Abstract P5-09-02: Tβ4 expression in cancer-associated endothelial cells enhances progression of invasive breast cancer

Background: Invasive breast cancer is a highly aggressive primary breast tumour with poor prognosis. As tumour angiogenesis is exhibited by invasive breast cancer, anti-angiogenic therapy has been intensively evaluated over the past decade. However, clinical studies were disappointing. Thymosin β4 (Tβ4), a multi-functional peptide, is associated with induction of angiogenesis, but the role of Tβ4 in tumorigenesis of invasive breast cancer is unknown. We tested whether Tβ4 inhibition could be a new target involved in tumour development and tumour angiogenesis for treatment of invasive breast cancer.

Methods: We have adapted a 3D co-culture system to acquire invasive breast cancer cells-associated endothelial cells (ECs), which is followed by characterising the differential gene expressions by PCR-based subtraction analysis. We performed Western blot analysis on the protein samples obtained from ECs-stimulated by invasive breast cancer cells. Expression of Tβ4 in invasive breast cancer was assessed by qPCR in the breast tissues (tumour, n=119; background, n=55), and protein expression confirmed by immunohistochemical examination in an invasive breast cancer tissue microarray. Finally, mice breast cancer xenografts plus non-invasively photoacoustic microscopy were used to analyse the effect of Tβ4 knockdown on the tumorigenesis of invasive breast cancer.

Results: We found that invasive breast cancer cells could stimulate an increase in Tβ4 expression in microvascular ECs. High Tβ4 levels were strongly associated with high malignant invasive breast cancer and poor clinical outcome. In vivo study showed that siRNA targeting Tβ4 blocked growth of invasive breast cancer in mice. Photoacoustic imaging revealed that knockdown of Tβ4 elicited anti-breast cancer growth, in part, through disruption of tumour vasculature. Our results demonstrate that endothelial cell-derived Tβ4 enhances the progression of breast cancer by up-regulating tumour angiogenesis and it indicates that a high level of tumour stromal Tβ4 is an independent predictor of poor outcome.

Conclusions: Inhibiting endothelial Tβ4 could be a new therapeutic target in anti-angiogenic strategy for treatment of invasive breast cancer.

Citation Format: Cai J, Jiang W. Tβ4 expression in cancer-associated endothelial cells enhances progression of invasive breast cancer [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 P5-09-02.

Association of Serum 25(OH) D Levels with Infarct Volumes and Stroke Severity in Acute Ischemic Stroke

BACKGROUND

The aim of this study is to investigate whether 25-hydroxyvitamin D [25(OH) D] is associated with initial stroke severity and infarct volume, using diffusion-weighted imaging (DWI) in patients with acute ischemic stroke.

METHODS

We studied a total of 235 patients who were admitted within 24 hours of acute ischemic stroke onset. Initial stroke severity was assessed using the NIH Stroke Scale (NIHSS) score. Infarct volume was measured using DWI. Multivariable linear and logistic regression analyses were used to test whether 25(OH) D represents an independent predictor of infarct volume and stroke severity (NIHSS score of ≥6).

RESULTS

Among 235 study patients, the median age was 64 years (IQR 56-75 years), and 125 (53.2%) were women. In multivariable models adjusted for other significant risk factors, 25(OH) D levels in the lowest and second interquartiles were associated with an increased risk of a NIHSS≥6 (with highest 25 (OH) D quartile as reference) with odd ratios (OR) 3.02(95% confidence interval [CI]:1.59-6.34) and 5.85(2.90-11.54). The median DWI infarct volumes for the serum 25(OH) D level quartiles (lowest to highest) were 12.35, 6.55, 2.44, and 1.59 ml. The median DWI infarct volume in the lowest serum 25(OH) D level quartile was larger than that in the other 3 quartiles (P<0.001). The median adjusted DWI infarct volume in the lowest serum 25(OH) D level quartile was statistically significantly larger than that in the other 3 quartiles (P<0.01).

CONCLUSION

In conclusion, reduced serum 25(OH) D levels in acute ischemic stroke are an early predictor of larger volumes of ischemic tissue and worse neurological deficit (assessed by the NIHSS).

