Investigating neuropathological changes and underlying neurobiological mechanisms in the early stages of primary blast-induced traumatic brain injury: Insights from a rat model

The utilization of explosives and chemicals has resulted in a rise in blast-induced traumatic brain injury (bTBI) in recent times. However, there is a dearth of diagnostic biomarkers and therapeutic targets for bTBI due to a limited understanding of biological mechanisms, particularly in the early stages. The objective of this study was to examine the early neuropathological characteristics and underlying biological mechanisms of primary bTBI. A total of 83 Sprague Dawley rats were employed, with their heads subjected to a blast shockwave of peak overpressure ranging from 172 to 421 kPa in the GI, GII, and GIII groups within a closed shock tube, while the body was shielded. Neuromotor dysfunctions, morphological changes, and neuropathological alterations were detected through modified neurologic severity scores, brain water content analysis, MRI scans, histological, TUNEL, and caspase-3 immunohistochemical staining. In addition, label-free quantitative (LFQ)-proteomics was utilized to investigate the biological mechanisms associated with the observed neuropathology. Notably, no evident damage was discernible in the GII and GI groups, whereas mild brain injury was observed in the GIII group. Neuropathological features of bTBI were characterized by morphologic changes, including neuronal injury and apoptosis, cerebral edema, and cerebrovascular injury in the shockwave's path. Subsequently, 3153 proteins were identified and quantified in the GIII group, with subsequent enriched neurological responses consistent with pathological findings. Further analysis revealed that signaling pathways such as relaxin signaling, hippo signaling, gap junction, chemokine signaling, and sphingolipid signaling, as well as hub proteins including Prkacb, Adcy5, and various G-protein subunits (Gnai2, Gnai3, Gnao1, Gnb1, Gnb2, Gnb4, and Gnb5), were closely associated with the observed neuropathology. The expression of hub proteins was confirmed via Western blotting. Accordingly, this study proposes signaling pathways and key proteins that exhibit sensitivity to brain injury and are correlated with the early pathologies of bTBI. Furthermore, it highlights the significance of G-protein subunits in bTBI pathophysiology, thereby establishing a theoretical foundation for early diagnosis and treatment strategies for primary bTBI.

Effects of different preservation on the mechanical properties of cortical bone under quasi-static and dynamic compression

Introduction: Mechanical properties of biological tissue are important for numerical simulations. Preservative treatments are necessary for disinfection and long-term storage when conducting biomechanical experimentation on materials. However, few studies have been focused on the effect of preservation on the mechanical properties of bone in a wide strain rate. The purpose of this study was to evaluate the influence of formalin and dehydration on the intrinsic mechanical properties of cortical bone from quasi-static to dynamic compression. Methods: Cube specimens were prepared from pig femur and divided into three groups (fresh, formalin, and dehydration). All samples underwent static and dynamic compression at a strain rate from 10^-3 s^-1 to 10³ s^-1. The ultimate stress, ultimate strain, elastic modulus, and strain-rate sensitivity exponent were calculated. A one-way ANOVA test was performed to determine if the preservation method showed significant differences in mechanical properties under at different strain rates. The morphology of the macroscopic and microscopic structure of bones was observed. Results: The results show that ultimate stress and ultimate strain increased as the strain rate increased, while the elastic modulus decreased. Formalin fixation and dehydration did not affect elastic modulus significantly whereas significantly increased the ultimate strain and ultimate stress. The strain-rate sensitivity exponent was the highest in the fresh group, followed by the formalin group and dehydration group. Different fracture mechanisms were observed on the fractured surface, with fresh and preserved bone tending to fracture along the oblique direction, and dried bone tending to fracture along the axial direction. Discussion: In conclusion, preservation with both formalin and dehydration showed an influence on mechanical properties. The influence of the preservation method on material properties should be fully considered in developing a numerical simulation model, especially for high strain rate simulation.

Research on skeletal muscle impact injury using a new rat model from a bioimpact machine

Introduction: Skeletal muscle impact injury occurs frequently during sports, falls, and road traffic accidents. From the reported studies on skeletal muscle injury, it is difficult to determine the injury parameters. Therefore, we developed a new model of gastrocnemius impact injury in rats with a bioimpact machine, with which the experimental operation could be conducted in feasibility from the recorded parameters. Through this novel model, we study the skeletal muscle impact injury mechanisms by combining temporal and spatial variation. Methods: The gastrocnemius of anesthetized rats was injured by a small pneumatic-driven bioimpact machine; the moving speed and impact force were determined, and the whole impact process was captured by a high-speed camera. We observed the general condition of rats and measured the changes in injured calf circumference, evaluating calf injuries using MRI, gait analysis system, and pathology at different times after the injury. Results: The gastrocnemius was injured at an impact speed of 6.63 m/s ± 0.25 m/s and a peak force of 1,556.80 N ± 110.79 N. The gait analysis system showed that the footprint area of the RH limb decreased significantly on the first day and then increased. The calf circumference of the injured limb increased rapidly on the first day post-injury and then decreased in the next few days. MRI showed edema of subcutaneous and gastrocnemius on the first day, and the area of edema decreased over the following days. HE staining showed edema of cells, extensive hyperemia of blood vessels, and infiltration of inflammatory cells on the first day. Cell edema was alleviated day by day, but inflammatory cell infiltration was the most on the third day. TEM showed that the sarcoplasmic reticulum was dilated on the first day, the mitochondrial vacuolation was obvious on the second day, and the glycogen deposition was prominent on the fifth day. Conclusion: In our experiment, we developed a new and effective experimental animal model that was feasible to operate; the injured area of the gastrocnemius began to show "map-like" changes in the light microscope on the third day. Meanwhile, the gastrocnemius showed a trend of "edema-mitochondrial vacuolation-inflammatory cell aggregation" after impact injury.

Biomechanical analysis of thorax-abdomen response of vehicle occupant under seat belt load considering different frontal crash pulses

PURPOSE

The purpose of this work was to understand the biomechanical response and injury risk of thorax and abdomen of vehicle front seat occupants caused by seat belt load under different frontal crash pulses.

METHODS

A vehicle-seat-occupant subsystem finite element (FE) model was developed using the a assembly of vehicle front seat and seat belt together with the THUMS (Total Human body Model for Safety) AM50 (50th% Adult Male) occupant model. Then the typical vehicle frontal crash pulses from different impact scenarios were applied to the vehicle-seat-occupant subsystem FE model, and the predictions from the occupant model were analyzed.

RESULTS

The modeling results indicate that the maximum sternal compression of the occupant caused by seat belt load is not sensitive to the peek of the crash pulse but sensitive to the energy contained by the crash pulse in the phrase before seat belt load reaching its limit. Injury risk analysis implies that seat belt load of the four crash scenarios considered in the current work could induce a high thorax AIS2+ injury risk (>80%) to the occupants older than 70 years, and a potential injury risk to the spleen.

CONCLUSIONS

The findings suggest that control of the energy in the first 75 ms of the crash pulse is crucial for vehicle safety design, and thorax tolerance of the older population and spleen injury prevention are the key considerations in developing of seat belt system.

