Physical activity patterns, genetic susceptibility, and risk of hip/knee osteoarthritis: a prospective cohort study based on the UK Biobank

OBJECTIVES

The effect of physical activity on hip/knee osteoarthritis (OA) and how it varies by genetic susceptibility to OA remains inconclusive.

METHODS

In a cohort study of UK Biobank, 436,166 OA-free participants were recruited in 2006-2010 and followed for knee/hip OA until the end of 2020. 28 physical activity-related items were collected at baseline. Cox regression was used to estimate associations between physical activity behaviors, as well as major activity patterns (i.e., significant principal components[PCs] identified by principal component analysis), and risk of OA, adjusting for multiple confounders. We further stratified the analyses by polygenic risk score (PRS) for OA to examine the impact of genetic susceptibility to OA on the studied association.

RESULTS

During a mean follow-up of 11.15 years, 13,227 hip and 21,119 knee OA cases were identified. 19, out of 28, studied items showed associations with increased OA risk. Compared with low adherence group(<1^st tertile of PC score for each pattern), individuals with high adherence to five identified patterns were associated with increased risk of OA. The moderate adherence to "strenuous sports"(HR = 0.93, 95%CI: 0.89-0.97) and "walking for pleasure"(HR = 0.93, 95%CI: 0.89-0.98) patterns was associated with reduced OA. Similar risk patterns were obtained in the stratified analysis by PRS levels for OA.

CONCLUSION

High intensity of most activity patterns were associated with increased OA. However, a protective effect was suggested for moderate adherence to patterns of "strenuous sports" and "walking for pleasure" that consistent across different genetic susceptibilities, underscoring the potential benefits of moderate-intensity physical activity on OA.

Analysis of synthetic electron cyclotron emission from the high field side of HL-2M tokamak plasmas

A synthetic electron cyclotron emission (ECE) diagnostic is used to interpret ECE signals from preset plasma equilibrium profiles, including magnetic field, electron density, and electron temperature. According to the simulation results, the electron temperature (T_e) profile covering the harmonic overlap region can be obtained by receiving ECE signals at the high field side (HFS) of the HL-2M plasma. The third harmonic ECE at the low field side (LFS) cannot pass through the second harmonic resonance layer at the HFS unless the optical thickness (τ) of the second harmonic becomes gray (τ ≤ 2). In addition, the impact of the relativistic frequency down-shift has been evaluated and corrected. The measurable range of the HFS ECE has been calculated by scanning different parameters (electron density, temperature, and magnetic field). Higher plasma parameters allow a wider radial range of electron temperature measurements. The minimum inner measurable position can reach R = 120 cm (r/a = -0.89) when the product of core temperature (T_e0) and density (n_e0) is greater than 35 × 10¹⁹ keV m^-3, which is extended by more than 30 cm inward compared with that of the LFS measurement. The HFS ECE will greatly improve the diagnostic ability of ECE systems on the HL-2M tokamak.

[Long-term safety and activity of humanized CD19 chimeric antigen receptor T cells for children and young adults with relapsed/refractory acute lymphoblastic leukemia]

Objective: To investigate the efficacy and safety of humanized CD19-specific chimeric antigen receptor T cells (hCART19s) in treating children and young adults with relapsed/refractory acute lymphoblastic leukemia (R/R ALL) and to analyze relevant factors affecting its curative effect and prognosis. Methods: We conducted a single-center clinical trial involving 31 children and young adult patients with R/R B-ALL who were treated with humanized CD19-specific CAR-T cells (hCART19s) from May 2016 to September 2021. Results: Results showed that 27 (87.1%) patients achieved complete remission (CR) or CR with incomplete count recovery (CRi) one month after CAR-T cell infusion. During treatment, 20 (64.5%) patients developed grade 1-2 cytokine release syndrome (CRS) , and 4 (12.9%) developed grade 3 CRS. Additionally, two patients had grade 1 neurological events. During the follow-up with a median time of 19.3 months, the median event-free survival (EFS) was 15.7 months (95% CI 8.7-22.5) , and the median overall survival (OS) was 32.2 months (95% CI 10.6-53.9) . EFS and OS rates were higher in patients who have undergone hemopoietic stem cell transplantation (HSCT) than in those without [EFS: (75.0 ± 12.5) % vs (21.1 ± 9.4) %, P=0.012; OS: (75.0 ± 12.5) % vs (24.6 ± 10.2) %, P=0.035]. The EFS and OS rates were significantly lower in patients with >3 treatment lines than in those with <3 treatment lines [EFS: 0 vs (49.5±10.4) %, P<0.001; OS: 0 vs (52.0±10.8) %, P<0.001]. To the cutoff date, 12 patients presented with CD19(+) relapse, and 1 had CD19(-) relapse. Conclusion: hCART19s are effective in treating pediatric and young adult R/R ALL patients, with a low incidence of severe adverse events and reversible symptoms. Following HSCT, the number of treatment lines can affect the long-term efficacy and prognosis of pediatric and young adult R/R ALL patients.

Effects of deoxynivalenol on the histomorphology of the liver and kidneys and the expression of MAPKs in weaned rabbits

Deoxynivalenol (DON) is widely present in grain-based feeds and food. It has attracted great attention due to its high contamination rate and strong toxicity. The objective of this study was to analyse the toxic effects of DON on the liver and kidneys of weaned rabbits. 45 weaned male rabbits were allocated into control, low DON dose (0.5 mg/kg body weight), and high DON dose (1.5 mg/kg body weight) groups. Saline or DON was administrated intragastrically in the empty stomach of rabbits every morning. After 24 days of treatment, liver and kidney samples were collected for histological, reverse transcription-quantitative polymerase chain reaction (qRT-PCR), and immunohistochemistry analyses. Haematoxylin eosin staining showed that 0.5 mg/kg BW DON caused mild damage to the liver and kidney morphology, while 1.5 mg/kg body weight DON resulted in hepatic vacuolation and necrosis, as well as tubular stenosis and lesions. Data from qRT-PCR, Western blot, and immunohistochemistry revealed that the mRNA and protein expression and the distribution range of extracellular signal-regulated kinase, p38, and c-Jun NH2-terminal kinase were increased in the liver and kidneys. In conclusion, DON at the tested concentrations damaged the liver and kidneys of rabbits by affecting the expression of key proteins from the mitogen-activated protein kinase signalling pathway. The damage extent was proportional to the amount of DON ingested.

