Large Isospin Asymmetry in ^{22}Si/^{22}O Mirror Gamow-Teller Transitions Reveals the Halo Structure of ^{22}Al

β-delayed one-proton emissions of ^{22}Si, the lightest nucleus with an isospin projection T_{z}=-3, are studied with a silicon array surrounded by high-purity germanium detectors. Properties of β-decay branches and the reduced transition probabilities for the transitions to the low-lying states of ^{22}Al are determined. Compared to the mirror β decay of ^{22}O, the largest value of mirror asymmetry in low-lying states by far, with δ=209(96), is found in the transition to the first 1^{+} excited state. Shell-model calculation with isospin-nonconserving forces, including the T=1, J=2, 3 interaction related to the s_{1/2} orbit that introduces explicitly the isospin-symmetry breaking force and describes the loosely bound nature of the wave functions of the s_{1/2} orbit, can reproduce the observed data well and consistently explain the observation that a large δ value occurs for the first but not for the second 1^{+} excited state of ^{22}Al. Our results, while supporting the proton-halo structure in ^{22}Al, might provide another means to identify halo nuclei.

Thrombocytopenia as a preoperative risk assessment tool in patients with type B aortic dissection after thoracic endovascular aortic repair

Background

Postoperative thrombocytopenia has been reported to be correlated with adverse events, but the prognostic value of baseline thrombocytopenia is unclear. This study was undertaken to evaluate the relationship between preoperative thrombocytopenia and adverse outcomes in patients with type B aortic dissection who underwent thoracic endovascular aortic repair (TEVAR).

Methods

A total of 825 patients with acute and sub-acute type B aortic dissection undergoing were TEVAR at a multidisciplinary aortic center were enrolled between January 2010 and December 2017. Patients were stratified on the basis of presence (n=149) or absence (n=676) of thrombocytopenia (platelet count, <150x109/L), according to preprocedural platelet counts. The primary outcome of interest was in-hospital mortality. Secondary outcomes of interest was long-term death.

Results

In the enrolled cohort, thrombocytopenia occurred in 149 (18.1%) patients. Patients with thrombocytopenia were older, were more commonly acute stage of TBAD, higher D-dimer level and had higher rates of abdominal vessel involvement and pericardial effusion. During the hospitalization period, 26 patients (3.2%) died, which was significantly higher in the thrombocytopenic group (8.1% versus 2.1%; P=0.001) Multivariate analyses revealed that thrombocytopenia was independently associated with in-hospital mortality (Table). During long-term follow-up (median duration 44.2 months), A total of 62 deaths were reported after discharge, including 40 (64.5%) aortic-related and unknown deaths, of which 12 and 50 patients for thrombocytopenia and non-thrombocytopenia group, respectively. Kaplan-Meier estimated rates of long-term all-cause mortality were higher for thrombocytopenia (log-rank test, P=0.014). Similar results were observed in a subset of aortic-related death (P=0.004) as well as aortic-related and unknown death (P=0.006), not non-aortic related death (P=0.878) (Figure 1).

Conclusion

Platelet counts, as simple and inexpensive indexes, were reliable to be used as a preoperative risk assessment tool for patients with type B aortic dissection undergoing thoracic endovascular aortic repair.

Figure 1. Long-term Mortality

Funding Acknowledgement

Type of funding source: Public hospital(s). Main funding source(s): This research was supported by grant DFJH201807 from High-level Hospital Construction Project of Guangdong Provincial People's Hospital.

Anal dysplasia as an incidental finding: the importance of specimen evaluation

AIM

The incidence of anal squamous cell carcinoma (SCC) has increased dramatically in the USA. The squamous intraepithelial lesion has been identified as a precursor lesion to SCC, stratifying the abnormality into low grade or high grade. There have been studies on the prevalence of incidentally found SCC in haemorrhoidectomy specimens, but there are no studies to date on the incidence of dysplasia. The purpose of this study was to establish a baseline incidence of dysplasia that provides helpful information for future epidemiological studies.

METHODS

This is a retrospective review of patients who underwent haemorrhoidectomy from 2005 to 2019. Pathology regarding the type of dysplasia, medications, and diagnoses that may predispose to immunosuppression were collected.

RESULTS

In all, 810 patients with a mean age of 51.7 (range 20-91) years underwent haemorrhoidectomy. Eighteen (2.2%) of the patients had abnormal pathology (low-grade squamous intraepithelial lesion, 3; high-grade squamous intraepithelial lesion, 12; SCC, 2; adenocarcinoma, 1). Thirty-seven (4.5%) of the entire cohort had some risk factors for immunosuppression: chronic steroid use (nine), human immunodeficiency virus (HIV) (13), biologic medications (six), transplant recipients (two) and immunocompromising diseases (four). Only 4/18 patients had an immunosuppression risk in that all four of these patients were HIV-positive. Surveillance following excision was undertaken for an average of 6 (range 1-12) months, during which time four patients underwent a repeat biopsy.

DISCUSSION

Anal dysplasia found in an otherwise asymptomatic population has a prevalence of 2.2%. This finding supports the routine examination of benign anorectal specimens undergoing microscopic examination. Interestingly, the majority of the patients identified had no immunosuppressant risk factors.

Risk stratification of ulcer-like projections in patients with acute type B aortic intramural hematoma

Background

Acute type B aortic intramural hematoma (IMH) with ulcer-like projections (ULP) is associated with various adverse aortic-related events (AAE) and recommended for preventive endovascular repair as alternative. However, we have no therapeutic criterion on which to decide preventive treatment.

Objectives

The purpose of this study was to determine the prognostic value and risk stratification of ULP in patients with acute type B IMH for proper treatment.

Methods

A retrospective study was conducted on 61 consecutive patients with acute type B IMH and with present of ULP from January 2015 to December 2018 in our center. All patients were treated medically initially and CT scans were performed on admission and during follow-up period.

Results

During a median follow-up of 4.5 months (range, 0.3 to 49.8 months) from onset, 36 patients (59.0%) had composites of adverse aortic events, including 1 patient died for aortic rupture, 6 patients converted to endovascular repair, 6 progressed into aortic dissection, and 28 developed to aortic enlargement. A cutoff value to estimate risk is 6.0 mm for maximal ULP width (72.2% sensitivity and 84.0% specificity) and 4.0 mm for maximal ULP depth (94.4% sensitivity and 52.0% specificity). Patients with widest (P=0.005) or deepest ULP (P=0.019) in aortic arch and proximal descending thoracic aorta had significant poorer aorta-related event-free survival rates. On multivariate analysis, maximal ULP width ≥6.0 mm [hazard ratio (HR) = 2.569, 95% confidence interval (CI):1.157 to 5.705, P=0.020], maximal ULP depth ≥4.0 mm (HR=5.198, 95% CI: 1.154 to 23.420, P=0.032) and widest ULP in aortic arch and proximal descending thoracic aorta (HR=2.363, 95% CI: 1.012 to 5.517, P=0.047) were independently associated with AAE. ULP with both risk location (widest ULP in aortic arch and proximal descending thoracic aorta) and size (maximal ULP width ≥6.0 mm) were significantly associated with a poorer aortic-related event-free survival rate than others (both P<0.001).

Conclusions

Maximal ULP width ≥6.0 mm, maximal ULP depth ≥4.0 mm and widest ULP in aortic arch and proximal descending thoracic aorta are predictive for progression of acute type B aortic intramural hematoma. For patients with ULP in both risk location and size, preventive endovascular treatment should be considered.

Figure 1

Funding Acknowledgement

Type of funding source: Public hospital(s). Main funding source(s): This research was supported by grant DFJH201807 from High-level Hospital Construction Project of Guangdong Provincial People's Hospital.

Impact of timing on major complications after thoracic endovascular aortic repair for uncomplicated type B aortic dissection

Background

This study aimed to analyze the impact of the timing of intervention from presentation of symptoms to TEVAR and its relation to major complications for uncomplicated TBAD.

Methods

We retrospectively analyzed the data of 390 patients who underwent TEVAR for acute, subacute and chronic uncomplicated type B aortic dissection from January, 2010 to December 2017. Standard univariate and survival methods were used. The primary outcome of interest was in-hospital mortality. The Secondary outcomes of interest was long-term death and in-hospital adverse events, including postoperative coma, postoperative endoleak, postoperative stroke, postoperative spinal cord ischemia, postoperative limb ischemia, postoperative mesenteric ischemia/infraction.

Results

Of the 390 TEVARs for uncomplicated TBAD, 145 were performed within 14 days of presentation of symptoms (acute), 172 between 14 hours and 90 days (sub-acute), and 73 were beyond 90 days (chronic). Demographic characteristics were similar among groups (Table 1). A slight increase of in-hospital death, post-operative endoleak and limb ischemia, were observed in the acute intervention group compared with the sub-acute group (4.8% vs 2.3%, 11.7% vs 9.3%, 2.8% vs 2.3%, respectively). The chronic group patients had a highest rates of post-operative endoleak. However, there are no significantly differences between the three groups (Table 2). During long-term follow-up (median duration 36.9 months, interquartile range, 22.5–67.7 months), overall survival was similar among groups (log-rank test, P=0.280) (Figure).

Conclusion

TEVER performed for uncomplicated TBAD within 14 days to the presentation of symptoms, as compared with TEVAR between 14 hours and 90 days or beyond 90 days, neither appear to increase the risk of in-hospital complications nor long-term mortality.

Long-term All-cause Mortality

Funding Acknowledgement

Type of funding source: Public hospital(s). Main funding source(s): This research was supported by grant DFJH201807 from High-level Hospital Construction Project of Guangdong Provincial People's Hospital.

DGCR5 suppresses the EMT of pediatric primary glioblastoma multiforme cell and serves as a prognostic biomarker

OBJECTIVE

Pediatric primary glioblastoma multiforme (GBM) is a common brain tumor among childhood. Nevertheless, the underlying mechanism of glioblastoma progresses remains to be illuminated. The current study explores the potential functions of long noncoding RNA (lncRNA) DGCR5 in the aggressiveness of GBM.

PATIENTS AND METHODS

The expression of DGCR5 was evaluated by quantitative real-time PCR (qRT-PCR). Immunoblotting was carried out to assess the protein expressions of N-cadherin and E-cadherin. Cell Counting Kit-8 (CCK-8), wound healing, transwell assay, and flow cytometry were applied to explore the roles of DGCR5 in glioblastoma cell malignant biological behaviors.

RESULTS

LncRNA DGCR5 was down expressed in glioblastoma. Transfection of DGCR5 markedly repressed cell viability and colony formation ability of U87 and U251 cells. Additional, DGCR5 overexpression caused cell cycle arrest and increased cell apoptosis. Moreover, upregulation of DGCR5 suppressed the growth and promoted cell apoptosis of U87 cell in vivo. Finally, overexpression of DGCR5 impaired the migration, invasiveness, and reversed epithelial-to-mesenchymal transition (EMT) process of glioblastoma cell.

