Relationship between the change in pacing threshold and the myocardial injury

OBJECTIVE

To investigate the effects of general conditions and past medical history of patients on the short-term pacing threshold after the implantation of active electrodes of a cardiac pacemaker, and to understand whether the application of active electrodes will cause muscle injury and the severity of the injury.

PATIENTS AND METHODS

A total of 156 patients who were treated with a cardiac pacemaker and implanted with single or double active electrodes in Cardiovascular Department of Central Hospital of Jiangjin District were enrolled, including 96 patients treated with a single active electrode and 60 patients treated with double active electrodes. Their clinical data were collected. During operation, the short-term atrial and ventricular pacing thresholds were monitored and recorded after the implantation of the active fixed electrode lead.

RESULTS

Multivariate Logistic regression analysis showed that female sex, age, smoking, drinking, coronary heart disease, diabetes mellitus and hyperlipidemia had effects on pacing thresholds in a short-term to some extent after the implantation of active fixed electrode lead of cardiac pacemaker. The levels of myocardial enzymes, myoglobin (MYO), creatine kinase (CK), creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH) and cardiac troponin I (cTNI), in patients were gradually increased after the implantation of active fixed electrode lead and reached the peak at 24 h, which were higher than those before operation (p < 0.05). The levels were decreased at 72 h with statistically significant differences.

CONCLUSIONS

Female sex, age, smoking, drinking, coronary heart disease, diabetes mellitus and hyperlipidemia are independent influencing factors of pacing thresholds in a short term after the implantation of active fixed electrode lead of cardiac pacemaker. The implantation of active electrodes can raise the myocardial enzyme indexes compared with those before operation, but will fall to the preoperative levels or normal, near normal levels at 72 h after operation. The implantation of active electrodes is safe and feasible for myocardial tissues.

[Value of mDIXON-Quant sequence, diffusion-weighted imaging in quantitatively diagnosing the sacroiliitis stages]

Objective: To evaluate the value of mDIXON-Quant sequence, diffusion-weighted imaging (DWI) in quantitative diagnosing of the sacroiliitis stages in patients with ankylosing spondylitis (AS). Methods: Based on the Bath Ankylosing Spondylitis Activity Index (BASDAI) and laboratory parameters, a total of 51 patients were diagnosed with AS. They were divided into two groups as early active group (n=20) and chronic active group (n=31), and at the same time, 25 healthy people from Tianjin were included as control group. The regular MRI sequences and mDIXON-Quant sequence, DWI were obtained. The apparent diffusion coefficient (ADC) and fat-signal fraction (FF) value of bone marrow with edema of the sacroiliac joints in early active group and chronic active group and of subchondral bone marrow of sacroiliac joint in control group all were measured by ADC maps and FF maps. Mean (FF, ADC) values were compared between groups. Results: The ADC value of the early active group, chronic active group and the control group is (1.07±0.20)×10(-3)mm(2)/s, (1.00±0.22)×10(-3)mm(2)/s, (0.25±0.07)×10(-3)mm(2)/s, respectively, and the differences of ADC value between early active group and control group, chronic active group and control group were significant (P<0.01), but the difference of the ADC value between early active group and chronic active group was not significant (P=0.394). That is to say, the ADC value can't distinguish the early active group and chronic active group. The differences of FF value between groups was significant (P<0.01), and the FF value of bone marrow with edema in chronic active group were higher than that in early active group. Conclusions: The mDIXON-Quant sequence can quantitatively diagnose early active group and chronic active group, and the diagnostic value is better than DWI. Thus, it can provide guidance for clinical treatment and prognosis.

Irf8 regulates the progression of myeloproliferative neoplasm-like syndrome via Mertk signaling in zebrafish

Interferon regulatory factor (IRF)-8 is a critical transcription factor involved in the pathogenesis of myeloid neoplasia. However, the underlying mechanisms in vivo are not well known. Investigation of irf8-mutant zebrafish in this study indicated that Irf8 is evolutionarily conserved as an essential neoplastic suppressor through tight control of the proliferation and longevity of myeloid cells. Surviving irf8 mutants quickly developed a myeloproliferative neoplasm (MPN)-like disease with enhanced output of the myeloid precursors, which recurred after transplantation. Multiple molecules presented notable alteration and Mertk signaling was aberrantly activated in the hematopoietic cells in irf8 mutants. Transgenic mertk overexpression in Tg(coro1a:mertk) zebrafish recapitulated the myeloid neoplasia-like syndrome in irf8 mutants. Moreover, functional interference with Mertk, via morpholino knockdown or genetic disruption, attenuated the myeloid expansion phenotype caused by Irf8 deficiency. Therefore, Mertk signaling is a critical downstream player in the Irf8-mediated regulation of the progression of myeloid neoplasia. Our study extends the understanding of the mechanisms underlying leukemogenesis.

