Combined effect of glycemic and blood pressure control on diabetic retinopathy among Chinese with type-2 diabetes mellitus

BACKGROUND

To explore the associations of glycemic and blood pressure (BP) control with diabetic retinopathy (DR), with special focus on whether different combinations of categories of these two interventions are additive.

METHODS

A community-based survey including 913 patients with known type-2 diabetes mellitus (T2DM) was conducted in Suzhou, China. Retinal photographs were graded for the presence of DR using the Airlie House classification system. BP and blood hemoglobin A1c (HbA1C) levels were measured by standardized protocols. Binary logistic regression models were established to examine the associations of risk factors with DR.

RESULTS

The overall prevalence of any DR was 18.0% [95% confidence interval (95% CI) 15.5-20.6%] in this population. Stratified by conventional control thresholds, lower levels of either systolic blood pressure (SBP, < 140 mmHg) or HbA1C (< 7.0%) were not significantly associated with decreased susceptibility to DR, while patients simultaneously with lower HbA1C and SBP levels demonstrated 43% reduced likelihood of developing DR [adjusted odds ratio (OR) = 0.57, 95% CI 0.33-0.99, P = 0.045)], comparing with those with both higher levels of HbA1C (≥ 7.0%) and SBP (≥ 140 mmHg). Meanwhile, the group achieved intensive HbA1C (< 6.5%) and SBP (< 120 mmHg) control goals were found to have the smallest OR, but failed in yielding statistical significance (P = 0.10).

CONCLUSIONS

In this community-based DR screening study of Chinese adults with T2DM, combination but not individual of lower SBP (< 140 mmHg) and HbA1C (< 7.0%) levels, were suggested to be associated with a significantly reduced likelihood of having DR.

Prevalence and risk factors for myopia in older adult east Chinese population

BACKGROUND

To determine the prevalence and associated factors for myopia and high myopia among older population in a rural community in Eastern China.

METHODS

A community-based, cross-sectional survey was conducted in the Weitang town located in Suzhou, an urban metropolis in East China. A total of 5613 Chinese residents aged 60 years and older were invited to complete a questionnaire and participated in a detailed eye examination,including measurements of visual acuity and refractive error using autorefraction and subjective refraction. Myopia and high myopia was defined as SE < -0.5 diopters (D) and < -5.0 D, respectively.

RESULTS

Among the 5613 participating individuals, 4795 (85.4%) complete refraction data of phakic right eye was included for analysis. The age-adjusted prevalence was 21.1% (95% confidence interval [CI], 19.9-22.2) for myopia and 2.5% (95% CI, 2.1-2.9) for high myopia. The prevalence of myopia tended to increase significantly with age(p < 0.001),and women had a higher rate of myopia than men (p < 0.001). According to multivariate logistic regression analysis, adults who were older (odds ration[OR]:1.05; 95% CI:1.04-1.07), spent more time for sleeping at night (OR:1.12;95% CI: 1.06-1.18),or had cataract (OR:1.60;95% CI:1.36-1.88) and family history of myopia (OR:1.47;95% CI:1.23-1.77), are more susceptible to myopia (p < 0.001). People who had older age, family history, cataract and specially longer night-time sleep duration, would have a higher risk of myopia.

CONCLUSION

Myopia and high myopia among rural old adult population in Eastern China presents common. The current literature unanticipated suggests that there was a positive significant association between prevalence of myopia and night-time sleep duration among adult. Our data provide some evidence of this relationship and highlight the need for larger studies to further investigate this relationship longitudinally and explore mechanism therein.

Refractive error in Chinese with type 2 diabetes and its association with glycaemic control

BACKGROUND

The aim of this study was to determine the prevalence of refractive errors and their association with glycaemic control among adults with type 2 diabetes mellitus (T2DM) in eastern China.

METHODS

A community-based survey, including 913 adults with T2DM aged 30 to 89 years, was conducted. Refractive error was assessed by autorefraction, after which subjective refraction was performed. Ocular biometric parameters were measured by non-contact partial coherence laser interferometry. Myopia was defined as spherical equivalent (SE) less than -0.50 dioptres (D), high myopia as SE less than -5.00 D, hyperopia as SE greater than 0.50 D and astigmatism as cylinder less than -0.50 D.