Measurement of the Frequency of the 2 ^{3}S-2 ^{3}P Transition of ^{4}He

The 2 ^{3}S-2 ^{3}P transition of ^{4}He was measured by comb-linked laser spectroscopy using a transverse-cooled atomic beam. The centroid frequency was determined to be 276 736 495 600.0(1.4) kHz, with a fractional uncertainty of 5.1×10^{-12}. This value is not only more accurate but also differs by as much as -49.5  kHz (20σ) from the previous result given by [Cancio Pastor et al., Phys. Rev. Lett. 92, 023001 (2004)PRLTAO0031-900710.1103/PhysRevLett.92.023001; Cancio Pastor et al.Phys. Rev. Lett.97, 139903(E) (2006)10.1103/PhysRevLett.97.139903; Cancio Pastor et al.Phys. Rev. Lett.108, 143001 (2012)10.1103/PhysRevLett.108.143001]. In combination with ongoing theoretical calculations, this work may allow the most accurate determination of the nuclear charge radius of helium.

Reticulocalbin-2 enhances hepatocellular carcinoma proliferation via modulating the EGFR-ERK pathway

This corrects the article DOI: 10.1038/onc.2017.230.

Abdominal obesity and risk of hip fracture: a meta-analysis of prospective studies

We conducted a meta-analysis to qualitatively summarize the evidence of the association between abdominal obesity and hip fracture risk. The results indicated that abdominal obesity as measured by waist circumference and waist-hip ratio might be associated with an increased risk of hip fracture.

INTRODUCTION

Epidemiological investigations evaluating the association of abdominal obesity with hip fracture risk have yielded conflicting results. Therefore, a meta-analysis was conducted to qualitatively summarize the evidence of the associations between waist circumference, waist-hip ratio, and hip circumference and the risk of hip fracture, respectively.

METHODS

PubMed, Embase, and Web of Science were searched for relevant articles published up to March 2017. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated with a random-effects model. Dose-response relationship was assessed by restricted cubic spline.

RESULTS

Seven studies involving 180,600 participants for hip circumference, six studies involving 199,828 participants for waist-hip ratio, and five studies involving 170,796 participants for waist circumference were finally included in this meta-analysis. The combined RRs with 95% CIs of hip fracture for the highest versus lowest category of waist circumference, waist-hip ratio, and hip circumference were 1.58 (95% CI 1.20-2.08), 1.32 (95% CI 1.15-1.52), and 0.87 (95% CI 0.74-1.02), respectively. For dose-response analysis, a nonlinear relationship was found (P _nonlinearity < 0.001) between waist circumference and the risk of hip fracture, and a linear relationship (P _nonlinearity = 0.911) suggested that the risk of hip fracture increased about 3.0% (1.03 (1.01-1.04)) for each 0.1 unit increment of waist-hip ratio.

CONCLUSIONS

This meta-analysis suggested that abdominal obesity as measured by waist circumference and waist-hip ratio might be associated with an increased risk of hip fracture. From a public health perspective, indicators of abdominal obesity may be usable predictors of hip fracture risk.

Apical stress distribution under vertical compaction of gutta-percha and occlusal loads in canals with varying apical sizes: a three-dimensional finite element analysis

AIM

To investigate and compare the effects of two apical canal instrumentation protocols on apical stress distribution at the root apex under vertical compaction of gutta-percha and occlusal loads using finite element analysis.

METHODOLOGY

Three finite element analysis models of a mandibular first premolar were reconstructed: an original canal model, a size 35, .04 taper apical canal enlargement model and a Lightspeed size 60 apical canal enlargement model. A 15 N compaction force was applied vertically to the gutta-percha 5 mm from the apex. A 175 N occlusal load in two directions (vertical and 45° to the longitudinal axis of the tooth) was simulated. Stresses in the apical 2 mm of the root were calculated and compared among the three models.

RESULTS

Under vertical compaction, stresses in the apical canal instrumented by Lightspeed size 60 (maximal 3.3 MPa) were higher than that of the size 35, .04 taper model (maximal 1.3 MPa). In the case of the two occlusal forces, the Lightspeed size 60 apical enlargement was associated with the greatest stress distribution in the apical region. The greatest stress and the most obvious stress difference between the models appeared at the tip of the root when occlusal and vertical compaction loads were applied.

CONCLUSIONS

Apical enlargement caused stress distribution changes in the apical region of roots. The larger apical size led to higher stress concentration at the root apex.

Enhancement of THz generation by feedback-optimized wavefront manipulation

We apply active feedback optimization methods to pyroelectric measurements of a THz signal generated by four wave mixing in air using 1 mJ to 12 mJ, 35 fs laser pulses operating at 12 kHz repetition rate. A genetic algorithm, using the THz signal as a figure of merit, determines the voltage settings to a deformable mirror and results in up to a 6 fold improvement in the THz signal compared with settings optimized for the best focus. It is possible to optimize for different THz generation processes using this technique.