CONCLUSIONS

LncRNA DGCR5 inhibited the proliferation, aggressiveness phenotypes, and EMT of glioblastoma cell.

Structure of a two-dimensional superparamagnetic system in a quadratic trap

Ground-state structures of a two-dimensional (2D) system composed of superparamagnetic charged particles are investigated by means of molecular dynamics simulation. The charged particles trapped in a quadratic potential interact with each other via the repulsive, attractive, and magnetic dipole-dipole forces. Simulations are performed within two regimes: a one-component system and a two-component system where the charged particles have the identical charge-to-mass ratio. The effects of magnetic dipole-dipole interaction, mixing ratio of the two species and confinement frequency on the ground-state structures are discussed. It is found that as the strength of the magnetic dipole increases, the charged particles tend to self-organize into chainlike structures. The two species particles exhibit different structural features, depending on the competition of electrostatic repulsive interaction, magnetic dipole-dipole interaction and confinement force. The potential lanes are observed through analyzing the global potential of the magnetic particles, which guide the unmagnetic particles aligning themselves in the direction of the potential lanes.

Non-ohmic conduction in sodium bismuth titanate: the influence of oxide-ion conduction

A nominal Bi-excess starting composition of sodium bismuth titanate, Na0.5Bi0.51TiO3.015 (NB0.51T) produces dielectric ceramics that exhibit mixed n-type and oxide-ion conductivity with an ionic transport number of ∼0.1 at ≥600 °C. The bulk electrical conductivity, σb, of NB0.51T ceramics under a dc bias field of ≤100 V cm-1 has been investigated by impedance spectroscopy. Over the temperature range ∼550 to 750 °C, σb increases by up to one order of magnitude under the dc bias and returns to its initial value on removal of the bias. The enhancement of conductivity is dependent on temperature, atmosphere, dc bias field and the electrode materials. A maximum conductivity enhancement of >2000% is achieved at 600 °C in nitrogen using Pt electrodes. This is in contrast to that observed for other n-type perovskite titanates and oxygen-deficient rutile where σb is suppressed under a dc bias. This 'unusual' non-ohmic behaviour is attributed mainly to the influence of highly mobile oxygen vacancies in NB0.51T. The field-enhanced σb is best described to be a consequence of increased pumping of oxygen from the cathode to the anode, in which the electrode reactions play an important role. In addition, dissociation of defect clusters may also contribute to the enhanced σb under a dc bias. The high, fast and reversible response to the dc bias voltage may expand the potential application of NBT-based materials to memory devices.

3-n-butylphthalide inhibits the apoptosis of nerve cells in rats with cerebral small vessel disease via the PI3K/Akt pathway

OBJECTIVE

The aim of this study was to investigate the effect of 3-n-butylphthalide (NBP) on the apoptosis of nerve cells in vascular dementia (VaD) model rats caused by cerebral small vessel disease (CSVD), and to explore its regulatory mechanism.

MATERIALS AND METHODS

The model of VaD was successfully established in rats by carotid artery ligation. All rats were randomly divided into three groups, including the sham operation group, model group and NBP group. The neurobehavioral score was used to verify whether the model was successfully established. The changes in learning and memory abilities of rats were detected via water maze experiment. The levels of Bcl-2-associated X protein (Bax) and cysteinyl aspartate specific proteinase-3 (Caspase-3) in the serum of rats was detected by enzyme-linked immunosorbent assay (ELISA). Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay was adopted to detect the apoptosis of nerve cells in brain tissues of rats. Moreover, the protein levels of phosphorylated phosphatidylinositol-3-kinase (PI3K) and phosphorylated protein kinase B (Akt) in brain tissues of rats were measured using Western blotting.

RESULTS

Compared with the sham operation group, the neurobehavioral score of rats increased significantly, whereas learning and memory abilities decreased markedly in the model group. The levels of Bax and Caspase-3 in rat serum were remarkably up-regulated, and the apoptosis rate of nerve cells in brain tissues of rats increased significantly in the model group as well. Meanwhile, the levels of phosphorylated PI3K and phosphorylated Akt were notably declined. Compared with the model group, the neurobehavioral score decreased markedly, while learning and memory abilities were remarkably improved in the NBP group. The levels of Bax and Caspase-3 in rat serum were significantly down-regulated, and the apoptosis rate of nerve cells in brain tissues of rats were reduced in the NBP group. Furthermore, the protein levels of phosphorylated PI3K and phosphorylated Akt were remarkably elevated in the NBP group.

CONCLUSIONS

NBP can improve the morphology of brain tissue cells and the learning and memory abilities, and inhibit the apoptosis of nerve cells in VaD model rats with CSVD. The possible underlying mechanism may be related to the activation of the PI3K/Akt signaling pathway.

The efficacy of simendan in the treatment of acute heart failure and its impact on NT-proBNP

OBJECTIVE

Simendan is a calcium sensitizer that enhances myocardial contractility but does not affect ventricular diastole. Simendan also has a vasodilatation effect, which causes coronary artery resistance and venous volume blood vessel relax, thereby improving coronary blood supply. This study adopted simendan on the basis of conventional anti-heart failure treatment to explore a new approach for the treatment of heart failure.

PATIENTS AND METHODS

Eighty patients with heart failure were randomly and equally divided into an observation group and control group according to the digital table method. The control group was given a conventional anti-heart failure treatment. The observation group was treated with simendan on the basis of the control group. The left ventricular ejection fraction (LEVF), stroke volume (SV), NT-proBNP, K+, and Ca2+ were measured before and after the treatment. The clinical efficacy and adverse reactions after treatment were compared. The 6-minute walking distance (6MWT) was recorded on the 60th day after treatment.

RESULTS

There were no significant differences in LVEF and SV between the two groups before the treatment. They were significantly increased after treatment and were significantly higher in the observation group than that in the control group (p < 0.05). The total effective rate in the observation group (92.50%) was significantly higher than that in the control group (67.50%). There was no statistical difference in the occurrence of adverse reactions between the two groups (p > 0.05). The 6MWT in the observation group was 452.63±86.51 meters, which was significantly higher than that in the control group (366.85±70.46 meters) (p < 0.05). There was no significant difference in plasma NT-proBNP levels between the two groups (p > 0.05). The plasma NT-proBNP level was significantly lower in the observation group than that in the control group after treatment (p < 0.05). Serum K+ and Ca2+ were not significantly changed after treatment in the control group (p > 0.05). Serum K+, but not Ca2+, was significantly elevated in the observation group.

CONCLUSIONS

Simendan can significantly reduce plasma NT-proBNP level; thus, it is relatively safe and effective for the treatment of acute heart failure (AHF).

Screen time and sleep disorder in preschool children: identifying the safe threshold in a digital world

OBJECTIVES

Sleep disorder is a common problem in children that can jeopardize their health and well-being. With the popularity of electronic devices such as portable tablets and smartphones in the 21st century, children are spending much more time on screen, but the impact of such change on children's sleep disorder has been less investigated so far. This study aims to examine the dose-response association between time spent on different electronic devices and children's sleep disorder.

STUDY DESIGN

The design of this study is a cross-sectional study.

METHODS

We randomly selected 2278 children aged 3-6 years from 15 kindergartens in Tongling, China. The potentially non-linear association between screen-viewing time (i.e. television [TV], computer, iPad, Phone) and the risk of sleep disorder was examined using a logistic generalized additive model.

RESULTS

We observed a J-shaped association between TV viewing time and the risk of sleep disorder, with a threshold of 1 h/day. For each 1 h/day increment in TV viewing time over the threshold, the risk of sleep disorder increased by 12.35% (95% confidence interval: 1.87-23.92%). This association seemed to be greater for girls than boys and for TV viewing at weekend than on weekdays, but the difference was not statistically significant (P-value>0.05). We did not find adequate evidence of an adverse effect of more time spent on computer, iPad and Phone.

CONCLUSIONS

This study suggests a positive but non-linear relationship between time spent on watching TV and sleep disorder in Chinese preschool children. Setting the TV viewing time limit less than 1 h/day may help reduce the risk of developing sleep disorder. Further investigation is also needed to examine and compare the effects of heavy use of other electronic devices on sleep disorder.

IGF-1 affects the development of myocarditis in LDL-R knockout mice by inhibiting peritoneal infiltration of macrophages

OBJECTIVE

Infiltration of the inflammatory cells, such as macrophages and myocardial necrosis, are involved in myocarditis. Insulin-like growth factor (IGF-1) exerts a variety of biological effects. However, the role of IGF-1 in myocarditis remains unclear.

PATIENTS AND METHODS

LDL-R knockout mice were randomly divided into the control group, myocarditis group, and IGF-1 siRNA group. Real Time-Polymerase Chain Reaction (PCR) and Western blot were used to measure IGF-1 expression in myocardial tissue. The myocardial tissue changes were analyzed by HE staining. The total cholesterol (TC) and low-density lipoprotein cholesterol (LDL) in each group were detected. Flow cytometry was used to analyze the number of macrophages. The secretion of TNF-α and INF-γ and macrophage migration inhibitory factor (MIF) were detected by enzyme-linked immunosorbent assay (ELISA).

RESULTS

Compared with the control group, IGF-1 expression, TC, and LDL in myocarditis group was significantly increased, along with decreased heart rate (HR), left ventricular end-systolic diameter (LVEDs), left ventricular end-diastolic diameter (LVEDd), and left ventricular mass index (LVMI). In addition, inflammatory cell infiltration, fibrosis, and macrophages number in the peritoneum were increased. Moreover, the secretion of TNF-α, INF-γ, and MIF was also significantly increased (p<0.05). However, IGF-1 siRNA treatment inhibited IGF-1 expression and reversed the changes in the myocarditis group with statistically significant differences compared with the myocarditis group (p<0.05).

CONCLUSIONS

IGF-1 expression is increased in myocarditis. The downregulation of IGF-1 expression inhibits macrophages infiltration, reduces the expression of MIF and inflammatory factors, and improves myocarditis injury.