RESULTS

After excluding participants who had undergone cataract surgery, 839 were included in the data analyses and 96.1 per cent were found to have refractive errors. The overall prevalences of myopia, high myopia, hyperopia and astigmatism were 28.2 per cent (95 per cent confidence interval [CI] 25.2-31.3), 6.3 per cent (95 per cent CI 4.7-8.0), 46.4 per cent (95 per cent CI 43.0-49.7) and 81.0 per cent (95 per cent CI 78.4-83.7) with no gender differences observed (all p > 0.10). In multivariate analysis, myopia was associated with decreasing age (odds ratio [OR] = 0.86, p = 0.01; per year increase), higher blood levels of haemoglobin A_1c (HbA_1c ) (OR = 1.12, p = 0.05; per unit increase), higher education levels (OR = 5.10, p < 0.001; university or college versus illiterate or primary school) and the presence of nuclear cataract (OR = 2.36, p < 0.001).

CONCLUSIONS

Refractive errors may be associated with glycaemic control among T2DM patients. Longitudinal analyses are warranted to examine the relationship between changes in HbA_1c and the development of refractive errors.

Hepatitis B virus reactivation in breast cancer patients undergoing chemotherapy: A review and meta-analysis of prophylaxis management

Hepatitis B virus (HBV) reactivation during or after chemotherapy in patients with breast cancer has become a remarkable clinical problem. Prophylactic nucleos(t)ide analogues (NAs) are recommended for patients with breast cancer who are hepatitis B surface antigen (HBsAg) positive before chemotherapy. We performed an up-to-date meta-analysis to compare the efficacy of prophylactic lamivudine use with nonprophylaxis in HBsAg-positive breast cancer patients undergoing chemotherapy. PubMed, the Cochrane Library and China National Knowledge Infrastructure (CNKI) databases were searched for relevant articles until June 2016. Eligible articles comparing the efficacy of prophylactic lamivudine use with nonprophylaxis in HBsAg-positive breast cancer patients undergoing chemotherapy were identified. Eight studies which had enrolled 709 HBsAg-positive breast cancer patients undergoing chemotherapy were analysed. Lamivudine prophylaxis significantly reduced the rates of chemotherapy-associated hepatitis B flares in chronic hepatitis B in breast cancer compared with patients with nonprophylaxis (odds ratio [OR]=0.15, 95% confidence interval [CI]: 0.07-0.35, P<.00001). Chemotherapy disruption rates attributed to HBV reactivation in the prophylaxis groups were significantly lower than the nonprophylaxis groups (OR=0.17, 95% CI: 0.07-0.43, P=.0002). Patients with lamivudine prophylaxis had a higher risk for tyrosine-methionine-aspartate-aspartate (YMDD) motif mutations than patients with nonprophylaxis (OR=6.33, 95% CI: 1.01-39.60, P=.05). Prophylactic antiviral therapy management is necessary for HBsAg-positive breast cancer patients undergoing chemotherapy, in spite of high correlation with lamivudine-resistant HBV variants with YMDD motif mutations.

Measurement of the Neutrino Mixing Angle θ_{23} in NOvA

This Letter reports new results on muon neutrino disappearance from NOvA, using a 14 kton detector equivalent exposure of 6.05×10^{20} protons on target from the NuMI beam at the Fermi National Accelerator Laboratory. The measurement probes the muon-tau symmetry hypothesis that requires maximal θ_{23} mixing (θ_{23}=π/4). Assuming the normal mass hierarchy, we find Δm_{32}^{2}=(2.67±0.11)×10^{-3}  eV^{2} and sin^{2}θ_{23} at the two statistically degenerate values 0.404_{-0.022}^{+0.030} and 0.624_{-0.030}^{+0.022}, both at the 68% confidence level. Our data disfavor the maximal mixing scenario with 2.6σ significance.

Abstract P2-01-08: A nomogram to predict the survival benefit of surgical axillary staging in T1 breast cancer patients

This abstract was withdrawn by the authors.

Abstract P2-01-09: The development of nomograms to predict axillary lymph node status in breast cancer patients

This abstract was withdrawn by the authors.