Biotic and Abiotic Transformation Pathways of a Short-Chain Chlorinated Paraffin Congener, 1,2,5,6,9,10-C10H16Cl6, in a Rice Seedling Hydroponic Exposure System

In this work, a typical congener of short-chain chlorinated paraffins (SCCPs) with six chlorine atoms (CP-4, 1,2,5,6,9,10-C₁₀H₁₆Cl₆, 250 ng/mL) was selected to elaborate the comprehensive environmental transformation of SCCPs in rice seedling exposure system. CP-4 was quickly absorbed, translocated, and phytovolatilized by seedlings with a small quality of CP-4 (5.81-36.5 ng) being detected in the gas phase. Only 21.4 ± 1.6% of an initial amount (10,000 ng) of CP-4 remained in the exposure system at the end of exposure. Among the transformed CP-4, some were attributed to the degradation of the rhizosphere microorganism (9.1 ± 5.8%), root exudates (2.2 ± 4.2%), and abiotic transformation (3.0 ± 2.8%) that were proved by several transformation products found in the root exudate exposure groups and unplanted controls, and a majority was phytotransformed by rice seedlings. Here, 61 products were determined through complex transformation pathways, including multihydroxylation, -HCl elimination, dechlorination, acetylation, sulfation, glycosylation, and amide acid conjugation. The acetylated and amide acid conjugates of CPs were first observed. Phase I and Phase II phytometabolic reactions of CPs were found intertwining. These findings demonstrate that multiactive transformation reactions contribute to the overlook of CPs accumulated in plants and are helpful for the environmental and health risk assessments of SCCPs in agricultural plants.

Exogenous insulin promotes the expression of B-cell translocation gene 1 and 2 in chicken pectoralis

B-cell translocation genes (BTG) have been proved to play important roles in carbohydrate metabolism through modifying insulin homeostasis and glucose metabolism. This study, therefore, was conducted to investigate the effects of exogenous insulin on the expression of BTG1 and BTG2 in chickens. Twenty-four-day-old broilers and layers were fasted for 16 h and randomly assigned to insulin treatment group (subcutaneously injected with 5 IU/kg body weight) or control group (received an equivalent volume of phosphate-buffered saline). Blood glucose concentration was measured, and it showed that the blood glucose concentrations in the layers were significantly (P < 0.05) higher than that in the broilers under fasting state. Response to exogenous insulin, the blood glucose concentrations were greatly reduced in both breeds. Of note, the blood glucose concentration restored to 62% of the basal state at 240 min (P < 0.05) after insulin stimulation in layers, whereas it was still in low level until 240 min in broilers (under fast state). Tissue profiling revealed that both BTG1 and BTG2 were abundantly expressed in the skeletal muscles of broilers. A negative correlation was observed between blood glucose and BTG1 (ρ = −0.289, P = 0.031) /BTG2 (ρ = −0.500, P < 0.001) in pectoralis, and BTG1 (ρ = −0.462, P < 0.001) in pancreas. As blood glucose decreased due to exogenous insulin administration (under fast state), the expression of both BTG1 and BTG2 notably upregulated in birds’ pectoralis at 120 min and/or 240 min, meanwhile pancreas BTG1 was also upregulated. Re-feeding at 120 min elevated the blood glucose and reduced the expression of BTG genes in pectoralis generally. In addition, the change of BTG1 and BTG2 expression showed distinct difference between layers and broilers at 120 min and 240 min after insulin stimulation in pectoralis, pancreas and heart tissue; even after re-feeding at 120 min, BTG2 expression at 240 min after insulin injection was downregulated in the pectoralis of layers, while it was upregulated in that broilers. Collectively, these results indicated that response to exogenous insulin, chicken blood glucose exhibited breed-specific dynamic change, and meanwhile the expressions of both BTG1 and BTG2 genes in chickens were significantly altered by exogenous insulin in a breed- and tissue-specific manner. BTG1 and BTG2 genes may negatively regulate bird's blood glucose by promoting the glucose uptake corporately in pectoralis, and through regulating the insulin secretion in pancreas (especially BTG1).

Optimization of environmental factors in a dual in vitro biofilm model of Candida albicans-Streptococcus mutans

The biofilm formation of Streptococcus mutans-Candida albicans is an important virulence factor for dental caries. The purpose of this study was to determine the effect of some environmental conditions on the biofilm formation like inoculation concentration, temperature, sugar, amino acid, metal ions and saliva, and then establish a persistent in vitro biofilm model for further research. Based on the single factor experiment, the factors participating in the biofilm formation including sugar, inoculation concentration, and saliva increased the biofilm mass, while amino acid, metal ions, temperatures reduced biofilm mass. Optimal conditions for biofilm formation were the inoculation dosage of S. mutans and C. albicans of 10⁸ and 10⁷ , respectively, the addition of 0·3 g l^-1 sucrose and sterile saliva. These results contribute to a deep understanding of the factors involved in oral biofilm formation of the important cariogenic pathogen S. mutans and the opportunistic pathogen C. albicans to study better for biofilm and promote the design of new therapeutic approaches. The present research also provides a model for evaluating the therapeutic potential for drugs in the future.

POS0074 IMMUNOLOGICAL DIFFERENCES BETWEEN PsA PATIENTS WHO ARE TUMOR NECROSIS FACTOR INHIBITOR-NAIVE AND WHO HAVE INADEQUATE RESPONSE TO TUMOR NECROSIS FACTOR INHIBITORS

Background

A better understanding of the immunological differences between psoriatic arthritis (PsA) patients (pts) who are tumor necrosis factor inhibitor (TNFi)-naïve & who have inadequate response to TNFi (TNFi-IR) may guide treatment choices. In DISCOVER-1, benefit of the IL-23p19 subunit inhibitor guselkumab (GUS) every-four-weeks (Q4W) & Q8W vs placebo (PBO) in improving PsA signs & symptoms was seen in adults with active PsA.1 The Ph3b COSMOS study of GUS Q8W vs PBO in TNFi-IR PsA pts corroborated these findings.2

Objectives

Assess baseline (BL) molecular differences between TNFi-naïve & -IR PsA pts & investigate GUS pharmacodynamic (PD) effect on cytokine expression over time in these cohorts.

Methods

Serum samples collected from consenting biomarker substudy pts in DISCOVER-11 (TNFi-naïve [n=101] & -IR [n=17]), DISCOVER-23 (TNFi-naïve [n=150]), & COSMOS2 (TNFi-IR [n=76]) were analyzed for selected serum cytokine levels. TNFi-IR pts in this post-hoc analysis had active PsA & discontinued 1-2 TNFi due to inadequate efficacy; these pts required a TNFi-specific washout period prior to starting GUS. PD effect of GUS Q8W on cytokine levels was assessed. Differential BL cytokine expression, associations between BL cytokine levels & clinical response (Psoriasis [PsO] Area & Severity Index 75% improvement from BL [PASI75] & American College of Rheumatology 20% improvement [ACR20]), & GUS effect on cytokine levels were analyzed with a General linear model & Spearman linear regression.

