlated with tumor diameter, patient gender, multifocality, tumor site, concomitant disease, lymph node metastasis in side region of neck, capsule invasion, and TNM staging(P>0.05). Conclusion: The value of BRAF V600E mutation in the prognosis of PTC remains to be studied. BRAF V600E mutation is of value for pathological diagnosis of PTC.

[Diagnosis and treatment experience of 161 cases of pancreatic serous cystic neoplasm in single center and analysis of cause of preoperation misjudgement]

Objective: To analyze the causes of preoperative miscarriage of pancreatic serous cystadenoma (SCN) and find the ways to improve it. Methods: Clinical data of 425 pancreatic cystic neoplasm patients who underwent surgical resection from January 2006 to December 2016 in Department of Pancreatic Surgery in Huashan Hospital were retrospectively analyzed.Excel database was created which covered 128 fields of 7 fields: general information of patients, preoperative blood biochemical indexes, tumor markers, surgical related data, postoperative complications, imaging findings and pathology.One hundred and sixty-one cases of SCN were analyzed in depth, mainly in three aspects: surgical benefit, preoperative imaging diagnostic value and interference factors in preoperative judgement.The classification data were analyzed by χ(2) test and the quantitative data were analyzed by t test.The Logistic regression model was used for multiple factor analysis. Results: Of the 425 PCN cases surgically removed, 161 cases (37.9%) were SCN, the incidence of operative complications was 40.4%(65/161), the hospitalization days was (20.7±12.1)days and the medical cost was (75 267±37 866) yuan.Only 3 of 161 cases of SCN were accurately diagnosed by preoperative imaging methods, 61 cases were diagnosed as "cystic lesions of pancreas" (37.9%) and 52 cases were diagnosed as "pancreatic cystadenoma" (32.3%). SCN was misdiagnosed as MCN(32.3%) and IPMN(28%) before operation.25.5% of them were diagnosed as SCN before operation, but still underwent radical operation.The rate of preoperative imaging diagnosis for identifying SCN was 62.8%.The lack of preoperative endoscopy and the lack of understanding of the image characteristics and biological behavior of SCN were the most important factors affecting the accuracy of preoperative judgment.Statistics found that gender, age, CA125 and tumor location can be used as independent factors contribute to the clinical identification(χ(2)=8.995, P=0.003; χ(2)=10.019, P=0.007; t=3.157, P=0.002; χ(2)=6.790, P=0.009). Logistic analysis showed that women, older than 60 years old, the tumors located in the pancreatic body and tail were the independent factors of SCN classification and diagnosis (OR=0.481, 0.376, 0.577, 0.666, 95% CI: 0.305-0.759, 0.199-0.710, 0.361-0.924, 0.433-1.024, P=0.002, 0.003, 0.022, 0.064). Conclusions: SCN has more benign biological behavior.Although surgical excision is acceptable for clinical safety, the corresponding benefit is very limited.It is possible to improve the rationality of SCN clinical operation decisions to some extent by performing endoscopic examination, imaging doctors to improve the SCN feature recognition and surgeons to enhance the awareness of SCN.

[Analysis of the clinical characteristics of fungus ball sphenoid sinusitis]

Objective:To analyze the clinical characteristics of fungus ball sphenoid sinusitis(FBSS) and its differences from fungus ball maxillary sinusitis(FBMS). Method:A retrospective analysis was made for 50 patients with FBSS and 273 patients with FBMS in the corresponding period, which were confirmed by postoperative pathological diagnosis. And the related factors and clinical characteristics of them were analyzed. Result:FBSS were common disease in women around 50 years old. The left side FBSS was more common than the right side. About 40 percent of patients' disease course was less than half a year.FBSS had many presenting symptoms such as headache, nasal obstruction, nasal mucus with blood, smelly nasal secretions, eye ache bilges or nasion acheand tears spill. However, headache, eye ache bilges and tears spill were more common in FBSS compared with FBMS(P<0.05). The CT scan showed that there were calcification shadows in the diseased softtissue of sinus cavity.It could be accompanied by local bone thickening, sclerosis and coloboma. Only one case had a secondary surgery in 50 cases of FBSS. The surgery cure rate was as high as 98 percent. Conclusion:FBSS had various of clinical symptoms.Some presenting symptoms such as headache, eye ache bilges, and tears spill had relative specificity. CT diagnosis was more specific, and the endoscopic sphenoidotomy was the most effective treatment.