Integrating In Vitro, Modeling, and In Vivo Approaches to Investigate Warfarin Bioequivalence

We demonstrate the use of modeling and simulation to investigate bioequivalence (BE) concerns raised about generic warfarin products. To test the hypothesis that the loss of isopropyl alcohol and slow dissolution in acidic pH has significant impact on the pharmacokinetics of warfarin sodium tablets, we conducted physiologically based pharmacokinetic absorption modeling and simulation using formulation factors or in vitro dissolution profiles as input parameters. Sensitivity analyses indicated that warfarin pharmacokinetics was not sensitive to solubility, particle size, density, or dissolution rate in pH 4.5, but was affected by dissolution rate in pH 6.8 and potency. Virtual BE studies suggested that stressed warfarin sodium tablets with slow dissolution rate in pH 4.5 but having similar dissolution rate in pH 6.8 would be bioequivalent to the unstressed warfarin sodium tablets. A four‐way, crossover, single‐dose BE study in healthy subjects was conducted to test the same hypothesis and confirmed the simulation conclusion.

Correction: Tailored theranostic apolipoprotein E3 porphyrin-lipid nanoparticles target glioblastoma

Correction for ‘Tailored theranostic apolipoprotein E3 porphyrin-lipid nanoparticles target glioblastoma’ by M. A. Rajora et al., Chem. Sci., 2017, DOI: ; 10.1039/c7sc00732a.

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.

Comparison of vertical and horizontal swimming behaviour of the weather loach Misgurnus anguillicaudatus

Experiments on the swimming kinetics and behaviour of weather loach Misgurnus anguillicaudatus showed that horizontal swim speed was significantly greater than swim speeds when ascending to or descending from the water surface to gulp air. Vertical swimming speeds during ascending or descending were similar. Misgurnus anguillicaudatus swam unsteadily during vertical movements compared with horizontal movements.

A new approach of splint-less orthognathic surgery using a personalized orthognathic surgical guide system: A preliminary study

The purpose of this study was to evaluate a personalized orthognathic surgical guide (POSG) system for bimaxillary surgery without the use of surgical splint. Ten patients with dentofacial deformities were enrolled. Surgeries were planned with the computer-aided surgical simulation method. The POSG system was designed for both maxillary and mandibular surgery. Each consisted of cutting guides and three-dimensionally (3D) printed custom titanium plates to guide the osteotomy and repositioning the bony segments without the use of the surgical splints. Finally, the outcome evaluation was completed by comparing planned outcomes with postoperative outcomes. All operations were successfully completed using the POSG system. The largest root-mean-square deviations were 0.74mm and 1.93° for the maxillary dental arch, 1.10mm and 2.82° for the mandibular arch, 0.83mm and 2.59° for the mandibular body, and 0.98mm and 2.45° for the proximal segments. The results of the study indicated that our POSG system is capable of accurately and effectively transferring the surgical plan without the use of surgical splint. A significant advantage is that the repositioning of the bony segments is independent to the mandibular autorotation, thus eliminates the potential problems associated with the surgical splint.

Tailored theranostic apolipoprotein E3 porphyrin-lipid nanoparticles target glioblastoma

Size-controlled discoidal and cholesteryl oleated-loaded spherical, intrinsically multimodal porphyrin-lipid nanoparticles targeted glioblastoma via apoE3 and LDLR.

The development of curative glioblastoma treatments and tumour-specific contrast agents that can overcome the blood–brain barrier (BBB) and infiltrative tumour morphology remains a challenge. Apolipoprotein E3 (apoE3) is a high density lipoprotein apolipoprotein that chaperones the transcytosis of nanoparticles across the BBB, and displays high-affinity binding with the low density lipoprotein receptor (LDLR), a cell-surface receptor overexpressed by glioblastoma cells. This LDLR overexpression and apoE3 binding capacity was exploited for the development of glioblastoma-targeted porphyrin-lipid apoE3 lipid nanoparticles (pyE-LNs) with intrinsic theranostic properties. Size-controlled discoidal and cholesteryl oleate (CO)-loaded spherical pyE-LNs were synthesized through the systematic variation of particle composition, which dictated nanoparticle size and morphology. Composition optimization yielded 30 nm pyE-LNs with stable loading of apoE3 and porphyrin-lipid that simultaneously conferred the nanoparticles with glioblastoma targeting and activatable near-infrared fluorescence imaging functionalities. A 4-fold higher uptake of pyE-LNs by LDLR-expressing U87 glioblastomas cells relative to minimally expressing ldlA7 cells was observed in vitro. This uptake was a result of receptor-mediated endocytosis, which could be inhibited through LDL competition and acetylation of particle apoE3 moieties. ApoE3-dependent delivery of pyE-LN to glioblastomas was also demonstrated in orthotopic U87-GFP tumour-bearing animals. Quantification of CO-loaded pyE-LN biodistribution demonstrated successful selective uptake of porphyrin by malignant tissue, with a 4 : 1 tumour : healthy tissue particle specificity. This allowed for the detection of strong, tumour-localized porphyrin fluorescence, which was diminished when apoE3-devoid py-LN particles were administered. Furthermore, this selective uptake yielded cell-specific potent PDT sensitization in vitro, resulting in an 83% reduction in glioblastoma cell viability. These results highlight the promising capacity of pyE-LNs to target porphyrin delivery to glioblastoma tumours for theranostic applications.