Results

BL pt demographics, disease characteristics, & conventional synthetic disease-modifying antirheumatic drug (csDMARD) use were comparable between TNFi-naïve (DISCOVER-1 & -2, N=251) & -IR (DISCOVER-1 & COSMOS, N=93) pts, with differences in mean PASI score (8.9 v 12.5), swollen joint count (SJC) (11.7 v 10.3), PsA duration (5.8 v 9.8 yrs), & PsO duration (16.7 v 20.4 yrs; Table 1). BL serum IL-22 & TNFα levels for pooled treatment groups were higher in TNFi-IR than -naïve pts (p<0.05). At W24, GUS reduced IL-22, IL-17A/F, IL-6, C-reactive protein (CRP), & serum amyloid A protein to similar levels in both cohorts (p<0.05; Figure 1). W24 PASI75 responders had higher BL IL-17F levels with GUS in both cohorts (p<0.05) & higher IL-22 levels in TNFi-IR pts only (p<0.05). A trend of upregulated BL IL-22 expression in W24 ACR20 responders was seen for TNFi-IR pts with GUS (p=0.07).

Table 1.

BL demographics, disease characteristics, & drug use in TNFi-naïve & -IR cohorts with available cytokine data in DISCOVER-1&2 & COSMOS.*

TNFi-naïve (N=251)TNFi-IR (N=93)Age [yrs]47.2 (11.3)48.5 (11.1)Female, n (%)132 (52.6)46 (49.5)Body mass index [kg/m2]29.6 (6.1)30.3 (6.4)Median (range) CRP [mg/dL]0.9 (0.0-12.9)1.0 (0.0-13.2)Log2 IL-22 / TNFα [pg/mL]2.0 (1.4) / 1.1 (0.6)2.5 (1.5) / 1.9 (1.2)Log2 IL-17A / F [pg/mL]-0.4 (1.5) / 1.7 (1.5)-0.1 (1.7) / 2.0 (1.6)SJC [0-66]11.7 (7.1)10.3 (8.3)TJC [0-68]20.3 (13.1)20.6 (14.2)PsA duration [yrs]5.8 (5.9)9.8 (8.2)PsO duration [yrs]16.7 (12.8)20.4 (12.0)PsO Body surface area (%)14.8 (18.6)19.1 (21.3)Investigator’s Global Assessment score [0-4]2.3 (0.9)2.3 (1.0)PASI score [0-72]8.9 (10.6)12.5 (12.0)Enthesitis [Y], n (%)160 (63.7)58 (62.4)csDMARD use [Y], n (%)164 (65.3)62 (66.7)Corticosteroid use (Y), n (%)45 (17.9)19 (20.4)Methotrexate use [Y], n (%)136 (54.2)54 (58.1)

Data are mean (SD) unless otherwise noted. *Pts with serum CRP level ≥0.3 mg/dL, SJC ≥3, & TJC ≥3 (to mimic D1 inclusion criteria1). TJC= tender joint count

Conclusion

Elevated BL IL-22 expression & association between BL IL-22 levels & W24 PASI75 response, & a W24 trend for an association between upregulated BL IL-22 & ACR20 response, in TNFi-IR pts seen in this exploratory analysis may suggest increased involvement of the IL-23 pathway in TNFi-IR pts. GUS showed comparable & significant PD effects for TNFi-naïve & -IR pts, consistent with observed clinical responses.

References

[1]Deodhar A, et al. Lancet. 2020;395:1115-25.

[2]Coates LC, et al. Ann Rheum Dis. 2021;80:140-1.

[3]Mease P, et al. Lancet. 2020;395:1126-36.

Disclosure of Interests

Stefan Siebert Speakers bureau: AbbVie, Biogen, GSK, Janssen, Novartis, UCB, Grant/research support from: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, GSK, Janssen, Novartis, and UCB, Laura Coates Speakers bureau: AbbVie, Amgen, Biogen, Celgene, Eli Lilly, Galapagos, Gilead, Janssen, Medac, Novartis, Pfizer and UCB, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Eli Lilly, Gilead, Galapagos, Janssen, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Amgen, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, and UCB, Georg Schett Speakers bureau: AbbVie, Amgen, Bristol Myers Squibb, Eli Lilly, Gilead, Janssen, Novartis, and UCB, Siba P Raychaudhuri Speakers bureau: AbbVie, Amgen, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, SUN Pharma, and UCB, Consultant of: AbbVie, Amgen, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, SUN Pharma, and UCB, Grant/research support from: AbbVie, Amgen, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, SUN Pharma, and UCB, Warner Chen Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC (a wholly owned subsidiary of Johnson & Johnson), Sheng Gao Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC (a wholly owned subsidiary of Johnson & Johnson), Soumya D Chakravarty Shareholder of: Johnson & Johnson, Employee of: Janssen Scientific Affairs, LLC (a wholly owned subsidiary of Johnson & Johnson), May Shawi Shareholder of: Johnson & Johnson, Employee of: Janssen Pharmaceutical Companies of Johnson & Johnson, Frederic Lavie Shareholder of: Johnson & Johnson, Employee of: Janssen Pharmaceutical Companies of Johnson & Johnson, Elke Theander Shareholder of: Johnson & Johnson, Employee of: Janssen Scientific Affairs, LLC (a wholly owned subsidiary of Johnson & Johnson), Marlies Neuhold Shareholder of: Johnson & Johnson, Employee of: Janssen Scientific Affairs, LLC (a wholly owned subsidiary of Johnson & Johnson), Alexa Kollmeier Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC (a wholly owned subsidiary of Johnson & Johnson), Xie L Xu Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC (a wholly owned subsidiary of Johnson & Johnson), Proton Rahman Consultant of: AbbVie, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Janssen, Merck, Novartis, Pfizer, and UCB, Grant/research support from: Janssen and Novartis, Philip J Mease Speakers bureau: AbbVie, Amgen, Eli Lilly, Janssen, Novartis, Pfizer, Sun Pharma, and UCB, Consultant of: AbbVie, Aclaris, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, GSK, Inmagene, Janssen, Novartis, Pfizer, Sun Pharma, and UCB, Grant/research support from: AbbVie, Amgen, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, Sun Pharma, and UCB, Atul Deodhar Speakers bureau: AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Aurinia, Bristol Myers Squibb, Celgene, Eli Lilly, GSK, Janssen, MoonLake, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Eli Lilly, GSK, Novartis, Pfizer, and UCB

POS0006 IDENTIFICATION OF FIBROTIC AND FIBROLYTIC ENDOTYPES IN RHEUMATIC DISEASE COHORTS

Background

Ankylosing spondylitis (AS), psoriatic arthritis (PsA) and systemic lupus erythematosus (SLE) are distinct diseases with common molecular features, such as an imbalance in fibrolysis and fibrosis of connective and calcified tissues. Type III, IV and VI collagens are abundant in connective tissue, and type I, II and X of the skeletal tissue. Blood biomarkers are available to measure fibrolysis (C1M, C2M, C3M, C4M, C6M, C10C) and fibrosis (PRO-C1, PRO-C2, PRO-C3, PRO-C4, PRO-C6) of these collagens.