[Study on Urinary Metabolic Profile in Rats with Deep Venous Thrombosis Based on Pattern Recognition]

OBJECTIVES

To study the urinary metabolic profile in rats with deep venous thrombosis （DVT） based on metabolomics and to screen out small molecular biomarkers for the diagnosis and forensic identification of DVT.

METHODS

Inferior vena cava of rats was ligated to construct DVT models. The rats were randomly divided into three groups： DVT, sham, and control groups, 10 in each group. The urine of DVT and sham rats was collected during 24 hours in the metabolic cage at 48 hours after operating, meanwhile, 24 hours urine was collected in control group. The metabolic profile was analyzed by nuclear magnetic resonance. SIMCA-P 14.1 software was used for pattern recognition. The variable importance in projection （VIP） value from orthogonal PLS-DA （OPLS-DA） model combined with Mann-Whitney U test were used to search the different metabolites in the urine.

RESULTS

The metabolic profiles of urine from DVT, sham, and control groups had significant differences. The DVT, sham, and control groups could be distinguished by the partial least squares method-discriminant analysis （PLS-DA） model. Compared with the urine of the rats in control groups, the levels of leucine, glutamine, creatine, creatinine and sucrose in the urine of DVT rats were up-regulated, and the levels of 3-hydroxybutyrate, lactate, acetone, α-oxoglutarate, citrate and hippurate were down-regulated.

CONCLUSIONS

The different metabolites in the urine of DVT rats are expected to become its candidate biomarkers. The results can provide a research basis for the diagnosis, treatment and forensic identification of DVT.

[Contrast study of double-balloon catheter with and without oxytocin for cervical ripening]

Objective: To evaluate the efficacy and related issues for cervical ripening by double-balloon catheter with and without oxytocin. Methods: The prospective non-randomly control research was conducted from March 2015 to June 2017 in Yuquan Hospital of Tsinghua University. The primipara with induced labor indications and balloon placement conditions were divided into two groups. Seventy-eight cases were in the balloon with oxytocin group, in which oxytocin was used if there were no contraction 1 hour after balloon placement. Meanwhile, 220 cases were in the single balloon group. Before and after balloon placement, the changes of cervical Bishop Scores and delivery outcome were compared between the groups. Results: The effective rate of cervical ripening in the balloon with oxytocin group was higher than that in the balloon group[92.3% (72/78) vs 82.7% (182/220), P<0.05], the proportion of parturiency within 12 hours was as well[15.4% (12/78) vs 7.3% (16/220), P<0.05]. The effective rate of cervical Bishop score 4-5 points was further improved in the balloon with oxytocin group[95.7%(66/69) vs 85.1% (165/194), P<0.05]. Taken out balloon, the cervical Bishop scores (8.1±1.1) points in the balloon with oxytocin group were higher than (6.5±1.2) points in the balloon group (P<0.05). For the maternal without parturiency in the balloon with oxytocin group, the cervical Bishop score reduced from (7.7±0.9) points to (6.6±0.6) points after removal balloon for 12 hours (P<0.05). The cesarean section proportion for intrauterine infection in the balloon with oxytocin group was higher than that of the balloon group ( P<0.05), but the placental pathological diagnosis proportion was no significant difference ( P>0.05). In the two groups, the cesarean section rate, the first labor stage, the episiotomy rate, the postpartum hemorrhage rate, neonatal weight, the neonatal asphyxia and referral rate showed no significant differences (P>0.05, respectively). Conclusions: The double-balloon catheter with oxytocin can further improve the efficiency of patients with cervical Bishop score 4-5 points for cervical ripening , and increase the chance of labor in 12 hours.