[Analysis of types and treatment methods of cervical massive hemorrhage]

Objective: To summarize the classification and clinical treatment experience of cervical massive hemorrhage in multiple centers. Methods: From April 2012 to October 2020, clinical data of 42 patients with cervical massive hemorrhage were retrospectively analyzed, including 27 cases from Shanghai Changzheng Hospital, 7 cases from Hunan Provincial People's Hospital, 4 cases from Longkou People's Hospital and 4 cases from Laizhou People's Hospital. According to bleeding position (P), bleeding vessel (V), cerebral blood supply (C), and the presence or absence of associated injury (A), 42 patients were classified as "PVCA", and summarize the methods of pre-hospital emergency and in-hospital treatment based on the "ABC" treatment principles: airway rebuild (A), effective arterial hemostasis and bleeding stop (B), and cerebral blood flow reconstruction within the time window (C). Results: Within the 42 cases of cervical massive hemorrhage, there were 3 cases of type P1 (below cricoid cartilage), 28 cases of type P2 (cricoid cartilage-mandibular angle), 11 cases of type P3 (mandibular angle-skull base); 22 cases of type V1 (arterial hemorrhage), 11 cases of type V2 (main venous hemorrhage), 7 cases of type V3 (simple superficial vein or small artery hemorrhage), 2 cases of type V4 (mixed arteriovenous hemorrhage); 5 cases of type C0 (no symptoms of cerebral ischemia and neurological dysfunction), 33 cases of type C1 (transient cerebral ischemia without sensory disturbance), 4 cases of type C2 (symptoms of cerebral ischemia and neurological dysfunction); 39 cases of type A0 (no other system damage was involved) and 3 cases of type A1 (combined with other system damage). All 42 patients received operations, 25 patients received open surgery of vascular reconstruction+hematoma/foreign body removal (7 cases of vascular ligation, 14 cases of direct suture repair, 4 cases of vascular interposition), 17 patients received hybrid surgery (carotid angiography+covered stent repair+hematoma/foreign body removal). The surgical technique success rate the was 100%. All the hemorrhagic shock was corrected, hematoma compression was relieved, and the symptoms of cephalic ischemia were improved. There were 4 cases of local cranial nerve injury, 1 case of incision hematoma and 6 cases of postoperative hyper perfusion. During the average 14.3 months follow-up, there was no operation related myocardial infarction, stroke or death, no re-rupture or re-dissection, and 50% asymptomatic restenosis was found in 1 case one year after received covered stent endovascular repair. Conclusion: Based on the "PVCA" classification and "ABC" treatment principle, it is safe and effective to rescue cervical massive hemorrhage.

Effects of spatial variation in water quality and hydrological factors on environmental flows

Environmental flow is the quantity, timing, and quality of water flows required to sustain freshwater and estuarine ecosystems and the human livelihoods and well-being that depend on these ecosystems. Environmental flows (e-flows) are crucial parameters for ecosystem restoration. Understanding the effects of spatial variation in the hydrological and water quality factors on e-flows aids the determination of recovery prior areas and helps to improve the success rate of ecosystem restoration projects. However, few studies have investigated the effects, which severely hinder the restoration of aquatic ecosystems and the sustainable use of water resources in inland waters. This paper therefore presents a framework for studying such effects. Spatial autocorrelation, a geostatistical method, is used to analyze the spatial variation in the hydrological and water quality factors and to further analyze the effects of various factors on the spatial heterogeneity of e-flows. Four different methods including the Tennant method, wetted perimeter method, AEHRA, and integrated water quality method are integrated to comprehensively evaluate e-flows. The former three methods consider the demands of biota on the streamflow, whereas the latter considers the demands on both the streamflow and the water quality. The results show that the Tennant and wetted perimeter methods, which focus on the statistics of only streamflow, result in similar spatial distribution of e-flows; the AEHRA and integrated water quality method, which consider the effects of water quality and other hydrological factors such as flow velocity and water depth on fish, also result in a similar spatial variation. Consideration of both demands on the hydrological factors and the water quality environmental factors makes the integrated water quality method more practical, particularly in developing regions with excessive pollutant discharge into rivers. In addition, spatial variation in the hydrological and water quality factors influenced the presence of principal fish species and consequently affected the e-flows. Of the 37 water quality factors identified, water transparency had a negative impact on e-flow because the increase in transparency could reduce the number of principal fish species. Of the four hydrological factors, flow velocity and river width had positive impacts on fish because the increase in flow velocity can provide breeding sites and habitats for more fish, respectively, both of which result in increases in the numbers of principal fish species. We found that spatial variation in the hydrology and water quality factors had a profound impact on the living environments of aquatic organisms; negative changes in these factors lowered the survival probability of principal species, which changed the hierarchy and structure of the ecosystems and thus led to variation in e-flows. The results can provide priori knowledge for e-flow methods selection and a reference for ecosystem restoration helping improve the success rate of project elsewhere in the world.

Curcumin inhibits hypoxia inducible factor-1α-induced inflammation and apoptosis in macrophages through an ERK dependent pathway

OBJECTIVE

Atherosclerosis, a kind of peripheral arterial disease with chronic inflammation, leads to the dysfunction of the vascular system and many other diseases. Hypoxia has been proven to participate in the progression of atherosclerosis, while curcumin can inhibit hypoxia-inducible factor 1α (HIF-1α). However, the underlying mechanisms are still elusive.

PATIENTS AND METHODS

qRT-PCR was used to examine the expression of HIF-1α, IL-6 and TNFα of macrophages under hypoxic condition. Western blot was applied to examine the changes of HIF-1α, ERK and p-ERK after treatment with curcumin. Oli Red O staining and enzymatic assay were used to examine the lipid and total cholesterol in macrophages, respectively. ELISA was used to examine the release of IL-6 and TNFα by macrophages. FACS and MTT assays were applied to examine the apoptosis and proliferation of macrophages.

RESULTS

Here, we found curcumin inhibited the expression of HIF-1α at the protein level in macrophages under hypoxic condition and curcumin and HIF-1α inhibitors repressed the total cholesterol and lipid level in macrophage under hypoxic condition. Moreover, curcumin also decreased the expression of HIF-1α downstream genes, VEGF, HMOX1, ROS and PDGF. Then, the data show the HIF-1α-induced apoptosis and inflammation of macrophages were inhibited by curcumin. Curcumin also rescued the proliferation defect of macrophages caused by hypoxia. Furthermore, we found it inhibited the expression of HIF-1α via ERK signaling pathway.

CONCLUSIONS

We describe that curcumin inhibited the HIF-1α-induced apoptosis and inflammation of macrophages via ERK signaling pathways. These results suggest curcumin can be used for the treatment of atherosclerosis.

