Abstract P4-03-04: Targeting the mevalonate pathway in HER2-positive breast cancer to overcome resistance to anti-HER2 therapy

Background: Despite the advent of HER2-targeted therapies for HER2+ breast cancer (BC), including the monoclonal antibody trastuzumab (T) either alone or in combinations, resistance still poses a major clinical challenge. Using our broad panel of HER2+ cell lines made resistant (R) to T alone (TR), and to lapatinib plus T (LTR), we observed that in resistant models where HER2 remains inhibited, especially the LTR derivative, the mevalonate (MVA) pathway is activated and provides an alternative proliferative signal, including the activation of mTOR, to drive resistance. While these resistant cell models were hypersensitive to the widely-used cholesterol-lowering statins, the role of other MVA pathway inhibitors such as zoledronic acid (ZA), which is in clinical use to treat bone metastasis, in overcoming resistance to HER2-targeted therapy has not been explored. Based on recent reports and our preliminary data using reverse phase protein array (RPPA) analysis, the YAP/TAZ transcription factor (TF) emerged as a potential mediator of MVA pathway signaling to mTOR. Here, we investigated the therapeutic efficacy of additional MVA pathway inhibitors and the role of YAP/TAZ in mediating resistance to HER2-targeted therapy.

Methods: HER2+ SKBR3 and AU565 BC cells and their LTR derivatives were used. Changes in cell growth upon genetic and pharmacologic inhibition of the MVA pathway were quantified by methylene blue staining. Luciferase reporter assays and western blots (WB) measured changes in total and phosphorylated (S127 and S381/inactive) YAP protein levels to examine activity of the YAP/TAZ TF complex. To validate the function of YAP/TAZ in resistance, we performed YAP/TAZ knockdown (siRNA), overexpression of dominant-active YAP constructs (S381A, S381/127A), and qRT-PCR assessment of YAP/TAZ target gene expression.

Results: ZA, like simvastatin (Sim), selectively inhibited the growth of resistant cells in a dose-dependent manner. This inhibition was rescued by geranyl geranyl pyrophosphate (GGPP), a downstream metabolite, but not by MVA, an upstream metabolite, indicating the on-target effect of ZA. Further, ZA and Sim combination showed a synergistic growth-inhibitory effect in R but not in parental (P) cells. YAP/TAZ luciferase reporter assays and phosphorylated YAP and total TAZ levels by WB, confirmed the increased activity of YAP/TAZ in R models, which was selectively inhibited by Sim or ZA and was rescued by the corresponding downstream metabolites. YAP/TAZ knockdown selectively inhibited resistant cell growth and mTOR signaling in R vs. P cells, and dominant-active YAP/TAZ rescued the mTOR inhibition by Sim. YAP/TAZ inhibition by siRNA or by Sim significantly decreased the expression of YAP/TAZ target gene survivin in R vs. P cells, and the Sim inhibition was rescued by MVA.

Conclusions: The MVA pathway plays a critical role in mediating resistance to anti-HER2 therapy, which was overcome by Sim and ZA either alone or in combination. Given the synergistic effect of Sim and ZA, their combination may offer a therapeutic strategy to overcome HER2-targeted therapy resistance. Our results also reveal the role of YAP/TAZ in MVA pathway-mediated HER2-targeted therapy resistance, which could suggest new biomarkers and therapeutic targets.

Citation Format: Sethunath V, Hu H, De Angelis C, Veeraraghavan J, Qin L, Rimawi MF, Osborne KC, Schiff R. Targeting the mevalonate pathway in HER2-positive breast cancer to overcome resistance to anti-HER2 therapy [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-03-04.

Abstract P3-16-01: Using the new pan-cancer clinical data resource (TCGA-CDR) to identify breast cancer genomic correlates associating with different survival outcome endpoints

Introduction The Cancer Genome Atlas (TCGA) generated abundant high quality molecular data, however its relatively short-term patient follow-up limited its immediate clinical utility. We led a PanCanAtlas effort to systematically collate, integrate, and quality check the large body of acquired clinicopathologic data, generated 4 primary clinical outcome endpoints for each case, and created a new Pan-Cancer Clinical Data Resource (TCGA-CDR) for public use. We report here on the utility and validity of this TCGA-CDR in relating breast cancer (BC) genomic information to survival endpoints.

Methods Clinicopathologic data from all data files were integrated and processed. Overall survival (OS), disease-specific survival (DSS, an approximation), progression-free interval (PFI), and disease-free interval (DFI)were derived.Tests of the adequacy of the follow-up intervals for each endpoint were performed, and quality evaluation of these endpoints was established by their comparison with different clinical features. As a case study we compared each survival endpoint for significant association (FDR <0.2) with chromosomal aneuploidy.

Results The 4 endpoints were derived for 1097 TCGA BC cases having a median follow-up time of 27.7 months. Median times to events/censorship for OS, DSS, PFI, and DFI were 41.8/25.0, 32.6/26.0, 26.0/25.0, and 25.4/25.0 months respectively. PFI and DFI passed tests for adequate follow-up times; OS and DSS partially passed the same tests signaling some caution with their use in genomic associations.

Using the endpoints, outcomes of patients with ER+ and ER- tumors were compared, along with those of patients with low (I&II) and high (III&IV) stage breast tumors. Univariate analyses suggested patients with ER+ tumors had significantly better survival than patients with ER- tumors when using PFI (p=0.005), DFI (p=0.001), and DSS (p=0.009), with OS not reaching significance (p=0.09). Patients with low stage tumors showed significantly better outcomes than patients with high stage tumors for each endpoint (p<0.001). The 4 endpoints were also evaluated for their significant associations with chromosomal arm aneuploidy. Adjusted for patient age and AJCC stage, tumors with a loss of 8q and 8p (p=0.019, FDR=0.37) had worse PFI; and those with loss of 8q, 20q, and 8p had worse DFI. Tumors with gain of 11q or loss of 14, 7q, 12q, 18q, 20q, 3p, 7p, 8p, 18p, and 20p had worse OS. In contrast, tumors with loss of 16q had better DSS, while those with loss of 3q, 12q, 17q, 18q, 19q, 20q, 3p, 8p, 12p, 18p, 19p, and 20p had worse DSS. The finding that 8p loss associated with worse survival for all 4 endpoints, while 18p loss associated with worse OS and DSS, agrees with literature reports.

Conclusion These findings confirm that PFI and DFI, as extracted from the TCGA-CDR, are valid and appropriate BC survival endpoints, while OS and DSS may be recommended with some caution when employing TCGA data to evaluate new relationships between breast cancer genomic abnormalities and clinical outcomes.

The views expressed in this article are those of the author and do not reflect the official policy of the Department of Army/Navy/Air Force, the Department of Defense, or U.S. Government.

Citation Format: Liu J, Lichtenberg T, Hoadley KA, Cherniack A, Poisson L, Kovatich AJ, Benz C, Thorsson V, TCGA PanCanAtlas Research Network, Shriver CD, Hu H. Using the new pan-cancer clinical data resource (TCGA-CDR) to identify breast cancer genomic correlates associating with different survival outcome endpoints [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-16-01.