[Magnetic resonance imaging morphological study of the effects of juvenile febrile convulsions on the brain structure of medial temporal lobe epilepsy]

Objective: To investigate the effect of febrile convulsions on gray matter volume (GMV) in medial temporal lobe epilepsy (mTLE) and its correlation with disease duration. Methods: A retrospective study was conducted to collect 41 mTLE patients with a history of febrile convulsions (mTLE-FC), 42 mTLE patients with no initial precipitating injury (mTLE-noIPI), and 42 normal and age and sex matched normal controls. High-resolution T1-weighted (T(1)WI) whole brain MR scans were performed on all subjects. Voxel-based morphometry were used to obtain GMV brain maps, and the GMV differences between the three groups of subjects were compared (P<0.01, GRF corrected). Finally, Spearmen rank correlation analysis was used to explore the correlation between GMV changes and the course of disease. Results: Compared with the normal control subjects, each mTLE group showed extensive GMV reduction, mainly in the affected hippocampus, thalamus, temporal lobe, and bilateral cerebellum. Further analysis found that mTLE-FC group had more significant reductions in GMV than the mTLE-noIPI group in the affected hippocampus, amygdala, inferior temporal gyrus, contralateral hippocampus, para hippocampus, and inner cingulate gyrus. At the same time, the affected amygdala and hippocampal GMV in the mTLE-FC group was significantly negatively related to the course of disease (r=-0.381, P=0.014), while the mTLE-noIPI group had no downward trend (r=0.081, P=0.611). The atrophic trend of the affected amygdala and hippocampus in patients with mTLE-FC was significantly greater than that in patients with mTLE-noIPI (P=0.029, permutation test). Conclusions: There is extensive damage to the gray matter structure of bilateral cerebral hemispheres, mainly in the hippocampus, in mTLE patients. The brain damage of mTLE patients with a history of juvenile fever convulsions is more extensive and serious, and the trend of progressive exacerbation with the course of the disease is more obvious, suggesting mTLE associated with juvenile fever convulsions may have different pathophysiological mechanisms.

Long non-coding RNA Tubulin Alpha 4B (TUBA4B) inhibited breast cancer proliferation and invasion by directly targeting miR-19

OBJECTIVE

Long non-coding RNA (lncRNA) is a significant member of the non-coding RNA family. New evidence has shown that it plays a pivotal role in the processes of tumor genesis and development. According to previous verification, the lncRNA Tubulin Alpha 4B (TUBA4B) is a tumor-associated molecule, but how TUBA4B expresses and functions in breast cancer is still not clear.

PATIENTS AND METHODS

We conducted this study to examine what expression and biological role TUBA4B plays in breast cancer. The expression of TUBA4B was measured in breast cancer samples and cell lines. CCK8 assays and transwell assays were used for evaluating the effects of TUBA4B on breast cancer cell proliferation and invasion. Luciferase reporter assays were used for identifying the direct target of TUBA4B.

RESULTS

According to the results, TUBA4B was largely downregulated in breast cancer samples and cell lines. The functional analysis demonstrated that breast cancer cells proliferation and invasion could be inhibited by overexpression of TUBA4B. The results of Luciferase reporter assays indicated that TUBA4B directly targeted miR-19, which could rescue the effects of TUBA4B on breast cancer cells.

CONCLUSIONS

It is suggested that TUBA4B was downregulated in breast cancer and suppressed proliferation and invasion of breast cancer by targeting miR-19.

Immunosensor-based rapid quantitative detection of Newcastle disease virus antibodies using innovative gold immunochromatographic assay

AIMS

A novel quantitative method for rapid Newcastle disease virus (NDV) antibody detection was developed based on an innovative gold immunochromatographic assay with a quantitative immunosensor.

METHODS AND RESULTS

NDV antibody-detecting test strips containing a two-reaction system and double-test lines (T1, T2) were prepared. The test results were judged according to the signal ratio between the test and control lines as measured by the quantitative immunosensor. The minimum detection limit of the test strips for NDV antibodies was 2² titres. In addition, the assay was highly specific because only NDV antibodies produced visible test lines on the strip. The clinical application of the strips was tested by detecting NDV antibodies in 506 serum samples collected from chickens. The results showed a coincidence of 92·49% with those of the haemagglutination inhibition assay.

CONCLUSIONS

The strips were successfully prepared and showed high specificity towards NDV, sensitivity and stability.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study describes a new method for detection of NDV antibody and provides a reference basis for rapid and quantitative monitoring of NDV antibodies. This new method overcomes the limitation of the existing colloidal gold immunochromatography, which only produces qualitative or semi-quantitative results.

Behaviour of novel low-cost blended elemental Ti-5Fe-xAl alloys fabricated via powder metallurgy

Ti alloys, generally made via wrought metallurgy, are commonly used as biomedical materials. The manufacturing of such alloys via powder metallurgy offers the possibility to reduce the cost as well as to develop innovative compositions not otherwise achievable. The aim of this study is to understand the effect that the progressive addition of Al has on the physical and mechanical behaviour of the low-cost powder metallurgy Ti-5Fe alloy for structural biomedical implants. Specifically, Ti-5Fe-xAl (x = 1-6 w.%) alloys were developed combining blending elemental and cold pressing plus vacuum sintering to further limit the manufacturing costs as Al is lighter and cheaper than Ti. This investigation demonstrates that the amount of Al added significantly changes the thermodynamics of the sintering process and induces microstructural modifications such as grain refinement. These effects jointly with the Al solid solution strengthening leads to progressively stronger and harder (but less ductile) α+β Ti alloys characterised by the typical α+β lamellar microstructure with mechanical behaviour suitable for a variety of structural biomedical implants.

Non-invasive prediction of fetal growth restriction by whole-genome promoter profiling of maternal plasma DNA: a nested case-control study

Objective

To predict fetal growth restriction (FGR) by whole‐genome promoter profiling of maternal plasma.

Design

Nested case–control study.

Setting

Hospital‐based.

Population or Sample

810 pregnancies: 162 FGR cases and 648 controls.

Methods

We identified gene promoters with a nucleosome footprint that differed between FGR cases and controls based on maternal plasma cell‐free DNA (cfDNA) nucleosome profiling. Optimal classifiers were developed using support vector machine (SVM) and logistic regression (LR) models.

Main outcome measures

Genes with differential coverages in promoter regions through the low‐coverage whole‐genome sequencing data analysis among FGR cases and controls. Receiver operating characteristic (ROC) analysis (area under the curve [AUC], accuracy, sensitivity and specificity) was used to evaluate the performance of classifiers.

Results

Through the low‐coverage whole‐genome sequencing data analysis of FGR cases and controls, genes with significantly differential DNA coverage at promoter regions (−1000 to +1000 bp of transcription start sites) were identified. The non‐invasive ‘FGR classifier 1’ (C_FGR1) had the highest classification performance (AUC, 0.803; 95% CI 0.767–0.839; accuracy, 83.2%) was developed based on 14 genes with differential promoter coverage using a support vector machine.

Conclusions

A promising FGR prediction method was successfully developed for assessing the risk of FGR at an early gestational age based on maternal plasma cfDNA nucleosome profiling.

Tweetable abstract

A promising FGR prediction method was successfully developed, based on maternal plasma cfDNA nucleosome profiling.

A promising FGR prediction method was successfully developed, based on maternal plasma cfDNA nucleosome profiling.

SAT0596 ASSOCIATIONS BETWEEN CIRCULATING LIPID MEDIATORS AND INCIDENT INFLAMMATORY ARTHRITIS IN AN ANTI-CITRULLINATED PROTEIN ANTIBODY POSITIVE POPULATION

Background:

Lipid mediators are endogenously derived from the metabolism of omega-3 and omega-6 polyunsaturated fatty acids (PUFAs) and have important roles in promoting and resolving inflammation in the body (1). Epidemiological studies have shown higher omega-3 PUFA status to be associated with a lower risk of both autoimmunity and progression to inflammatory arthritis (IA) (2,3).

Objectives:

To determine the association of lipid mediators with progression from rheumatoid arthritis (RA)-related autoimmunity to inflammatory arthritis (IA).

Methods:

We conducted a prospective cohort study using data from the Studies of the Etiologies of Rheumatoid Arthritis (SERA). SERA enrolled first-degree relatives (FDRs) of individuals with RA (FDR cohort) and individuals who screened positive for RA-related autoantibodies at health fairs (screened cohort). We followed 133 anti-CCP3.1 positive participants, of which 29 developed IA (22 classified as RA by 2010 ACR/EULAR criteria). We quantified lipid mediators from stored plasma samples via liquid chromatography tandem mass spectrometry methods validated against the collection and storage methods used in the study. A priori, we selected 5S-HETE, 15S-HETE and 17S-HDHA because they are precursors to leukotrienes, Lipoxin A4 and Resolvin D series lipid mediators, respectively. We fit Cox proportional hazard models for each lipid mediator as a time-varying covariate. For lipid mediators significantly associated with progression to IA we then examined IL-1β, IL-6, IL-8 and TNF-α (Bio-Plex Pro™ assay) as potential mediators of this relationship.

Results:

Higher plasma 5S-HETE levels were associated with an increased risk of incident IA after adjusting for age at baseline, cohort (FDR or screened), and shared epitope (SE) status (Table 1). The models examining 15S-HETE and 17S-HDHA had the same trend but did not reach statistical significance. We did not find evidence that the association between 5S-HETE and IA risk was mediated by the tested pro-inflammatory cytokines, suggesting a direct role for this lipid mediator in conversion to IA.

Table 1.

Hazard ratios and 95% confidence intervals of lipid mediator concentrations associated with IA, n=29 IA cases

Lipid mediatorCrudeAdjustedb5S-HETE2.10 (1.12, 3.92)2.41 (1.43, 4.07)15S-HETE1.61 (0.88, 2.93)1.52 (0.87, 2.65)17-HDHAa1.59 (0.68, 3.74)1.61 (0.72, 3.56)

adichotomized as <limit of detection (reference) or detected

bAdjusted for SE, age at baseline and cohort

Conclusion:

In a prospective cohort of anti-CCP positive individuals, higher circulating levels of 5S-HETE, an important precursor to pro-inflammatory leukotrienes, was associated with subsequent IA. Our findings highlight the potential pathologic and prognostic significance of these PUFA metabolites in inflammatory processes in pre-RA populations.

References:

[1]Serhan CN. Pro-resolving lipid mediators are leads for resolution physiology. Nature. 2014;510(7503):92-101.

[2]Gan RW, Bemis EA, Demoruelle MK, Striebich CC, Brake S, Feser ML, et al. The association between omega-3 fatty acid biomarkers and inflammatory arthritis in an anti-citrullinated protein antibody positive population. Rheumatology. 2017.

[3]Gan RW, Young KA, Zerbe GO, Demoruelle MK, Weisman MH, Buckner JH, et al. Lower omega-3 fatty acids are associated with the presence of anti-cyclic citrullinated peptide autoantibodies in a population at risk for future rheumatoid arthritis: a nested case-control study. Rheumatology. 2016;55(2):367-76.

Disclosure of Interests:

Kristen Polinski: None declared, Elizabeth Bemis: None declared, Kristen Demoruelle Grant/research support from: Pfizer, Jennifer Seifert: None declared, Tessa Crume: None declared, Fan Yang: None declared, William Robinson: None declared, Michael Clare-Salzler: None declared, Kevin Deane Grant/research support from: Janssen, Consultant of: Inova, ThermoFisher, Janseen, BMS and Microdrop, Michael Holers Shareholder of: AdMIRx, Grant/research support from: AdMIRx, Pfizer, Janssen R&D, Consultant of: AdMIRx, Janssen R&D, Celgene, Bristol-Myers Squibb, Jill Norris Grant/research support from: Janssen R&D, Pfizer, Consultant of: Celgene, BMS

AB0691 CHARACTERIZATION OF DIFFERENT GROUPS WITH IMAGING AND NON-IMAGING FINDINGS OF ANKYLOSING SPONDYLITIS COMBINE WITH HIP LESION IN WESTERN CHINESE

Background:

Hip joint lesion are the main cause of disability in patients with Ankylosing Spondylitis(AS) in western China. Seriously affect the quality of life of patients.The early clinical characteristics of hip joint disease are not typical, the disease is insidious, and the radiological diagnosis is delayed.The main prevention is early screening and early diagnosis.