[Unerupted first deciduous molar located higher to the first premolar: a case report]

Tooth eruption is defined as the movement of a tooth from its site of development within the alveolar process to its functional position in the oral cavity. The process of tooth eruption can be divided into different phases: pre-eruptive bone stage, alveolar bone stage, mucosal stage, preocclusal stage, occlusal stage and maturation stage. Any disturbance in these phases can lead to eruptive anomalies. The incidence of unerupted teeth is usually higher among permanent teeth than among deciduous ones. Of the primary teeth reported as unerupted, second deciduous molars are the teeth most frequently involved, followed by primary central incisors. At present almost no coverage is seen about the impaction of the first deciduous molar. In this case, a 4-year-old boy who presented with an impacted left maxillary first deciduous molar came to the Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology. This tooth, located higher to the left maxillary first premolar, was well near to the maxillary sinus. The family and medical histories were noncontributory and his physical findings were within normal limits. The mother was reported as having experienced no illness or other complications and taken no medications during pregnancy. His clinical extraoral examination was noncontributory. His clinical intra-oral examination revealed that the maxillary left first primary molar was not present. No enlargement of the area was apparent visually or on palpation. The remaining primary dentition was well aligned and in good condition. His oral hygiene was good, although there were incipient occlusal carious lesions in the mandibular second primary molars. There was no history or evidence of dental trauma. A diagnosis of a left maxillary first deciduous molar was made on the basis of the clinical and radiographic evidence. Numerous local etiologic factors have been described for impacted teeth. These include anomalous teeth, malposition, fusion with adjacent or supernumerary teeth, odontoma, dentigerous cysts, tumors, underdevelopment of the jaws, keratinized epithelial lining, hereditary conditions, and trauma. In this case, the reason for impaction was not clear. After the comprehensive clinical evaluation, treatment consisted of placement of a space maintainer, the periodic examination was indicated for the follow-up, so that early interventions, such as subsequent surgical intervention and orthodontic traction could be recommended timely to manage orofacial disfigurement and to avoid consequent problems with resultant proper functioning and good periodontal health.

Modelling genome-wide topological associating domains in mouse embryonic stem cells

Chromosome conformation capture (3C)-based techniques such as chromosome conformation capture carbon copy (5C) and Hi-C revealed that the folding of mammalian chromosomes is highly hierarchical. A fundamental structural unit in the hierarchy is represented by topologically associating domains (TADs), sub-megabase regions of the genome within which the chromatin fibre preferentially interacts. 3C-based methods provide the mean contact probabilities between chromosomal loci, averaged over a large number of cells, and do not give immediate access to the single-cell conformations of the chromatin fibre. However, coarse-grained polymer models based on 5C data can be used to extract the single-cell conformations of single TADs. Here, we extend this approach to analyse around 2500 TADs in murine embryonic stem cells based on high-resolution Hi-C data. This allowed to predict the cell-to-cell variability in single contacts within genome-wide TADs and correlations between them. Based on these results, we predict that TADs are more similar to ideal chains than to globules in terms of their physical size and three-dimensional shape distribution. Furthermore, we show that their physical size and the degree of structural anisotropy of single TADs are correlated with the level of transcriptional activity of the genes that it harbours. Finally, we show that a large number of multiplets of genomic loci co-localize more often than expected by random, and these loci are particularly enriched in promoters, enhancers and CTCF-bound sites. These results provide the first genome-wide structural reconstruction of TADs using polymeric models obeying the laws of thermodynamics and reveal important universal trends in the correlation between chromosome structure and transcription.