The prohibitin-repressive interaction with E2F1 is rapidly inhibited by androgen signalling in prostate cancer cells

Prohibitin (PHB) is a tumour suppressor molecule with pleiotropic activities across several cellular compartments including mitochondria, cell membrane and the nucleus. PHB and the steroid-activated androgen receptor (AR) have an interplay where AR downregulates PHB, and PHB represses AR. Additionally, their cellular locations and chromatin interactions are in dynamic opposition. We investigated the mechanisms of cell cycle inhibition by PHB and how this is modulated by AR in prostate cancer. Using a prostate cancer cell line overexpressing PHB, we analysed the gene expression changes associated with PHB-mediated cell cycle arrest. Over 1000 gene expression changes were found to be significant and gene ontology analysis confirmed PHB-mediated repression of genes essential for DNA replication and synthesis, for example, MCMs and TK1, via an E2F1 regulated pathway—agreeing with its G1/S cell cycle arrest activity. PHB is known to inhibit E2F1-mediated transcription, and the PHB:E2F1 interaction was seen in LNCaP nuclear extracts, which was then reduced by androgen treatment. Upon two-dimensional western blot analysis, the PHB protein itself showed androgen-mediated charge differentiation (only in AR-positive cells), indicating a potential dephosphorylation event. Kinexus phosphoprotein array analysis indicated that Src kinase was the main interacting intracellular signalling hub in androgen-treated LNCaP cells, and that Src inhibition could reduce this AR-mediated charge differentiation. PHB charge change may be associated with rapid dissociation from chromatin and E2F1, allowing the cell cycle to proceed. The AR and androgens may deactivate the repressive functions of PHB upon E2F1 leading to cell cycle progression, and indicates a role for AR in DNA replication licensing.

[Inflammatory myofibroblastic tumour of thyroid: a case report]

A elderly woman patient，with a unclear boundary,solid,smooth surface,moderately active mass that estimated 0.4 cm at its greatest diameter in the left lobe of thyroid. Ultrasonography revealed a hypoechoic mass in the left lobe and Computed Tomography showed a 38 mm×25 mm×23 mm oval lesion with uniform density in the left lobe also. The surgical findings revealed tumor located in the inner side of left thyroid lobe near the isthmus,with unclear boundary. Pathological examination showed unclear boundaries between thyroid and tumor,the tumor cells attack into the muscle tissue,braided/ fascicles spindle shaped or star shaped myofibroblasts cells in the tumor area with myxedema inflammatory background and the lesion did not have any mitotic figures. Immunohistochemical analysis indicated that the spindle cells were positive for Vim,ACT,SMA,Bcl2 and ClyD1,and focal lesion histiocytes showed focal positive for CD68,CK and S-100,but negative for DES,Mgo,CD99,CD34,CD117,IgG4,ALK-1.The pathological diagnosis supports inflammatory myofibroblastic tumor of thyroid. Imaging and immunohistochemistry and others are useful in differential diagnosis.

Etoposide and cisplatin versus paclitaxel and carboplatin with concurrent thoracic radiotherapy in unresectable stage III non-small cell lung cancer: a multicenter randomized phase III trial

Background

The optimal chemotherapy regimen administered currently with radiation in patients with stage III non-small cell lung cancer (NSCLC) remains unclear. A multicenter phase III trial was conducted to compare the efficacy of concurrent thoracic radiation therapy with either etoposide/cisplatin (EP) or carboplatin/paclitaxel (PC) in patients with stage III NSCLC.

Patients and methods

Patients were randomly received 60-66 Gy of thoracic radiation therapy concurrent with either etoposide 50 mg/m2 on days 1-5 and cisplatin 50 mg/m2 on days 1 and 8 every 4 weeks for two cycles (EP arm), or paclitaxel 45 mg/m2 and carboplatin (AUC 2) on day 1 weekly (PC arm). The primary end point was overall survival (OS). The study was designed with 80% power to detect a 17% superiority in 3-year OS with a type I error rate of 0.05.