Objectives

To profile AS, PsA and SLE patients (pts) using blood biomarkers of collagen formation and degradation.

Methods

Baseline serum samples from consenting pts of the AS (NCT02437162/NCT02438787), PsA (NCT0315828), and SLE (NCT02349061) studies were included in the analyses. Healthy donor samples were acquired from Discovery LS. Biomarkers were measured by immunoassays. Biomarker levels were compared by Kruskal-Wallis test. Before hierarchical clustering (Ward.D2), biomarker levels were log-transformed and standardized by median centering and scaling by median absolute deviation (MAD).

Results

When compared with healthy individuals, VICM was elevated in all indications (although markedly less so in SLE pts). The fibrosis marker PRO-C3 was elevated in all indications vs. healthy, while PRO-C4 and PRO-C6 were elevated only in AS and PsA. The fibrolysis markers C3M, C4M and C6M were elevated in all indications. The cartilage fibrosis marker PRO-C2, but not C2M, was elevated in AS and PsA, but not in SLE, ps. The bone fibrosis marker PRO-C1 was at the level of healthy for all. The fibrolysis marker C1M was elevated in all, while elevated C10C was seen only in PsA and SLE, pts (Table 1). Four clusters (C) of blood markers were extracted (Figure 1). C1 was characterized by low biomarker levels (68% of healthy, 1% of PsA, 3% of SLE pts). C2 was described by high levels of C10C and median levels of VICM (20% of healthy, 12% of AS, 19% of PsA, 42% of SLE pts). C3 was described by median biomarker levels (8% of healthy, 67% of AS, 48% of PsA, 46% of SLE pts). C4 had high biomarker levels (4% of healthy, 21% of AS, 31% of PsA, 9% of SLE pts).

Conclusion

Fibrosis and fibrolysis blood biomarkers were significantly elevated in AS, PsA and SLE pts. Subsets of pts from each indication were found in clusters with either low (C1/2), median (C3) or high (C4) levels of fibrosis/fibrolysis biomarkers. These findings may provide a first step towards precision medicine for guiding the use of anti-inflammatory vs. anti-fibrotic treatments in pts with rheumatological disorders.

Disclosure of Interests

Anne-Christine Bay-Jensen Shareholder of: Nordic Bioscience A/S, Employee of: Nordic Bioscience A/S, Signe Holm Nielsen Shareholder of: Nordic Bioscience A/S, Employee of: Nordic Bioscience A/S, Peder Frederiksen Employee of: Nordic Bioscience A/S, Morten Karsdal Shareholder of: Nordic Bioscience A/S, Employee of: Nordic Bioscience A/S, Warner Chen Employee of: Janssen Research & Development, Sheng Gao Employee of: Janssen Research & Development

Effects of dietary inclusion of cassava starch-extraction-residue meal on egg production, egg quality, oxidative status, and yolk fatty acid profile in laying ducks

This study was designed to evaluate the effects of different dietary levels of cassava starch extraction residue meal (CReM) on egg production, egg quality, oxidative status, egg yolk fatty acid profile, and hepatic expression of fatty acid metabolism-related genes. In total, 288 Longyan laying ducks aged 21 wk with similar BW were randomly assigned to 4 dietary treatments, each consisting of 6 replicates of 12 birds. The birds were fed a typical corn-soybean meal diet, which contained 0% (control), 5%, 10%, and 15% CReM, mainly replacing wheat bran, and the experiment lasted for 16 wk. The tested CReM levels did not show significant effects on the egg production, nonmarketable egg percentage, egg weight, daily egg mass, and FCR (g feed: g egg), but daily feed intake was reduced with increased CReM level (linear P < 0.001, quadratic P < 0.05). Yolk color increased (linear and quadratic, P < 0.01) with the increase in CReM level, but the Haugh unit, yolk proportion, albumen proportion, shell proportion, eggshell thickness, and eggshell strength were unaffected. Yolk contents of C11:0 and C12:0 (linear, quadratic, P < 0.01) and total saturated fatty acids increased, and the C22:1 level decreased (linear P < 0.01, quadratic P < 0.05) with the increase in CReM level, but the total monounsaturated fatty acids, the individual and total polyunsaturated fatty acids and n−6 and n−3 fatty acids, triglycerides, and total cholesterol in egg yolk were not affected. Hepatic gene expression revealed a significant increase in peroxisome proliferators-activated receptors γ (linear, quadratic, P < 0.001), but the expression of fatty acid synthase, sterol regulatory element binding protein 1 and apolipoprotein A1 genes were unaffected by CReM level. In conclusion, the results of the current study indicated that the CReM could be included up to 15% in laying duck diets without negative effects on the egg-laying rate, egg quality, and oxidative status. Dietary inclusion of CReM increased the yolk content of total saturated fatty acids and SOD activity in the liver.

POS0969 GENETIC AND MOLECULAR DISTINCTIONS BETWEEN AXIAL PSORIATIC ARTHRITIS AND ANKYLOSING SPONDYLITIS

Background

Psoriatic arthritis (PsA) and ankylosing spondylitis (AS) represent the prototypical spondyloarthritides. PsA patients may also suffer from axial disease (axPsA). Despite overlapping symptoms, axPsA and AS may be distinct disorders with differing clinical manifestations, genetic associations, and radiographic findings.1 These disorders also respond differently to immunomodulatory therapies such as anti-interleukin (IL)-23 inhibitors. While guselkumab, a human monoclonal antibody targeting the IL-23p19 subunit, improved symptoms of axPsA,2 risankizumab, a humanized monoclonal antibody targeting the IL-23p19 subunit, did not show improvement in the primary endpoint of proportion of AS patients achieving an Assessment of SpondyloArthritis International Society 40% (ASAS40) response at week (W) 12.3

Objectives

To understand molecular distinctions between axPsA and AS to differentiate these diseases and guide treatment choice.