[Effects of long non-coding RNA FLJ37505 on the proliferation and migration of bladder cancer cells]

Objective: To examine the expression of long-chain non-coding RNA (lncRNA) FLJ37505 in bladder cancer tissues and cell lines, and to analyze the molecular mechanism of FLJ37505 to inhibit the proliferation and migration of bladder cancer cells. Methods: Quantitative Real-time PCR(qPCR) was used to analyze the relative expression of FLJ37505 in 63 cases of bladder cancer tissues and bladder cancer cell lines (T24, J82, 5637, BIU-87 and UM-UC-3). The bladder cancer cell lines with the least expression of FLJ37505 were divided into control group (transfected with blank plasmid) and FLJ37505 group (transfected with a plasmid carrying the FLJ37505 sequence) according to random number method. MTS assay and scratch assay were used to detect the effect of up-regulation of FLJ37505 expression on cell proliferation and migration. Bioinformatics predicts the target gene of FLJ37505. The dual luciferase reporter system detects the binding of FLJ37505 to the target gene. qPCR and Western blot were used to detect the effect of FLJ37505 on the expression of target gene. Results: Compared with adjacent tissues, FLJ37505 expression was lower in bladder cancer tissue [(4.90±0.79) vs (0.89±0.28), P<0.05]. Compared with human normal bladder tubular epithelial cells, the expression of FLJ37505 was lower in bladder cancer cell lines (P<0.05), and FLJ37505 has the lowest expression in UM-UC-3 cells (P<0.01). Compared with the control group, the expression of FLJ37505 in UM-UC-3 cells of FLJ37505 group was higher [(0.79±0.04) vs (9.92±1.17), P<0.01]. Compared with the control group, the proliferation ability of UM-UC-3 cells in FLJ37505 group was inhibited (P<0.05), and the cell migration ability was also inhibited (P<0.01). Bioinformatics showed that the target gene of FLJ37505 is miR-203a-3p, and the target gene of miR-203a-3p is inositol polyphosphate 4-phosphatase typeⅡ (INPP4B). The dual luciferase reporter gene system showed that FLJ37505 could complement the miR-203a-3p (P<0.01), and miR-203a-3p could complement the INPP4B mRNA (P<0.01). Compared with the control group, the expression of miR-203a-3p was lower [(1.00±0.05) vs (0.20±0.02), P<0.01], the expression of INPP4B in mRNA and protein levels of UM-UC-3 cells in FLJ37505 group was significantly increased (all P<0.01). Conclusions: The expression of FLJ37505 was significantly decreased in bladder cell carcinoma and bladder cancer cells. Up-regulation of FLJ37505 significantly inhibits the proliferation and migration of bladder cell carcinoma UM-UC-3 cells, and the mechanism might be up-regulating the expression of the INPP4B gene by adsorbing miR-203a-3p.

O-GlcNAcylation promotes malignant phenotypes of bladder cancer cells

O-GlcNAcylation (O-GlcNAc) is a posttranslational modification that is mediated by O-GlcNAc-transferase (OGT) and reversed by O-GlcNAcase (OGA). Increasing evidence indicates that protein O-GlcNAcylation is increased in various types of cancer. In the present study, we aimed to evaluate the expression and function of both OGT and OGA in bladder cancer cells in vitro and in vivo. Expression data of OGT and OGA at the mRNA level was obtained from the Oncomine database. Effects of OGT and OGA on cell proliferate, invasive, and migratory abilities were assessed using MTT, wound healing, cell invasive assay, and cell cycle analysis. In vivo assay was also performed in nude mice. The results revealed that the expression of OGT in bladder cancer tissues was higher than that of normal tissues, while the OGA level was found to be lower in cancer tissues. We also found that knockdown of OGT could inhibit cell proliferation, migration, invasion, and induce cell cycle arrest, while these are reversed when OGA is inhibited. We also observed that O-GlcNAcylation could promote tumor formation in vivo, compared with a negative control. In summary, this study describes the oncogenic role of O-GlcNAcylation in bladder cancer cells.

Central vein sign for multiple sclerosis: A systematic review and meta-analysis

AIMS

To systematically review the diagnostic value of the central vein sign (CVS) in multiple sclerosis (MS) and to meta-analyse the proportion of positive lesions for CVS needed to distinguish MS from non-MS mimics.

MATERIALS AND METHODS

A literature review was performed and a proportion meta-analysis was performed to examine the proportion of the CVS in MS lesions. Studies reporting a threshold of the CVS containing lesions with 100% diagnostic accuracy were included in the meta-analysis. This was compared to MS mimics in order to establish the discriminative value of the CVS.

RESULTS

The CVS was found to be viable at lower field strengths (3 T and 1.5 T) and automated analysis is currently less accurate than manual counting. Five studies were included for the proportional meta-analysis. From the analysis, a proportion of 45% of lesions having the CVS was suggested given that the findings that the weighted proportion was 46.4% (95% confidence interval [CI]: of 40.3%-52.6%) with low heterogeneity (I² = 0.0%; p=0.5).

CONCLUSION

Although the CVS is a clinically relevant and viable sign, further work is needed to integrate this into the existing diagnostic criteria. As manual determination is a time-consuming process, the development of automated methods will be beneficial. With improvements in computational imaging techniques, the CVS will have an important role in the diagnosis and differentiation of MS.

Impact of spatial variations in water quality and hydrological factors on the food-web structure in urban aquatic environments

Global aquatic ecosystems are essential to human existence and have deteriorated seriously in recent years. Understanding the influence mechanism of habitat variation on the structure of the food-web allows the effective recovery of the health of degraded ecosystems. Whereas most previous studies focused on the selection of driving habitat factors, the impact of habitat variation on the food-web structure was rarely studied, resulting in the low success rate of ecosystem restoration projects globally. This paper presents a framework for exploring the effects of spatial variations in water quality and hydrological habitat factors on the food-web structure in city waters. Indices for the evaluation of the food-web structure are first determined by integrating model-parameter extraction via literature refinement. The key water quality and hydrological factors are then determined by coupling canonical correspondence analysis with partial least squares regression. Their spatial variation is investigated using spatial autocorrelation. Finally, fuzzy clustering is applied to analyze the influence of the spatial variations in water quality and hydrological factors on the food-web structure. The results obtained in Ji'nan, the pilot city of water ecological civilization in China, show that the Shannon diversity index, connectance index, omnivory index, and the ratio of total primary production to the total respiration are important indicators of food-web structural change. They show that the driving factors affecting the aquatic food-web structure in Ji'nan are hydrological factors (e.g., river width, water depth, and stream flow), physical aspects of water quality (e.g., air temperature, water temperature, electrical conductivity, and transparency), and chemical aspects (e.g., potassium, dissolved oxygen, calcium, and total hardness). They also show that the stability of the food-web is more prone to spatial variations in water quality than in hydrological factors. Higher electrical conductivity, potassium, total hardness, and air temperature lead to deteriorated food-web structures, whereas better transparency improves structure and stability. We found that water and air temperature are the most important factors in the spatial variation of the food-web structure in the study area, followed by total hardness. Transparency is the least important factor. Large disparities and varied spatial distributions exist in the driving effects of water quality and hydrological factors across regions attributable to differences in geographical environments, water salinity (fresh vs. sea water), and environmental factors (e.g., water pollution). The above methods and results serve as a theoretical and scientific basis for a high success rate of aquatic ecosystem restoration projects in the study area and other cities worldwide.