Objectives:

This study attempted to find out the main characteristics and related factors in different groups of AS combine with hip joint lesion in western China.

Methods:

A-First evaluation:How many patients have 1) active SIJ changes on MRI. 2) chronic SIJ changes (each for erosion, clerosis, ankylosis, or any of those) on MRI. 3) a combination of active changes and chronic changes (each for erosion, sclerosis, ankylosis, or any of those) on MRI. 4) active hip changes on MRI. 5) chonic hip changes (erosion, effusion any of those) on MRI. 6) a combination of active changes and chronic hanges (erosion, effusion any of those) on MRI. B-Then, combination SIJ / hip. 7) active SIJ changes on MRI and in parallel active hip changes on MRI. 8) chronic (see above) SIJ changes on MRI and in parallel active hip changes on MRI. 9) chronic (see above) SIJ changes on MRI and in parallel chronic (see above) hip changes on MRI. 10) chronic (see above) SIJ changes on MRI and in parallel any (active or chronic) hip changes on MRI. C-Then, characterization of these groups with non-imaging findings. Characteristics of groups 7-10 above, for age, sex, Disease duration, Hip pain, Joint pain, enthesitis, Diarrhea, uveitis, ASDAS-CRP, BASDAI, BASFI, BASMI, Pat. Global, CRP, ESR, Harris Score, HLA-B27.

Results:

Retrospective analysis total 558 SpA patients (mean age 29, mean duration 5 years). 1) HIP-Active+Chronic group (N=288, AS=151) vs SIJ+HIP-Active group (N=241, AS=138): hip pain (p<0.0001), diarrhea (p<0.0001), joint pain (p<0.0001) and BASFI (p<0.05); 2) HIP-Active+Chronic(N=117, AS=58) vs SIJ-Chronic+HIP-Active group (N=214, AS=134): hip pain(p<0.0001), joint pain (p<0.0001), enthesitis (p<0.0001), ASDAS-CRP (p<0.05) and ESR (p<0.05); 3) SIJ-Active+Chronic group (N=204, AS=125) vs SIJ-Chronic+HIP-Active group (N=214, AS=134): hip pain (p<0.0001), joint pain (p<0.0001); 4) SIJ-Active+Chronic group (N=204, AS=125) vs SIJ+HIP-Chronic group (N=72, AS=40):hip pain (p<0.0001), Pat. Global (p<0.05); 5) SIJ+HIP-Active group (N=241, AS=138) vs SIJ-Chronic+HIP-Active group (N=214, AS=134): HLA-B27 positive (Chi-square, df, 24.98, 4) (p<0.0001); 6) SIJ+HIP-Chronic group (N=72, AS=40) vs SIJ-Chronic+HIP-Active/Chronic group (N=228, AS=144): Pat. Global (p<0.05), ESR (p<0.05).

Conclusion:

Hip joint lesion are closely related to sacroiliac joint lesion and HLA-B27 positive in AS. Hip pain is the main clinical manifestation of hip joint lesion in AS. Hip joint lesion may lead to function declines, disease activity in AS.

References:

[1]Vander C B, Munoz-Gomariz E, Font P, et al. Hip involvement in ankylosing spondylitis:epidemiology and risk factors associated with hip replacement surgery[J]. Rheumatology (Oxford), 2010,49(1):73-81.

[2]Sieper J, Rudwaleit M, Baraliakos X, et al. The Assessment of SpondyloArthritis international Society (ASAS) handbook: a guide to assess spondyloarthritis[J]. Ann Rheum Dis, 2009,68 Suppl 2:i1-i44.

[3]Ward M M, Deodhar A, Akl E A, et al. American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis[J]. Arthritis Rheumatol, 2016,68(2):282-298.

Disclosure of Interests:

Qing Han: None declared, Zhaohui Zheng: None declared, Kui Zhang: None declared, Zheng Yu: None declared, Fengfan Yang: None declared, Qiang Liang: None declared, Ping Zhu: None declared, Xenofon Baraliakos Grant/research support from: Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen

SAT0563 SINGLE-PHOTON EMISSION COMPUTED TOMOGRAPHY-COMPUTED TOMOGRAPHY IS EQUIVALENT TO MAGNETIC RESONANCE IMAGING IN THE EARLY DIAGNOSIS OF SPONDYLOARTHRITIS: A RETROSPECTIVE STUDY

Background:

SpA has historically been a difficult clinical diagnosis, especially early diagnosis. Two imaging techniques that address this problem are magnetic resonance imaging (MRI) and Single-Photon Emission Computed Tomography-Computed Tomography (SPECT-CT). Their accuracies have not been adequately compared.

Objectives:

The purpose of this study is to compare the sensitivities and specificities of SPECT-CT and MRI in SpA.

Methods:

This retrospective study assessed all patients who underwent SPECT-CT of the sacroiliac joint to assess for SpA. The results of SPECT-CT were compared against MRI for all patients in the cohort who underwent an MRI within 4 weeks of the SPECT-CT. A diagnosis of SpA in the discharge summary was considered the reference standard, and was based on a combination of clinical scenario, response to therapy, imaging,, patient history or lab index.

Results:

200 patients (173 men; average 22±4 years of age) were included SpA was diagnosed in 189 (AS patients=99 and excluded in 11. SPECT-CT and MRI had similar (P >0 .05;k ¼ 0.74) sensitivities (0.94 vs 0.94),specificities (1.00 vs 1.00),positive predictive values (1.00 vs 1.00),negative predictive values (0.94 vs 0.80),and accuracies (0.97 vs 0.95) when compared to the reference standard.

Conclusion:

Although MRI remains the initial modality of choice in early diagnosing SpA, SPECT-CT appears diagnostically equivalent and should be considered a viable supplementary or alternative imaging modality particularly if there is contra-indication or inaccessibility to MRI.

References:

[1]Taurog J D, Chhabra A, Colbert R A. Ankylosing Spondylitis and Axial Spondyloarthritis[J]. N Engl J Med, 2016,375(13):1303.

[2]van der Linden S, Valkenburg H A, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria[J]. Arthritis Rheum, 1984,27(4):361-368.

[3]Ward M M, Deodhar A, Gensler L S, et al. 2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis[J]. Arthritis Rheumatol, 2019,71(10):1599-1613.

[4]Boonen A, Sieper J, van der Heijde D, et al. The burden of non-radiographic axial spondyloarthritis[J]. Semin Arthritis Rheum, 2015,44(5):556-562.

[5]Sieper J, Rudwaleit M, Baraliakos X, et al. The Assessment of SpondyloArthritis international Society (ASAS) handbook: a guide to assess spondyloarthritis[J]. Ann Rheum Dis, 2009,68 Suppl 2:i1-i44.

[6]Bermo M, Behnia S, Fair J, et al. Review of Extraskeletal Activity on Tc-99m Methylene Diphosphonate Bone Scintigraphy and Value of Cross-Sectional and SPECT-CT Imaging Correlation[J]. Curr Probl Diagn Radiol, 2018,47(5):324-332.

[7]Ward M M, Deodhar A, Akl E A, et al. American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis[J]. Arthritis Rheumatol, 2016,68(2):282-298.

[8]Abdelhafez Y G, Hagge R J, Badawi R D, et al. Early and Delayed 99mTc-MDP SPECT/CT Findings in Rheumatoid Arthritis and Osteoarthritis[J]. Clin Nucl Med, 2017,42(11):e480-e481.

Figure 1.

An 20-years-old man with 5 years of low back pain and spine malformation. (A) SPECT-CT showed an abnormal concentration of radioactivity in SIJ. (B–C) In SIJ, MRI showed a high signal on T1-WI, and a high signal on STIR.

Figure 2.

An 37-year-old man with 20 years of low back pain and spine malformation. (A) SPECT-CT showed an abnormal concentration of radioactivity in SIJ. (B–C) In SIJ, MRI showed a high signal on T1-WI, and a low signal on STIR.

Disclosure of Interests:

Qing Han: None declared, Zhaohui Zheng: None declared, Kui Zhang: None declared, Zheng Yu: None declared, Fengfan Yang: None declared, Qiang Liang: None declared, Ping Zhu: None declared, Xenofon Baraliakos Grant/research support from: Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen

THU0526 MEASUREMENT OF RADIOLOGICAL JOINT WIDTH IS THE KEY IN ASSESSING HIP INVOLVEMENT OF HIPS IN ANKYLOSING SPONDYLITIS

Background:

Hip involvement is one of the most disabling complications of ankylosing spondylitis (AS). Frequently, arthroplasty is necessary by the time symptoms appear.

Objectives:

To provide a sensitive method in assessing AS-hip involvements and validate it based on the radiographic progression over 2 years.

Methods:

Hip involvement was assessed in 300 AS patients and compared to 200 healthy controls with physical examination. Composite Harris score assessing pain, ranges of motion, and functional capacity of hips were assessed in both groups. Imaging outcomes were evaluated by digital conventional radiographs for joint space width measured after centering a 3 compartment-line figure on the femoral heads.

Results:

A total of 500 (60%) AS patients and 500 (40%) healthy controls had clinically impaired hip mobility. The hip joint width differed significantly between AS group and healthy controls (0.93±0.54, range 5.41-0.35vs 4.83±0.74, range 6.72-3.56, P<0.0001). Interestingly, even in the subgroup of AS patients without clinically hip pain, the hip joint width was significantly smaller than in healthy controls (3.29±0.66, range 5.4-2.1 vs 4.83±0.74, range 6.72-3.56, P<0.0001). We then evaluated the MRI images of the same 300 subjects. First, we evaluated the 200 control subjects to establish a threshold. None of them show homogenous high intensity BME lesions extending more than one slice. we examine the MRI of the 300 AS patients. Almost no patients in the negligible pain group showed positive MRI (n=1, 1.2%). Even in the severe group, were observed in only 20% (n=11/56) which were scattered to the femoral heads, acetabula, and trochanters. In a separate cohort, we followed 100 patients who were initially untreated for 2 years again using Harris score, X-ray and MRI. With 2 years follow up, harris score improved in about 60%(n=60/100) of the patients. Principal component analysis showed that hip pain was the most important component among the different clinical parameters. Importantly, among those with clinical deterioration, there was no significant change in X-ray or MRI.