Methods

Whole blood and serum samples were collected from consenting patients in the NCT03162796/NCT0315828 studies of guselkumab in PsA and the NCT02437162/NCT02438787 studies of ustekinumab in AS. axPsA patients were investigator-verified as having magnetic resonance imaging- or pelvic x-ray-confirmed sacroiliitis at screening (locally read). Human leukocyte antigen (HLA) genotypes were determined by RNA sequencing, limited to Caucasian patients to reduce genetic variability,4 and select serum cytokine levels were analyzed alongside samples from healthy individuals. Differential prevalence of HLA alleles in axPsA versus AS was determined using a Fisher’s Exact test. Statistical significance of differential baseline serum cytokine expression among axPsA versus non-axPsA versus AS patients, and of guselkumab effect on serum cytokine reduction versus placebo among axPsA and non-axPsA patients, were determined with a generalized linear model performed on log2-transformed data. Biomarker data from guselkumab every-4-weeks and every-8-weeks treatment arms were pooled.

Results

Among the 186/234 Caucasian axPsA/AS patients with available data, 34%/15% were female, 70%/14% used methotrexate at baseline, mean serum C-reactive protein (CRP) levels were 2.8/2.4 mg/dL and mean Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores were 6.4/7.5, respectively. Aside from race, baseline demographics and disease characteristics were representative of the overall population. The prevalence of class I HLA allele -B27, -C01, and -C02 carriers was significantly lower in axPsA than AS patients (30.7% versus 92.3%, p<0.001; 5.9% versus 31.6%, p<0.001; and 28.0% versus 62.0%, p<0.001, respectively), while the prevalence of HLA-C06 was significantly higher in axPsA than AS populations (36.0% versus 8.6%, p<0.001). Baseline serum levels of IL-17A and IL-17F were significantly higher in axPsA (N=71) than in AS (N=58) patients (p<0.01 and p<0.001, respectively). Comparable IL-17A/F expression was seen for axPsA and non-axPsA (N=229) patients (both p=not significant). Significant and comparable reductions from baseline in serum IL-17A/F in axPsA and non-axPsA patients were seen with guselkumab treatment (axPsA N=41, non-axPsA N=160) versus placebo (axPsA N=30, non-axPsA N=69) at W4/24 (all p<0.05).

Conclusion

Adults with axPsA and AS exhibit different genetic risk factors and serum IL-17 levels, supporting the concept of distinct disorders. Guselkumab demonstrated significant pharmacodynamic effects in axPsA patients that aligned with such effects in non-axPsA patients, consistent with observed clinical improvement.2

References

[1]Feld et al. Nat Rev Rheumatol. 2018;14(6):363-371.

[2]Mease et al. Lancet Rheumatol. 2021;3(10)E715-E723.

[3]Baeten et al. Ann Rheum Dis. 2018;77(9):1295-1302.

[4]Buchkovich et al. Genome Med. 2017;9(86).

Disclosure of Interests

Arthur Kavanaugh Consultant of: AbbVie, Amgen, BMS, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer and UCB, Xenofon Baraliakos Consultant of: AbbVie, Chugai, Eli Lilly, Galapagos, Janssen, MSD, Novartis, Pfizer, Roche, and UCB, Grant/research support from: AbbVie, MSD, and Novartis, Sheng Gao Employee of: Janssen Research & Development, LLC, and may own stock or stock options in Johnson & Johnson, Warner Chen Employee of: Janssen Research & Development, LLC, and may own stock or stock options in Johnson & Johnson, Kristen Sweet Employee of: Janssen Research & Development, LLC, and may own stock or stock options in Johnson & Johnson, Soumya D Chakravarty Employee of: Janssen Scientific Affairs, LLC, and may own stock or stock options in Johnson & Johnson, Qingxuan Song Employee of: Janssen Research & Development, LLC, and may own stock or stock options in Johnson & Johnson, May Shawi Employee of: Janssen Pharmaceutical Companies of Johnson & Johnson, and may own stock or stock options in Johnson & Johnson, Frank Behrens Speakers bureau: AbbVie, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Chugai, Eli Lilly, Galapagos, Genzyme, Gilead, Janssen, MSD, Novartis, Pfizer, Roche, Sanofi, and UCB, Consultant of: AbbVie, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Chugai, Eli Lilly, Galapagos, Genzyme, Gilead, Janssen, MSD, Novartis, Pfizer, Roche, Sanofi, and UCB, Grant/research support from: Celgene, Chugai, Janssen, Pfizer, and Roche, Proton Rahman Consultant of: AbbVie, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Janssen, Merck, Novartis, Pfizer, and UCB, Grant/research support from: Janssen, research grants from Janssen and Novartis

POS0308 EFFECT OF GUSELKUMAB ON SERUM BIOMARKERS IN PSORIATIC ARTHRITIS PATIENTS WITH INADEQUATE RESPONSE OR INTOLERANCE TO TUMOR NECROSIS FACTOR INHIBITORS: RESULTS FROM THE COSMOS STUDY

Background

Guselkumab (GUS), a selective IL-23 inhibitor, is efficacious in treating bio-naïve and TNFi-experienced active PsA patients (pts).1.2 In the COSMOS study of active PsA pts with lack of efficacy/intolerance, i.e., inadequate response (IR), to 1-2 TNFi, GUS demonstrated significantly greater response rates and mean improvements in PsA signs and symptoms vs. placebo (PBO) at Week (W) 24.3

Objectives

Evaluate baseline (BL) serum levels of pro-inflammatory biomarkers (CRP, serum amyloid A [SAA], TNFα, IFNɣ, IL-6, IL-10, IL-17F, IL-17A, IL-22) and their relationship to BL disease activity, GUS treatment (tx), and clinical response in COSMOS TNFi-IR pts.

Methods

TNFi-IR pts ≥18 yrs with active PsA (≥3 swollen & ≥3 tender joint counts [SJC/TJC]) were randomized 2:1 to GUS 100 mg every 8 W (Q8W) through W44 or PBO with early escape (W16) or crossover (W24) to GUS Q8W. Samples for serum biomarker analyses, collected at W0, 4, 16, 24, and 48 from consenting pts, were compared with healthy controls (HC; independent of COSMOS). Associations between early biomarker changes and BL disease activity, GUS tx, and clinical response at W24 were assessed.