Functional Relationship and Gene Ontology Classification of Breast Cancer Biomarkers

Breast cancer is a complex disease that still imposes a significant healthcare burden on women worldwide. The etiology of breast cancer is not known but significant advances have been made in the area of early detection and treatment. The advent of advanced molecular biology techniques, mapping of the human genome and availability of high throughput genomic and proteomic strategies opens up new opportunities and will potentially lead to the discovery of novel biomarkers for early detection and prognostication of breast cancer. Currently, many biomarkers, particularly the hormonal and epidermal growth factor receptors, are being utilized for breast cancer prognosis. Unfortunately, none of the biomarkers in use have sufficient diagnostic, prognostic and/or predictive power across all categories and stages of breast cancer. It is recognized that more useful information can be generated if tumors are interrogated with multiple markers. But choosing the right combination of biomarkers is challenging, because 1) multiple pathways are involved, 2) up to 62 genes and their protein products are potentially involved in breast cancer-related mechanisms and 3) the more markers evaluated, the more the time and cost involved. This review summarizes the current literature on selected biomarkers for breast cancer, discusses the functional relationships, and groups the selected genes based on a Gene Ontology™ classification.

Dietary Intake is Positively Associated with Cognitive Function of a Chinese Older Adults Sample

OBJECTIVE

The relationship between cognitive function and dietary intake in older adults was under-studied in China. This study examined this relationship in a Chinese sample while controlling for the effects of sleep quality and socio demographic confounders.

METHODS

The sample consisted of 340 Chinese older adults (age > 60) who were randomly selected from Wuhan city in central China. Cognitive function was assessed by the Mini-mental State Examination [MMSE], sleep quality by the Pittsburgh Sleep Quality Index [PSQI], and dietary intake by frequencies of intake of meat products, fruits, fish/seafood/aquatic products, nuts and mushroom/algae over the past year. First, confirmatory factor analysis (CFA) was conducted to evaluate the measurement properties of cognitive function, dietary intake, and sleep quality. Second, structural equation modeling (SEM) was conducted to examine the relations of cognitive function, dietary intake, and sleep quality.

RESULTS

Dietary intake was found to be positively related to cognitive function. Older age, lower education status, monthly income, and living alone or without a spouse were significantly associated with poorer cognitive function. SES status had an indirect effect on cognitive function via dietary intake.

CONCLUSION

Dietary intake may be critical to maintain normal cognitive function of older adults in China.

BMI, Waist Circumference and All-Cause Mortality in a Middle-Aged and Elderly Chinese Population

OBJECTIVE

To investigate the association of obesity and all-cause mortality in a sample of middle-aged and elderly population.

DESIGN AND SETTING

Information of participants was collected in the Dongfeng-Tongji study, a perspective cohort study of Chinese occupational population. The main outcome was risk of death after 8.5 years of follow-up.

PARTICIPANTS AND MEASUREMENTS

We examined the association of BMI, waist circumference (WC, and waist-height ratio (WHtR) with all-cause mortality in the Dongfeng-Tongji cohort study (n=26,143). Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) for all-cause mortality. Area under the receiver operating characteristic curves and net reclassification improvement (NRI) were used to calculate the power of prediction models.

RESULTS

During a mean of 8.5 years of follow-up, 2,246 deaths were identified. There is a U-shaped association of BMI with all-cause mortality in the middle-aged and elderly Chinese population. Compared with individuals with normal BMI, underweight was positively (HR=2.16, 95% CI: 1.73, 2.69) while overweight (HR=0.75, 95% CI: 0.67, 0.84) and obesity (HR=0.67, 95% CI: 0.56, 0.79) were negatively associated with all-cause mortality after adjustment for potential confounders including WC. In contrast, WC (Q5 vs. Q1, HR=1.55, 95% CI: 1.29, 1.86) and WHtR (Q5 vs.Q1, HR=1.69, 95% CI: 1.40, 2.04) were positively associated with mortality after further adjustment for BMI (P trend < 0.001). Addition of both BMI and WC into the all-cause mortality predictive model significantly increased AUC (P =0.0002) and NRI (NRI = 2.57%, P = 0.0007).

CONCLUSIONS

BMI and WC/WHtR were independently associated with all-cause mortality after mutual adjustment. Combination of BMI and WC/WHtR improved the predictive ability of all-cause mortality risk in the middle-aged and elderly population.

A small-molecule inhibitor of the Wnt pathway (SM04690) as a potential disease modifying agent for the treatment of osteoarthritis of the knee

OBJECTIVES

Osteoarthritis (OA) is a degenerative disease characterized by loss of cartilage and increased subchondral bone within synovial joints. Wnt signaling affects the pathogenesis of OA as this pathway modulates both the differentiation of osteoblasts and chondrocytes, and production of catabolic proteases. A novel small-molecule Wnt pathway inhibitor, SM04690, was evaluated in a series of in vitro and in vivo animal studies to determine its effects on chondrogenesis, cartilage protection and synovial-lined joint pathology.

DESIGN

A high-throughput screen was performed using a cell-based reporter assay for Wnt pathway activity to develop a small molecule designated SM04690. Its properties were evaluated in bone-marrow-derived human mesenchymal stem cells (hMSCs) to assess chondrocyte differentiation and effects on cartilage catabolism by immunocytochemistry and gene expression, and glycosaminoglycan breakdown. In vivo effects of SM04690 on Wnt signaling, cartilage regeneration and protection were measured using biochemical and histopathological techniques in a rodent acute cruciate ligament tear and partial medial meniscectomy (ACLT + pMMx) OA model.

RESULTS

SM04690 induced hMSC differentiation into mature, functional chondrocytes and decreased cartilage catabolic marker levels compared to vehicle. A single SM04690 intra-articular (IA) injection was efficacious in a rodent OA model, with increased cartilage thickness, evidence for cartilage regeneration, and protection from cartilage catabolism observed, resulting in significantly improved Osteoarthritis Research Society International (OARSI) histology scores and biomarkers, compared to vehicle.

CONCLUSIONS

SM04690 induced chondrogenesis and appeared to inhibit joint destruction in a rat OA model, and is a candidate for a potential disease modifying therapy for OA.

Long non-coding RNA CHCHD4P4 promotes epithelial-mesenchymal transition and inhibits cell proliferation in calcium oxalate-induced kidney damage

Kidney stone disease is a major cause of chronic renal insufficiency. The role of long non-coding RNAs (lncRNAs) in calcium oxalate-induced kidney damage is unclear. Therefore, we aimed to explore the roles of lncRNAs in glyoxylate-exposed and healthy mouse kidneys using microarray technology and bioinformatics analyses. A total 376 mouse lncRNAs were differentially expressed between the two groups. Using BLAST, 15 lncRNA homologs, including AU015836 and CHCHD4P4, were identified in mice and humans. The AU015836 expression in mice exposed to glyoxylate and the CHCHD4P4 expression in human proximal tubular epithelial (HK-2) cells exposed to calcium oxalate monohydrate were analyzed, and both lncRNAs were found to be upregulated in response to calcium oxalate. To further evaluate the effects of CHCHD4P4 on the cell behavior, we constructed stable CHCHD4P4-overexpressing and CHCHD4P4-knockdown HK-2 cells. The results showed that CHCHD4P4 inhibited cell proliferation and promoted the epithelial-mesenchymal transition in kidney damage and fibrosis caused by calcium oxalate crystallization and deposition. The silencing of CHCHD4P4 reduced the kidney damage and fibrosis and may thus be a potential molecular target for the treatment of kidney stones.