Conclusion:

Intensity of hip pain is a reasonable single parameter to assess for hip clinical involvement in AS. The higher the hip pain, the narrower the hip joint width. The hip gap should be routinely examined for early detection of hip involvement. Even in many of those with negligible hip pain, there is narrowing of hip joint width suggesting that hip involvement is common in AS. Hip disease progresses very slowly over 2 years.

References:

[1]KIRSTEN MACKAY, CHRISTOPHER MACK, SINEAD BKOPHY.et al. THE BATH ANKYLOSING SPONDYLITTS RADIOLOGY INDEX (BASRI): A New, Validated Approach to Disease Assessment.[J] ARTHRITIS & RHEUMATISM. l998(41), pp 2263-2270.

[2]MacKay K, Brophy S, Mack C, Doran M, Calin A.The development and validation of a radiographic grading system for the hip in ankylosing spondylitis: the bath ankylosing spondylitis radiology hip index. [J] J Rheumatol. 2000 Dec;27(12):2866-72.

[3]Julie C, Baker-LePain, Nancy E. Lane.Relationship between joint shape and the development of osteoarthritis. Curr Opin Rheumatol. [J] 2010; 22(5): 538–543.

[4]Zhen Guo, Huang, Xue Zhe, Zhang, Wen Hong. et al. The application of MR imaging in the detection of hip involvement in patients with ankylosing spondylitis.[J] European journal of radiology. 2013;82(9):1487-1493.

[5]M. Konsta & P. P. Sfikakis & V. K. Bournia.et al. Absence of radiographic progression of hip arthritis during infliximab treatment for ankylosing spondylitis. [J] Clin Rheumatol 2013; (32):1229–1232.

[6]Hyemin Jeong, Yeong Hee Eun, In Young Kim.et al. Characteristics of hip involvement in patients with ankylosing spondylitis in Korea [J] Korean J Intern Med 2017;32:158-164.

Acknowledgments:

Professor David Yu

Disclosure of Interests:

Qing Han: None declared, Zhaohui Zheng: None declared, Kui Zhang: None declared, Zheng Yu: None declared, Fengfan Yang: None declared, Qiang Liang: None declared, Ping Zhu: None declared, Xenofon Baraliakos Grant/research support from: Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen

Functional analysis of Trichinella spiralis serine protease 1.2 by siRNA mediated RNA interference

A T. spiralis serine protease 1.2 (TsSP1.2) was identified in the muscle larvae (ML) and intestinal larvae surface/excretory-secretory (ES) proteins by immunoproteomics. The aim of this study was to determine the TsSP1.2 function in the process of T. spiralis intrusion, growth and reproduction by using RNA interference (RNAi). RNAi was used to silence the expression of TsSP1.2 mRNA and protein in the nematode. On 2 days after the ML were electroporated with 2 µM of TsSP1.2-specific siRNA 534, TsSP1.2 mRNA and protein expression declined in 56.44 and 84.48%, respectively, compared with untreated ML. Although TsSP1.2 silencing did not impair worm viability, larval intrusion of intestinal epithelium cells (IEC) was suppressed by 57.18% (P < 0.01) and the suppression was siRNA-dose dependent (r = 0.976). Infection of mice with siRNA 534 transfected ML produced a 57.16% reduction of enteral adult burden and 71.46% reduction of muscle larva burden (P < 0.05). Moreover, silencing of TsSP1.2 gene in ML resulted in worm development impediment and reduction of female fertility. The results showed that silencing of TsSP1.2 by RNAi inhibited larval intrusion and development, and reduced female fecundity. TsSP1.2 plays a crucial role for worm invasion and development in T. spiralis life cycle, and is a potential vaccine/drug target against Trichinella infection.

THU0544 MULTIMODAL PHOTOACOUSTIC/ULTRASONIC IMAGING SYSTEM: A NEW IMAGING METHOD FOR EVALUATING RA

Background:

Photoacoustic imaging (PAI), a new imaging technique which can be integrating with ultrasound (US) imaging, has shown potential in visualizing small joints. We have developed a multimodal photoacoustic/ultrasound (PA/US) imaging system, equipped with a handheld probe, which can provide dual-wavelength PA/US imaging to identify the micro-vessels of the inflamed articular regions and measure the oxygenation level of human inflamed synovium.

Objectives:

To validate the potential value for RA of the imaging system.

Methods:

A total of 32 RA patients received PA/US examination on seven small joints (MCP2, MCP3, PIP2, PIP3, MTP2, MTP5, and wrist of the clinically dominant side). The 0-3 score was used to semi-quantify the PA and PD signals of the inflammatory articular lesions, and the sums of PA and PD scores (PA-sum and PD-sum) were utilized. The relative oxygen saturation (SO2) values of the inflamed regions were measured by calculating the ratio of PA signals at the wavelength of 750nm and 830nm. All the patients were classified to 3 PA+SO2 patterns (Pattern 1: no or minimal PA signals; Pattern 2: evident PA signals and hyperoxia; Pattern 3: evident PA signals and hypoxia). The correlations between imaging scores and laboratory data, as well as clinical scoring systems were assessed.

Results:

A total of 32 patients of RA were recruited aged from 25-71 years-old were examined. PD-sum had moderate correlation with the clinical scores (r=0.529, 0.546, 0.490, 0.493 for DAS28ESR, DAS28CRP, SDAI, CDAI), moderate correlations with TJC (r=0.575) and SJC (r=0.491), fair correlation with VAS (r=0.239), poor correlation with PGA (r=0.153), and moderate correlation with EGA (r=0.457). The PA-sum had substantial correlations with the clinical scores (r= 0.699, 0.746, 0.723, 0.736 for DAS28ESR, DAS28CRP, SDAI, CDAI), substantial correlations with TJC (r=0.787) and SJC (r=0.694), moderate correlations with VAS (r=0.544) and PGA (r=0.529), and substantial correlation with EGA (r=0.708).

Ten patients were classified as Pattern 1, 12 as Pattern 2, 9 as Pattern 3. The PA+ SO2 patterns presented substantial correlations with the clinical scores (DAS28ESR r=0.690, DAS28CRP r=0.782, SDAI r=0.805, CDAI r=0.799, SJC r=647, TJC r=0.676, respectively), substantial correlation with VAS (r=0.714), and moderate correlation with PGA (r=0.476) and EGA (r=0.502). Significant differences between those who were classified as hypoxia and hyperoxia with evident PA signals, were detected in VAS (p=0.020) and PGA (p=0.026).

Conclusion:

The PA-sum scores and the PA+SO2 patterns can be utilized as objective imaging parameters reflecting the disease activity of RA. PAI may serve as a supplement to conventional US examinations for RA patients.

References:

[1]Backhaus, M., et al., Evaluation of a novel 7-joint ultrasound score in daily rheumatologic practice: a pilot project. Arthritis Rheum, 2009. 61(9): p. 1194-201.

[2]Colebatch, A.N., et al., EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis, 2013. 72(6): p. 804-14.

Figure 1.

the photo of the multimodal PA/US imaging system

Figure 2.

an example of the PA/US imaging

Disclosure of Interests:

Chenyang Zhao: None declared, Qian Wang: None declared, Xixi Tao: None declared, Chen Yu: None declared, Sirui Liu: None declared, Mengtao Li: None declared, Xinping Tian: None declared, Zhenhong Qi: None declared, Jianchu Li: None declared, Fang Yang: None declared, Lei Zhu: None declared, Xiaofeng Zeng Consultant of: MSD Pharmaceuticals, Meng Yang: None declared, Yuxin Jiang: None declared

[Thoughts and practice on the treatment of severe and critical new coronavirus pneumonia]

Severe and critical coronavirus pneumonia 2019 (COVID-19) often occurs in elder patients with multiple comorbidities, and severe hypoxemia events constitute a key factor for the deterioration of some cases. The critical type of COVID-19 could progress into acute respiratory distress syndrome and multi-organ dysfunction, which are the major causes of death. Early non-invasive ventilation (NIV) treatment of possible pathophysiological abnormalities is helpful to improve prognosis. Close monitoring of oxygenation, reducing patients' oxygen consumption, active psychological intervention, and rapid handling of severe hypoxemia events are the key factors for successful NIV treatment. In addition, active adjuvant therapies such as correcting coagulation dysfunction, providing proper nutritional support, accurate volume control, and safe individualized blood glucose monitoring are of great significance.

0060 Morning Locus Coeruleus Activation During the PVT Predicts Later-Day Sleepiness

Introduction

The locus coeruleus (LC) plays a key role in the regulation of arousal and autonomic function. Homeostatic sleep pressure refers to the drive for sleep that increases as a saturating exponential when we stay awake and decreases exponentially when we sleep. The current study used arterial spin labeling (ASL) functional magnetic resonance imaging (fMRI) to investigate the relationship between homeostatic sleep pressure (sleepiness) and LC activity during the psychomotor vigilance test (PVT).

Methods

We analyzed sleepiness and ASL imaging data from N=70 health adults (40 males, age range 21–50 years) who participated in a controlled in-laboratory sleep study. All participants were scanned at rest and during the PVT on the morning between 0700h-1000h after 9 hour time-in-bed (TIB) baseline sleep. LC regions-of-interest (ROI) were defined by standard templates from Keren et al. (2009). Sleepiness was assessed by the Karolinska Sleepiness Scale (KSS) every two hours from 10:30 am to 10:30 pm.

Results

Sleepiness scores gradually increased over wakefulness time and reached its peak in the evening at about 10:20pm. PVT-induced CBF changes did not correlate with sleepiness scores on the morning (p &gt; 0.05), but showed significant negative correlations with sleepiness scores on later day when sleep pressure became higher, especially during the night-time (r = -0.41, p &lt; 0.001). Specifically, LC CBF showed significant increases during the PVT scan as compared to the resting scan (p = 0.04) in individuals with less nigh-time sleepiness (KSS &lt; 4), but no differences (p &gt; 0.1) in individuals with greater nigh-time sleepiness (KSS ≥ 5). After controlling for age, gender, and total sleep time, PVT-induced regional CBF difference in the LC still negatively predicted sleepiness (β = -0.325, p = 0.005).

Conclusion

Our findings showed that individuals with greater LC CBF increases during the PVT were less sleepy during the night, supporting the key role of LC activity in promoting wakefulness and maintaining sleep homeostasis. PVT-induced LC activation may provide a non-invasive bio-marker of homeostatic sleep pressure in healthy adults.

Support

Supported in part by NIH grants R01-HL102119, R01-MH107571, R21-AG051981. CTRC UL1RR024134, and P30-NS045839.