[Efficacy and safety of domestic dasatinib as second-line treatment for chronic myeloid leukemia patients in the chronic phase]

目的

探讨国产酪氨酸激酶抑制剂（TKI）达沙替尼（商品名：依尼舒）二线治疗慢性髓性白血病慢性期（CML-CP）患者的疗效及安全性。

方法

回顾性分析2016年3月至2018年7月湖北省CML协作组成员医院收治的二线服用国产达沙替尼的CML-CP患者的病例资料，统计患者治疗3、6和12个月时最佳反应率、累积完全细胞遗传学反应（CCyR）率、累积主要分子学反应（MMR）率、无进展生存（PFS）、无事件生存（EFS）情况及不良反应情况。

结果

共纳入83例CML-CP患者，中位随访时间为23（4~45）个月，达沙替尼治疗3、6、12个月最佳反应率分别为77.5%（54/71）、72.6%（61/75）、60.7%（51/69）。至随访截止，累积CCyR率、MMR率分别为65.5%（55/80）、57.1%（48/73），达CCyR和MMR的中位时间均为3个月。随访时间内，PFS率为94.0%（79/83），EFS率为77.4%（65/83）。国产达沙替尼最常见非血液学不良反应为水肿（32.5%），其次为皮疹瘙痒（18.1%）、乏力（13.3%），血液学不良反应主要有血小板减少（31.3%）、白细胞减少（19.3%）和贫血（6.0%）。

结论

国产达沙替尼二线治疗CML-CP患者具有较好的疗效及安全性，可作为CML-CP患者的治疗选择。

Predicting future river health in a minimally influenced mountainous area under climate change

It has been shown that climate change impacts the overall health of a river's ecosystem. Although predicting river health under climate change would be useful for stakeholders to adapt to the change and better conserve river health, little research on this topic exists. This paper presents a methodology predicting river health under different climate change scenarios. First, a multi-source, distributed, time-variant gain hydrological model (MS-DTVGM) was used to predict the runoff from a mountainous river in eastern China using the data from three existing IPCC5 climate change models (RCP2.6, RCP4.5, and RCP8.4). Next, a model was developed to predict the river's water quality under these scenarios. Finally, a multidimensional response model utilizing hydrology, water quality, and biology was used to predict the river's biological status and ascertain the impact of climate change on its overall health. The river is in a mountainous area near Jinan City, one of China's first "pilot" cities recognized as a "healthy water ecological community." Our results predict that the overall health of the Yufu River, which is minimally influenced by human activities, will improve by 2030 due to the increased river flow due to an increase in rainfall frequency and subsequent peak runoff. However, the total nitrogen concentration is predicted to increase, which is a potential eutrophication risk. Therefore, effective control of nitrogen pollutants entering the river will be necessary. The increase in flow velocity (the annual average increase is ~0.5 m/s) is favorable for fish reproduction. Our methods and results will provide scientific guidance for policy makers and river managers and will help people to better understand how global climate change impacts river health.

Abstract P6-03-05: Not presented

This abstract was not presented at the conference.

Citation Format: Guangping L, Wei L, Xiang H, Shidai J, Dengshun M, Ziyi F, Jinhai T, Yongmei Y. Not presented [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-03-05.

Abstract P1-18-03: Phase I trial to assess the safety, pharmacokinetics and pharmacodynamics of receptor activator of nuclear factor-κB ligand inhibitor (TK006) in patients with bone metastases from breast cancer

Background

Within the bone microenvironment, tumor cells secrete factors that stimulate osteoblasts to express and secrete receptor activator of nuclear factor-κB ligand (RANKL), which binds to its receptor RANK on the surface of osteoclasts, thus enhancing the osteoclast-mediated bone resorption and promoting skeletal complications.TK006 is a fully human monoclonal antibody that binds and inhibits RANKL, thus inhibiting osteoclast-mediated bone destruction.

Objective

To investigate the safety, pharmacokinetics and pharmacodynamics of TK006 in patients with bone metastases from breast cancer.

Patients and methods

In this dose-escalating study, patients were sequentially enrolled into 60 mg, 120 mg, 180 mg single-dosing and 120 multiple-dosing cohorts. Before making dose escalation decision, the safety of TK006 during the 14-day period after dosing in the prior cohort must be confirmed. In the three single-dosing cohorts, patients were followed up for 16 weeks after dosing. In the 120 mg multiple-dosing cohort, patents were treated with 120 mg TK006 every 4 weeks for 3 times totally, and followed up for 20 weeks after the first dosing. The primary outcome was safety profile, and the secondary outcomes were pharmacokinetics, pharmacodynamics and immunogenicity. Pharmacodynamics was measured by level of serum bone alkaline phosphatase (BALP) and urine creatinine corrected cross-linked N-telopeptides of type I collagen (uNTX/Cr).

Patients aged 18 to 65 years with breast cancer related bone metastasis were eligible. It was planned to enroll 10 subjects in each cohort for a total sample size of 40 subjects.

Result

As of May 24 2018, the common adverse events (AEs) related to treatment (≥10%) included: hypocalcemia (25.0%), limbs pain (20.0%), gamma-glutamyl transferase increased (17.5%), lactate dehydrogenase increased (12.5%), alpha-hydroxybutyric dehydrogenase increased (12.5%), aspertate aminotransferase increased (12.5%), alanine aminotransferase (10.0%),osphyalgia (10.0%) toothache (10.0%) and hypertriglyceridemia (10%). Most adverse reactions were mild or moderate except one case of grade 3 hypertriglyceridemia and two cases of grade 3 gamma-glutamyl transferase increasement. No esteonecrosis of the jaw or treatment-related SAE was reported.

In the 60 mg single-dosing cohort, a significant reduction in median uNTX/Cr was observed as early as day 1, the nadir of median uNTX/Cr was reach at day 28 and started to return towards the baseline level at day 112 (Table 1).

Only modest decreasing from baseline in median bone-specific alkaline phosphatase was observed.

Table 1.Effects of 60 mg TK006 therapy on bone turnover markers uNTX/Cr, % change from baseline, medianBALP , % change from baseline, medianD1-38.6-4.7D7-63.01.7D14-55.30.2D28-69.2-0.2D56-57.9-12.1D84-33.4-0.4D1121.3-18.7

Ostalgia was measured by visual analogue scale (VAS). In the 60 mg single-dosing cohort, scores were reduced to 2 from 5 and 3 in two patients individually. No increasing in pain was observed in the remaining 8 patients.

Conclusion

These results suggested a potential therapeutic role for TK006 in patients with bone metastases from breast cancer.

Citation Format: Mei YY, Hai TJ, Wei L, Xiang H, Hao W, Ming ZX, An LX. Phase I trial to assess the safety, pharmacokinetics and pharmacodynamics of receptor activator of nuclear factor-κB ligand inhibitor (TK006) in patients with bone metastases from breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-18-03.

Effects of altitude changes on mild-to-moderate closed-head injury in rats following acute high-altitude exposure

Mild-to-moderate closed-head injury (mmCHI) is an acute disease induced by high-altitudes. It is general practice to transfer patients to lower altitudes for treatment, but the pathophysiological changes at different altitudes following mmCHI remain unknown. The present study simulated acute high-altitude exposure (6,000 m above sea level) in rats to establish a model of mmCHI and recorded their vital signs. The rats were then randomly assigned into different altitude exposure groups (6,000, 4,500 and 3,000 m) and neurological severity score (NSS), body weight (BW), brain magnetic resonance imaging (MRI), brain water content (BWC) and the ratio of BW/BWC at 6, 12 and 24 h following mmCHI, and the glial fibrillary acidic protein levels were analysed in all groups. The results revealed that within the first 24 h following acute high-altitude exposure, mmCHI induced dehydration, brain oedema and neuronal damage. Brain injury in rats was significantly reversed following descent to 4,500 m compared with the results from 6,000 or 3,000 m. The results indicated that subjects should be transported as early as possible. Furthermore, avoiding large-span descent altitude was beneficial to reduce neurological impairment. The examination of brain-specific biomarkers and MRI may further be useful in determining the prognosis of high-altitude mmCHI. These results may provide guidance for rescuing high altitude injuries.

