The association between plasma IgG N-glycosylation and neonatal hypoxic-ischemic encephalopathy: a case-control study

Introduction

Hypoxic-ischemic encephalopathy (HIE) is one of severe neonatal brain injuries, resulting from inflammation and the immune response after perinatal hypoxia and ischemia. IgG N-glycosylation plays a crucial role in various inflammatory diseases through mediating the balance between anti-inflammatory and pro-inflammatory responses. This study aimed to explore the effect of IgG N-glycosylation on the development of HIE.

Methods

This case-control study included 53 HIE patients and 57 control neonates. An ultrahigh-performance liquid chromatography (UPLC) method was used to determine the features of the plasma IgG N-glycans, by which 24 initial glycan peaks (GPs) were quantified. Multivariate logistic regression was used to examine the association between initial glycans and HIE, by which the significant parameters were used to develop a diagnostic model. Though receiver operating characteristic (ROC) curves, area under the curve (AUC) and 95% confidence interval (CI) were calculated to assess the performance of the diagnostic model.

Results

There were significant differences in 11 initial glycans between the patient and control groups. The levels of fucosylated and galactosylated glycans were significantly lower in HIE patients than in control individuals, while sialylated glycans were higher in HIE patients (p < 0.05). A prediction model was developed using three initial IgG N-glycans and fetal distress, low birth weight, and globulin. The ROC analysis showed that this model was able to discriminate between HIE patients and healthy individuals [AUC = 0.798, 95% CI: (0.716-0.880)].

Discussion

IgG N-glycosylation may play a role in the pathogenesis of HIE. Plasma IgG N-glycans are potential noninvasive biomarkers for screening individuals at high risk of HIE.

[Research progress on differential diagnosis of thalassemia trait and iron deficiency anemia by blood erythrocyte parameters]

Thalassemia trait is an autosomal recessive genetic disease, which is a hemolytic anemia caused by disturbance of erythrocyte hemoglobin production caused by gene mutation or deletion. Iron deficiency anemia is caused by a lack of iron in the body due to an imbalance between the demand and supply of iron. The laboratory manifestations of both are microcytic hypochromic anemia, but the treatment schemes are completely different, and it is difficult to distinguish them from the results of blood count. Erythrocyte parameters can be used to establish a formula or model to differentiate them, which can achieve the purpose of early screening, early diagnosis and early treatment,preventing the occurrence of severe anemia and providing a scientific basis for the thalassemia and iron deficiency anemia prevention. This article will review the research progress of using erythrocyte parameters to distinguish thalassemia trait with iron deficiency anemia.

Association between immunoglobulin G N-glycosylation and lupus nephritis in female patients with systemic lupus erythematosus: a case-control study

Background

Lupus nephritis (LN) is a crucial complication of systemic lupus erythematosus (SLE) and has important clinical implications in guiding treatment. N-glycosylation of immunoglobulin G (IgG) plays a key role in the development of SLE by affecting the balance of anti-inflammatory and proinflammatory responses. This study aimed to evaluate the performance of IgG N-glycosylation for diagnosing LN in a sample of female SLE patients.

Methods

This case-control study recruited 188 women with SLE, including 94 patients with LN and 94 age-matched patients without LN. The profiles of plasma IgG N-glycans were detected by hydrophilic interaction chromatography with ultra-performance liquid chromatography (HILIC-UPLC). A multivariate logistic regression model was used to explore the associations between IgG N-glycans and LN. A diagnostic model was developed using the significant glycans as well as demographic factors. The performance of IgG N-glycans in the diagnosis of LN was evaluated by receiver operating characteristic (ROC) curve analysis, and the area under the curve (AUC) and its 95% confidence interval (CI) were calculated.

Results

There were significant differences in 9 initial glycans (GP2, GP4, GP6, GP8, GP10, GP14, GP16, GP18 and GP23) between women with SLE with and without LN (P < 0.05). The levels of sialylated, galactosylated and fucosylated glycans were significantly lower in the LN patients than in the control group, while bisected N-acetylglucosamine (GlcNAc) glycans were increased in LN patients (P < 0.05). GP8, GP10, GP18, and anemia were included in our diagnostic model, which performed well in differentiating female SLE patients with LN from those without LN (AUC = 0.792, 95% CI: 0.727 to 0.858).

Conclusion

Our findings indicate that decreased sialylation, galactosylation, and core fucosylation and increased bisecting GlcNAc might play a role in the development of LN by upregulating the proinflammatory response of IgG. IgG N-glycans can serve as potential biomarkers to differentiate individuals with LN among SLE patients.