Efficient electro-optic modulation in low-loss graphene-plasmonic slot waveguides

Surface plasmon polaritons enable light concentration within subwavelength regions, opening thereby new avenues for miniaturizing the device and strengthening light-matter interactions. Here we realize efficient electro-optic modulation in low-loss plasmonic waveguides with the aid of graphene, and the devices are fully integrated in the silicon-on-insulator platform. By advantageously exploiting low-loss plasmonic slot-waveguide modes, which weakly leak into a substrate while featuring strong fields within the two-layer-graphene covered slots in metals, we successfully achieve a tunability of 0.13 dB μm^-1 for our fabricated graphene-plasmonic waveguide devices with extremely low insertion loss, which outperforms previously reported graphene-plasmonic devices. Our results highlight the potential of graphene plasmonic leaky-mode hybrid waveguides to realize active ultra-compact devices for optoelectronic applications.

[Comparison and discussion of different surgical methods used to treat vesicovaginal fistulas]

OBJECTIVE

To compare the feasibility and prognosis of different surgical methods used for vesicovaginal fistulas and to explore the value of electrocoagulation treating small ones.

METHODS

The medical data of 19 patients who had undertaken transvaginal VVF repairs in Peking University People's Hospital between October 2008 and November 2016 were retrospectively collected. The follow-ups were performed. The patients' age ranged from 31 to 55 years with the median age of 48 years and the history length ranged from 1 month to 24 months with the median length of 3 months. Their fistula situation, surgical methods and prognosis were analyzed and the differences and similarities were compared.

RESULTS

Three patients (15.79%) was performed by electrocoagulation, 4 (21.05%) by transvaginal repair, 5 (21.32%) by laparoscopic repair and 7(36.84%) by open operation. Except one patient who rejected urinary catheter and D-J catheters, the rest of the patients discharged with catheters. Twelve patients (63.2%) got full satisfaction with one operation. One of the 3 patients who undertook electrocoagulation repeated the operation for twice and got completely cured within 1 month while the other two undertook the operation once and got dry within 1 month. Three patients who undertook transvaginal repair got dry within 1 month. Two of the 5 patients who undertook laparoscopic repair had readmission for a second operation and the other 3 got dry after operation. Five of the 7 open repair patients got dry while the other 2 attempted other center for treatment.

CONCLUSION

Transvaginal repair has been the main surgery procedure for VVF, but it is limited by the location of fistula and the condition of vaginal. For patients not suitable for transvaginal repair, laparoscopic repair and open surgery are feasible. However both laparoscopic repair and open surgery are more invasive. Based on that, electrocoagulation becomes a better choice. In our research, patients with small and high location fistula treated by electrocoagulation got a higher cure rate and bear less surgical trauma. Electrocoagulation used in the treatment of VVF showed advantages of less trauma, less bleeding and better satisfaction. Fistulas with low location were more suitable for transvaginal repair. Complex VVF, especially with narrow ureteral open and ureteral fistulas, were more suitable for open and laparoscopic repair. As for single and small fistula, the electrocoagulation can be the first choice.

Long Non-Coding RNA: An Emerging Paradigm of Pancreatic Cancer

Pancreatic cancer remains a worldwide issue and burden that is hard to resolve given its low resection rate and chemo-resistance. Early diagnosis and early treatment are critical for conquering pancreatic cancer. Therefore, new biomarkers for diagnosis and prognosis are urgently needed. Previously, researchers mainly focused on protein-coding genetic and epigenetic changes in many types of cancers, and regarded the noncoding part as waste. Recently, however, long non-coding RNA (lncRNA) has emerged as a major participant in carcinogenesis, as it regulates cell proliferation, migration, invasion, metastasis, chemo-resistance, etc. The underlying mechanisms are summarized as signaling, decoy, guide and scaffold, yet the specific regulation networks remain to be uncovered. Several studies have revealed that some lncRNAs are dysregulated in pancreatic cancer, participating in biological functions. In this review, we will briefly outline the functional lncRNAs in pancreatic cancer, decipher possible mechanisms of lncRNAs, and further explore their significance in pancreatic cancer.

Neurogenic and myogenic patterns of electrical activity in isolated intact mouse colon

BACKGROUND

Relatively little is known about the electrical rhythmicity of the whole colon, where long neural pathways are preserved.

METHODS

Smooth muscle electrical activity was recorded extracellularly from the serosa of isolated flat-sheet preparations consisting of the whole mouse colon (n=31).

KEY RESULTS

Two distinct electrical patterns were observed. The first, long intense spike bursts, occurred every 349±256 seconds (0.2±0.2 cpm), firing action potentials for 31±11 seconds at 2.1±0.5 Hz. They were hexamethonium- and tetrodotoxin-sensitive, but persisted in nicardipine as 2 Hz electrical oscillations lacking action potentials. This pattern is called here neurogenic spike bursts. The second pattern, short spike bursts, occurred about every 30 seconds (2.0±0.6 cpm), with action potentials firing at about 1 Hz for 9 seconds (1.0±0.2 Hz, 9±4 seconds). Short spike bursts were hexamethonium- and tetrodotoxin-resistant but nicardipine-sensitive and thus called here myogenic spike bursts. Neurogenic spike bursts transiently delayed myogenic spike bursts, while blocking neurogenic activity enhanced myogenic spike burst durations. External stimuli significantly affected neurogenic but not myogenic spike bursts. Aboral electrical or mechanical stimuli evoked premature neurogenic spike bursts. Circumferential stretch significantly decreased intervals between neurogenic spike bursts. Lesioning the colon down to 10 mm segments significantly increased intervals or abolished neurogenic spike bursts, while myogenic spike bursts persisted.

CONCLUSIONS & INFERENCES

Distinct neurogenic and myogenic electrical patterns were recorded from mouse colonic muscularis externa. Neurogenic spike bursts likely correlate with neurogenic colonic migrating motor complexes (CMMC) and are highly sensitive to mechanical stimuli. Myogenic spike bursts may correspond to slow myogenic contractions, whose duration can be modulated by enteric neural activity.

Combined diffusion-weighted imaging and dynamic contrast-enhanced MRI for differentiating radiologically indeterminate malignant from benign orbital masses

AIM

To evaluate the performance of the combination of diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) for differentiating radiologically indeterminate malignant from benign orbital masses.