Ultrastretchable Fiber Sensor with High Sensitivity in Whole Workable Range for Wearable Electronics and Implantable Medicine

Fast progress in material science has led to the development of flexible and stretchable wearable sensing electronics. However, mechanical mismatches between the devices and soft human tissue usually impact the sensing performance. An effective way to solve this problem is to develop mechanically superelastic and compatible sensors that have high sensitivity in whole workable strain range. Here, a buckled sheath-core fiber-based ultrastretchable sensor with enormous stain gauge enhancement is reported. Owing to its unique sheath and buckled microstructure on a multilayered carbon nanotube/thermal plastic elastomer composite, the fiber strain sensor has a large workable strain range (>1135%), fast response time (≈16 ms), high sensitivity (GF of 21.3 at 0-150%, and 34.22 at 200-1135%), and repeatability and stability (20 000 cycles load/unload test). These features endow the sensor with a strong ability to monitor both subtle and large muscle motions of the human body. Moreover, attaching the sensor to a rat tendon as an implantable device allowes quantitative evaluation of tendon injury rehabilitation.

Significant association between paraoxonase 1 rs662 polymorphism and coronary heart disease : A meta-analysis in the Chinese population

BACKGROUND

A growing number of studies have suggested that the single nucleotide polymorphism (SNP) rs662 (G>A) in paraoxonase 1 (PON1) is significantly associated with susceptibility to coronary heart disease (CHD) in the Chinese population. To further evaluate the effects of the PON1 RS662 (G>A) polymorphism on the risk of CHD, we performed a meta-analysis in a Chinese population.

METHODS

PubMed, Embase, Wanfang Data, Chinese National Knowledge Infrastructure (CNKI) were searched to identify eligible studies. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the strength of the associations between RS662 (G>A) and CHD.

RESULT

In the meta-analysis, we identified 14 articles, including a total of 4835 CHD patients and 5111 controls in the Chinese population. Our result showed that overall rs662 (G>A) was significantly associated with susceptibility to CHD in the Chinese population when compared with healthy controls. Furthermore, a G allele suggested an elevated risk of CHD. In the subgroup analyses stratified by ethnicity and geographic areas, significant associations were found in Chinese Han and South China, but not in North China.

CONCLUSION

The present meta-analysis suggests that rs662 (G>A) SNP in PON1 is associated with CHD risk; the G allele might be the risk allele for CHD susceptibility in the Chinese population. However, more research is required to make a definite conclusion.

Widespread white matter microstructural differences in schizophrenia across 4322 individuals: results from the ENIGMA Schizophrenia DTI Working Group

The regional distribution of white matter (WM) abnormalities in schizophrenia remains poorly understood, and reported disease effects on the brain vary widely between studies. In an effort to identify commonalities across studies, we perform what we believe is the first ever large-scale coordinated study of WM microstructural differences in schizophrenia. Our analysis consisted of 2359 healthy controls and 1963 schizophrenia patients from 29 independent international studies; we harmonized the processing and statistical analyses of diffusion tensor imaging (DTI) data across sites and meta-analyzed effects across studies. Significant reductions in fractional anisotropy (FA) in schizophrenia patients were widespread, and detected in 20 of 25 regions of interest within a WM skeleton representing all major WM fasciculi. Effect sizes varied by region, peaking at (d=0.42) for the entire WM skeleton, driven more by peripheral areas as opposed to the core WM where regions of interest were defined. The anterior corona radiata (d=0.40) and corpus callosum (d=0.39), specifically its body (d=0.39) and genu (d=0.37), showed greatest effects. Significant decreases, to lesser degrees, were observed in almost all regions analyzed. Larger effect sizes were observed for FA than diffusivity measures; significantly higher mean and radial diffusivity was observed for schizophrenia patients compared with controls. No significant effects of age at onset of schizophrenia or medication dosage were detected. As the largest coordinated analysis of WM differences in a psychiatric disorder to date, the present study provides a robust profile of widespread WM abnormalities in schizophrenia patients worldwide. Interactive three-dimensional visualization of the results is available at www.enigma-viewer.org.

The haemtrack home therapy reporting system: Design, implementation, strengths and weaknesses: A report from UK Haemophilia Centre Doctors Organisation

INTRODUCTION

Haemtrack is an electronic home treatment diary for patients with inherited bleeding disorders, introduced in 2008. It aimed to improve the timeliness and completeness of patient-reported treatment records, to facilitate analysis of treatment and outcome trends. The system is easy to use, responsive and accessible.

METHODS

The software uses Microsoft technologies with a SQL Server database and an ASP.net website front-end, running on personal computers, android and I-phones. Haemtrack interfaces with the UK Haemophilia Centre Information System and the National Haemophilia Database (NHD). Data are validated locally by Haemophilia Centres and centrally by NHD. Data collected include as follows: treatment brand, dose and batch number, time/date of bleed onset and drug administration, reasons for treatment (prophylaxis, bleed, follow-up), bleed site, severity, pain-score and outcome.

RESULTS

Haemtrack was used by 90% of haemophilia treatment centres (HTCs) in 2015, registering 2683 patients using home therapy of whom 1923 used Haemtrack, entering >17 000 treatments per month. This included 68% of all UK patients with severe haemophilia A. Reporting compliance varied and 55% of patients reported ≥75% of potential usage. Centres had a median 78% compliance overall. A strategy for progressively improving compliance is in place. Age distribution and treatment intensity were similar in Haemtrack users/non-users with severe haemophilia treated prophylactically.

CONCLUSION

The Haemtrack system is a valuable tool that may improve treatment compliance and optimize treatment regimen. Analysis of national treatment trends and large-scale longitudinal, within-patient analysis of changes in regimen and/or product will provide valuable insights that will guide future clinical practice.

Dendritic Cells from Rheumatoid Arthritis Patient Peripheral Blood Induce Th17 Cell Differentiation via miR-363/Integrin αv/TGF-β Axis

Dendritic cells (DCs) are critical regulators of immune responses. This study was to observe the effect of DCs from peripheral blood on the differentiation of Th17 in patients with rheumatoid arthritis (RA). Peripheral blood samples were collected from 30 patients with RA and 20 healthy controls, respectively. Flow cytometry results showed that in contrast to Treg cells, the proportion of Th17 cells in T cells and the Th17/Treg ratio were both increased in patients with RA. The RT-PCR results showed that Foxp3、ROR γt and miR-363 expression in PBMC of patients with RA were reduced, but the ITGAV expression was increased, which was negatively related to miR-363 expression. IL-17, TGF-β and IL-6 levels detected by ELISA were increased in peripheral blood serum of patients with RA. Moreover, we noted that the CD11C⁺ αν⁺ /CD11C⁺ DCs ratio was obvious increased in patients with RA and has positive correlation to the Th17/Treg ratio. In cocultured system, Th17 cell differentiation was significantly inhibited in the presence of ITGF-β suggesting that Th17 cell differentiation was controlled by active TGF-β (aTGF-β). After DCs transfecting with miR-363 mimics and cocultured with T cells, Th17 cell number, IL-17 level and ROR-γt expression were significantly reduced in the presence of latent TGF-β (ITGF-β). In addition, the integrin αv protein expression was both reduced in the presence of aTGF-β or ITGF-β. These data demonstrated that DCs induced Th17 cell differentiation through miR-363/Integrin αv/TGF-β pathway in patients with RA.