Results

A total of 200 patients were randomized and 191 patients were treated (95 in the EP arm and 96 in the PC arm). With a median follow-up time of 73 months, the 3-year OS was significantly higher in the EP arm than that of the PC arm. The estimated difference was 15.0% (95% CI 2.0%-28.0%) and P value of 0.024. Median survival times were 23.3 months in the EP arm and 20.7 months in the PC arm (log-rank test P = 0.095, HR 0.76, 95%CI 0.55-1.05). The incidence of Grade ≥2 radiation pneumonitis was higher in the PC arm (33.3% versus 18.9%, P = 0.036), while the incidence of Grade ≥3 esophagitis was higher in the EP arm (20.0% versus 6.3%, P = 0.009).

Conclusion

EP might be superior to weekly PC in terms of OS in the setting of concurrent chemoradiation for unresectable stage III NSCLC.

Trial registration ID

NCT01494558.

Neutron Generation by Laser-Driven Spherically Convergent Plasma Fusion

We investigate a new laser-driven spherically convergent plasma fusion scheme (SCPF) that can produce thermonuclear neutrons stably and efficiently. In the SCPF scheme, laser beams of nanosecond pulse duration and 10^{14}-10^{15}  W/cm^{2} intensity uniformly irradiate the fuel layer lined inside a spherical hohlraum. The fuel layer is ablated and heated to expand inwards. Eventually, the hot fuel plasmas converge, collide, merge, and stagnate at the central region, converting most of their kinetic energy to internal energy, forming a thermonuclear fusion fireball. With the assumptions of steady ablation and adiabatic expansion, we theoretically predict the neutron yield Y_{n} to be related to the laser energy E_{L}, the hohlraum radius R_{h}, and the pulse duration τ through a scaling law of Y_{n}∝(E_{L}/R_{h}^{1.2}τ^{0.2})^{2.5}. We have done experiments at the ShengGuangIII-prototype facility to demonstrate the principle of the SCPF scheme. Some important implications are discussed.

Pretreatment Predictors of Early Response Revealed by Quantitative Cerebral Blood Flow in Major Depressive Disorder

Objective

The potential pattern of regional cerebral blood flow (rCBF) in major depressive disorder (MDD) underlies different response to antidepressants medication remain unclear. This study aimed to investigate the differences of rCBF between patients with different treatment response.

Methods

Eighty MDD patients [(44 treatment-responsive depression (RD) and 36 non-responding depression (NRD)] and 42 healthy controls (HC) underwent pulsed arterial spin labeling (PASL) scans in magnetic resonance imaging and clinical estimates. The exact rCBF values of each groups were obtained via quantification evaluation.

Results

Compared to NRD, the RD patients showed decreased rCBF values in frontal sensorimotor network (i.e. left paracentral lobule, left medial frontal gyrus, right superior frontal gyrus and right middle frontal gyrus), and further receiver operating curve (ROC) analyses demonstrated that the altered rCBF in these four regions exhibited outstanding performance on distinguishing NRD from RD. The NRD also exhibited reduced rCBF in bilateral cerebellum posterior lobe and right middle occipital gyrus and elevated rCBF in right postcentral gyrus and right middle frontal gyrus as compared to HC.

Conclusions

The decreased rCBF in frontal sensorimotor network appeared to be distinct characteristics for NRD, and might be severed as promising neuroimaging markers to differentiate depressed patients with weak early response to antidepressant medication. These findings expand our understanding of neural substrate underlying the antidepressant efficacy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Abstract P4-22-04: A randomized, double-blind, phase 2 study of ruxolitinib (RUX) or placebo (PBO) in combination with capecitabine (CAPE) in patients (pts) with advanced HER2-negative breast cancer (ABC) and elevated C-reactive protein (CRP), a marker of systemic inflammation