[Analysis on missed diagnosis or misdiagnosis of anomalous origin of left coronary artery from pulmonary artery by echocardiography from one single medical center]

Objectives: To analyze the reasons of missed diagnosis or misdiagnosis on anomalous origin of left coronary artery from pulmonary artery (ALCAPA) by echocardiography. Methods: This is a retrospective study. Patients with ALCAPA who underwent surgical treatment in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from August 2008 to December 2021 were included. According to the results of preoperative echocardiography and surgical diagnosis, the patients were divided into confirmed group or missed diagnosis/misdiagnosis group. The results of preoperative echocardiography were collected, and the specific echocardiographic signs were analyzed. According to the experience of the doctors, the echocardiographic signs were divided into four types, namely clear displayed, vague/doubtful displayed, no display and no notice, and the display rate of each sign was calculated (display rate=number of clearly displayed cases/total number of cases×100%). By referring the surgical data, we analyzed and recorded the pathological anatomy and pathophysiological characteristics of the patients, and the rate of missed diagnosis/misdiagnosis of echocardiography in patients with different characteristics was compared. Results: A total of 21 patients were enrolled, including 11 males, aged 1.8 (0.8, 12.3) years (range 1 month to 47 years). Except for one patient with anomalous origin of left anterior descending artery, the others were all originated from the main left coronary artery (LCA). There were 13 cases of ALCAPA in infant and children, and 8 cases of adult ALCAPA. There were 15 cases in the confirmed group (diagnostic accuracy was 71.4% (15/21)), and 6 cases in the missed diagnosis/misdiagnosis group (three cases were misdiagnosed as primary endocardial fibroelastosis, two cases were misdiagnosed as coronary-pulmonary artery fistula; and one case was missed diagnosis). The working years of the physicians in the confirmed group were longer than those in the missed diagnosis/misdiagnosed group ((12.8±5.6) years vs. (8.3±4.7) years, P=0.045). In infants with ALCAPA, the detection rate of LCA-pulmonary shunt (8/10 vs. 0, P=0.035) and coronary collateral circulation (7/10 vs. 0, P=0.042) in confirmed group was higher than that in missed diagnosis/misdiagnosed group. In adult ALCAPA patients, the detection rate of LCA-pulmonary artery shunt was higher in confirmed group than that in missed diagnosis/misdiagnosed group (4/5 vs. 0, P=0.021). The missed diagnosis/misdiagnosis rate of adult type was higher than that of infant type (3/8 vs. 3/13, P=0.410). The rate of missed diagnosis/misdiagnosis was higher in patients with abnormal origin of branches than that of abnormal origin of main trunk (1/1 vs. 5/21, P=0.028). The rate of missed diagnosis/misdiagnosis in patients with LCA running between the main and pulmonary arteries was higher than that distant from the main pulmonary artery septum (4/7 vs. 2/14, P=0.064). The rate of missed diagnosis/misdiagnosis in patients with severe pulmonary hypertension was higher than that in patients without severe pulmonary hypertension (2/3 vs. 4/18, P=0.184). The reasons with an echocardiography missed diagnosis/misdiagnosis rate of≥50% included that (1) the proximal segment of LCA ran between the main and pulmonary arteries; (2) abnormal opening of LCA at the right posterior part of the pulmonary artery; (3) abnormal origin of LCA branches; (4) complicated with severe pulmonary hypertension. Conclusions: Echocardiography physicians' knowledge of ALCAPA and diagnostic vigilance are critical to the accuracy of diagnosis. Attention should be paid to the pediatric cases with no obvious precipitating factors of left ventricular enlargement, regardless of whether the left ventricular function is normal or not, the origin of coronary artery should be routinely explored.

Mechanistic insights into the selective adsorption of phosphorus from wastewater by MgO(100)-functionalized cellulose sponge

Metal oxides have remained state-of-the-art adsorbents for recovering phosphorus from aqueous solutions, but their practical application is still limited by their unsatisfactory adsorption capacities and selectivities in wastewater. Here, using MgO as a model metal oxide, the strategy of employing porous cellulose sponge to support metal oxides featuring exposed specific crystal facets was proposed to develop promising phosphate adsorbents. The phosphate adsorption isotherms and kinetics were measured and the phosphate adsorption mechanism was explored. The results show that cellulose sponge-supported MgO(100) (C-MgO(100)) has a saturation capacity of 28.3 mg P/g, over ten times higher than MgO(100) particles. Importantly, the phosphate adsorption properties of C-MgO(100) are almost not affected in wastewater, demonstrating its exceptional selectivity for phosphate adsorption. In contrast, the saturation capacity of MgO(111)-functionalized cellulose sponge is obviously declined in wastewater. Experimental together with theoretical analyses indicate that phosphate is chemically adsorbed on C-MgO(100) with obvious electrons transfer from the p-orbital of phosphate, and the adsorption energy of C-MgO(100) towards phosphate is maintained in the presence of coexisting anions. Ultimately, regeneration experiments reveal that a regenerant formulation composed of KOH (wt.1 %) and tap water is suitable for the regeneration of C-MgO(100) with >82.6 % phosphate desorption efficiencies after 5 cycles, further confirming its potential in practical application for the treatment of real water.