Effect of propolis on preserving human periodontal ligament cells and regulating pro-inflammatory cytokines

BACKGROUND/AIM

Propolis has been suggested as a storage medium for avulsed teeth. The aim of this study was to compare the effectiveness of Brazilian propolis with Hank's balanced salt solution and milk in maintaining the viability of human periodontal ligament cells, their osteogenic differentiation potential, and pro-inflammatory cytokine expression.

MATERIAL AND METHODS

Cell Counting Kit 8 assays were performed to test human periodontal ligament cell viability in different storage media. The preservative effect on osteogenic differentiation was evaluated using alkaline phosphatase staining and activity assays, Alizarin Red S staining, and western blotting. Quantification of pro-inflammatory cytokines was performed using real-time PCR and enzyme-linked immunosorbent assays.

RESULTS

Brazilian propolis at 10 μg/ml was not cytotoxic toward human periodontal ligament cells. The milk group showed the highest cell viability. Brazilian propolis and Hank's balanced salt solution groups showed similar cell viabilities. Alkaline phosphatase staining and activity were similar in all groups. Calcium deposition and mineralization nodule formation were similar in the Brazilian propolis and Hank's balanced salt solution groups, but were higher in the milk group. Osteogenic marker gene and protein levels were similar in all groups. The genes and protein expression levels of IL1β, IL6, and IL8 decreased significantly after treatment with Brazilian propolis. TNFα mRNA expression showed no significant difference among the experimental groups. Pro-inflammatory cytokine levels in the milk group were higher than in the Brazilian propolis and Hank's balanced salt solution groups.

CONCLUSIONS

Brazilian propolis, Hank's balanced salt solution, and milk maintained the viability of human periodontal ligament cells and preserved their osteogenic differentiation ability similarly. However, Brazilian propolis showed a better anti-inflammatory effect. This article is protected by copyright. All rights reserved.

[A preliminary observation of implanting a double-eyelet capsular tension ring in eyes with serious lens subluxation]

Objective: To evaluate the clinical efficiency of an iris hook combined with a modified double-eyelet capsular tension ring (MCTR) in the treatment of serious lens subluxation. Methods: Retrospective case series. A total of 16 patients (20 eyes) with serious lens subluxation were enrolled in Zhongshan Ophthalmic Center from March 2016 to December 2016. All the patients had an iris hook inserted to support the capsule during the phacoemulsification. Then an MCTR was implanted and sutured onto the sclera. Both intraoperative and postoperative complications, such as posterior capsular opacification and macular edema, were recorded. The postoperative examinations included visual acuity, intraocular pressure, slit-lamp examination, and Pentacam for evaluation of the positions of the capsule and the intraocular lens(IOL). The best corrected visual acuities before and after operation were compared with the matched t test. Results: There were 11 males(12 eyes) and 5 females (8 eyes) among the 16 patients (20 eyes) aged (36±16) years, including 5 cases of Marfan's syndrome (7 eyes), spontaneous ectopia lentis in 7 patients (9 eyes), and traumatic lens dislocation in 4 patients (4 eyes). All the MCTRs were successfully implanted into the capsule. The best corrected visual acuity ranged from 0.3 to 1.0, with 0.5 or higher accounting for 90% (18 eyes). It was 0.20±0.14 and 0.21±0.13, respectively, at 3 and 6 months, which was significantly better than the preoperative best corrected visual acuity (logarithm of the minimal angle of resolution) (0.74±0.51;t=5.302, P<0.001; t=5.131;P<0.001). One eye had macular edema 3 months after surgery, and then was treated by conservative management. Two eyes(2 case) developed mild posterior capsular opacification 6 months after operation. No intraocular hypertension was persistently observed. All IOLs and capsular bags were in the expected position without an obvious tilt or displacement. Conclusion: The surgical strategy of iris hooks combined with MCTRs in the treatment of serious lens subluxation could maintain long-term stability of the capsule. (Chin J Ophthalmol, 2018, 54: 343-348).