Background: Systemic inflammation is associated with poor prognosis in pts with ABC. The JAK/STAT pathway is a key regulator of inflammatory signaling, associated with tumorigenesis, cell survival, and progression. We evaluated the efficacy and safety of RUX, a JAK1/JAK2 inhibitor, plus CAPE in pts with HER2-negative ABC and high systemic inflammation defined by the modified Glasgow Prognostic Score (mGPS). Methods: In this double-blind phase 2 trial, pts were randomized 1:1 to 21 day cycles of RUX+CAPE or PBO+CAPE: RUX 15 mg or PBO PO BID for 21 d; CAPE 1000 mg/m2 PO BID for 14 d. Key inclusion criteria were systemic inflammation by mGPS of 1 or 2 (ie, CRP &gt;10 mg/L), ECOG performance status ≤2, ≤2 prior chemotherapy regimens, and no prior CAPE. The primary endpoint was overall survival (OS); key secondary endpoints were progression-free survival (PFS), objective response rate (ORR; complete [CR] + partial response [PR]) per RECIST v1.1, clinical benefit rate (CBR; CR + PR + stable disease for ≥6 mo), duration of response, and safety. Treatment differences in OS and PFS were analyzed by the log-rank test; HRs and CIs were analyzed by the Cox proportional hazards model. Results: Baseline characteristics were similar between pts randomized to RUX+CAPE (n=76) vs PBO+CAPE (n=73): mGPS status (1, 82.9% vs 83.6%), hormone receptor (HR) status (positive, 67.1% vs 63.0%), and number of prior chemotherapy regimens for ABC (0, 50.0% vs 50.7%; 1, 38.2% vs 34.2%; 2, 9.2% vs 13.7%). Median treatment durations were 85 d with RUX in the RUX+CAPE group and 65 d with PBO in the PBO+CAPE group. Median OS was 11.2 mo with RUX+CAPE vs 10.9 mo with PBO+CAPE (HR, 0.932; 95% CI, 0.59–1.46; P=0.762). Median OS was 6.1 mo with RUX+CAPE vs 5.5 mo with PBO+CAPE in HR-negative pts and 11.7 mo and 12.2 mo in HR-positive pts. Median PFS was 4.5 mo with RUX+CAPE and 2.5 mo with PBO+CAPE (HR, 0.737; 95% CI, 0.49–1.12; P=0.151). Median PFS was 2.1 mo with RUX+CAPE vs 2.2 mo with PBO+CAPE in HR-negative pts and 6.1 mo and 4.1 mo in HR-positive pts. ORRs were 28.9% and 13.7% (P=0.024) in the RUX+CAPE and PBO+CAPE arms, respectively. The CBRs were 13.2% and 6.8%, respectively (P=0.278). Worsening of hematologic toxicity was higher and rates of grade 3/4 palmar-plantar erythrodysethesia (PPE) were lower (1.4% vs 12.7%, respectively) with RUX+CAPE (Table).

Safety RUX+CAPE (n=71)PBO+CAPE (n=71)%All-GradeGrade 3/4All-GradeGrade 3/4Nonhematologic Adverse Event*Fatigue56.35.643.74.2Nausea54.98.549.35.6Diarrhea47.98.526.82.8PPE46.51.438.012.7Vomiting38.05.629.64.2Hypokalemia15.58.57.02.8Worsening of Hematologic Toxicity†Anemia80.323.956.37.0Lymphopenia40.815.545.112.7Neutropenia39.411.322.52.8Thrombocytopenia39.411.315.51.4*Most common all-grade (≥35%) or grade 3/4 (≥5%) events in the RUX+CAPE arm (safety group). †Laboratory abnormalities.

Conclusion: These data support the prognostic capabilities of the mGPS. The addition of RUX to CAPE for pts with ABC and high systemic inflammation was associated with an improved ORR compared with PBO+CAPE, but did not improve OS or PFS.

Citation Format: O'Shaughnessy J, DeMichele A, Ma C, Richards P, Yardley DA, Wright G, Kalinsky K, Steis R, Diab S, Kennealey G, Geschwindt R, Jiang W, Rugo H. A randomized, double-blind, phase 2 study of ruxolitinib (RUX) or placebo (PBO) in combination with capecitabine (CAPE) in patients (pts) with advanced HER2-negative breast cancer (ABC) and elevated C-reactive protein (CRP), a marker of systemic inflammation [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 P4-22-04.

Laser Spectroscopy of the Fine-Structure Splitting in the 2^{3}P_{J} Levels of ^{4}He

The fine-structure splitting in the 2^{3}P_{J} (J=0, 1, 2) levels of ^{4}He is of great interest for tests of quantum electrodynamics and for the determination of the fine-structure constant α. The 2^{3}P_{0}-2^{3}P_{2} and 2^{3}P_{1}-2^{3}P_{2} intervals are measured by laser spectroscopy of the ^{3}P_{J}-2^{3}S_{1} transitions at 1083 nm in an atomic beam, and are determined to be 31 908 130.98±0.13  kHz and 2 291 177.56±0.19  kHz, respectively. Compared with calculations, which include terms up to α^{5}Ry, the deviation for the α-sensitive interval 2^{3}P_{0}-2^{3}P_{2} is only 0.22 kHz. It opens the window for further improvement of theoretical predictions and an independent determination of the fine-structure constant α with a precision of 2×10^{-9}.