MATERIALS AND METHODS

Sixty-five patients with orbital masses (36 benign and 29 malignant) underwent DW and DCE MRI examinations for pre-treatment evaluation. The apparent diffusion coefficient (ADC) was derived from DW imaging data using the mono-exponential model. The volume transfer constant (K^trans), the flux rate constant between the extravascular extracellular space and the plasma (K_ep), and the extravascular extracellular volume fraction (V_e) were calculated using modified Tofts model. Differences in quantitative metrics were tested using independent-samples t test. Receiver operating characteristic (ROC) curve analyses were used to determine and compare the diagnostic ability of each significant metric.

RESULTS

The malignant group demonstrated significantly lower ADC (0.711±0.260 versus 1.187±0.389, p<0.001) and higher K_ep values (1.265±0.637 versus 0.871±0.610, p=0.008) than the benign group. Optimal diagnostic performance (area under the ROC curve [AUC], 0.941; sensitivity, 0.966; specificity, 0.917) could be achieved using combined ADC and K_ep values as the diagnostic index. The diagnostic performance of the combination of ADC and K_ep was significantly better than K_ep alone (p=0.006). Compared with ADC alone, combined ADC and K_ep values also showed higher AUC (0.941 versus 0.898), although the difference did not reach statistical significance (p=0.220).

CONCLUSION

K_ep and ADC could help to differentiate radiologically indeterminate malignant from benign orbital masses. The combination of DW and DCE MRI might improve the differentiating performance.

Analysis of changes in joint function and peripheral blood mononuclear cells in patients with systemic lupus erythematosus and intervention effects of different drugs

OBJECTIVE

To investigate the therapeutic effect of drug therapy with cyclophosphamide and leflunomide on the joint function damage of patients with systemic lupus erythematosus (SLE) and its regulatory effects on expression levels of programmed death receptor 1, Notch signaling pathway genes and interferon-inducible protein 10 in peripheral blood mononuclear cells.

PATIENTS AND METHODS

A total of 60 patients with SLE were randomly divided into two groups. They were treated with cyclophosphamide and leflunomide, respectively. The number of painful joints, joint tenderness index, joint swelling index and erythrocyte sedimentation rate of patients before and after treatment were evaluated, and the peripheral blood was collected from patients in the two groups; the peripheral blood mononuclear cells were extracted.

RESULTS

We observed that the number of painful joints, joint tenderness index and joint swelling index in cyclophosphamide group were decreased after treatment (p<0.05), and the erythrocyte sedimentation rate was significantly decreased (p<0.05). The number of painful joints, joint tenderness index and joint swelling index in leflunomide group were decreased after treatment (p<0.05), and the erythrocyte sedimentation rate was significantly decreased (p<0.05). The comparisons of changes in joint functions and erythrocyte sedimentation rates between cyclophosphamide group and leflunomide group after drug therapy showed that the curative effect in leflunomide group was superior to that in cyclophosphamide group (p<0.05). The positive expression rate of peripheral blood mononuclear cell Notch1 in leflunomide group after treatment was significantly decreased, and the curative effect was superior to that in cyclophosphamide group (p<0.05). The comparisons of changes in programmed death receptor 1 of lymphocytes and interferon-inducible protein 10 between cyclophosphamide group and leflunomide group after drug therapy showed that the curative effect in leflunomide group was superior to that in cyclophosphamide group (p<0.05). The comparison of positive expression rate of nuclear factor-κB (NF-κB) in peripheral blood mononuclear cells between the two groups after treatment showed that the curative effect in leflunomide group was superior to that in cyclophosphamide group (p<0.05). There were positive correlations of the expression level of programmed death receptor 1 of peripheral blood lymphocytes in SLE patients with double-stranded DNA (ds-DNA) and SLE disease activity index (p<0.05). There were positive correlations of the expression level of peripheral interferon-inducible protein 10 in SLE patients with ds-DNA and SLE disease activity index (p<0.05).

CONCLUSIONS

This study proved that both leflunomide and cyclophosphamide have therapeutic effects on the joint functions and immune dysfunction of peripheral blood mononuclear cells of SLE patients; however, and the effect of leflunomide is better. There are positive correlations of SLE disease activity index with the Notch signaling pathway genes, programmed death receptor 1 and interferon-inducible protein 10 in peripheral blood mononuclear cells, suggesting that these factors are related to the immune dysfunction of peripheral blood mononuclear cells.

Staphylococcus aureus dry-surface biofilms are more resistant to heat treatment than traditional hydrated biofilms

BACKGROUND

The importance of biofilms to clinical practice is being increasingly realized. Biofilm tolerance to antibiotics is well described but limited work has been conducted on the efficacy of heat disinfection and sterilization against biofilms.

AIM

To test the susceptibility of planktonic, hydrated biofilm and dry-surface biofilm forms of Staphylococcus aureus, to dry-heat and wet-heat treatments.

METHODS

S. aureus was grown as both hydrated biofilm and dry-surface biofilm in the CDC biofilm generator. Biofilm was subjected to a range of temperatures in a hot-air oven (dry heat), water bath or autoclave (wet heat).

FINDINGS

Dry-surface biofilms remained culture positive even when treated with the harshest dry-heat condition of 100°C for 60min. Following autoclaving samples were culture negative but 62-74% of bacteria in dry-surface biofilms remained alive as demonstrated by live/dead staining and confocal microscopy. Dry-surface biofilms subjected to autoclaving at 121°C for up to 30min recovered and released planktonic cells. Recovery did not occur following autoclaving for longer or at 134°C, at least during the time-period tested. Hydrated biofilm recovered following dry-heat treatment up to 100°C for 10min but failed to recover following autoclaving despite the presence of 43-60% live cells as demonstrated by live/dead staining.

CONCLUSION

S. aureus dry-surface biofilms are less susceptible to killing by dry heat and steam autoclaving than hydrated biofilms, which are less susceptible to heat treatment than planktonic suspensions.

Self-dsDNA in the pathogenesis of systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is a systemic and poly-aetiological autoimmune disease characterized by the production of antibodies to autologous double-stranded DNA (dsDNA) which serve as diagnostic and prognostic markers. The defective clearance of apoptotic material, together with neutrophil extracellular traps (NETs), provides abundant chromatin or self-dsDNA to trigger the production of anti-dsDNA antibodies, although the mechanisms remain to be elucidated. In SLE patients, the immune complex (IC) of dsDNA and its autoantibodies trigger the robust type I interferon (IFN-I) production through intracellular DNA sensors, which drives the adaptive immune system to break down self-tolerance. In this review, we will discuss the potential resources of self-dsDNA, the mechanisms of self-dsDNA-mediated inflammation through various DNA sensors and its functions in SLE pathogenesis.

Common types and countermeasures of ankle ligament injury caused by intense basketball movement

OBJECTIVE

To analyze ankle ligament injury of basketball players caused during movement, summarize injury types, analyze the causes of injury, and put forward corresponding control measures.

METHODS

The author selected 3100 basketball players with ankle ligament injury during basketball movement and admitted to different hospitals from June 2011 to June 2015 for stochastic analysis. Through the literature, investigation, and observation, etc., common types of injuries of basketball players are analyzed, and damage preventive measures of basketball players are discussed, so as to find measures to prevent and treat ankle ligament injury of basketball players and promote physical rehabilitation of players, which is in favor of their better career development.