Results

Among 285 COSMOS pts, 50/95 PBO and 100/190 GUS pts had available biomarker data. BL characteristics of the biomarker cohort were similar to the overall COSMOS population and well balanced across tx arms. At BL, levels of TNFα, IFNɣ, IL-6, IL-10, IL-17A, IL-17F, and IL-22 were significantly upregulated in TNFi-IR pts vs. HC (Table 1). IL-6, CRP, and SAA levels were associated with BL joint disease severity per Disease Activity Score (DAS) 28-CRP (but not with SJC [0-66]/TJC [0-68]). IL-17A and IL-17F levels were associated with BL PASI score. Through W24, significant decreases from BL in levels of CRP, SAA, IL-6, IL-17A, IL-17F, and IL-22 were seen in GUS-, but not PBO-tx pts. Reductions in IL-17A, IL-17F and IL-22 with GUS were significant by W4, decreased further by W16, and were sustained through W24 and W48. In GUS-tx pts, serum levels of IL-17F (from W16) and IL-22 (from W4) were not significantly different vs. HC. At W48, reductions in these same markers were seen in PBO-tx pts who crossed over to GUS at W16/24 (Figure 1; IL-17A, IL-17F, & IL-22 data shown). In these TNFi-IR pts, GUS-tx pts achieving ACR20 at W24 exhibited higher IL-22 and IFNɣ levels at BL than nonresponders (NR). All other biomarkers evaluated were not significantly associated with ACR20 response to GUS. In the subset of pts with IGA of psoriasis assessed, BL IL-6 and SAA levels were upregulated in W24 IGA 0/1 responders (R) vs. NR in the GUS arm. ACR20 and IGA 0/1 R at W24 exhibited an early greater reduction in IL-6 expression (at W4) than did respective NR in the GUS arm. No BL biomarkers were associated with ACR50 or PASI75 responses to GUS at W24.

Table 1.

Select Serum Biomarkers at BL in TNFi-IR pts vs. HC▫

Biomarker, pg/mLHC N=24TNFi-IR N=150Fold differencep-valueCRP22.1 (1.5)22.8 (2.2)1.60.2895SAA21.7 (1.2)22.8 (2.4)2.10.0794IL-60.07 (1.1)0.98 (1.7)1.90.0314*IL-10-2.3 (1.1)-1.7 (1.0)1.50.0272*IL-17A-2.1 (1.3)-0.3 (1.5)3.3<0.0001*IL-17F0.05 (1.1)1.3 (1.5)2.40.0007*IL-221.9 (1.1)3.1 (1.3)2.40.0002*TNFα0.5 (0.75)1.4 (1.1)1.80.0002*IFNɣ2.4 (0.84)2.9 (1.3)1.50.0259*

Data are mean (SD); *p<0.05 and |fold difference| >1.4; ▫adjusted for confounding factors age & sex.

Conclusion

GUS-tx TNFi-IR pts showed response-specific associations with BL biomarkers (IL-22, IFNɣ, IL-6, and SAA). GUS resulted in decreased levels of elevated CRP, SAA, IL-6, IL-17A, IL-17F, and IL-22, while no significant change was observed with PBO tx. Reductions in these biomarkers were evident as early as W4 and approximated levels seen in HC from W16 onward (W4 for IL-22), suggesting apparent normalization of effector cytokines associated with the IL-23/Th17 axis following GUS tx.

References

[1]Deodhar A et al. Lancet 2020;395:1115-25.

[2]Mease PJ et al. Lancet 2020;395:1126-36.

[3]Coates LC et al. doi:10.1136/annrheumdis-2021-220991.

Disclosure of Interests

Georg Schett Speakers bureau: Amgen, AbbVie, Bristol Myers Squibb, Eli Lilly, Gilead, Janssen, Novartis and UCB, Warner Chen Shareholder of: Janssen, Employee of: Janssen, Sheng Gao Shareholder of: Janssen, Employee of: Janssen, Soumya D Chakravarty Shareholder of: Janssen, Employee of: Janssen, May Shawi Shareholder of: Janssen, Employee of: Janssen, Frederic Lavie Shareholder of: Janssen, Employee of: Janssen, Elke Theander Shareholder of: Janssen, Employee of: Janssen, Marlies Neuhold Shareholder of: Janssen, Employee of: Janssen, Laura Coates Speakers bureau: AbbVie, Amgen, Biogen, Celgene, Eli Lilly, Galapagos, Gilead, Janssen, Medac, Novartis, Pfizer and UCB, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Eli Lilly, Gilead, Galapagos, Janssen, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Amgen, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, and UCB, Stefan Siebert Speakers bureau: AbbVie, Biogen, GSK, Janssen, Novartis, UCB, Grant/research support from: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, GSK, Janssen, Novartis, UCB

[Regulatory effects and signaling mechanism of sodium ferulate on the proliferation and apoptosis of human skin hypertrophic scar fibroblasts]

Objective: To investigate the regulatory effects and signaling mechanism of sodium ferulate on the proliferation and apoptosis of human skin hypertrophic scar fibroblasts (HSFbs). Methods: The experimental research methods were used. The 4th-6th passage of HSFbs from human skin were used for the following experiments. HSFbs were co-cultured with sodium ferulate at final mass concentrations of 1, 1×10-1, 1×10-2, 1×10-3, 1×10-4, 1×10-5, and 1×10-6 mg/mL for 48 hours, and methyl thiazolyl tetrazolium method was used to determine the cell absorbance values and linear regression was used to analyze the half lethal concentration (LC50) of sodium ferulate (n=6). HSFbs were co-cultured with sodium ferulate at final mass concentrations of 0.1, 0.2, 0.3, and 0.4 mg/mL for 24, 48, 72, and 96 hours, and methyl thiazolyl tetrazolium method was used to determine the cell absorbance values and the cell proliferation inhibition rate was calculated (n=3). According to the random number table, the cells were divided into 0.300 mg/mL sodium ferulate group, 0.030 mg/mL sodium ferulate group, 0.003 mg/mL sodium ferulate group treated with sodium ferulate at corresponding final mass concentrations, and negative control group without any treatment. After 72 hours of culture, the cell absorbance values were determined by methyl thiazolyl tetrazolium method (n=5), the microscopic morphology of cells was observed by transmission electron microscope (n=3), the cell apoptosis was detected by TdT-mediated dUTP-biotin nick end labeling (TUNEL) assay and the apoptosis index was calculated (n=4), the protein expressions of B lymphocystoma-2 (Bcl-2), Bcl-2-associated X protein (Bax), and cysteine aspartic acid specific protease-3 (caspase-3) were determined by immunohistochemistry (n=4), and the protein expressions of transformed growth factor β1 (TGF-β1), phosphorylated Smad2/3, phosphorylated Smad4, and phosphorylated Smad7 were detected by Western blotting (n=4). Data were statistically analyzed with one-way analysis of variance and Dunnett test. Results: The LC50 of sodium ferulate was 0.307 5 mg/mL. After being cultured for 24-96 hours, the cell proliferation inhibition rates of cells treated with sodium ferulate at four different mass concentrations tended to increase at first but decrease later, which reached the highest after 72 hours of culture, so 72 hours was chosen as the processing time for the subsequent experiments. After 72 hours of culture, the cell absorbance values in 0.003 mg/mL sodium ferulate group, 0.030 mg/mL sodium ferulate group, and 0.300 mg/mL sodium ferulate group were 0.57±0.06, 0.53±0.04, 0.45±0.05, respectively, which were significantly lower than 0.69±0.06 in negative control group (P<0.01). After 72 hours of culture, compared with those in negative control group, the cells in the three groups treated with sodium ferulate showed varying degrees of nuclear pyknosis, fracture, or lysis, and chromatin loss. In the cytoplasm, mitochondria were swollen, the rough endoplasmic reticulum was expanded, and local vacuolation gradually appeared. After 72 hours of culture, compared with that in negative control group, the apoptosis indexes of cells were increased significantly in 0.003 mg/mL sodium ferulate group, 0.030 mg/mL sodium ferulate group, and 0.300 mg/mL sodium ferulate group (P<0.05 or P<0.01). After 72 hours of culture, compared with those in negative control group, the protein expressions of Bcl-2 of cells in 0.300 mg/mL sodium ferulate group was significantly decreased (P<0.01), the protein expressions of Bax of cells in 0.030 mg/mL sodium ferulate group and 0.300 mg/mL sodium ferulate group were significantly increased (P<0.05), and the protein expression of caspase-3 of cells in 0.300 mg/mL sodium ferulate group was significantly increased (P<0.01). After 72 hours of culture, compared with those in negative control group, the protein expression levels of TGF-β1, phosphorylated Smad2/3, and phosphorylated Smad4 of cells in 0.030 mg/mL sodium ferulate group and 0.300 mg/mL sodium ferulate group were significantly decreased (P<0.05 or P<0.01), and the protein expression levels of phosphorylated Smad7 of cells in 0.003 mg/mL sodium ferulate group, 0.030 mg/mL sodium ferulate group, and 0.300 mg/mL sodium ferulate group were significantly increased (P<0.01). Conclusions: Sodium ferulate can inhibit the proliferation of HSFbs of human skin and promote the apoptosis of HSFbs of human skin by blocking the expression of key proteins on the TGF-β/Smad signaling pathway and synergistically activating the mitochon- drial apoptosis pathway.