[Distribution and associated factors of high-risk HPV genotypes infection among HPV-positive women who participated cervical screening test in Shenzhen, 2014-2016, China]

Objective: To analyze the distribution and associated factors of high-risk genotypes of HPV in cervical infection among women in Shenzhen. Methods: The information on sociodemographic characteristics and HPV genotypes of HPV-positive women who participated cervical screening test from January 2014 to December 2016 was downloaded from Shenzhen Maternity and Child Healthcare Management Information System. According to the pathogenicity, the high-risk HPV genotypes were divided into 15 types including HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66 and 68; and there were 6 low-risk genotypes including HPV 6, 11, 42, 43, 44, and 81. Chi-square tests were applied to compare the proportions of high-risk HPV infection among women who had different sociodemographic characteristics. A non-conditional logistic regression model was used to analyze the associated factors for high-risk HPV infection. Results: In total, all HIV positives received HPV genotyping, with an average age of (38.08±9.38) years old. There were 9 979 (93.9%) high-risk and 645 (6.1%) low-risk HPV infections. The proportions of HPV infections for high-risk type in each year were 91.5%, 93.8%, and 95.6%, increasing with the screening years (χ(2)=54.79, P<0.001). Multivariate logistic regression analysis showed that compared with women younger than 25 years old, women in other age groups (at age 26 to 30 years, 31 to 35 years, 36 to 40 years, 41 to 45 years, and 50 years or older) had increased risks of high-risk HPV infection, with OR (95%CI) of 1.67 (1.20-2.31), 1.49 (1.09-2.03), 1.71 (1.23-2.37), 1.65 (1.19-2.31), and 1.84 (1.26-2.67), respectively; compared with the married, single women had a decreased risk of high-risk HPV infection (OR (95%CI): 0.71 (0.50-1.00)); women received HPV testing in 2015 and 2016 showed higher risk of high-risk HPV infection than those in 2014 (OR (95%CI): 1.43 (1.17-1.74) and 2.03 (1.68-2.46)). The 5 most common HPV genotypes were HPV52 (25.1%, 2 670 cases), followed by HPV16 (19.2%, 2 041 cases), HPV58 (13.3%, 1 413 cases), HPV18 (9.9%, 1 048 cases), and HPV51 (9.3%, 993 cases). Conclusion: Age, marital status, and screening year were associated with high-risk HPV infections. Besides HPV16 and HPV18, the prevention and control on HPV infections for HPV52, HPV58, and HPV51 should be prioritized in Shenzhen area.

[Time-dependent Expression of Nrf2 Protein and its Effects on Wound Repair in Skeletal Muscle]

OBJECTIVES

To detect the expression of nuclear factor erythroid 2-related factor 2 （Nrf2） to explore its change rule and effects in the repair process of skeletal muscle.

METHODS

An injury model of skeletal muscle was established by injection of cardiotoxin into the gastrocnemius muscle of SD male rats. The muscle samples were taken from control group and injury group at each time point （1 h, 4 h, 8 h, 12 h, 16 h, 1 d, 3 d, 5 d, 7 d, 9 d, 13 d, 17 d, 21 d）. The morphological changes of skeletal muscle in repair process were observed by HE staining, and the content of reactive oxygen species （ROS） was detected. The expression level of Nrf2 protein was investigated by Western blotting and immunohistochemistry staining.

RESULTS

After the skeletal muscle injury, the injury region was infiltrated with inflammatory cells which constituted mainly by lymphocyte neutrophils and mononuclear cells. There were large amounts of immature muscle cells appeared at the 5th day and the muscle repair was completed at the 21th day. Comparing with control group, the ROS content decreased in injury group at the 12th hour （P<0.05）, while Nrf2 expression increased at the 16th hour （P<0.05）. Moreover, the positive rate of Nrf2 increased after injury, and peaked at 16 h-1 d, then decreased gradually and returned to the level of control group （P<0.05）.

CONCLUSIONS

The Nrf2 protein involves in the regulation of the repair of skeletal muscle injury. The positive rate of Nrf2 shows a time-dependent expression, which can be used to estimate the wound age of skeletal muscle.