A facile synthesis of 3,4-dimercaptofurans via sulfenylation of (E)-β-chlorovinyl ketones and 1,2-sulfur migration

A facile access to 3,4-dimercaptofurans was developed by the sulfenylation of β-chlorovinyl ketones followed by a novel 1,2-sulfur migration.

Effect of endothelial progenitor cells derived from human umbilical cord blood on oxygen-induced retinopathy in mice by intravitreal transplantation

AIM

To investigate the effect of endothelial progenitor cells (EPCs) labeled by carboxy fluorescein diacetate succinimidyl ester (CFSE) on murine oxygen-induced retinopathy (OIR) by intravitreal transplantation.

METHODS

After isolated from human umbilical cord blood mononuclear cells, EPCs were cultivated and then labeled with CFSE in vitro. C57BL/6J mice were placed to 75% hyperoxia chamber from P7 to P12 to establish OIR model. At P12, OIR mice were intravitreally injected with 1 µL suspension contained 2×10⁵ EPCs (EPCs group) or isometric phosphate buffered saline (PBS group). The contralateral eye of each mice received no injection (OIR group). Evans blue angiography and frozen section were examined to track the labeled cells in OIR group at P15 and P19. Using retina paraffin sections and adenosinediphos phatase staining at P12 and P19, the effect of EPCs on OIR mice was evaluated quantitatively and qualitatively.

RESULTS

The retinas from EPCs group with less non-perfusion area and fewer peripheral tufts were observed at P19, comparing with that from PBS or OIR group. The retinopathy in EPCs group receded earlier with less non-ganglion cells and neovascular nuclei, together with relatively regular distribution. The counts of the neovascular nuclei at P19 were reduced by 44% or 45%, compared with those of OIR group or PBS group respectively. Three days after EPCs injection, a large number of EPCs appeared in the vitreous cavity and adhered to the retinal surface. While at one week, the cells gathered between the internal plexiform layer and the inner limiting membrane, and some EPCs appeared in retinal vessels.

CONCLUSION

EPCs transplantation can participate in the reparative procedure of the neovascularization in OIR.

Early introduction of palliative care and advanced care planning for children with complex chronic medical conditions: a pilot study

BACKGROUND

Children with complex chronic medical conditions benefit from early introduction of palliative care services and advanced care planning for symptom management and to support quality of life and medical decision-making. This study evaluated whether introducing palliative care during primary care appointments (1) was feasible; (2) increased access and improved knowledge of palliative care; and (3) facilitated advanced care planning.

METHODS

Pilot study of a multi-modal intervention including targeted education for primary care providers (PCPs), an informational packet for families and presence of a palliative care team member in the outpatient clinic. PCPs completed pre- and post-surveys assessing experience, knowledge and comfort with palliative care. Enrolled families received an information packet; a subset also met a palliative care team member. All families were encouraged to make an appointment with the palliative care team, during which the team assessed palliative care needs and goals of care. Upon study completion, the investigators assessed family and PCP satisfaction and collected feedback on project feasibility.

RESULTS

Twenty families were enrolled and received the information packet; 15 met a palliative care team member. Of the 17 participating families who were reached and completed a post-study survey, 11 families had never heard of palliative care and 13 were unaware that the palliative care team existed. Most families perceived palliative care information as 'very helpful' and 'very important'. All would recommend palliative care team services to others. Nine families followed up with the palliative care team, but none was prepared to complete an advanced care plan. PCPs reported lack of training in communicating bad news and conducting goals of care discussions. However, they felt increasingly comfortable introducing palliative care to families and supported program continuation.

CONCLUSIONS

Initiating palliative care services in the outpatient primary care setting is logistically challenging but increases access to palliative care for children with complex chronic medical conditions and improves palliative care knowledge and comfort for PCPs.

Abstract P2-12-19: Comparison between ultrasound-guided-vacuum-assisted excision and surgical excision of benign phyllodes tumor of the breast: A single center retrospective study

Background: Wide local excision (WLE) is the recommended treatment for patients with phyllodes tumor of the breast, regardless of the tumor subtype (benign, borderline and malignant). However, the association between margin status and local recurrence is still controversial. In our institution, surgical excision (SE) alone (margin width&lt;1cm) is the standard treatment for patients with benign phyllodes tumor. In addition, ultrasound-guided-vacuum-assisted excision (UGVAE) is also employed as an alternative, minimally invasive way to remove benign phyllodes tumor. We hypothesized that UGVAE alone is adequate and as safe as SE alone for benign phyllodes tumor.