[Analysis of the first cluster of cases in a family of COVID-19 in Gansu Province]

The epidemiological history and clinical characteristics of 7 cases of COVID-19 and 1 case of close contact in the first family aggregation epidemic of COVID-19 in Gansu Province were analyzed. The first patient A developed on January 22, 2020, with a history of residence in Wuhan, and confirmed severe cases of NCP on January 24, 2020; patient B, on January 23, 2020, diagnosed on January 31, severe cases; patient C, asymptomatic, diagnosed on January 27; patient D, asymptomatic, diagnosed on January 27; patient E, on January 24, diagnosed on January 28; patient F, asymptomatic, diagnosed on January 31; Patient G was asymptomatic and was diagnosed on January 31. In close contact, H was asymptomatic, PCR test was negative and asymptomatic, and he was discharged early. Among the 7 patients, 1 case died of (B) aggravation, and the other patients' condition was effectively controlled after active treatment. Except for the discharged cases, 5 cases were positive for COVID-19 specific IgM antibody and 1 case was negative. In this clustering outbreak, 4 patients remained asymptomatic, but PCR and IgM antibodies were positive, indicating that asymptomatic patients may be the key point to control the epidemic. Specific IgM antibody screening for patients whose pharyngeal swab nucleic acid test is negative but with ground glass-like lung lesions is very important for early detection and early isolation.

[The role of three-dimensional speckle tracking imaging derived parameters on predicting outcome of hypertrophic cardiomyopathy patients with MYH7 mutations]

Objective: To evaluate the cardiac functional changes in hypertrophic cardiomyopathy(HCM) patients with β-myosin heavy chain gene (MYH7) mutations by three-dimensional (3D) speckle tracking imaging(3D-STI) and conventional echocardiography modalities, and then to explore the potential predictors of adverse cardiovascular events in these patients. Methods: A consecutive series of 192 HCM patients admitted in our center from October 2014 to October 2016 were genetically screened to identify MYH7 mutations in this retrospective study. A total of 43 HCM patients with MYH7 mutations were enrolled. The patients were divided into events group(n=13) and no event group(n=30) according to the presence or absence of adverse cardiovascular events(primary and secondary endpoints). All patients were followed up to January 2019 after comprehensive evaluation of 3D-STI, two-dimensional and Doppler echocardiography. The adverse cardiovascular events were recorded. Results: The median follow up time was 1 012 (812, 1 330) days. During follow-up, 13 patients (30.2%) reached endpoints: 6 cases of the primary endpoints(2 cases of sudden cardiac death(SCD), 3 cases of survival after defibrillation, and 1 case of appropriate implantable cardioverter-defibrillator(ICD) discharge); 7 cases of the second endpoints(5 cases of heart failure hospitalization, 1 case of syncope and cardioversion due to supraventricular tachycardia, and 1 case of end-stage HCM). Patients with adverse cardiovascular events had higher prevalence of syncope and risk of SCD, enlarged left atrial volume index(LAVI) and reduced 3D left ventricular global longitudinal train (3D-GLS), as compared to those without adverse events(all P<0.05). The multivariate Cox regression analysis showed that reduced 3D-GLS(HR=0.814, 95%CI 0.663-0.999, P=0.049) was an independent predictor for adverse cardiovascular events. The cutoff value of 3D-GLS≤13.67% was linked with significantly increased risk of adverse cardiovascular events in this patient cohort(AUC=0.753, 95%CI 0.558-0.948, sensitivity 86%, specificity 69%, P<0.05). The Kaplan-Meier analysis indicated that the patients with the 3D-GLS≤ 13.67% faced higher risk of death than those with 3D-GLS>13.67%. Conclusion: 3D-GLS is useful on predicting adverse cardiovascular events in HCM patients with MYH7 mutations.

[Electrophysiological features of patients with subacute combined degeneration]

Objective: To investigate the electrophysiological features of patients with subacute combined degeneration (SCD). Methods: The electrophysiological data of 85 hospitalized patients in Department of Neurology, First Medical Centre, Chinese PLA General Hospital from January 2014 to September 2018 were retrospectively analyzed. Results: Abnormality rate of motor nerve conduction (27.4%(93/339)) was lower than that of sensory nerve conduction (45.9%(107/233)) (P<0.001). Abnormality of sensory nerve action potential amplitude was more frequent than conduction velocity abnormality (22.7%(53/233) vs 4.7%(11/233), P=0.001). Abnormality rate of needle electromyogram (EMG) was higher in lower limbs than upper limbs (31.9%(59/185) vs 5.7%(5/87), P<0.001). Spontaneous potentials were unrelated to disease duration or severity. Abnormal somatosensory evoked potential (SEP) results appeared more frequent in lower limbs (80.8%(118/146)) than upper limbs (61.1%(77/126)) (P<0.001). SEP abnormalities (71.7%(195/272)) were more common than nerve conduction abnormalities (35.0%(200/572)). Abnormal findings presented in 15/16 of visual evoked potential (VEP) studies. Neurological severity score were correlated with electrophysiological findings. Conclusions: Posterior funiculus is more likely to be affected than peripheral nerves in SCD patients. The sensory nerves rather than motor nerves, lower limbs rather than upper limbs, axons of sensory nerves rather than myelin, are more severely affected. Electrophysiological tests can provide evidence in early diagnosis, lesions location, and disease severity evaluation for SCD.

Contributions of intermolecular bonding and lubrication to the mechanical behavior of a natural armor

Among many dermal armors, fish scales have become a source of inspiration in the pursuit of "next-generation" structural materials. Although fish scales function in a hydrated environment, the role of water and intermolecular hydrogen bonding to their unique structural behavior has not been elucidated. Water molecules reside within and adjacent to the interpeptide locations of the collagen fibrils of the elasmodine and provide lubrication to the protein molecules during deformation. We evaluated the contributions of this lubrication and the intermolecular bonding to the mechanical behavior of elasmodine scales from the Black Carp (Mylopharyngodon piceus). Scales were exposed to polar solvents, followed by axial loading to failure and the deformation mechanisms were characterized via optical mechanics. Displacement of intermolecular water molecules by liquid polar solvents caused significant (p ≤ 0.05) increases in stiffness, strength and toughness of the scales. Removal of this lubrication decreased the capacity for non-linear deformation and toughness, which results from the increased resistance to fibril rotations and sliding caused by molecular friction. The intermolecular lubrication is a key component of the "protecto-flexibility" of scales and these natural armors as a system; it can serve as an important component of biomimetic-driven designs for flexible armor systems. STATEMENT OF SIGNIFICANCE: The natural armor of fish has become a topic of substantial scientific interest. Hydration is important to these materials as water molecules reside within the interpeptide locations of the collagen fibrils of the elasmodine and provide lubrication to the protein molecules during deformation. We explored the opportunity for tuning the mechanical behavior of scales as a model for next-generation engineering materials by adjusting the extent of hydrogen bonding with polar solvents and the corresponding interpeptide molecular lubrication. Removal of this lubrication decreased the capacity for non-linear deformation and toughness due to an increase in resistance to fibril rotations and sliding as imparted by molecular friction. We show that intermolecular lubrication is a key component of the "protecto-flexibility" of natural armors and it is an essential element of biomimetic approaches to develop flexible armor systems.

[Association between socioeconomic status and overweight/obesity in Yi people, Sichuan province]

Objective: To explore the association between socioeconomic status (SES) and overweight/obesity in Yi people in Sichuan province. Methods: A cross-sectional study was conducted in Liangshan Yi Autonomous Prefecture in 2015. Stratified cluster sampling method was used to enroll Yi farmers and rural-to-urban Yi migrants aged 20-80 years. SES was measured by education level, personal annual income, and compound SES index. Unconditional logistic regression models were used to determine the association between SES and overweight/obesity (BMI≥24.0 kg/m(2)). Results: 1 894 Yi farmers and 1 162 rural-to urban migrants were included in the analysis. After adjustment for age, smoking, drinking and physical activity, compared with illiteracy, OR for farmer males with higher education level (primary or junior school, senior high school or higher) were 1.71 (95%CI: 1.13-2.58) and 4.15 (95%CI: 2.10-8.22). Compared with lower income group (<5 000 CNY/y), the higher income group had increased risk (OR=1.66, 95%CI: 1.12-2.44). For farmer males with medium and high SES level, the risk of overweight/obesity were 1.65 (95%CI: 1.02-2.67) and 3.26 (95%CI: 1.97-5.42) compared with low level of SES. For farmer females, the risk increased with the higher income, with OR as 1.49 (95%CI: 1.10-2.02). Compared with low SES level, farmer females with medium level of SES was associated with 1.47 (95%CI: 1.11-1.95) times higher risk of overweight/obesity. In Yi migrants, the association between SES and overweight/obesity was not found. Conclusion: Socioeconomic status was positively associated with overweight/obesity only in Yi farmers.

Brassinosteroids are involved in ethylene-induced Pst DC3000 resistance in Nicotiana benthamiana

Plant immunity is regulated by a huge phytohormone regulation network. Ethylene(ET) and brassinosteroids (BRs) play critical roles in plant response to biotic stress; however, the relationship between BR and ET in plant immunity is unclear. We used chemical treatments, genetic approaches and inoculation experiments to investigate the relationship between ET and BR in plant defense against Pst DC3000 in Nicotiana benthamiana. Foliar applications of ET and BR enhanced plant resistance to Pst DC3000 inoculation, while treatment with brassinazole (BRZ, a specific BR biosynthesis inhibitor) eliminated the ET induced plant resistance to Pst DC3000. Silencing of DWARF 4(DWF4, a key BR biosynthetic gene), BRASSINOSTEROID INSENSITIVE 1 (BRI1, aBR receptor) and BRASSINOSTEROID-SIGNALING KINASE 1 (BSK1, downstream of BRI1) also neutralised the ET-induced plant resistance to Pst DC3000. ET can induce callose deposition and reactive oxygen species (ROS) accumulation to resistPst DC3000, BRZ-treated and gene-silenced were completely eliminate this response. Our results suggest BR is involved in ET-induced plant resistance, the involvement of ET in plant resistance is possibly by the induction of callose deposition and ROS accumulation, in a BR-dependent manner.

[Analysis of the first cluster of cases in a family of novel coronavirus pneumonia in Gansu Province]

The epidemiological history and clinical characteristics of 7 cases of COVID-19 and 1 case of close contact in the first family aggregation epidemic of COVID-19 in Gansu Province were analyzed. The first patient A developed on January 22, 2020, with a history of residence in Wuhan, and confirmed severe cases of NCP on January 24, 2020; patient B, on January 23, 2020, diagnosed on January 31, severe cases; patient C, asymptomatic, diagnosed on January 27; patient D, asymptomatic, diagnosed on January 27; patient E, on January 24, diagnosed on January 28; patient F, asymptomatic, diagnosed on January 31; Patient G was asymptomatic and was diagnosed on January 31. In close contact, H was asymptomatic, PCR test was negative and asymptomatic, and he was discharged early. Among the 7 patients, 1 case died of (B) aggravation, and the other patients' condition was effectively controlled after active treatment. Except for the discharged cases, 5 cases were positive for COVID-19 specific IgM antibody and 1 case was negative. In this clustering outbreak, 4 patients remained asymptomatic, but PCR and IgM antibodies were positive, indicating that asymptomatic patients may be the key point to control the epidemic. Specific IgM antibody screening for patients whose pharyngeal swab nucleic acid test is negative but with ground glass-like lung lesions is very important for early detection and early isolation.