[Application of adjacent micro flap in the repair of skin defect in head and face]

Objective:The aim of this study is to sum up the different surgical repair methods and techniques for the skin defect of head and face.Method:A retrospective study on 97 cases of the face and head skin defect caused by trauma and tumor resection in nearly five years, including 37 cases on nasal, 21 cases on cheek, 9 cases on frontal, 13 cases on temporal, and 17 cases on ear. After resecting skin lesion in security boundary, skin defect were repaired by transposition adjacent flap, zone vascular pedicle flap, myocutaneous flap and the mucosal flap.Result:Seventy-one cases of the postoperative flap healed and stitches discharged in a week; 24 cases of flap edge small necrosis in small, one flap occurred most necrosis, and one skin flap occurred infection and necrosis.Conclusion:Facial skin defect can be repaired primarily by various types of micro adjacent flap. Flap survival is closely related to surgical techniques and postoperative treatment. Retroauricular groove flap has been widely used to repair skin defect of multiple regions for ear.

Aspartate β-hydroxylase disrupts mitochondrial DNA stability and function in hepatocellular carcinoma

The mechanism of aberrant mitochondrial genome and function in hepatocellular carcinoma (HCC) remains largely unknown. Our previous study demonstrated an increased expression of aspartate β-hydroxylase (ASPH) in HCC tissues, which was associated with tumor invasiveness and a worse prognosis. Currently, we unexpectedly observed the presence of ASPH in purified mitochondrial protein fraction. In addition, immunostaining of both exogenously and endogenously expressed ASPH showed a colocalization with mitochondrial biomarkers. This study aimed to investigate whether the mitochondrial ASPH is involved in mitochondrial malfunction in HCC. Our results showed that ASPH overexpression in HCC tissues was correlated with decreased copy numbers of displacement loop (D-loop) and NADH dehydrogenase subunit 1 (ND-1) and enhanced D-loop mutation, suggesting the disrupted mitochondrial DNA (mtDNA) stability. The reduced mtDNA copy numbers were associated with aggressive clinicopathological features of HCC. The loss of mtDNA integrity induced by enforced expression of ASPH was accompanied with mitochondrial dysfunction, which was characterized by the aberrant mitochondrial membrane potential, decreased ATP generation and enhanced reactive oxygen species. In contrast, knocking down ASPH by siRNA in HCC cell lines showed the opposite impact on mtDNA integrity and function. Mass spectrometry and co-immunoprecipitation further identified that ASPH interacted with histone H2A member X (H2AX). ASPH overexpression diminished the interaction between H2AX and mitochondrial transcription factor A (mtTFA), an important DNA-binding protein for mtDNA replication, which then reduced the binding of mtTFA to D-loop region. Collectively, our results demonstrate that ASPH overexpression disrupts the mtDNA integrity through H2AX-mtTFA signal, thereby affecting mitochondrial functions in HCC.

Study on the mechanism of AMPK signaling pathway and its effect on apoptosis of human hepatocellular carcinoma SMMC-7721 cells by curcumin

OBJECTIVE

Liver cancer is a common malignant tumor in the digestive system. Curcumin is a kind of phenolic pigment, which is extracted from herbage and has a plenty of physiological roles in anti-inflammation, anti-oxidation and anti-tumor. In our study, human hepatoma SMMC-7721 cell lines were selected and treated with curcumin to detect its effects on the apoptosis and AMPK signaling pathway.

MATERIALS AND METHODS

Human liver cancer cell strain SMMC-7721 was cultured and treated with different curcumin concentrations for different times followed by measuring the changes of cell proliferation activity and cycle by MTT and flow cytometry, respectively. Protein expression of Bcl-2, Bax and Caspase-3 were tested by Western blot, and the activation level of AMPK was also detected.

RESULTS

Different concentrations of curcumin could inhibit the proliferation of tumor cells in a dose-dependent manner. After 48 h inhibition by curcumin with a concentration of 40 mmol/L, the inhibitory effect was more obvious with statistically significant (p<0.05). The number of human liver cancer SMMC-7721 cells increased in G1 stage and decreased in S stage after treated with different concentrations of curcumin. During the G1 stage to the S stage, inhibition occurred and the effect of curcumin intervention group with 40 mmol/L was more evident than that of 10 mmol/L group, 20 mmol/L group and the control group with statistically significant (p<0.05). SMMC-7721 cell stains had been intervening by curcumin with concentrations of 10 mmol/L, 20 mmol/L and 40 mmol/L for 12 h, 24 h and 48 h, as the drug concentration increased, the reaction time prolonged, the protein expressions of Bcl-2 and Survivin were significantly decreased and Bax protein expression was significantly increased (p<0.05).

CONCLUSIONS

Curcumin decreased the proliferation activity of tumor cells, increased the cell quantities in G1 stage and decreased the cell numbers in S stage in human liver cancer SMMC-7721 cells. The Bcl-2 and Survivin proteins were downregulated and Bax protein was upregulated; furthermore, the AMPK signaling pathway was activated.

Preliminary study on alterations of altitude road traffic in China from 2006 to 2013

Introduction

Road traffic can play an important role in strengthening regional economic activities, especially at high altitude, and it is necessary to know important traffic-related information. Although previous studies reported on road traffic in China, there has been little research on high-altitude road traffic to date.

Method

The annual official census of road traffic safety from 2006 to 2013 was used to obtain data on the general population, registered drivers, registered vehicles, newly built roads, road traffic accidents (RTAs), mortality rate per 100 000 populations and per 10 000 vehicles in high-altitude provinces, including Tibet, Qinghai, Xinjiang, Gansu, Yunnan, Sichuan, and Chongqing. These provincial data were reviewed retrospectively, with the national data as the reference. Statistical analysis (i.e., t test) was used to compare the estimated average annual change rate of population, number of registered drivers, registered vehicles, and newly built roads in high-altitude provinces with the national rates.

Results

Compared with the national data, there are significantly higher annual rates of population growth in Tibet and Xinjiang, registered drivers in Gansu, registered vehicles in Gansu, Sichuan, and Chongqing, and newly built roads in Tibet and Qinghai. Among the investigated provinces, Tibet, Qinghai, and Yunnan had a higher proportion of the roads with the high class. RTAs and RTA-induced casualties in the high-altitude provinces indicated a decreasing trend. The mortality rate per 10 000 vehicles and per 100 000 populations showed a decreasing trend, while the RTA-related mortality rate in Tibet, Qinghai, Xinjiang and Gansu remained high.

Conclusions

Major changes for road traffic in high-altitude provinces have occurred over the past decade; however, the RTA-related mortality rate in high-altitude provinces has remained high. This study furthers understanding about road traffic safety in China; further studies on road traffic safety at high altitude should be performed.

Outcomes of standard dose EC-MPS with low exposure to CsA in DCD renal transplantation recipients with DGF

AIMS

The lower limit of exposure to cyclosporine A (CsA) has not yet been established in donation after cardiac death (DCD) renal transplantation recipients with delayed graft function (DGF) receiving enteric-coated mycophenolate sodium (EC-MPS) therapy. Stable and adequate mycophenolic acid (MPA) dosing may facilitate lower CsA exposure after DCD renal transplantation in recipients with DGF without compromising safety.

METHODS

A 12-month, single-centre open-label prospective trial was performed in our centre. According to their DGF risk index using the previous DGF prediction models, we divided up the patients on oral CsA into either a DGF group (n = 26) and no DGF group (n = 48). All of the patients initially received the standard EC-MPS dosing (1440 mg/day). The initial dose of CsA in the low risk of DGF group was 4.5 mg/kg/day and in the high risk of DGF group was 2.5 mg/kg/day. Efficacy parameters, safety and tolerability were assessed over a 12-month study period.