Method:

We searched our database for patients with benign phyllodes tumor diagnosed in Sun Yat-sen Memorial Hospital between 2000 and 2014, and identified 136 patients with valid follow-up information. Formalin fixed slices of each patient were reviewed for pathology diagnosis. In UGVAE group, we used 8G Mammotome to remove all lesions detected by ultrasound and surgical re-excision after pathology diagnosis was not performed. In SE group, patients received SE with no intention to achieve a surgical margin &gt;=1cm. Macroscopically negative margins is guaranteed by gross examination. Comparison of patients' features were performed using student t-test, Mann–Whitney u-test or Chi-sqaure test, when appropriate. Association between surgery (UGVAE & SE) and local recurrence was analyzed using univariate (Kaplan-Meier analysis) and multivariate approaches (Cox-regression analysis). Age, tumor size and the presence of accompanied fibroadenoma were included in the multivariate analysis.

Results:

Patients had significantly smaller tumor in the UGVAE group and those in the SE group (Median size: 2.1 vs. 3.0cm, P&lt;0.01). There were more patients in the UGVAE group that had accompanied fibroadenoma, when compared with those in the SE group (67.2% vs. 29.1%, P&lt;0.01). The median age was 38 and 37 in the UGVAE and SE group, respectively (P=0.66). With a median follow-up of 43 months, the 3-year and 5-year recurrence-free survival was 89.6% and 86.5% in UGVAE group, 97.3% and 90.0% in SE group, respectively (Log-rank test: P=0.26). In multivariate analysis, Surgery type (UGVAE or SE) (HR=0.37, P=0.19), age(HR=0.97, P=0.45), tumor size (HR=0.88, P=0.58) and the presence of accompanied fibroadenoma (HR=0.38, P=0.16) were not associated with recurrence-free survival.

Conclusion: UGVAE alone did not significantly increase the local recurrence rate of benign phyllodes tumor, when compared with SE, in this study. A prospective study with more patients and longer follow-up is needed in future.

Citation Format: Ouyang Q, Chen K, Zhu L, Song E, Su F. Comparison between ultrasound-guided-vacuum-assisted excision and surgical excision of benign phyllodes tumor of the breast: A single center retrospective study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-12-19.

Ribosomal protein S15A augments human osteosarcoma cell proliferation in vitro

As a highly conserved housekeeping gene, the biological implications of ribosomal protein S15A (RPS15A) during various processes, including carcinogenesis, remain elusive. Herein, the authors reported that knockdown of RPS15A expression significantly inhibited human osteosarcoma U2OS cell proliferation and colony formation in vitro by using a lentivirus-mediated RNA interference (RNAi) system. Moreover, an excess accumulation of cells in the G0/G1 phase was observed in U2OS cells transduced with lentivirus targeting RPS15A, suggesting that the growth inhibition mediated by RPS15A knockdown in osteosarcoma cells was probably due to the induction of cell cycle arrest. Taken together, this study highlights the crucial role of RPS15A in promoting osteosarcoma cell proliferation, and provides a foundation for further study into the clinical potential of inhibition of RPS15A for the treatment of osteosarcoma.

Chrysophanol affords neuroprotection against microglial activation and free radical-mediated oxidative damage in BV2 murine microglia

In this study, chrysophanol, isolated from a marine fungus, was examined for its protective effects against inflammatory responses and oxidative stress in BV2 microglia. Chrysophanol was studied to assess its capabilities of protecting against lipopolysaccharide (LPS)-induced inflammatory responses in BV2 cells. It was found that chrysophanol reduced the level of nitric oxide (NO) and prostaglandin-E2 (PGE2) production by diminishing reducing the expression of inducible NO synthase (iNOS) and cyclooxygenase-2 (COX-2). Assessment of the inhibitory activities of chrysophanol on the generation of pro-inflammatory cytokines was also performed. Furthermore, Chrysophanol treatment significantly reduced intracellular reactive oxygen species (ROS)-mediated cell damage and inhibited DNA oxidation in BV2 cells. Moreover, antioxidative mechanisms by of chrysophanol were evaluated investigated by measuring the expression levels of antioxidative enzymes such superoxide dismutase (SOD) and glutathione (GSH). Therefore, results suggested that chrysophanol has potential antioxidant and anti-inflammatory activities in microglia and further might be a useful therapeutic agent for the treatment of neurodegenerative diseases.