RESULTS

Basketball players are prone to ankle ligament injury in training or competition, which has a direct relationship with players' poor safety consciousness and insufficient preparation during movement.

CONCLUSION

Basketball players will often have serious ankle ligament injury in the process of movement. Basketball coaches and players should reduce serious injury to players in training or competition, so as to stimulate passion of more professional basketball sports students for basketball, which also has a positive meaning for their future career.

[IgG4-related lung disease: analysis of 8 cases and literature review]

Objective: To improve the understanding and treatment of IgG4-related lung disease (IgG4-RLD). Methods: The clinical characteristics, serum IgG4 levels, pathological features, chest CT, therapy and prognosis of 8 patients with IgG4-RLD were retrospectively analyzed. These patients were admitted to the People's Liberation Army General Hospital and the pathological diagnosis was made between December 2005 and March 2016. Relevant literatures were reviewed. Results: The 8 patients with IgG4-RLD included 4 men and 4 women, with an average age of (59±4) years (range, 37-74). The respiratory symptoms included shortness of breath, cough, and expectoration. Extra-pulmonary symptoms included abdominal pain, facial edema, and fever. Extrapulmonary organs were involved in 7 cases. Serum IgG4 levels were elevated in 8 cases, with an average concentration of(17±6)g/L. Chest CT showed solid lung nodules in 6, alveolar-interstitial infiltration in 5, bronchovascular lesions in 3 and ground glass shadows in 2 cases. PET/CT was performed in 2 cases and it showed multiple organ involvement with higher radioactivity uptake(SUVmax2.9-4.2). The pathological examination found lymphocyte and plasma cell infiltration in 7, fibrous tissue hyperplasia in 5, and occlusive vasculitis in 2 cases. On immunohistochemical staining, the ratio of IgG4-positive plasma cells to IgG-positive plasma cells was higher than 40%in 3 cases. The number of IgG4-positive plasma cells was 10-50/HP in 8 cases. The misdiagnosis rate was 100% before the final diagnosis was made. Three cases received glucocorticoids with immunosuppressant therapy, 2 received surgery combined with glucocorticoid therapy, 2 received glucocorticoid therapy alone, and 1 only received surgery. The follow-up time was 4-132 months, with remission in 7 cases, and disease progression in 1 case, but no death. A total of 195 cases of IgG4-RLD were reviewed from the literature, among whom 111 cases were admitted with respiratory symptoms, 144 with extra-pulmonary involvement. Serum IgG4 levels were detected in 179 cases, with an average concentration of 5.408 g/L. The nodular type was predominant, accounting for 36.9%. Of these cases, 178 received glucocorticoid treatment with disease remission. Conclusions: The major clinical manifestations of IgG4-RLD were shortness of breath, cough and expectoration. Multiple organ lesions were common. The misdiagnosis rate was extremely high. The diagnosis could be made based on pathological features and IgG4 serum levels . Glucocorticoid treatment was effective.

[Analysis of outcomes of tension-free mid-urethral sling procedure in women with mixed urinary incontinence]

OBJECTIVE

To evaluate the medium and long term outcomes of tension-free mid-urethral sling in the treatment of female patients with mixed urinary incontinence (MUI).

METHODS

Twenty-six patients who underwent the tension-free mid-urethral sling procedure for MUI from April, 2010 to September, 2016, were followed up. Four of the 26 patients underwent retropubic tension free mid-urethral sling (TVT), and 22 of them underwent transurethral middle obturator sling (TOT). Scales were used in the follow-up, such as urinary incontinence severity score (UISS), detrusor instability score (DIS), incontinence quality of life scale evaluation (I-QOL), Urogenital Distress Inventory short form (UDI-6), and the outcomes before and after the procedure were compared.

RESULTS

The mean age was 62 years, with a range of 42-80 years. The mean body mass index (BMI) was 26.82 kg/m², with a range of 21.48-31.14 kg/m². The mean follow-up time was 26 months, with a range of 8-69 months. Twelve patients never took M-blockers and the rest 14 patients took M-blockers within two weeks. None of the patients had complications, including dysuria, injury of bladder, urethra, obturator vessel or nerve during the surgery. After pulling out the catheter, no one suffered moderate or severe pain or difficulty of urination. The overall cure rate for stress urinary incontinence (SUI) was 96.15% with 25 patients cured, and for urge urinary incontinence (UUI) was 76.92% with 20 patients cured. The patients' life quality also improved significantly (P<0.05).

CONCLUSION

Ten of the 26 patients showed an overactive bladder according to urodynamic study, from whom all of the six failed patient were. And 16 patients didn't show an overactive bladder, which may due to two reasons. One is that their sense of urge is not so serious, the other one is that their sense of urge is from urethra. Proximal urethra is full of nerve, which plays a role in sense and urine control. The sense of urge may come from urethra instead of bladder. tension-free mid-urethral sling procedure is an effective treatment for women with mixed urinary incontinence. Even without taking the M-blockers, the cure rate for urge incontinence reached 76.92%. The efficacy of surgery remained stable in medium and long term, and the patients' quality of life improved significantly.

Inhibitory effect and mechanism of mesenchymal stem cells on melanoma cells

PURPOSE

To explore the inhibitory effect and mechanism of MSCs on melanoma proliferation.

METHODS

The inhibitory effect of MSCs on melanoma A375 cells was detected by co-culture and conditioned medium (CM) experiments using MTT method. The cell cycle was analyzed by flow cytometry. Then, Western Blot experiment detected the expression of proteins related to NF-κB signaling in A375 cells. The expression of IL-1Ra in MSCs was proved by RT-PCR. The over-expression and silencing vector pcDNA3.1-EGFP-IL-1Ra and pGPH1-IL-1R were constructed and transfected into MSCs cells. After that, the changes of inhibitory effect and cell cycle from MSCs-S and MSCs-O CM on A375 cells were explored. The expression of proteins related to NF-κB signaling in A375 cells after MSCs-S or MSCs-O CM treatment was detected by Western Blot. MSCs, MSCs-S, or MSCs-O and A375 cells were co-injected into nude mice under the arms, the growth of tumor was observed, the frozen sections were made, and H&E staining of tumor tissue was performed.

RESULTS

The proliferation of A375 cells was inhibited and the cell cycle of A375 was arrested by MSCs. The expressions of cytokines related to NF-κB signaling were down-regulated. Over-expression and silence of Interleukin 1 receptor antagonist (IL-1Ra), specifically blocking activation of NF-κB signaling, indicated that inhibitory effect from MSCs was enhanced or weakened respectively, which suggested that IL-1Ra was involved in the inhibitory effect. In vivo, tumor initiation and growth were significantly inhibited when A375 cells were co-injected with MSCs into nude mice, which were related to the expression level of IL-1Ra.

CONCLUSION

MSCs could inhibit the proliferation and tumor initiation of melanoma A375 cells through NF-κB signaling. MSCs could secret IL-1Ra and inhibit expressions of NF-κB signaling-related factors of tumor cells, and cause cell cycle arrest in G1 phase.