[Predictive value of dynamic enhanced MR synovial wash in rate in progression to rheumatoid arthritis in patients with undifferentiated arthritis]

Objective: To investigate the predictive value of dynamic enhanced MR synovial wash in rate (WASHIN) in progression to rheumatoid arthritis (RA) in patients with undifferentiated arthritis (UA). Methods: The data of dynamic enhanced MR synovial WASHIN and C- reactive protein (CRP) of 33 patients with UA were analyzed between October 2014 and January 2016 from Tianjin First Center Hospital, so as to evaluate the correlation between the two indicators. According to the value of CRP, the patients were divided into two groups, the CRP>8 mg/L for CRP positive group (18 cases), CRP≤8 mg/L for CRP negative group (15 cases). Ranked sum test was used to compare the difference of WASHIN between two groups. The ROC curve analysis was carried out to test the diagnostic power of WASHIN. Results: In 33 patients with UA, the correlation between WASHIN and CRP was positive, r=0.767, P<0.01; as for the WASHIN, there was significant difference between CRP positive group(49.51±19.79)/s and CRP negative group(19.90±14.51)/s (P<0.01). 9 cases were clinically diagnosed with RA during follow-up, of which 8 cases for CRP positive group and 1 case for CRP negative group. The biggest area under the ROC curve of synovial WASHIN was 0.944, the biggest Youden index was 0.85, sensitivity was 100.0%, specificity was 87.5%. 2 cases were clinically diagnosed with osteoarthrosis during follow-up, synovial WASHIN respectively of 18.42 and 21.48 /s. Conclusion: Synovial WASHIN can improve the sensitivity and specificity to predict the prognosis from UA to RA, and can provide certain guiding significance for clinical work.

Looping probability of random heteropolymers helps to understand the scaling properties of biopolymers

Random heteropolymers are a minimal description of biopolymers and can provide a theoretical framework to the investigate the formation of loops in biophysical experiments. The looping probability as a function of polymer length was observed to display in some biopolymers, like chromosomes in cell nuclei or long RNA chains, anomalous scaling exponents. Combining a two-state model with self-adjusting simulated-tempering calculations, we calculate numerically the looping properties of several realizations of the random interactions within the chain. We find a continuous set of exponents upon varying the temperature, which arises from finite-size effects and is amplified by the disorder of the interactions. We suggest that this could provide a simple explanation for the anomalous scaling exponents found in experiments. In addition, our results have important implications notably for the study of chromosome folding as they show that scaling exponents cannot be the sole criteria for testing hypothesis-driven models of chromosome architecture.

Kinetic analysis of RNA editing of Newcastle disease virus P gene in the early period of infection

As a paramyxovirus, Newcastle disease virus (NDV) has the ability to edit its P (phosphoprotein) gene to synthesize three kinds of viral protein (P, V and W). It is technically very difficult to differentiate P, V and W mRNAs, and little was known about NDV regulation of RNA-editing frequency. To investigate the rules of NDV RNA editing, the ratio of the P gene-derived transcripts (P, V and W) was determined by sequencing at different time points post-infection. The results showed unstable ratio of V and W mRNA at different time points, and the frequency of NDV editing was significantly increased at the early period of infection (P 

KEYWORDS

Newcastle disease virus; phosphoprotein; RNA editing; G insertion.

β-Arrestin1 inhibits chemotherapy-induced intestinal stem cell apoptosis and mucositis

The mechanism of chemotherapy-induced gastrointestinal (GI) syndrome (CIGIS) is still controversial, and it is unclear whether chemotherapy induces intestinal stem cell (ISC) apoptosis. β-Arrestins are regulators and mediators of G protein-coupled receptor signaling in cell apoptosis, division and growth. In this study, we aimed to investigate whether chemotherapy induces ISC apoptosis to contribute to mucositis in CIGIS and whether β-arrestin1 (β-arr1) is involved in this apoptosis. Different chemotherapeutic agents were used to generate a CIGIS model. Lgr5-EGFP-IRES-creERT2^+/− knock-in mice were used as a CIGIS model to investigate ISC apoptosis. β-arr1 knockout mice were used to determine whether β-arr1 is involved in the apoptosis in CIGIS. Intestinal histology was performed, the ISC apoptosis was analyzed and the mucosal barrier was examined. The effects of β-arr1 in apoptosis were investigated in the samples from humans and mice as well as in cell lines. Here, we demonstrate that chemotherapy induced intestinal mucositis by promoting crypt cell apoptosis, especially in Lgr5+ stem cells and Paneth cells but not in goblet cells, epithelial cells or vascular endothelial cells. Furthermore, β-arr1 deficiency exacerbated the Lgr5+ stem cell apoptosis, but not Paneth cell apoptosis, in CIGIS. In addition, the data showed that β-arr1 reduced the chemotherapy-induced Lgr5+ stem cell apoptosis by inhibiting endoplasmic reticulum stress-mediated mitochondrial apoptotic signaling. Our study indicates that β-arr1 inhibits chemotherapy-induced ISC apoptosis to alleviate intestinal mucositis in CIGIS.