Xanthotoxol alleviates secondary brain injury after intracerebral hemorrhage by inhibiting microglia-mediated neuroinflammation and oxidative stress

BACKGROUND

Oxidative damage and inflammation are two critical mechanisms underlying secondary brain injury (SBI) following intracerebral hemorrhage (ICH). Xanthotoxol is reported to alleviate brain edema and inhibit inflammatory responses. Herein, we investigated the effects of xanthotoxol and its related mechanisms in SBI post-ICH.

METHODS

To explore the clinical effects of xanthotoxol an animal model of ICH was established. Neurological scores, survival rates and brain water content were measured. Inflammatory responses and oxidative damage in the peri-hemorrhagic areas were determined by measuring pro-inflammatory cytokines and oxidative related factors. The activation of the M1/M2 phenotype was detected by western blotting and immunofluorescence.

RESULTS

Xanthotoxol improved the neurological functions and reduced cerebral edema in ICH mice. Additionally, xanthotoxol inhibited microglia activation and promotes microglial phagocytosis. Simultaneously, xanthotoxol promoted the transformation of BV2 cells from M1 phenotype to M2 phenotype, and protected BV2 cells against hemin-induced inflammation and oxidative stress. Mechanistically, xanthotoxol inactivated the NF-κB p65 signaling pathway in the hemin-challenged BV2 cells.

CONCLUSION

Xanthotoxol ameliorates SBI post-ICH by suppressing microglia-mediated neuroinflammation and oxidative stress and enhancing microglial phagocytosis through inhibition of NF-κB signaling.

Metal Oxyhydroxide Catalysts Promoted CO2 Absorption and Desorption in Amine-Based Carbon Capture: A Feasibility Study

The huge energy penalty of CO₂ desorption is the greatest challenge impeding the commercial application of amine-based CO₂ capture. To deal with this problem, a series of metal oxide and oxyhydroxide catalysts were synthesized in this study to kinetically facilitate the CO₂ desorption from 5.0 M monoethanolamine (MEA). The effects of selected catalysts on CO₂ absorption kinetics, CO₂ absorption capacity, CO₂ reaction enthalpy, and desorption duty reduction of 2.0 M MEA were investigated by a true heat flow reaction calorimeter to access the practical feasibility of the catalytic CO₂ desorption. The kinetic study of catalytic CO₂ desorption was also carried out. CO₂ desorption chemistry, catalyst characterization, and structure-function relationships were investigated to reveal the underlying mechanisms. Results show that addition of the catalyst had slight effects on the CO₂ absorption kinetics and CO₂ reaction enthalpy of MEA. In contrast, the CO₂ desorption efficiency greatly increased from 28% in reference MEA to 52% in ZrO(OH)₂-aided MEA. Compared to the benchmark catalyst HZSM-5, ZrO(OH)₂ exhibited a 13% improvement in CO₂ desorption efficiency. More importantly, compared to the reference MEA, the CO₂ desorption duties of ZrO(OH)₂ and FeOOH-aided MEA significantly reduced by 45 and 47% respectively, which are better than those of most other reported catalysts. The large surface area, pore volume, pore diameter, and amount of surface hydroxyl groups of ZrO(OH)₂ and FeOOH afforded the catalytic performance by promoting the adsorption of alkaline speciation (e.g., MEA and HCO₃ ^-) onto the particle surface.