Next Generation DNA Sequencing of Tissues from Infected Diabetic Foot Ulcers

We used next generation DNA sequencing to profile the microbiome of infected Diabetic Foot Ulcers (DFUs). The microbiota was correlated to clinical parameters and treatment outcomes to determine if directed antimicrobial therapy based on conventional microbiological cultures are relevant based on genomic analysis. Patients≥18years presenting with a new Diabetic Foot Infection (DFI) who had not received topical or oral antimicrobials in the two weeks prior to presentation, were eligible for enrolment. Tissue punch biopsies were obtained from infected DFUs for analysis. Demographics, clinical and laboratory data were collected and correlated against microbiota data. Thirty-nine patients with infected DFUs were recruited over twelve-months. Shorter duration DFUs (<six weeks) all had one dominant bacterial species (n=5 of 5, 100%, p<0.001), Staphylococcus aureus in three cases and Streptococcus agalactiae in two. Longer duration DFUs (≥six weeks) were diversely polymicrobial (p<0.01) with an average of 63 (range 19-125) bacterial species. Severe DFIs had complex microbiomes and were distinctly dissimilar to less severe infections (p=0.02), characterised by the presence of low frequency microorganisms. Nineteen patients (49%) during the study period experienced antimicrobial treatment failure, but no overall differences existed in the microbiome of patients who failed therapy and those who experienced treatment success (p=0.2). Our results confirm that short DFUs have a simpler microbiome consisting of pyogenic cocci but chronic DFUs have a highly polymicrobial microbiome. The duration of a DFU may be useful as a guide to directing antimicrobial therapy.

Effect of hand hygiene and glove use on cleanliness of reusable surgical instruments

BACKGROUND

During functionality testing and packaging of reusable surgical instruments (RSI) for sterilization, instruments are frequently touched. There is a lack of standards relating to hand hygiene frequency and use of gloves in the sterilizing service unit packing area.

AIM

To determine the effect of hand hygiene and glove use on maintenance of RSI cleanliness.

METHODS

Following manual and automated cleaning, Halsted-mosquito forceps were assessed for adenosine triphosphate (ATP), protein and microbial contamination after handling with gloved and ungloved but washed hands using an ATP surface swab test, bicinchoninic acid assay, and standard culture plate/broth, respectively. Gram's stain was used to classify the isolates. RSI contamination was assessed immediately following and 1, 2, and 4 h after washing hands.

FINDINGS

Packing instruments with hands that had been unwashed for 2 or 4 h resulted in a significant increase in contaminating ATP when compared with all other treatment groups (P < 0.05). There was a significant correlation between the time since washing hands, the amount of ATP (r = 0.93; P ≤ 0.001), and the microbial load (r = 0.83; P ≤ 0.001) contaminating the forceps, where the longer the time the hands remained unwashed the higher the contamination. Significantly more contaminating protein was found on forceps handled with ungloved hands that had not been washed for 2 or 4 h (P < 0.001).

CONCLUSION

Critical RSI inspection, assembling, lubricating and packing should be performed using either gloves or within 1 h of washing hands.

MicroRNA-20a-mediated loss of autophagy contributes to breast tumorigenesis by promoting genomic damage and instability

Gene expression analysis of The Cancer Genome Atlas (TCGA) breast cancer data set show that miR-20a is upregulated in human breast cancer, especially in triple-negative subtype. Gene Set Enrichment Analysis suggests that miR-20a expression negatively correlates with the autophagy/lysosome pathway. We report here that miR-20a inhibits the basal and nutrient starvation-induced autophagic flux and lysosomal proteolytic activity, increases intracellular reactive oxygen species levels and DNA damage response by targeting several key regulators of autophagy, including BECN1, ATG16L1 and SQSTM1. Re-introduction of exogenous BECN1, ATG16L1 or SQSTM1 reverses the inhibitory effect of miR-20a on autophagy and decreases DNA damage. A negative correlation between miR-20a and its target genes is observed in breast cancer tissues. Lower levels of BECN1, ATG16L1 and SQSTM1 are more common in triple-negative cancers than in other subtypes. High levels of miR-20a also associate with higher frequency of copy-number alterations and DNA mutations in breast cancer patients. Further studies in a xenograft mouse model show that miR-20a promotes tumor initiation and tumor growth. Collectively, these findings suggest that miR-20a-mediated autophagy defect might be a new mechanism underlying the oncogenic function of miRNA during breast tumorigenesis.

Failure mechanisms of air entrainment in drop impact on lubricated surfaces

Lubricated surfaces have recently been introduced and studied due to their potential benefit in various configurations and applications. Combining the techniques of total internal reflection microscopy and reflection interference microscopy, we examine the dynamics of an underlying air film upon drop impact on a lubricated substrate where the thin liquid film is immiscible to the drop. In contrast to drop impact on solid surfaces where even the smallest asperities cause random breakup of the entraining air film, we report two air film failure mechanisms on lubricated surfaces. In particular, using ≈5 μm thick liquid films of high viscosity, which should make the substrate nearly atomically smooth, we show that air film rupture shifts from asperity-driven to a controlled event. At low Weber numbers (We < 2, We = ρ_lU₀²R/σ, U₀ the impact velocity, R the drop radius, and ρ_l the density and σ the surface tension of the droplet) the droplet bounces. At intermediate We (2 < We < 10), the air film fails at the center as the top surface of the drop crashes downward owing to impact-induced capillary waves; the resulting liquid-liquid contact time is found to be independent of We. In contrast, at high We (We > 10), the air film failure occurs much earlier in time at the first inflection point of the air film shape away from the drop center, where the liquid-liquid van der Waals interactions become important. The predictable failure modes of the air film upon drop impact sheds light on droplet deposition in applications such as lubricant-infused self-cleaning surfaces.

Abstract P1-05-11: Comprehensive comparison of breast cancer molecular portraits by African and European ancestry in the cancer genome atlas

Background: African American breast cancer patients have worse survival rates than European American patients. Although racial differences in the distribution of breast cancer intrinsic subtype are known, it is unclear if there are other inherent genomic differences contributing to this racial outcome disparity.

Methods: We defined patient race based on genomic ancestry and compared multiple molecular features of breast cancer between 154 black and 776 white patients in The Cancer Genome Atlas (TCGA). We examined the contribution of these molecular features to survival outcomes using Cox proportional hazards models. We also estimated the heritability of breast cancer subtypes using a mixed effect model.

Results: Compared to whites, black patients had higher odds of basal-like (odds ratio=3.80, p&lt;0.001) and HER2-enriched (odds ratio=2.22, p=0.027) breast cancers in reference to luminal A subtype. Beyond differences in relative frequency of intrinsic subtypes, black and white patients had distinct gene expression, protein expression, and somatic mutation landscapes. However, the majority of these molecular differences were eliminated after adjusting for subtype; in the subtype-adjusted models, we found 142 genes, 16 methylation probes, 4 copy number segments, 1 protein, and no somatic mutation were differentially expressed or present between black and white patients. Using the top 40 differentially expressed genes, we built a race-enriched gene signature, which had excellent capacity of distinguishing breast tumors from black versus white patients (c-index=0.852 in the validation dataset). We also estimated the heritability of breast cancer subtype (basal vs. non-basal) to be 0.436 (p=1.5x10-14) and showed that two genetic variants (rs1078806 in FGFR2, rs34084277 in BABAM1) were associated with intrinsic subtype and can partially explain racial differences in subtype frequencies.