Patterns of Growth and Decline in Lung Function in Persistent Childhood Asthma

BACKGROUND

Tracking longitudinal measurements of growth and decline in lung function in patients with persistent childhood asthma may reveal links between asthma and subsequent chronic airflow obstruction.

METHODS

We classified children with asthma according to four characteristic patterns of lung-function growth and decline on the basis of graphs showing forced expiratory volume in 1 second (FEV1), representing spirometric measurements performed from childhood into adulthood. Risk factors associated with abnormal patterns were also examined. To define normal values, we used FEV1 values from participants in the National Health and Nutrition Examination Survey who did not have asthma.

RESULTS

Of the 684 study participants, 170 (25%) had a normal pattern of lung-function growth without early decline, and 514 (75%) had abnormal patterns: 176 (26%) had reduced growth and an early decline, 160 (23%) had reduced growth only, and 178 (26%) had normal growth and an early decline. Lower baseline values for FEV1, smaller bronchodilator response, airway hyperresponsiveness at baseline, and male sex were associated with reduced growth (P<0.001 for all comparisons). At the last spirometric measurement (mean [±SD] age, 26.0±1.8 years), 73 participants (11%) met Global Initiative for Chronic Obstructive Lung Disease spirometric criteria for lung-function impairment that was consistent with chronic obstructive pulmonary disease (COPD); these participants were more likely to have a reduced pattern of growth than a normal pattern (18% vs. 3%, P<0.001).

CONCLUSIONS

Childhood impairment of lung function and male sex were the most significant predictors of abnormal longitudinal patterns of lung-function growth and decline. Children with persistent asthma and reduced growth of lung function are at increased risk for fixed airflow obstruction and possibly COPD in early adulthood. (Funded by the Parker B. Francis Foundation and others; ClinicalTrials.gov number, NCT00000575.).

Abstract P3-05-08: High prevalence of splicing variant AR-V7 in triple negative breast carcinoma

The androgen receptor (AR) and its pathway have been implicated in tumorigenesis and progression of breast cancer. Anti-androgen therapy has shown efficacy in the metastatic breast cancer and numerous clinical trials are underway to study efficacy in various clinical settings. 15 splicing variants of AR (AR-Vs) have been described in prostate cancer. Structurally, AR-Vs have insertions of cryptic exons downstream of the exons that encode the DNA-binding domain or deletions of the exons encoding the ligand-binding domain, resulting in a disrupted AR open reading frame and expression of ligand-binding-domain-truncated AR proteins. In prostate cancer, some of the AR-Vs especially AR-V7 are associated with aggressive disease and resistance to anti-AR therapy. The AR-V prevalence in human breast cancer specimens has hitherto not been studied. We aimed at studying the expression of AR-Vs in breast cancer specimens and present the data on AR-V1, AR-V7, AR8, and ARV567, in AR-positive triple negative (TNBC) and ER+/Her2- breast cancer.

Design: 98 cases of TNBC, 40 cases of ER+/Her2 breast cancer and 17 cases with reduction mammoplasty were abstracted from NYULMC pathology database and screened for AR expression by immunohistochemistry (IHC). IHC for AR was performed using antibody clone N-20 (Santa Cruz) at 1:100 dilution. Normal breast tissue was used as internal control and 10% nuclear staining was used for categorizing a tumor as AR positive. A subset of cases which over-expressed AR were macrodissected from formalin fixed paraffin embedded sections with total RNA extracted by using the PureLink® FFPE RNA Isolation Kit (Invitrogen). Reverse-transcription was performed by using the SuperScript® III Reverse Transcriptase Kit (Invitrogen). AR-V expression was presented as cycle number difference to housekeeping gene (delta CT) for real-time PCR or as absolute copy number for digital PCR.

Results: AR+ TNBC and AR+/ER+ cases ranged from stage 1A to IIIA. IHC for AR showed &gt; 10% staining in 27 of 98 TNBC cases and in 39 of 40 ER+/Her2- cases.

AR Positive Prevalence in TNBC and ER+ Breast Carcinoma AR+AR-TNBC2771ER+/Her2-391

AR-V7 was expressed in 11 of 13 AR+/TNBC cases (p &lt; 0.05); AR-V1 and AR-V4 were expressed in 4; ARV8 and ARv567es were expressed in 3 and 2 cases respectively. In 25 AR+/ER+/Her2- cases AR-V7 was expressed in 14; AR-V4 in 9; ARV567 in 5, AR-V1 in 3 cases.