Enhancing the Ammonia Selectivity by Using Nanofiber PVDF Composite Membranes Fabricated with Functionalized Carbon Nanotubes

Conventional hydrophobic membrane-based membrane distillation (MD) has been applied for ammonia recovery from an anaerobic digestion (AD) effluent. However, the typical hydrophobic membranes do not have selectivity for ammonia and water vapor, which results in high energy consumption from the water evaporation. To enhance the selectivity during the ammonia recovery process, the functionalized carbon nanotubes (CNTs)/polyvinylidene fluoride (PVDF) nanofiber membranes were fabricated by electrospinning, and the effects of different CNTs and their contents on the performance of nanofiber membranes were investigated. The results indicate that CNTs can be successfully incorporated into nanofibers by electrospinning. The contact angles of the composite membrane are all higher than those of commercial membrane, and the highest value 138° can be obtained. Most importantly, under the condition of no pH adjustment, the ammonia nitrogen transfer coefficient reaches the maximum value of 3.41 × 10^-6 m/s, which is about twice higher than that of commercial membranes. The ammonia separation factor of the carboxylated CNT (C-CNT) composite membrane is higher than that of the hydroxylated CNT(H-CNT) composite membrane. Compared with the application of the novel C-CNT composite membrane, the ammonia separation factor is 47% and 25% higher than that of commercial and neat PVDF membranes. This work gives a novel approach for enhancing ammonia and water selectivity during AD effluent treatment.

Expression Profile of Immunoglobulin G Glycosylation in Children With Epilepsy in Han Nationality

Background

Epilepsy is a chronic brain disease that recurs during childhood, and more than half of adult epilepsy originates from childhood. Studies suggested that immunoglobulin G (IgG) glycosylation are closely related to neurological diseases. Here we analyzed the characteristics of the immunoglobulin glycosylation profile of children with epilepsy.

Methods

Patients were recruited in Taian, Shandong Province from December 2019 to March 2020. Serum IgG glycome composition was analyzed by hydrophilic interaction liquid chromatography with ultra-high-performance liquid chromatography approach.

Results

The proportion of fucosylated glycans in total IgG glycans was 93.72% in the epilepsy patients, which was significantly lower than that in the control group (94.94%). A lower level of total monogalactosylated and digalactosylated glycans were observed in the epilepsy patients group (30.76 and 40.14%) than that in the controls (36.17 and 42.69%). There was no significant difference between the two groups in bisected GlcNAc glycans and sialylated glycans.

Conclusion

The decrease of core fucosylation and galactosylation may promote the inflammatory reaction of the body and participate in the occurrence of epilepsy in children.

POS0718 SIROLIMUS MONOTHERAPY FOR THROMBOCYTOPENIA IN PRIMARY ANTIPHOSPHOLIPID SYNDROME: A PILOT STUDY FROM A TERTIARY REFERRAL CENTER

Background

Thrombocytopenia (TP) is considered as a warning sign of high-risk antiphospholipid syndrome (APS) and sometimes a paradoxical sign of anti-thrombosis treatment. Currently there is an extreme paucity of effective and safe drugs for long-term management of TP in primary APS patients.

Objectives

We aimed to explore the efficacy and safety of sirolimus monotherapy.

Methods

In this real-world study, we included 7 consecutive patients with primary APS who received sirolimus monotherapy for TP. Oral sirolimus was initiated at a dose of 1-2 mg once daily and then adjusted primarily based on clinical efficacy and tolerance, with consideration of sirolimus trough concentration of ≤15 ng/ml.

Results

Of included patients, the median age was 58 years with median disease course of 1.5 years and 4 patients were treatment-naïve. All patients completed 6 months of sirolimus therapy with median follow-up of 6 months (range: 6-15). All patients received sirolimus monotherapy for TP during entire follow-up, without adding any additional agents. Overall, platelet count exhibited substantially increasing trend after sirolimus administration during the first six months (p<0.001) and being stable later. Specifically, median platelet count was significantly increased from 59×109/L before sirolimus to 90×109/L at month 1 (p=0.028), 131×109/L at 3 months (p=0.028) and 178×109/L at 6 months (P=0.018). Overall and complete response were respectively achieved in 6 (85.7%) and 5 (71.4%) patients at month 6. Importantly, overall response was achieved in all 4 treatment-naïve patients. Additionally, there was different extents of decline in the titers of antiphospholipid antibodies after sirolimus treatment. Regrading safety, only one patient experienced elevated cholesterol level with recovery after atorvastatin treatment.

Conclusion

Sirolimus monotherapy confers good efficacy and tolerance for TP in primary APS patients, and therefore may be considered as a first-line therapy.

Figure 1.

Changes in platelets levels after sirolimus therapy in primary antiphospholipid syndrome patients with thrombocytopenia, (A) platelet count of individual patient during the whole follow-up, (B) Median platelet count of included patients during the first six months.

Disclosure of Interests

None declared

POS0720 LOW-DOSE GLUCOCORTICOIDS WITHDRAWN IN SYSTEMIC LUPUS ERYTHEMATOSUS: A DESIRABLE AND ATTAINABLE GOAL

Background

Prolonged use of GC may cause irreversible organ damage, leading to impaired quality of life and even increased mortality. However, many physicians are worried about severe flares after GC withdrawal in daily practice.