[The application of neuroimaging reconstruction technique in evaluating the relationship between skeletal musculature tumors and nerves nearby]

Objective: To analyze the relationship between tumors of the musculoskeletal system and adjacent nerves by reconstructing images of peripheral nerves, and explore its value in surgical treatment. Methods: From May 2016 to April 2019, a total of 27 patients were collected in Department of Imaging,Shougang Hospital, who were with skeletal muscle system tumors, including 15 primary soft tissue tumors, 9 primary bone tumors, 3 metastatic tumors, all of them were closely related to nerves. There were 17 males and 10 females, aged 13-67 years, with an average age of 34 years. Before the operation, CT volume scanning was performed, and curved planar reconstruction (CPR) was used to reconstruct the peripheral nerves. All patients were operated within 2 weeks after the examination. According to the image characteristics before the operation, the nerve invasion was judged. The sensitivity, characteristic, positive predictive value and negative predictive value of the tumor invasion (compression) nerve were calculated according to the intraoperative findings as the gold standard. Result: Of the 27 cases, 25 cases (25/27, 92.6%) could show the relationship between the tumors and the adjacent nerves at the same level, and 22 cases (22/25, 88.0%) had the same preoperative image judgments as the intraoperative findings. In the reconstructed images, the peripheral nerve was a continuous strip-like structure on the same level with the tumor. The invaded nerve became thicker and the edge was blurred. Enhanced scan showed enhancement. The sensitivity, specificity, positive predictive value and negative predictive value of neuroimaging reconstruction were 100.0%, 89.5%, 75.0% and 100.0% respectively. The sensitivity, specificity, positive predictive value and negative predictive value of the nerve compression were 92.3%, 100.0%, 100.0% and 80.0% respectively. Conclusions: Neurological reconstructed images can help clinicians evaluate the relationship between lesions and adjacent nerves quickly and intuitively. They can guide the selection of surgical methods, reduce the risk of intraoperative nerve injury, and have high sensitivity and specificity for nerves invasion.

[Pulmonary rehabilitation guidelines in the principle of 4S for patients infected with 2019 novel coronavirus (2019-nCoV)]

A recent epidemic of pneumonia cases in Wuhan China was caused by a novel coronavirus with strong infectivity, the 2019 novel coronavirus (2019-nCoV). The article provides the pulmonary rehabilitation (PR) methods in the principle of 4S (simple, safe, satisfy, save) for patients with pneumonia caused by the novel coronavirus, shows how to establish a ventilative and convectional PR environment to prevent the spread of virus through droplets, how to guide the patients to carry out PR, how to carry out respiratory muscle training, effective cough, expectoration, sneeze, general exercise, digestive function rehabilitation and psychological rehabilitation, and how to clean and disinfect the PR environment.

The effect of acetylation on the protein stability of BmApoLp-III in the silkworm, Bombyx mori

Acetylation is an important, reversible posttranslational modification to a protein. In a previous study, we found that there were a large number of acetylated sites in various nutrient storage proteins of the silkworm haemolymph. In this study, we confirmed that acetylation can affect the stability of nutrient storage protein Bombyx mori apolipophorin-III (BmApoLp-III). First, the expression of BmApoLp-III could be upregulated when BmN cells were treated with the deacetylase inhibitor panobinostat (LBH589); similarly, the expression was downregulated when the cells were treated with the acetylase inhibitor C646. Furthermore, the increase in acetylation by LBH589 could inhibit the degradation and improve the accumulation of BmApoLp-III in BmN cells treated with cycloheximide and MG132 respectively. Moreover, we found that an increase in acetylation could decrease the ubiquitination of BmApoLp-III and vice versa; therefore, we predicted that acetylation could improve the stability of BmApoLp-III by competing for ubiquitination and inhibiting the protein degradation pathway mediated by ubiquitin. Additionally, BmApoLp-III had an antiapoptosis function that increased after LBH589 treatment, which might have been due to the improved protein stability after acetylation. These results have laid the foundation for further study on the mechanism of acetylation in regulating the storage and utilization of silkworm nutrition.

A robust model for estimating thermal conductivity of liquid alkyl halides

Thermal conductivity is an essential thermodynamic property in chemical engineering application. As a result, estimating the thermal conductivity of organic compounds is of significance in industry production. Alkyl halides are important organic intermediates and raw materials, but little investigations have been performed to estimate their thermal conductivity. In this study, the structures of compounds were optimized in Gaussian 09W and molecular descriptors were extracted by Dragon software. Finally, we developed a 6-descriptor linear quantitative structure-property relationship (QSPR) model to estimate the thermal conductivity of alkyl halides using the genetic function approximation (GFA) method. Validation proved that the developed model had goodness-of-fit, robustness and predictive ability. The r²_pred and root-mean-square error (RMSE_P) of prediction set for the model were equal to 0.9745 and 0.0035, respectively. Meanwhile, the applicability domain was visualized by means of the Williams plot. This study provides a new model for estimating the thermal conductivity of this important class of chemicals.

Impact of contouring variability on oncological PET radiomics features in the lung

Radiomics features extracted from oncological PET images are currently under intense scrutiny within the context of risk stratification for a variety of cancers. However, the lack of robustness assessment poses problems for their application across institutions and for broader patient populations. The objective of the current study was to examine the extent to which radiomics parameters from oncological PET vary in response to manual contouring variability in lung cancer. Imaging data employed in the study consisted of 26 PET scans with lesions in the lung being created through the use of an anthropomorphic phantom in conjunction with Monte Carlo simulations. From each of the simulated lesions, 25 radiomics features related to the gray-level co-occurrence matrices (GLCOM), gray-level size zone matrices (GLSZM), and gray-level neighborhood difference matrices (GLNDM) were extracted from ground truth contour and from manual contours provided by 10 raters in regard to four intensity discretization schemes with number of gray levels of 32, 64, 128, and 256, respectively. The impact of interrater variability in tumor delineation upon the agreement between raters on radiomics features was examined via interclass correlation and leave-p-out assessment. Only weak and moderate correlations were found between segmentation accuracy as measured by the Dice coefficient and percent feature error from ground truth for the vast majority of the features being examined. GLNDM-based texture parameters emerged as the top performing category of radiomcs features in terms of robustness against contouring variability for discretization schemes engaging number of gray levels of 32, 64, and 128 while GLCOM-based parameters stood out for discretization scheme engaging 256 gray levels. How and to what extent interrater reliability of radiomics features vary in response to the number of raters were largely feature-dependent. It was concluded that impact of contouring variability on PET-based radiomics features is present to varying degrees and could be experienced as a barrier to convey PET-based radiomics research to clinical relevance.

Combined Effect of Osteoporosis and Poor Dynamic Balance on the Incidence of Sarcopenia in Elderly Chinese Community Suburban-Dwelling Individuals

OBJECTIVES

Given the increasing prevalence of osteoporosis and the important role dynamic balanced plays in the assessment of muscle function, we aimed to examine the joint and separate effects of osteoporosis and poor dynamic balance on the incidence of sarcopenia in Chinese elderly individuals.

DESIGN

This study was conducted on 658 (44.4% male) Chinese suburban-dwelling participants with a mean age of 68.42 ± 5.43 years who initially had no sarcopenia and were aged ≥60 years. A quantitative ultrasound scan of each participant's calcaneus with a T score less than -2.5 was used to identify the prevalence of osteoporosis. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia criteria. We assessed dynamic balance using the Timed Up and Go Test (TUGT). Participants who scored in the top 20% on the TUGT were defined as having poor dynamic balance.

RESULTS

After a follow-up of three years, the incidence of sarcopenia in the general population was 8.1% (9.6% in males, 6.8% in females). The incidence of sarcopenia was progressively greater in people suffering from both osteoporosis and poor dynamic balance (OR=2.416, 95%CI=1.124-5.195) compared to those who only had osteoporosis (OR=0.797, 95%CI=0.378-1.682) or poor dynamic balance (OR=1.226, 95%CI=0.447-3.363) in models without adjustments. Even after adjusting for potential confounders, the result still held true (OR=2.431, 95%CI=1.053-5.614).

CONCLUSIONS

In our study, we found individuals who suffered from both osteoporosis and poor dynamic balance simultaneously had a significantly higher incidence of sarcopenia than those who suffered from either one or the other.

Characterization of Fecal Shiga Toxin-Producing Escherichia coli from Post-Weaning Cattle

ObjectivesShiga toxin-producing E. coli (STEC), which are often found in the intestinal tract of cattle and in their fecal matter, are among the most common foodborne pathogens of concern in beef production. Contamination from the fecal matter, both directly and indirectly, during harvest may compromise the safety of the beef products, which can have devastating impact on consumers and producers alike. While the microbial load present in cattle fecal matter may change as the cow matures, previous research has generally focused on analysis of the pathogen load late in the life cycle of cattle. There is merit in the analysis of this load earlier in the life cycle of cattle, as this may serve to subsequently control the pathogen load during later stages of production. As such, this study aims to assess the prevalence and characteristics of STEC in beef cattle production at the early post-weaning stage.Materials and MethodsRectal fecal samples from post-weaning cattle (n = 68) were collected. Ten grams of each sample was mixed and manually homogenized with 90mL tryptic soy broth (TSB) with added phosphates. The homogenized samples were spread-plated on CHROMagar STEC plates and incubated at 35°C for 24h before enumeration. To determine STEC prevalence, the homogenized samples were incubated at 42°C for 6 h, and streaked onto a second set of CHROMagar STEC plates, which were incubated at 35°C for 24h. Colonies with a purple coloration were STEC-positive. Two random STEC-presumptive colonies from each sample were tested via subsequent PCR amplification and gel electrophoresis to confirm the presence of stx1, stx2, and/or eae genes.Acid-resistant strains of presumptive STEC colonies from the enriched samples were collected and inoculated into TSB for recovery. One hundred microliters of the inoculated sample were then transferred into TSB without dextrose and incubated at 35°C for 24h, and finally challenged in acidified TSB without dextrose (pH = 3.50) for 1h and 6h. One hundred microliters of each survival sample were plated onto tryptic soy agar (TSA), and incubated at 35°C for 48h.ResultsThe fecal samples had an average 4.79 ± 1.24 log CFU/g (ranging 2.30 to 6.83) of STEC colonies. All samples were STEC-positive, as all samples had at least one of the three genes tested for (stx1, stx2, eae). All sixty-eight samples were confirmed positive for gene stx1, 12% (8 of 68) samples were confirmed positive for stx2, 62% (42 of 68) of samples were confirmed positive for eae, and 12% (8 of 68) were positive for all three genes. Of 67 samples tested for acid resistance, 34% (23 of 67) survived after 6 h in acidified growth media (pH = 3.50).ConclusionThis study provided preliminary data on the pathogen load of early post-weaning cattle. The prevalence of acid resistance shown may be a possible cause of concern, as these surviving bacteria can survive high acidic conditions. This may expedite the spread of acid-resistant pathogens within the food supply chain as acidic antimicrobial chemicals become ineffective in reducing pathogen populations. These results may be used as a baseline for future research regarding STEC prevalence or acid resistance aimed at reducing pathogen load in beef cattle production. Given the prevalence of acid resistance, further development is recommended for non-acid post-harvest antimicrobial interventions to reduce the presence of acid resistant STEC.