Abstract P4-10-06: Influence of older age on triple negative breast cancer (TNBC) clinical-pathological characteristics and outcomes

Background: The impact of age at diagnosis on clinical presentation and treatment delivery for triple negative breast cancer (TNBC) is unclear. Utilizing data from a prospective registry, the aim of this study was to further elucidate the age-dependent correlation between TNBC clinical-pathological features, and the implications of age-bias on treatment delivery and prognosis.

Methods: 480 subjects with stage I-III TNBC were enrolled in an IRB approved multisite prospective registry between 2011 and 2016. Clinical, demographic, treatment information was collected and patients were followed for recurrence and survival. Patients were categorized as older (&gt;60 years) or younger groups (&lt;60 years). Recurrence free survival (RFS) and overall survival (OS) were estimated according to the Kaplan-Meier method and compared among groups by log-rank test.

Results: 145 (30%) of 480 TNBC patients were older (&gt; 60 years) at time of diagnosis. Compared to younger patients, older patients were more likely to present with screen detected vs symptomatic cancer (47% vs 25% p=&lt;0.001), more likely to have node negative cancer (71% vs 61% p=0.030), stage I disease (42% vs 28% p=0.003), and low level (1-10%) ER or PR positivity (19% vs 12% p=0.046). Compared to the younger patients, older patients were less likely to have a BRCA1/2 mutation (6% vs 23% p=0.0002) but more likely to have a prior history of hormone positive breast cancer (7% vs 1% p=0.0002). Compared to younger counterparts, older patients were less likely to receive neo/adjuvant chemotherapy (93% vs 99% p=0.0006), and less likely to receive &gt; 4 cycles of neo/adjuvant chemotherapy (61% vs 78%, p=0.0003). Three year RFS for the entire cohort was 80% and was identical for older and younger patients at 80%. Three year OS for the entire cohort was 87% and was similar for older and younger patients. On multivariable analysis only tumor size and nodal status significantly impacted RFS.

Conclusions: A significant fraction (30%) of TNBC patients are older (&gt; 60 years) at time of diagnosis. Despite presenting a with more favorable disease stage, older TNBC patients did not demonstrate better outcomes compared to the higher risk younger patients. The underlying reasons for this observation may be tumor biology differences between older and younger TNBC patients or perhaps could be related to underutilization of appropriate systemic chemotherapy (39% of older patients received &lt; 4 cycles of chemotherapy). Further studies are warranted on this subject.

Citation Format: Mina A, Lehn C, Wang YY, Klemp JR, O'Dea AP, Elia M, Hoffmann M, Crane G, Sheehan M, Madhusudhana S, Jensen RA, Godwin AK, Khan QJ, Kimler BF, Sharma P. Influence of older age on triple negative breast cancer (TNBC) clinical-pathological characteristics and outcomes [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 P4-10-06.

Time-dependent Expression of MT1A mRNA and MT2A mRNA in the Contused Skeletal Muscle of Rats

OBJECTIVES

To investigate the time-dependent expression of metallothionein （MT） 1A mRNA and MT2A mRNA in contused skeletal muscle of rats.

METHODS

A total of 54 Sprague-Dawley rats were used in this study. The rats were divided into two parts: control group （n=6） and contusion groups （0.5, 1, 6, 12, 18, 24, 30, and 36 h after contusion, n=6）. Total RNA was extracted from skeletal muscle. The expression levels of MT1A mRNA and MT2A mRNA were detected by SYBR Green I real-time PCR.

RESULTS

The expression trends of the two potential marker genes were related to wound age. In addition to 0.5 h, there were significant contrasts between the control group and contused group （P<0.05）, about the expression levels of MT1A mRNA and MT2A mRNA in different phases. As the extension of wound age, the relative expression of MT1A mRNA and MT2A mRNA at 1 h, 6 h, 12 h and 18 h after contusion demonstrated upgrade tendency until its expression levels in 18 h peak with 239.41±15.20 and 717.42±50.76, respectively. When time extends to 24 h after injury, the expression of above two marks decreased, respectively. The MT1A mRNA and MT2A mRNA expression levels increased at 30 h and then decreased.

CONCLUSIONS

Determination of MT1A mRNA and MT2A mRNA levels by real-time PCR may be useful for the estimation of wound age.