Performance of Redox Active and Chelatable Iron Assays to Determine Labile Iron Release From Intravenous Iron Formulations

Emerging data from global markets outside the United States, where many generic iron sucrose formulations are available, have revealed that non‐US generic intravenous (i.v.) iron formulations may have iron release profiles that differ from the reference listed drug (RLD). The first generic i.v. iron approved in the United States was sodium ferric gluconate complex in 2011. We evaluated chelatable and redox labile iron assay methods to measure the amount of labile iron released from i.v. iron formulations in biorelevant matrices in vitro. The majority of published labile iron assays evaluated were not suitable for use in vitro due to overwhelming interference by the presence of the i.v. iron products. However, an optimized high‐performance liquid chromatography (HPLC)‐based method performed well for use in vitro labile iron detection in a biorelevant matrix. Application of this method may enhance bioequivalence evaluation of generic i.v. iron formulations in the future.

[Prospective evaluation on ventilator-associated events: a cohort study from eight intensive care units]

OBJECTIVE

The aim of this study was to prospectively investigate the incidence of ventilator associated events (VAEs) in intensive care units (ICUs) among adult patients, and to evaluate the correlation between VAEs and ventilator associated pneumonia (VAP).

METHODS

A prospective 3-month cohort study (January 2015 to March 2015) was carried out. VAEs were divided into three groups: with ventilator-associated condition (VAC), with infection related ventilator-associated complication (IVAC) and with possible VAP (PVAP). Sensitivity and specificity of VAEs were evaluated and compared to the traditional VAP. Kappa test was applied to judge the consistency of VAC and VAP.

RESULTS

During Jan. 2015 and Mar. 2015, 1 014 patients were admitted to 8 ICUs, with 7 977 patients per day. In total, 197 patients used the mechanical ventilation installation, with, a total number of 3 152 ventilator-days. Finally, 1 214 ventilation days in the VAC group and 1 938 ventilation days in the non-VAC group) that were available for final analysis. 46 VAC cases were identified including 22 classified as IVAC (14.59 and 6.98 per 1 000 ventilation days, respectively). Length of ICU stay and duration on mechanical ventilation for VAC patients were both significantly longer than those for non-VAC patients (P<0.05). Sensitivity and specificity of the VAC criteria for the detection of VAP were 36.92% and 83.33%, respectively.

CONCLUSION

The VAEs surveillance paradigms could be applied to monitor patients on the use of mechanical ventilation installation. However, sensitivity and specificity of VAC were under pool for the diagnosis of VAP. However, automatically surveillance programs was relied on the improvement of auto-information systems.

Phosphorylation of NFAT3 by CDK3 induces cell transformation and promotes tumor growth in skin cancer

The nuclear factor of activated T cells (NFAT) family proteins are transcription factors that regulate the expression of pro-inflammatory cytokines and other genes during the immune response. Although the NFAT proteins have been extensively investigated in the immune system, their role in cancer progression remains controversial. Here, we report that NFAT3 is highly expressed in various skin cancer cell lines and tumor tissues. Knockdown of endogenous NFAT3 expression by short hairpin RNA (shRNA) significantly inhibited tumor cell proliferation, colony formation and anchorage-independent cell growth. Furthermore, results of the mammalian two-hybrid assay showed that cyclin-dependent kinase 3 (CDK3) directly interacted with NFAT3 and phosphorylated NFAT3 at serine 259 (Ser259), which enhanced the transactivation and transcriptional activity of NFAT3. The phosphorylation site of NFAT3 was critical for epidermal growth factor (EGF)-stimulated cell transformation of the HaCaT immortalized skin cell line and mutation of NFAT3 at Ser259 led to a reduction of colony formation in soft agar. We also found that overexpressing wildtype NFAT3, but not mutant NFAT3-S259A, promoted A431 xenograft tumor growth. Importantly, we showed that CDK3, NFAT3 and phosphorylated NFAT3-Ser259 were highly expressed in skin cancer compared with normal skin tissues. These results provided evidence supporting the oncogenic potential of NFAT3 and suggested that CDK3-mediated phosphorylation of NFAT3 has an important role in skin tumorigenesis.