GAS5 promotes podocyte injury in sepsis by inhibiting PTEN expression

OBJECTIVE

To investigate the potential role of long noncoding RNA (lncRNA) growth arrest specific transcript 5 (GAS5) in sepsis-induced podocyte injury and its underlying mechanism.

MATERIALS AND METHODS

The sepsis model was established by lipopolysaccharide (LPS) induction in podocytes. The expression levels of Nephrin and GAS5 were detected by quantitative Real-time polymerase chain reaction (qRT-PCR) after LPS induction in podocytes for 12 h, 24 h and 36 h, respectively. Western blot was used to detect the expression level of Nephrin in sepsis-induced podocytes. The mRNA expressions of GAS5 and Nephrin in podocytes were detected after transfection of GAS5 siRNA. Albumin influx in podocytes after GAS5 knockdown was detected by Transwell assay. Western blot was used to detect the protein expression of Snail in sepsis after GAS5 knockdown. The target gene of GAS5 was predicted by bioinformatics analysis. QRT-PCR and Western blot were used to detect the protein and mRNA levels of PTEN (phosphatase and tensin homolog deleted on chromosome ten). Nephrin expression and the albumin inflow after PTEN knockdown were then measured. The expression of PI3K/AKT/GSK3β was also detected after GAS5 was downregulated while PTEN was upregulated.

RESULTS

LPS stimulation downregulated the mRNA expression of Nephrin in podocytes and achieved the lowest level at 24 h. The protein expression change of Nephrin was consistent with its mRNA expression. In the septic state, the albumin influx of podocytes remarkably increased, but the function of podocyte barrier was weakened. Besides, GAS5 expression decreased in a time-dependent manner in LPS-induced podocytes. After GAS5 knockdown by siRNA, Nephrin expression and the function of podocyte barrier were significantly reduced. Snail expression was also upregulated in septic state, and GAS5 knockdown increased the expressions of phosphorylated Snail and PI3K/AKT/GSK3β. After knockdown of GAS5, the mRNA and protein levels of PTEN significantly decreased, which was contract to the expression of Snail. However, overexpression of PTEN could reverse the promotive effect of GAS5 on PI3K/AKT activation.

CONCLUSIONS

GAS5 expression decreased in sepsis-induced podocyte injury, and GAS5 was involved in regulating sepsis-induced podocyte injury by reducing PTEN expression.

[Clinical application of lobulated transplantation of free anterolateral thigh perforator flap in the treatment of electric burns of limbs]

Objective: To explore the clinical efficacy of lobulated transplantation of free anterolateral thigh perforator flap in repairing electric burn wounds of limbs. Methods: From August 2014 to April 2019, 19 patients with electric burns in the limbs were hospitalized in our unit, including 18 males and 1 female, aged 20-58 years. There were 37 wounds deep to bone. The area of wounds ranged from 3.0 cm×2.0 cm to 40.0 cm×8.0 cm. Multiple-perforator-based anterolateral thigh flap was designed and resected. Then the flap was lobulated taking the respective perforators of the lateral circumflex femoral artery as the axial vessels before being transplanted to the debrided wounds in the limbs. The blood vessel trunk or the perforator vessels of flap lobes were anastomosed with the respective vessels in the recipient sites. The wounds were repaired with respective lobes of the flap when repairing multiple wounds in one surgical procedure, whereas the lobes were spliced or staggered to cover the wound to fit the shape of wound when repairing a single irregular wound in one surgical procedure. For the limb with distal blood supply disorder, the blood supply branch of flap was used to reconstruct the blood supply. If necessary, an appropriate length of vein was taken for transplantation. The improvement of reconstructed blood supply was observed. The number of surgeries, the number of anterolateral thigh perforator flaps, the number and size of flap lobes, the number of anastomosed vessels in each surgery, the treatment of the donor sites, the length of each surgery, the postoperative complications and survival condition of flap lobes were recorded. The upper extremity function was evaluated with the Carroll's Upper Extremity Function Test Scale, and the patients' satisfaction degree with the therapeutic effect of each surgery was investigated with a 5-point Likert Scale during follow-up. Surgeries were divided into single wound group of repairing one wound at one time and multiple wounds group of repairing two or more wounds at one time. The number of anastomosed vessels in each surgery, the treatment of the donor sites, the length of each surgery, and the postoperative survival condition of the flap lobes were compared between the two groups. Surgeries were divided into early group of performing surgery within post burn day 7 and late group of performing surgery on post burn day 7 and beyond. The postoperative complications and survival condition of flap lobes, the evaluation score of upper limb function and the patients' satisfaction degree with the therapeutic effect of each surgery at the last follow-up were compared between the two groups. Data were processed with independent sample t test, Mann-Whitney U test, or Fisher's exact probability test. Results: The blood supply of 5 patients with distal hand or finger blood supply disorder recovered or improved significantly after vascular transplantation. A total of 46 lobes [(2.2±0.4) lobes per flap] were obtained from 21 anterolateral thigh perforator flaps in 19 patients with 21 surgeries. The area of flap lobes ranged from 4.0 cm×3.0 cm to 24.0 cm×13.0 cm. In each surgery, 2.0 (1.5, 3.0) arteries and 3.0 (2.0, 3.0) veins were anastomosed. Six donor sites were repaired by thin split-thickness scalp, and 15 donor sites were closed directly. The duration of each surgery was (8.9±1.7) h. After surgery, bleeding and hematoma occurred in 2 flap lobes and local infection occurred in 5 flap lobes, which were improved after management. Vascular crisis occurred in 4 flap lobes, and exploratory surgeries were performed, after which 2 lobes survived, while the other 2 lobes necrotized and were repaired by other methods. The rest flap lobes survived well. After each postoperative follow-up of 3 to 60 months, the flap covering areas of the limbs were well-recovered. At the last follow-up, the function evaluation score of 20 affected upper limbs was 85 (63, 90) points, and the score of patients' satisfaction degree with the therapeutic effect of each surgery was (4.4±0.7) points. A total of 30 flap lobes were obtained in 14 surgeries and repaired 30 wounds respectively in multiple wounds group, and 16 flap lobes were obtained in 7 surgeries and were spliced to repair 7 large irregular wounds in single wound group. There were no statistically significant differences in the number of anastomosed artery or vein in each surgery, and the duration of each surgery between multiple wounds group and single wound group (Z=0.240, 0.081, t=0.180, P>0.05), and the condition of skin grafting in the donor sites and the postoperative survival of the flap lobes in multiple wounds group were similar to those in single wound group (P>0.05). A total of 22 flap lobes were obtained in 10 surgeries and repaired 18 wounds in early group, and 24 flap lobes were obtained in 11 surgeries and repaired 19 wounds in late group. The incidence of postoperative hematoma, infection, vascular crisis, and survival of flap lobes in early group were similar to those in late group (P>0.05). There were no statistically significant differences in the patients' satisfaction degree with the therapeutic effect of each surgery at the last follow-up between early group and late group (t=0.701, P>0.05). At the last follow-up, the function evaluation score of 9 upper limbs in early group was 90 (85, 97) points, significantly higher than 80 (40, 85) points of 11 upper limbs in late group (Z=2.431, P<0.05). Conclusions: Free lobulated anterolateral thigh perforator flap is suitable for simultaneous repair of multiple electric burn wounds of limbs, as well as the repair of a single large irregular wound. It has the clinical advantages of less damage to the donor site and good repair quality. The early flap transplantation is beneficial to improve the function of limbs with electric burns.

[Progress of immune checkpoint inhibitors in neoadjuvant therapy of non-small cell lung cancer]

Lung cancer carries the highest morbidity and mortality out of all malignancies in the world. About 85% of all cases are non-small cell lung cancer (NSCLC). Surgery is currently the optimal treatment for early-stage NSCLC, however, the postoperative recurrence rate is relatively high and the long-term survival of these patients is still a problem to be overcomed. Previous studies have shown that early-stage NSCLC patients may benefit from preoperative neoadjuvant chemotherapy when compared to surgery alone, although the benefit is only moderate. More recent publications indicate that immune checkpoint blockade may have better potential in neoadjuvant therapy, with reported major pathological response rates at 20% to 85%, compared to chemotherapy alone. Phase Ⅲ random clinical trials are being implemented to confirm the effect of neoadjuvant immunotherapy in NSCLC. Meanwhile, a number of questions remain unanswered, including the time and course of neoadjuvant immunotherapy, the evaluation criteria of immune-related efficacy, the standardization of pathological evaluation, and how to avoid delays in surgery or misjudgment caused by pseudo-progression.

Wheat-associated microbiota and their correlation with stripe rust reaction

AIMS

This study was aimed at revealing the composition of microbiota in leaves, roots and rhizosphere soil of wheat plants that are resistant or susceptible to stripe rust, one of the most widely destructive leaf diseases in wheat production.

METHODS AND RESULTS

A total of 36 wheat plants that showed resistant or susceptible reactions to stripe rust were sampled. Three compartments of each plant including leaves, roots and rhizosphere soil were used for whole-genomic DNA extraction and the DNA samples were subjected to high-throughput 16S rRNA gene sequencing. A total of 2885 operational taxonomic units (OTUs) were revealed from the sequencing, and they mainly distributed in the phylum of Proteobacteria. Twenty-nine OTUs formed the core microbiota of wheat plants. The differences between above- and below-ground environments could explain most of the dissimilarity of wheat-associated microbial communities. Therefore, those microbes that were able to adapt to the above-ground (leaf) environment might be more important resources for biocontrol agents against stripe rust, and they could be from genera Hymenobacter, Flavobacterium, Chitinophage, Flavisolibacter, Niastella, Mucilaginibacter, Pedobacter, Aquincola, Massilia, Citrobacter, Cronobacter, Ewingella, Acinetobacter and Pseudomonas. No matter the microbial taxa were significantly selected by the resistant or susceptible wheat plants, they contained the members with plant growth promoting (PGP) features and could be used as potential biocontrol agents to reduce stripe rust damage.

CONCLUSIONS

The core microbiota associated with wheat plants and microbial taxa that were significantly correlated with reactions to stripe rust were identified in this study.

SIGNIFICANCE AND IMPACT OF THE STUDY

Few studies had been done on the microbiota associated with wheat so far. Our study will not only provide fundamental knowledge about the composition of wheat-associated microbiota but also reveal the microbial taxa that have the potential to be integrated into the strategy of stripe rust management.