Effects of oriental medicine music therapy in an ovarian cancer patient with So-Eum-type constitution: a case report

The cancer incidence in Korea has been increasing, although there is a serious lack of supportive care for the treatment and management of the rapidly increasing number of cancer patients, and there is an immense need for therapeutic interventions to support cancer patients. A 47-year-old So-Eum-type Korean female patient, who was diagnosed with ovarian cancer, had been receiving chemotherapies. She was experiencing pain due to swelling of her hands and feet, and under extreme stress due to hardships of life. During the patient's fourth chemotherapy treatment, she received oriental medicine music therapy twice per week for 2 weeks, for 1 hour each time (4 sessions in total). A self-administered questionnaire and the visual analog scale were used to assess and determine the level of negative and positive feelings. After receiving the oriental medicine music therapy, her negative and positive feelings as well as the visual analog scale score that reflects subjective health conditions have improved and stabilized. This case report suggests the potential of oriental medicine music therapy as a complementary and alternative medical treatment method to promote and enhance quality of life and health conditions of cancer patients in postsurgical care and chemotherapy treatment.

IL-1β induces IL-6 production in retinal Müller cells predominantly through the activation of p38 MAPK/NF-κB signaling pathway

IL-6 plays an important role in various inflammatory ocular diseases, including diabetic retinopathy. Müller cells are the major source of inflammatory mediators, including IL-6, in the retina. However, the mechanism of regulating IL-6 production in these cells remains unclear. Examination of signaling pathways in human retinal Müller cells (MIO-M1 cell line) cultured with IL-1β, TNF-α, IL-6, IL-8, VEGF, IFN-γ, glucose or mannitol showed that IL-1β was the most potent stimulator of IL-6 production. In addition, IL-1 β also increased NF-κB p50 protein level and phosphorylation of p38 MAPK, ERK1/2 and c-Jun. Induction of IL-6 production by IL-1β was significantly reduced by addition of p38 MAPK (SB203580), MEK1/2 (U0126) or NF-κB (BAY11-7082) inhibitors, with the highest effect being observed with SB203580. To explore the specific elements in IL-6 promoter responsible for IL-1β-induction of IL-6 expression, a series of plasmids bearing various IL-6 promoter mutations were transiently expressed in MIO-MI cells cultured in the presence or absence of IL-1β (10ng/ml) and/or SB203580 (10µM). Results showed that IL-6 promoter activity of the parent pIL-6-Luc651 was significantly enhanced by IL-1β, but the level was significantly attenuated by SB203580. Furthermore, the IL-6 promoter activity was also reduced upon deletion of NF-κB, AP-1 or C/EBP binding sites, with NF-κB deletion being the greatest. These results are the first demonstration that IL-1β induces IL-6 production in Müller cells by activation of IL-6 promoter activity predominantly through the p38 MAPK/NF-κB pathway.

Lentivirus-mediated silencing of spindle and kinetochore-associated protein 1 inhibits the proliferation and invasion of neuronal glioblastoma cells

Spindle and kinetochore‑associated protein 1 (SKA1) is an important component of the human kinetochore, which plays a key role in mitosis. The resent study was designed to investigate the role of SKA1 in human glioblastoma. The results of the present study demonstrated that SKA1 was expressed in human glioblastoma cells. In addition, the knockdown of SKA1 expression in the A172 and U251 human glioblastoma cell lines was accomplished using a lentivirus infection method. An MTT assay demonstrated that downregulation of SKA1 may inhibit cell proliferation, without affecting the cell cycle. Furthermore, knockdown of SKA1 expression resulted in reduced cell invasion. The results of the present study indicated that SKA1 may be a potential target protein for antiproliferative and anti‑invasive therapeutic strategies of human glioblastoma.