The Effects of an Integrated Exercise Intervention on the Attenuation of Frailty in Elderly Nursing Homes: A Cluster Randomized Controlled Trial

OBJECTIVES

The frail elderly have an increased risk of frailty because of reduced physical activity, cognitive ability and quality of life. This study aims to evaluate the effects of integrated exercise intervention on the attenuation of frailty in elderly nursing home residents.

DESIGN

This study was a cluster randomized controlled trial.

SETTING AND PARTICIPANTS

146 elderly frailty people from 8 elderly nursing homes in Harbin, China, were randomly assigned into the intervention group and control group after obtaining their informed consent.

INTERVENTION

The intervention group performed integrated exercise interventions for 12 months, while the control group only continued with their daily activities.

MEASUREMENTS

Sociodemographic, health-related data, frailty levels, gait parameters, cognition, and quality of life were evaluated.

RESULTS

The mean age of participants was 80.74± 2.89 years, and 70.37% (n=95) were female. The Difference-in-difference regression showed that, compared with the control group, phenotypic frailty score (β3 =-1.40, p < 0.001) and stride time (β3 = -0.38, p <0.001) decreased significantly in the intervention group, stride velocity (β3 = 0.24, p < 0.001), step length (β3 = 0.08, p <0.001), cadence (β3 = 17.79, p < 0.001), MMSE total score (β3 = 1.90, p < 0.001) and QOL total score (β3 = 11.84, p < 0.001) increased significantly in the intervention group.

CONCLUSION

The integrated exercise intervention can effectively improve the attenuation of frailty, gait parameters, cognitive function, and quality of life in elderly nursing homes. We can use the findings of this study as a reference for the design of activities for the elderly nursing home residents, to provide them with appropriate exercises, improve their physical functions, and improve or delay their frailty level, which is principally important for developing countries in east Asia where rehabilitation resources are generally scarce.

[Analysis on repetitive reporting of hepatitis B in Fujian province, 2016-2020]

Objective: To analyze the repetitive reporting of hepatitis B in Fujian province during 2016-2020, and provide evidence for the improvement of hepatitis B surveillance. Methods: The reporting cards from the China Information System for Disease Control and Prevention were collected and divided into repetitive reporting cards and non-repetitive reporting cards from the report cards collected according to the valid ID number on the cards, and the proportion of repetitive report cards and related factors were analyzed by using software SAS 9.4. Results: A total of 314 551 hepatitis B reporting cards were submitted in Fujian from 2016 to 2020, in which 90.93% (286 020/314 551) were included in the analysis. The repetitive reporting cards accounted for 10.48% (29 982/286 020). The annual proportion of the repetitive reporting cards from 2016 to 2020 was between 2.98% and 3.71%, showing an overall increasing trend year by year (Z=2.26, P=0.024). The proportions of the repetitive reporting cards in 1-5 years were 3.17%, 5.40%, 7.74%, 9.27% and 10.48%, respectively, showing an increase trend with year (Z=128.16, P<0.001). The proportions of the repetitive reporting cards in 10 areas of Fujian ranged from 5.44% to 13.48% with significant difference (χ²=2 050.41, P<0.001) and increased with the increase of reported incidence of hepatitis B (Z=26.92, P<0.001). There were significant differences in relationships between repetitive reporting proportion and sex, age and type of the cases between the areas with high incidence and low incidence of hepatitis B. Conclusions: The reported incidence of hepatitis B was seriously affected by the repetitive reporting in Fujian from 2016 to 2020. A cross-year and cross-area surveillance mechanism for hepatitis B should be established and targeted measures should be taken to strengthen the control of the repetitive reporting and improve the surveillance for hepatitis B.

[The clinical efficacy of the stratification medical treatment based on the risk estimation of motor complications in Parkinson's disease]