Conclusion: On the molecular level, once intrinsic subtype frequency differences are accounted for, there are few genomic or proteomic differences observed between blacks and whites. More than 40% of breast cancer subtype frequency differences may be due to genetic ancestry. These results suggest that future studies are warranted to investigate genetic and non-genetic factors that contribute to the development and progression of breast cancer subtypes in order to reduce racial disparity.

Citation Format: Huo D, Hu H, Rhie SK, Gamazon ER, Cherniack AD, Liu J, Yoshimatsu TF, Pitt JJ, Hoadley KA, Troester M, Ru Y, Lichtenberg T, Sturtz LA, Shelley CS, Mills GB, Laird PW, Shriver CD, Perou CM, Olopade OI. Comprehensive comparison of breast cancer molecular portraits by African and European ancestry in the cancer genome atlas [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-05-11.

Abstract PD6-01: Analysis of breast cancer in young women in the department of defense (DOD) database

Background: Women under the age of 40 account for approximately 7% percent of breast cancer patients. Breast tumors from young women are often ER-negative, occur in African-American patients, and have other indicators of high risk: yet, multivariate analyses demonstrated that young age is an independent predictor of poor outcome. Due to the unique nature of the patient population served by DOD, a disproportionate number of breast cancer cases in young women are seen. We compare the characteristics, treatment, and outcomes of young patients diagnosed with breast cancer with those of older patients.

Methods: The databases of the Military Health System Repository and the DOD Central Registration were used to identify female breast cancer patients treated at DOD facilities between 1998 and 2007. Information on demographics, breast cancer stage at diagnosis, definitive surgical treatments, systemic treatment, recurrence rate and overall survival was analyzed by age groups at the time of diagnosis (less than 40 years old, 40 to 49 years, and 50 years or older) using X2 testing with significance defined as p&lt; 0.05.

Results: We identified 10,066 women who were diagnosed with invasive breast cancer at DOD facilities between 1998 and 2007, of which 11.3% (1139) were less than 40 years old at diagnosis. 53% of this young cohort were white, 25% were African-American and 8% were Hispanic (14% undisclosed). The percentage of breast cancer among African-American women in the young cohort was higher than in the older cohorts (19.3% in 40-49yo and 10.6% in ≥50yo). High-grade tumors were significantly more frequent in the younger cohort when compared to the older group (49.5% vs 34.7% and 25.2%, p&lt;0.001). &lt;40yo most commonly presented with Stage II disease (45.3%) at diagnosis, while older groups were mostly diagnosed with Stage I disease (41.6% and 52.4%). The most common subtype of breast cancer across ages was ER+ disease, however, &lt;40yo group had proportionally less ER+ (49% vs 61% and 67.3%, P&lt;0.001). There was a higher rate of bilateral mastectomies among the young women (18.4% vs 9.1% and 5.0%, p&lt;0.0001). Independently of the stage of disease, chemotherapy was given significantly more frequently to &lt;40y (90.43%) and 40-49yo (81.44%) than ≥50yo (53.71%). The 10-year overall survival of younger women was similar to the ≥50yo cohort, despite intensive treatment.

Discussion: This study is one of the largest retrospective studies of women under 40 years old with breast cancer. Younger women with invasive breast cancer had more aggressive tumors presenting at higher stages. In this group with good access to healthcare, younger women still had a similar overall survival rate to older women despite receiving more aggressive treatment and potentially having fewer comorbidities than the older group.

Citation Format: Zimmer AS, Gatti-Mays M, Soltani S, Lipkowitz S, Steeg PS, Zhu K, Perkins JG, Hu H, Shao S, Brown D, Shriver CD. Analysis of breast cancer in young women in the department of defense (DOD) database [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr PD6-01.

Abstract P4-01-02: Diagnostic value of breast specific gamma imaging for breast cancer

In this study, 422 female patients who presented with clinical indications and underwent ultrasound (US), mammography (MMG), and breast specific gamma imaging (BSGI) before surgery during the period from July 2013 to June 2015 were retrospectively reviewed. Twenty-two of the patients had no pathological report available and were excluded. These patients who presented with clinical indications underwent both ultrasound and mammographic examinations initially. If both US and MMG were positive, the patient was recommended for a BSGI examination for pre-surgical planning. A BSGI examination was also recommended for patients with negative or indeterminate mammographic findings.

The diagnostic results were compared with histological examination and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for each modality were determined. Combinations of either two or three of the diagnostic results were also reviewed and the corresponding diagnostic indicators calculated. For these combinations, a positive indication on one of the two (or three) diagnostic tests were interpreted as a positive result. The sensitivity of US, MMG, BSGI, the combination of US and MMG, US and BSGI, MMG and BSGI, and the combination of all three together in the diagnosis of breast carcinoma were determined for the 400 patients included in the study and are listed in Table 1, column 1. The specificity, PPV, and NPV for each of these modalities and combinations of modalities were also determined and are shown Table 1, column 2-4.

Table 1 SensitivitySpecificityPPVNPVUS61.389.289.759.8MMG67.594.394.765.2BSGI83.187.991.477.1US & MMG86.884.789.880.6US & BSGI91.382.889.186.1MMG & BSGI92.283.489.585.6US & MMG & BSGI97.579.087.895.4

The population was comprised of 243 patients with 245 malignant lesions and 157 patients with 189 benign lesions. The malignant lesions were primarily infiltrating ductal carcinoma (76%) and ductal carcinoma in situ (14%), with the remaining lesions (10%) being invasive lobular carcinoma, Paget's disease and mixed carcinomas. The benign lesions were primarily fibroadenoma (39%), adenosis (40%) and papilloma (10%), with the remaining lesions (11%) being duct ectasia, inflammation or phyllodes. There were 79 false negative cases by MMG, however, when ultrasound and BSGI were combined, 73 out of 79 were accurately identified. Additionally, there were nine, seventeen and eighteen Ductal Carcinoma in situ (DCIS) misdiagnosed by BSGI, MMG, and ultrasound respectively, but through joint imaging of BSGI+MMG+US; 33 out of 35 were accurately judged.

BSGI is a useful adjunct modality for the diagnosis of breast carcinoma. It is also extremely useful for diagnosis of non-calcified DCIS, and circumvents limitations of mammography in identifying malignant lesion in dense breast. Moreover, it is helpful for improving the diagnosis accuracy of breast carcinoma when BSGI is combined together with MMG and US.

Citation Format: Mallik DK, Zhang H, Shi H, Tan H, Shen L, Hu G, Hu H, Sejdinaj F, Pang Y, Zhu W, Yang W. Diagnostic value of breast specific gamma imaging for breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-01-02.