AR Spliced Variant Incidence in TNBC, ER+ and Benign breast tissue Benign (N=17)ER+/AR+ (N=25)TNBC+/AR+(N=13)P ValueAR-V113(12%)4(25%)0.145AR-V419(36%)4(25%)0.35AR-V78(47%)14(56%)11(85%)0.021AR-V801(4%)3(19%)0.474AR-V56715(20%)2(12.5%)0.092

Conclusion: We report expression of various spliced variants in TNBC, ER+/Her2- breast cancer. A statistically significant expression of AR-V7 is seen in TNBC. Since AR-V7 predicts for poor prognosis and lack of response to anti-AR therapy in prostate cancer, AR-V7 expression maybe a useful biomarker to analyze response data in on going breast cancer clinical trials.

Citation Format: Singh B, Deng F-M, Kane Y, Zhan Y, Qi Y, Liu X, Zhang H, Dong Y, Brody R, Wieczorek R, Lee P. High prevalence of splicing variant AR-V7 in triple negative breast carcinoma. [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 P3-05-08.

Monoclonal antibody against macrophage colony-stimulating factor suppresses circulating monocytes and tissue macrophage function but does not alter cell infiltration/activation in cutaneous lesions or clinical outcomes in patients with cutaneous lupus erythematosus

This study's objective was to assess the effects of PD-0360324, a fully human immunoglobulin G2 monoclonal antibody against macrophage colony-stimulating factor in cutaneous lupus erythematosus (CLE). Patients with active subacute CLE or discoid lupus erythematosus were randomized to receive 100 or 150 mg PD-0360324 or placebo via intravenous infusion every 2 weeks for 3 months. Blood and urine samples were obtained pre- and post-treatment to analyse pharmacokinetics and pharmacodynamic changes in CD14(+) CD16(+) monocytes, urinary N-terminal telopeptide (uNTX), alanine/aspartate aminotransferases (ALT/AST) and creatine kinase (CK); tissue biopsy samples were taken to evaluate macrophage populations and T cells using immunohistochemistry. Clinical efficacy assessments included the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI). Among 28 randomized/analysed patients, peak/trough plasma concentrations increased in a greater-than-dose-proportional manner with dose increases from 100 to 150 mg. Statistically significant differences were observed between active treatment and placebo groups in changes from baseline in CD14(+) CD16(+) cells, uNTX, ALT, AST and CK levels at most time-points. The numbers, density and activation states of tissue macrophages and T cells did not change from baseline to treatment end. No between-group differences were seen in CLASI. Patients receiving PD-0360324 reported significantly more adverse events than those receiving placebo, but no serious adverse events. In patients with CLE, 100 and 150 mg PD-0360324 every 2 weeks for 3 months suppressed a subset of circulating monocytes and altered activity of some tissue macrophages without affecting cell populations in CLE skin lesions or improving clinical end-points.

Endometrial microbiome at the time of embryo transfer: next-generation sequencing of the 16S ribosomal subunit

PURPOSE

Characterization of the human microbiome has become more precise with the application of powerful molecular tools utilizing the unique 16S ribosomal subunit's hypervariable regions to greatly increase sensitivity. The microbiome of the lower genital tract can prognosticate obstetrical outcome while the upper reproductive tract remains poorly characterized. Here, the endometrial microbiome at the time of single embryo transfer (SET) is characterized by reproductive outcome.

METHODS

Consecutive patients undergoing euploid, SET was included in the analysis. After embryo transfer, performed as per routine, the most distal 5-mm portion of the transfer catheter was sterilely placed in a DNA free PCR tube. Next-generation sequencing of the bacteria specific 16S ribosome gene was performed, allowing genus and species calls for microorganisms.

RESULTS

Taxonomy assignments were made on 35 samples from 33 patients and 2 Escherichia coli controls. Of the 33 patients, 18 had ongoing pregnancies and 15 did not. There were a total of 278 different genus calls present across patient samples. The microbiome at time of transfer for those patients with ongoing pregnancy vs. those without ongoing pregnancy was characterized by top genera by sum fraction. Lactobacillus was the top species call for both outcomes.

CONCLUSIONS

The data presented here show the microbiome at the time of embryo transfer can successfully be characterized without altering standard clinical practice. This novel approach, both in specimen collection and analysis, is the first step toward the goal of determining physiologic from pathophysiologic microbiota. Further studies will help delineate if differences in the microbiome at the time of embryo transfer have a reliable impact on pregnancy outcome.