RESULTS

The incidence of DGF was 18.5% in the 162 DCD recipients. Between the DGF group and the no DGF group, the 1-year patient survival and graft survival were not significantly different. The incidence of BPAR was higher in the DGF group (26.9% vs. 8.3%, p = 0.032). Most patients in the DGF group had recovery of renal function after 1 month. The adverse events between the two groups were not significantly different. The daily EC-MPS doses of the DGF group were significantly higher than the no DGF group before the 6-month follow-up period. There were no significant differences between the two groups regarding the mean AUC levels during the follow-up period.

CONCLUSIONS

These results show that low expose CsA with standard dosing of EC-MPS and thymoglobulin was efficacious, safe and well-tolerated in DCD renal transplant recipients with DGF in China. Furthermore, stable and adequate MPA exposure helped to reduce the dose of and exposure to CsA. Thus, this may lead to less-induced nephrotoxicity and better renal function recovery.

Holocord spinal epidural abscess: Case report and literature review

Holocord spinal epidural abscess (SEA) is a rare condition. To our knowledge, five cases of SEA have been reported so far, and no consensus has been made on the treatment yet. In this article, we report a case of holocord SEA and review literature to further understanding of SEA. The advent of antibiotic treatment and the recognition of surgical debridement have been important in searching for alternatives to recovery, so the patient was treated surgically together with systemic antibiotics. The patient remained neurologically stable and continued to be clinically in good condition without any low back pain after 1 year. Surgical drainage, together with systemic antibiotics, is the main treatment choice for extensive SEAs. Although treatment should be considered that highlights the importance of examining the factors related to the health and condition of the patients and the anatomy and extent of the abscess, early surgical treatment associated with prolonged antibiotic treatment is necessary.

[Co-overexpression of human tissue kallikrein 1 and human metalloproteinase 1 tissue inhibitor inhibits neointima formation in the rat artery after balloon angioplasty]

OBJECTIVE

To investigate the effects of adenovirus-mediated human tissue kallikrein 1(hTK-1) and/or human tissue metalloproteinase inhibitor 1 (hTIMP-1) gene delivery on the neointima formation in balloon-injured rat carotids and related mechanism.

METHODS

Forty-six male Sprague-Dawley rats were randomly assigned into 6 groups with the random number table: (1) sham-operated group(n=6), (2) angioplasty group (n=8), (3) vector virus group (n=8), (4) hTK-1 group (n=8), (5) hTIMP-1 group (n=8), (6) hTK-1-hTIMP-1 group (n=8). Except sham rats, all rats underwent carotid artery balloon injury and local delivery of saline or different recombined adenoviruses respectively. Rats were sacrificed 14 days later. Intima/media area ratio was assessed on hematoxylin-eosin stained tissue section. Immunofluorescence images stained for hTK-1, hTIMP-1 were obtained and analyzed by the confocal microscope for co-localization examination of hTK-1 and hTIMP-1. The protein expression levels of hTK-1, hTIMP-1, matrix metalloproteinases(MMP)-2 and MMP-9 were determined by Western blot. Immune histochemical staining for PCNA was also performed.

RESULTS

(1)Intima area, intima/media area ratio, PCNA, MMP-2 and MMP-9 levels were all significantly increased in rats underwent angioplasty (did or did not receive vector virus) compared with sham-operated rats (all P<0.01) while above parameters were similar between rats underwent angioplasty or vector virus delivery (all P>0.05). (2) The intima area of rats received vector virus, hTK-1, hTIMP-1 or dual gene transfer were (0.160±0.010), (0.110±0.015), (0.121±0.016) or (0.081±0.008) mm(2) respectively, intima area was similar between rats received hTK-1 or hTIMP-1 (P>0.05), differences were found between other groups (all P<0.01). The intima/media area ratio of rats received vector virus, hTK-1, hTIMP-1 or dual gene transfer were 2.035±0.117, 1.443±0.097, 1.522±0.078 or 0.972±0.072 respectively, no difference was found between rats received hTK-1 or hTIMP-1 in intima/media area ratio (all P>0.05), differences were found between other groups (all P<0.01). The MMP-2 and MMP-9 expression of rats received vector virus, hTK-1, hTIMP-1 or dual gene transfer were 0.817±0.036, 0.606±0.044, 0.571±0.061 or 0.455±0.030 and 0.745±0.057, 0.613±0.038, 0.582±0.050 or 0.473±0.038 respectively, no difference was found between rats received hTK-1 or hTIMP-1 in MMP-2 or MMP-9 expression (all P>0.05), differences were found between other groups (all P<0.01). The PCNA expression of rats received vector virus, hTK-1, hTIMP-1 or dual gene transfer were 0.065±0.007, 0.052±0.004, 0.055±0.007 or 0.031±0.004 respectively, no difference was found between rats received hTK-1or hTIMP-1 in PCNA expression (all P>0.05), differences were found between other groups (all P<0.01).

CONCLUSION

hTK-1 and hTIMP-1 co-overexpression may synergistically inhibit neointimal hyperplasia, attenuate vascular remodeling and reduce restenosis possibly via down regulating the expressions of PCNA, MMP-2 and MMP-9 in balloon-injured rat carotids.

[The pathogenic gene screening in a cardiomyopathy pedigree of Yunnan province]

OBJECTIVE

In this study, the sreening of candidate pathogenic gene is done among family members of an dilated cardiomyopathy(DCM)and hypertrophic cardiomyopathy (HCM) coexistence, and find the relationship between the genotype and the phenotype.

METHODS

The inheritance atlas was drawn, analysis of genetic characteristics and clinical phenotype.Peripheral venous blood samples of proband and family members were candidated gene exon high-throughput sequencing sub target capture, make the result compares with related database, ultimately screening the target area of the exon and mutations of candidate genes and then using bidirectional sequencing of Sanger to sequence other family members and the health group which were matching with gender and age to testify whether there is the above mutations.

RESULTS

In this family, the proband and his father carry three missense mutations, about TTNc.604 A>G(p.Lys202Glu)、TAZ c. 580A>G(p.Ile194Val)and MYH7c.730 T>C(p.Phe244Leu). The heart function of proband was failure, and accompanied malignant arrhythmia.But his father has no obvious clinical symptoms.In this family, the same genetic mutation of disease causing gene lead to different clinical phenotype, but different genetic mutation of disease causing gene lead to the same clinical phenotype.None of the mutations found in this family was found in the health group.

CONCLUSION

The patient of this family carries the genetic mutation of MYH7, TTN and TAZ.The patient of this family carries the composite mutation of MYH7(+) /TTN(+) heterozygous missense mutation and TAZ(+) /TTN(+) heterozygous missense mutation may be show the performance of the genetic characteristics of early onset, severe phenotype.

Mechanical Characterization of Immature Porcine Brainstem in Tension at Dynamic Strain Rates

Background

Many brain injury cases involve pediatric road traffic accidents, and among these, brainstem injury causes disastrous outcomes. A thorough understanding of the tensile characterization of immature brainstem tissue is crucial in modeling traumatic brain injury sustained by children, but limited experimental data in tension is available for the immature brain tissue at dynamic strain rates.

Material/Methods

We harvested brainstem tissue from immature pigs (about 4 weeks old, and at a developmental stage similar to that of human toddlers) as a byproduct from a local slaughter house and very carefully prepared the samples. Tensile tests were performed on specimens at dynamic strain rates of 2/s, 20/s, and 100/s using a biological material instrument. The constitutive models, Fung, Ogden, Gent, and exponential function, for immature brainstem tissue material property were developed for the recorded experimental data using OriginPro^® 8.0 software. The t test was performed for infinitesimal shear modules.