Spray-assisted alignment of Layer-by-Layer assembled silver nanowires: a general approach for the preparation of highly anisotropic nano-composite films

The present article focuses on the build-up and the properties of oriented silver nanowire monolayer films and Layer-by-Layer assembled multilayer films. We describe the template-free oriented spray-assisted assembly of silver nanowires at solid/air-interfaces using Grazing Incidence Spraying, a simple and versatile approach that allows the formation of highly oriented thin films with a tunable density and in-plane orientation. Depending on the spraying conditions the nematic order parameter, which describes the angular spread of misaligned nanowires, can be as high as 0.98 (a value of 1.00 corresponding to a perfectly parallel alignment). The combination with the Layer-by-Layer assembly allows building multilayer thin films possessing in-plane anisotropy. In order to demonstrate that the local alignment does not cancel out on the macroscopic scale but leads to direction-dependent properties, we use linearly polarized UV-Vis-NIR spectroscopy to probe the selective excitation of the transverse and longitudinal localized plasmon resonances of the nanowires. The polarization efficiency of the thin films increases strongly with the in-plane density, the degree of orientation, and the number of silver nanowire layers. Multilayer films containing 4 layers of nanowires oriented in the same direction reach a polarization efficiency of up to 97% in the near-infrared region.

Severe ovarian hyperstimulation syndrome in a naturally conceived singleton pregnancy after ovulation induction: a case report

OBJECTIVE

To present a case of severe ovarian hyperstimulation syndrome (OHSS) in a naturally conceived singleton pregnancy after ovulation induction.

CASE

A 31-year-old woman with polycystic ovarian syndrome (PCOS) underwent ovulation induction therapy. Six days later, she was admitted to the present hospital with the symptoms of OHSS. Ultrasonography confirmed the single live intrauterine pregnancy, as well as enlarged multicystic ovaries and marked ascites that required abdominal paracentesis. The woman was treated with intravenous infusion, exogenous colloid supplementation, essentiale liver treatment, rocephin anti-infective therapy for skin lymphangitis of left lower limb, and drainage of the ascites. She recovered by day 45 of admission.

CONCLUSION

Severe OHSS may develop in women with PCOS who undergo ovulation induction therapy. Serious complications may develop rapidly and therefore OHSS must be treated urgently and with multidisciplinary management.

High Free Fatty Acid Levels Are Associated with Stroke Recurrence and Poor Functional Outcome in Chinese Patients with Ischemic Stroke

BACKGROUND

The aim of this study is to investigate whether serum and cerebrospinal fluid (CSF) free fatty acid (FFA) levels are associated with outcome and recurrence in a cohort of patients with an acute ischemic stroke (AIS).

METHODS

From December 2013 to May 2015, patients with first-ever AIS were included. FFA level and NIH stroke scale (NIHSS) were measured at the time of admission. Logistic regression analysis was used to evaluate the stroke outcome and recurrence according to FFA level. Clinical follow-up was performed at 6 month.

RESULTS

In our study, we studied 296 patients (52.7% male). We have found a positive correlation between serum and CSF levels of FFA. Patients with a poor outcome and recurrence had significantly increased FFA serum and CSF levels on admission (all p<0.0001). Multivariate logistic regression analysis adjusted for common risk factors showed that FFA was an independent predictor of poor functional outcome and recurrence. Odds ratios (OR) values were more significant for the higher levels of FFA.

CONCLUSION

In summary, baseline serum and CSF FFA level were associated with stroke poor function outcome and recurrence, suggesting an effect of FFA on disease course in AIS.

[Effect of age on urodynamic parameters of women with urinary incontinence]

OBJECTIVE

To investigate age related changes in urodynamic parameters of women with urinary incontinence.

METHODS

From May 2008 to October 2015, a total of 214 patients diagnosed with urinary incontinence in Peking University People's Hospital was involved in this study. Average age was (56.97±10.68) years, ranging from 30 to 82 years, and average history was (8.44±8.85) years, ranging from one month to 50 years. Urodynamic examinations of each patient were taken before operation routinely in Department of Urology, Peking University People's Hospital. The urodynamic study was composed of non-invasive and invasive procedures. Analysis included maximal flow rate (Qmax), average flow rate, time to Qmax, voiding time, detrusor pressure at Qmax, maximal detrusor pressure, voided volume, post-void residual urine volume (PVR), the total capacity of bladder, first-, strong-, and urge-desire to void, cough leak point pressure (CLPP), and Valsalva leak point pressure (VLPP). Patients were divided into four groups according to age, Kolmogorov-Smirnov test and one-way ANOVA were used for data analysis.

RESULTS

A total of 214 patients were enrolled in this study. The data of Qmax, average flow rate, voided volume, and total capacity of bladder decreased with statistical significance. The value of residual urine volume and voiding time increased without statistical significance, while the value of maximal detrusor pressure decreased.

CONCLUSION

Urodynamic examination data of females with urinary incontinence changes along with the elapse of age, which was mainly observed as age ascends, and the changes in urodynamic parameters of women with urinary incontinence suggest that the value of Qmax, average flow rate, voided volume, and total capacity of bladder decreased significantly, while the value of PVR and the voiding time increased and the value of maximal detrusor pressure decreased.

[Trends in Gleason scores of Chinese prostate carcinoma from 1995 to 2014]

OBJECTIVE

To assess the changing trends in Gleason score (GS) of Chinese prostate carcinoma (PCa) from January 1995 to December 2014.

METHODS

In the study, 875 patients admitted to hospital from January 1995 to December 2004 (1995-2004) and from January 2005 to December 2014 (2005-2014) were divided into two groups. The mean levels and proportions of GS, primary and secondary grades were studied. The patients were divided into four groups according to age: <60, 60-69, 70-79 and ≥80 years. Types of specimen included needle biopsy (NB), transurethral resection of the prostate (TURP) and radical prostatectomy (RP). Histological types were made up by acinar carcinoma and other types (including atrophic, pseudohyperplastic, foam, signet ring cell and ductal carcinoma, and so on). The total prostate-specific antigen (tPSA) involved groups of <20.0 μg/L and ≥20.0 μg/L. We observed the mean levels and proportions of GS in age, types of specimen, histological types and total prostate-specific antigen in different periods, and used SPSS 17.0 software for statistical analysis.

RESULTS

Compared with 1995-2004, the mean levels of GS, primary and secondary grades decreased 0.32 (P=0.003), 0.19 (P=0.001) and 0.12 (P=0.016) in 2005-2014, respectively. The proportions of ≤6 in GS increased 10.9% (P=0.003), and ≥8 decreased 14.0% (P<0.001). The difference of GS 7 was not statistically significant. In the primary grade, the ratio of grades≤3 increased 12.8% (P=0.001), and grade 4 decreased 7.4% (P=0.037), grade 5 decreased 5.5% (P=0.007). The ratio of secondary grades ≤3 increased 7.6% (P=0.037). The difference of grades 4 and 5 was not statistically significant.

CONCLUSION

GS in Chinese patients with PCa showed a downward trend, which is one of the notable features in the past 20 years in China. The types of specimen and age are important factors in GS, while the histological types and tPSA have less impact on the GS.