Landscape of expression profiles in esophageal carcinoma by The Cancer Genome Atlas data

In this study, we explored the gene and microRNA (miRNA) expressions profile of esophageal carcinoma. The expression data for messenger RNAs and miRNAs in normal and cancerous esophageal tissues were obtained from the Cancer Genome Atlas database and then the differentially expressed genes and miRNAs were identified. As a result, we identified 2962 genes and 45 miRNAs differentially expressed in esophageal carcinoma compared with normal esophageal tissues. Subsequently, the altered gene functions and signaling pathways were investigated using gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses, and these differentially expressed genes were significantly enriched in the cell cycle, cell migration, mitogen-activated protein kinase (MAPK) and toll-like receptor signaling pathway, and so on. Then the regulatory relationships between the differentially expressed miRNAs and genes were examined with Targetscan and Miranda, and the potential target sites of transcription factors (TFs) in the promoter regions of these miRNAs and genes were identified using the TRANSFAC database. Finally the TF-miRNA-gene network in esophageal cancer was established, summarizing the regulatory links among the TFs, differentially expressed miRNAs and differentially expressed genes. Factors such as core promoter-binding protein (CPBP), nuclear factor of activated T-cells 1 (NFAT-1), miR-30c-5p, were located in the central hub of this network, highlighting their vital roles in esophageal tumorigenesis. These findings may extend our understanding of the molecular mechanisms underlying esophageal carcinoma and promote new perspectives for prevention, diagnosis and treatment.

Interplay between mast cells, enterochromaffin cells, and sensory signaling in the aging human bowel

BACKGROUND

Advanced age is associated with a reduction in clinical visceral pain perception. However, the underlying mechanisms remain largely unknown. Previous studies have suggested that an abnormal interplay between mast cells, enterochromaffin (EC) cells, and afferent nerves contribute to nociception in gastrointestinal disorders. The aim of this study was to investigate how aging affects afferent sensitivity and neuro-immune association in the human bowel.

METHODS

Mechanical and chemical sensitivity of human bowel afferents were examined by ex vivo afferent nerve recordings. Age-related changes in the density of mast cells, EC cells, sensory nerve terminals, and mast cell-nerve micro-anatomical association were investigated by histological and immune staining.

KEY RESULTS

Human afferents could be broadly classified into subpopulations displaying mechanical and chemical sensitivity, adaptation, chemo-sensitization, and recruitment. Interestingly human bowel afferent nerve sensitivity was attenuated with age. The density of substance P-immunoreactive (SP-IR) nerve varicosities was also reduced with age. In contrast, the density of ileal and colonic mucosal mast cells was increased with age, as was ileal EC cell number. An increased proportion of mast cells was found in close apposition to SP-IR nerves.

CONCLUSIONS & INFERENCES

Afferent sensitivity in human bowel was reduced with advancing age. Augmentation of mast cells and EC cell numbers and the mast cell-nerve association suggest a compensatory mechanism for sensory neurodegeneration.

qKAT: a high-throughput qPCR method for KIR gene copy number and haplotype determination

Killer cell immunoglobulin-like receptors (KIRs), expressed on natural killer cells and T cells, have considerable biomedical relevance playing significant roles in immunity, pregnancy and transplantation. The KIR locus is one of the most complex and polymorphic regions of the human genome. Extensive sequence homology and copy number variation makes KIRs technically laborious and expensive to type. To aid the investigation of KIRs in human disease we developed a high-throughput, multiplex real-time polymerase chain reaction method to determine gene copy number for each KIR locus. We used reference DNA samples to validate the accuracy and a cohort of 1698 individuals to evaluate capability for precise copy number discrimination. The method provides improved information and identifies KIR haplotype alterations that were not previously visible using other approaches.

Regulation of 1-MCP-Treated Banana Fruit Quality by Exogenous Ethylene and Temperature

Ripe green banana (Musa sp., AAA group, cv. Zhonggang) fruits treated with 1-methylcyclopropene (1-MCP) significantly delayed the peaks of respiration rate and ethylene production but did not reduce the peak height. Mature banana fruits were also treated with 1-MCP for 24 h at 20 C and then exposed to 50 mL/L ethylene or stored at different temperatures to analyse the effects of external added ethylene. Reductions in firmness, titratable acidity (TA) and starch content (SC) of banana fruits were remarkably delayed by 1-MCP treatment. 1-MCP treatment also delayed the increase of total soluble sugar (TSS) and soluble pectin (SP) contents. Soluble solids (SS) content in the 1-MCP-treated fruit remained almost unchanged during the first 10 days of storage at 20 C. No significant differences in TA, TSS, SP and SS levels were observed between the fruit treated with 1-MCP alone and the fruit treated with 1-MCP plus ethylene. The 1-MCP effects on all the parameters related to banana ripening were enhanced by low temperature storage and reduced by high temperature storage.