Results

The curves of stress-versus-stretch ratio were convex in shape, and inflection points were found in all the test groups at the strain of about 2.5%. The average Lagrange stress of the immature brainstem specimen at the 30% strain at the strain rates of 2, 20, and 100/s was 273±114, 515±107, and 1121±197 Pa, respectively. The adjusted R-Square (R²) of Fung, Ogden, Gent, and exponential model was 0.820≤R²≤0.933, 0.774≤R²≤0.940, 0.650≤R²≤0.922, and 0.852≤R²≤0.981, respectively. The infinitesimal shear modulus of the strain energy functions showed a significant association with the strain rate (p<0.01).

Conclusions

The immature brainstem is a rate-dependent material in dynamic tensile tests, and the tissue becomes stiffer with increased strain rate. The reported results may be useful in the study of brain injuries in children who sustain injuries in road traffic accidents. Further research in more detail should be performed in the future.

Cervical cytology ASCUS patients with HPV detection and clinical value

OBJECTIVE

Patients whose cervical cytological exams produced a result of atypical squamous cells of undetermined significance (ASCUS) were asked to undergo human papillomavirus (HPV DNA) genotyping detection to assess the role of HPV infection in ASCUS.

MATERIALS AND METHODS

This study included 1,219 patients with ASCUS that were randomly divided into two groups. The first group contained 618 patients. These participants underwent colposcopy with cervical biopsy. The remaining 601 underwent colposcopy and biopsy with HPV DNA detection.

RESULTS

Out of the 56,000 patients with ASCUS who underwent ThinPrep cytology test (TCT) de- tection in the authors' hospitals' gynecological outpatient clinics, 1,604 were diagnosed with ASCUS (2.86%). Among the 1,219 patients with ASCUS, the rate of detection of cervical intraepithelial neoplasia (CIN) and cancerization was 22.89% (279/1,219). Among the 601 patients who underwent HPV testing, 182 were positive for high-risk HPV (30.28%). Among HPV-positive samples, the most common high-risk types were HPV16, and HPV58. The most common low-risk types were HPV6 and HPV 11. The rate of detection among high- risk patients who were positive for HPV and cervical carcinoma with intraepithelial neoplasia was 70.88% (129/182). The rate of detection for HPV-negative patients with cervical cancer with intraepithelial neoplasia was 11.55% (47/407). The rate of detection of high-risk HPV was higher than among patients who had not undergone HPV detection and among patients who were negative for HPV (p < 0.05).

CONCLUSION

The results of cervical cytological examination showed that the manner of progression from inflammation to cancer could differ considerably. HPV DNA examination is an effective means of categorizing and managing ASCUS.

Expression profiles of differentially expressed genes affecting fecundity in goat ovarian tissues

Although RNA-Seq is an effective method for identifying and exploring novel functional genes in mammals, it has rarely been applied to study fertility-related genes in the goat. In this study, RNA-Seq was used to screen the estrus ovaries of uniparous and multiparous Anhui white goats (AWGs). In total, 15,890 genes were identified and 2201 of these were found to be differentially expressed between the genetic libraries from uniparous and multiparous goats. Compared to the uniparous library, 1583 genes were up-regulated and 618 genes were down-regulated in the multiparous library. The FER1L4 gene showed the level of highest up-regulation in the multiparous library, while SRD5A2 expression showed the greatest down-regulation. In order to determine the functions of FER1L4 and SRD5A2 in goats, the expression profiles of the two genes in different tissues from AWGs and Boer goats at diestrus were analyzed by quantitative PCR. FER1L4 and SRD5A2 showed tissue specific expression patterns and were highly expressed in ovaries from both AWGs and Boer goats. FER1L4 was more highly expressed in ovaries from multiparous than uniparous AWGs. In contrast, SRD5A2 was expressed at a lower level in multiparous AWGs. These results indicated that FER1L4 and SRD5A2 may be associated with the high fecundity of AWGs.

Identification of key micro-organisms involved in Douchi fermentation by statistical analysis and their use in an experimental fermentation

AIMS

To screen and identify safe micro-organisms used during Douchi fermentation, and verify the feasibility of producing high-quality Douchi using these identified micro-organisms.

METHODS AND RESULTS

PCR-denaturing gradient gel electrophoresis (DGGE) and automatic amino-acid analyser were used to investigate the microbial diversity and free amino acids (FAAs) content of 10 commercial Douchi samples. The correlations between microbial communities and FAAs were analysed by statistical analysis. Ten strains with significant positive correlation were identified. Then an experiment on Douchi fermentation by identified strains was carried out, and the nutritional composition in Douchi was analysed. Results showed that FAAs and relative content of isoflavone aglycones in verification Douchi samples were generally higher than those in commercial Douchi samples.

CONCLUSIONS

Our study indicated that fungi, yeasts, Bacillus and lactic acid bacteria were the key players in Douchi fermentation, and with identified probiotic micro-organisms participating in fermentation, a higher quality Douchi product was produced.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is the first report to analyse and confirm the key micro-organisms during Douchi fermentation by statistical analysis. This work proves fermentation micro-organisms to be the key influencing factor of Douchi quality, and demonstrates the feasibility of fermenting Douchi using identified starter micro-organisms.

Which is more suitable for kidney transplantation at the early post-transplantation phase in China - low dosing or standard dosing of enteric-coated mycophenolate sodium?

AIMS

To investigate the pharmacokinetics of enteric-coated mycophenolate sodium (EC-MPS) and the clinical outcome in kidney transplant recipients in the early post-transplantation phase. Then explain which regimen is more suitable for Chinese renal transplant recipients.

METHODOLOGY

In total, 60 de novo kidney transplant recipients treated with tacrolimus and steroids were randomised to receive EC-MPS at standard dose (SD; 1440 mg/day; n = 28) or low dose (LD; 1080 mg/day; n = 32). Efficacy parameters, safety and tolerability were assessed over a 6-month study period. Full mycophenolic acid (MPA) areas under the curve (AUCs) were completed on days 3 and 5, whereas a three-point limited sampling strategy (LSS) was utilised for MPA AUC assessments at 2 weeks and months 1, 3 and 6 (the LSS for three-time-point MPA AUC 0-12 h (mg h/l) = 15.99 + 0.87C1 h  + 0.68C2 h  + 7.85C4 h ; r(2)  = 0.8670.

RESULTS

The mean AUC levels at day 3 and day 5 in the SD group were significantly higher than in the LD group (57.4 mg·h/l vs. 38.2 mg·h/l and 59.3 mg·h/l vs. 44.8 mg·h/l, respectively, p < 0.01). There was a trend for fewer clinically diagnosed acute rejections in the SD group vs. the LD group at 6 months (7.1% vs. 12.5%). This trend was also present when acute rejection was analysed as biopsy-proven cases. There were significantly more acute rejections (all definitions) in patients with MPA AUC levels < 30 mg·h/l compared with those with MPA AUC levels ≥ 30 mg·h/l within 6 months (p < 0.05). Renal function, incidence of infection and haematological disorders were not significantly different in either study group.

CONCLUSIONS

Early adequate MPA exposure in renal transplant recipients can be achieved with a higher starting dose. In addition, a SD regimen was as well-tolerated as a LD regimen. Furthermore, early adequate MPA exposure significantly lowered the rate of acute rejection without compromising safety and tolerability.