Objectives: To evaluate the clinical efficacy of the stratification medical treatment based on the motor complications risk estimation in improving the quality of life, motor symptoms and delaying the motor complications in Parkinson's patients. Methods: Outpatients and inpatients from Xinhua Hospital, Shanghai Jiao Tong University, were recruited between November 2019 and June 2020. The participants were all clinically diagnosed with PD and treated with anti-PD medications, but had no history of motor complications, with the 8-item Parkinson's disease questionnaire summary index (PDQ-8 SI)>18.59. At baseline, the demographic characteristics, PD medical history, levodopa dosage (LD) and levodopa equivalent dosage (LED) were collected, and the evaluation of PDQ-8, Unified Parkinson's disease rating scale (UPDRS)-Ⅱ and Ⅲ, Hoehn and Yahr (H&Y) grade, Hamilton anxiety scale-14 (HAMA-14), Hamilton depression scale-24 (HAMD-24), mini-mental state examination (MMSE), Pittsburgh sleep quality index (PSQI), and Epworth sleepiness scale (ESS) tools was accomplished in all participants. Meanwhile, a Parkinson's disease risk estimation scale for motor complications was used to assess patients' risk of motor complications, and thus the medication was stratified in PD patients accordingly. During the 6-month and 12-month follow-ups, the evaluation of the above-mentioned parameters was repeated in all participants. At the 3-month and 9-month follow-ups, the information of anti-PD medications, the occurrence of motor complications (motor fluctuations and dyskinesia) and adverse drug reactions were recorded, and PDQ-8 was also evaluated. Results: Two hundred and fifty-one patients completed the 1-year follow-up, with 135 males and 116 females. At baseline, the median age of the patients was 66 (60, 71) years and the median PDQ-8 SI was 31.2 (21.9, 40.6). Additionally, 15.9% (40/251) of the patients were at high risk of motor fluctuation, and 7.2% (18/251) were at high risk of dyskinesia. There were significant differences in the age of onset, disease duration, PD treatment duration, the scores of UPDRS-Ⅱ and Ⅲ, H&Y Grade, and PDQ-8 SI among PD patients of different risk groups (all P<0.05). In the 12th month, the median of PDQ-8 SI, Δ PDQ-8 SI and Δ UPDRS-Ⅲ was 12.5 (9.4, 18.8), -15.6 (-21.9, -9.4) and -9(-16, -4), respectively, which was statistically different from that of baseline (all P<0.05). The change of UPDRS-Ⅱ scores in the group with high risk of motor fluctuation was statistically different from that in the groups with low and moderate risk (P<0.05). The changes of PSQI score, LD and LED in the group with high risk of dyskinesia was statistically different from those in the groups with low and moderate risk (all P<0.05). During the follow-up, the incidence of motor fluctuation and dyskinesia was 9.56% (24/251) and 5.97% (15/251), respectively. Conclusion: The stratification medical treatment might have a positive intervention effect on promoting a better quality of life, improving motor symptoms and delaying motor complications in PD patients.

Morphological classification and measurement of the glenoid cavity using three-dimensional reconstruction in a Chinese population

BACKGROUND

The purpose of this study was to examine the various shapes and record the morphometric data of the glenoid cavity in a Chinese population.

MATERIALS AND METHODS

A total of 501 scapulae, 247 left and 254 right, were analyzed. We classified the shape of the glenoid cavity as type Ⅰ (pear-shaped), type Ⅱ (oval-shaped), type Ⅲ (teardrop-shaped), type Ⅳ (calabash-shaped) or type Ⅴ (inverted comma-shaped). Four defined parameters, the superior-inferior glenoid diameter (AB), upper anterior-posterior glenoid diameter (CD), lower anterior-posterior glenoid diameter (EF) and glenoid index (GI), were measured, and five shapes were classified via three-dimensional reconstruction.

RESULTS

The mean AB, CD, EF and GI values of the glenoid were 3.51±0.41 cm, 1.95±0.28 cm, 2.60±0.34 cm, and 1.35±0.12 cm, respectively. The AB value of type Ⅱ glenoid cavities was significantly smaller than that of type Ⅰ and Ⅲ glenoid cavities (P<0.05), but the GI value of type Ⅱ glenoid cavities was larger than that of type Ⅲ cavities (P<0.05). The CD value showed a difference between type Ⅰ and type Ⅲ glenoid cavities (P<0.05). For the EF parameter, the values of type Ⅲ glenoid cavities were significantly larger than those of type Ⅰ and Ⅱ glenoid cavities (P<0.05).

CONCLUSIONS

Measuring and observing the variety of shapes and sizes of the glenoid cavity in Chinese people is conducive to for better understand its morphological features. This information can also guide surgeons in the design and selection of suitable prostheses for total shoulder arthroplasty in the Chinese population in order to reduce postoperative complications.

[Clinical application effects of two longitudes three transverses method in perforator location of thoracodorsal artery perforator flap and deep wound repair]

Objective: To explore the clinical application value of two longitudes three transverses method in the location of the perforator of thoracodorsal artery perforator and deep wound repair. Methods: The retrospectively observational study was conducted. From December 2018 to June 2020, 17 patients with deep wounds who were admitted to the Affiliated Hospital of Zunyi Medical University met the inclusion criteria and were included in this study, including 7 males and 10 females, aged 12 to 72 years. The wound areas of patients after debridement were 7 cm×3 cm to 11 cm×7 cm. Two longitudinal lines were located through the midpoint of the armpit, the posterior superior iliac spine, and the protruding point of the sacroiliac joint, and three transverse lines were located 5, 10, and 15 cm below the midpoint of the armpit between the two longitudinal lines, i.e. two longitudes three transverses method, resulting in two trapezoidal areas. And then the thoracodorsal artery perforators in two trapezoidal areas were explored by the portable Doppler blood flow detector. On this account, a single or lobulated free thoracodorsal artery perforator flap or flap that carrying partial latissimus dorsi muscle, with an area of 7 cm×4 cm to 12 cm×8 cm was designed and harvested to repair the wound. The donor sites were all closed by suturing directly. The number and location of thoracodorsal artery perforators, and the distance from the position where the first perforator (the perforator closest to the axillary apex) exits the muscle to the lateral border of the latissimus dorsi in preoperative localization and intraoperative exploration, the diameter of thoracodorsal artery perforator measured during operation, and the flap types were recorded. The survivals of flaps and appearances of donor sites were followed up. Results: The number and location of thoracodorsal artery perforators located before operation in each patient were consistent with the results of intraoperative exploration. A total of 42 perforators were found in two trapezoidal areas, with 2 or 3 perforators each patient. The perforators were all located in two trapezoid areas, and a stable perforator (the first perforator) was located and detected in the first trapezoidal area. There were averagely 1.47 perforators in the second trapezoidal area. The position where the first perforator exits the muscle was 2.1-3.1 cm away from the lateral border of the latissimus dorsi. The diameters of thoracodorsal artery perforators were 0.4-0.6 mm. In this group, 12 cases were repaired with single thoracodorsal artery perforator flap, 3 cases with lobulated thoracodorsal artery perforator flap, and 2 cases with thoracodorsal artery perforator flap carrying partial latissimus dorsi muscle. The patients were followed up for 6 to 16 months. All the 17 flaps survived with good elasticity, blood circulation, and soft texture. Only linear scar was left in the donor area. Conclusions: The two longitudes three transverses method is helpful to locate the perforator of thoracodorsal artery perforator flap. The method is simple and reliable. The thoracodorsal artery perforator flap designed and harvested based on this method has good clinical effects in repairing deep wound, with minimal donor site damage.