Objectives

To assess the risk of flare in systemic lupus erythematosus (SLE) patients after low dose glucocorticoids (GC) discontinuation and evaluate the risk factors of flare.

Methods

SLE patients who ever discontinued GC were identified from PKUFHS cohort. The disease flare profile after GC discontinuation were analyzed. Flare rate was analyzed using Kaplan-Meier analysis. COX regression was used to determine the effect of variables on SLE flare. A prognostic nomogram using Cox proportional hazards regression modeling were developed.

Results

132 SLE patients were eligible for the final analysis. They were followed up for a median (IQR) period of 21.8 (9.01, 36.7) months. The cumulative probability of flare after GC discontinuation was 8.3 % at 6 months, 16.8% at year 1 and 27.5% at year 2 (Figure 1A). In multivariate COX analysis, hypocomplementemia and serologically active clinically quiescent (SACQ) were independent risk factors of flare [HR 2.53, 95% CI (1.32, 4.88); HR 3.17, 95% CI (1.44, 6.97), respectively]. Age ≥ 40y at GC withdrawal and hydroxychloroquine usage were independent protective factors of flare [HR 0.53, 95% CI (0.29, 0.99); HR 0.32, 95% CI (0.17, 0.62), respectively] (Table 1). The protective effect of hydroxychloroquine was dosage related. From the prospective of different tapering strategies embodied as duration from prednisone 5mg/d to complete discontinuation, slower tapering strategy (12-24 months) significantly reduced the risk of flare compared to faster tapering strategy (< 3 months) [HR 0.30, 95% CI (0.11, 0.82), p=0.019]. The prognostic nomogram including aforementioned factors effectively predicted 1- and 2-year probability of flare-free (Figure 1B).

Table 1.

Predictors of flare by univariate and multivariate COX analysis.

UnivariatepMultivariatepMultivariatepModel 1Model 2age≥40y at GC withdrawal0.59 (0.33,1.07)0.0840.53 (0.29, 0.99)0.0490.63 (0.33, 1.18)0.147Age at onset ≥18y2.03 (0.62, 6.66)0.2442.75 (0.77, 9.85)0.1212.88 (0.81, 10.2)0.103Remission duration≥60 months since the last flare0.66 (0.35, 1.27)0.2170.81 (0.41, 1.57)0.5260.73 (0.38, 1.41)0.346history of thrombocytopenia1.73 (0.94, 3.18)0.0771.36 (0.70, 2.65)0.3591.45 (0.74, 2.83)0.278history of lupus nephritis0.86 (0.47, 1.55)0.610////Hypocomplementemia1.97 (1.06, 3.66)0.0312.53 (1.32, 4.88)0.005//anti-dsDNA positive1.25 (0.70, 2.23)0.456////SACQ (both)2.91 (1.38, 6.15)0.005//3.17 (1.44, 6.97)0.004SACQ (or)1.29 (0.73, 2.30)0.380////Hydroxychloroquine or not0.29 (0.16, 0.53)<0.0010.29 (0.15, 0.56)<0.0010.32 (0.17, 0.62)0.001Immunosuppressant or not0.77 (0.40, 1.48)0.426////

There was strong collinearity between hypocomplementemia and SACQ, so the two parameters were separated into two models. SACQ (both): anti-dsDNA positive and hypocomplementemia; SACQ (or): anti-dsDNA positive or hypocomplementemia; GC: glucocorticoids. Data were shown as HR (95% CI).

Figure 1.

Conclusion

Low-dose GC is feasibly discontinued with infrequent flare in real-life setting. SACQ and younger age are potential risk factors of SLE flare, while hydroxychloroquine usage and slow GC tapering to withdrawal can reduce relapse. The visualized model we developed may help to predict risk of flare among SLE patients who discontinued GC.

Disclosure of Interests

None declared

AB0030 THE BIOLOGICAL FUNCTION AND MECHANISM EXPLORATION OF TACI IN SJOGREN’S SYNDROME

Background

primary Sjogren’s syndrome (pSS) is a chronic autoimmune disease that affects the lacrimal, salivary and other exocrine glands. More and more studies have shown that B cells play a central role in the pathogenesis of SS.

Objectives

We intended to explore the expression of the transmembrane activator, calcium modulator and cyclophilin ligand interactor (TACI) on the B cells, its role in pSS, and possible signal transduction pathways.

Methods

We included 34 naive pSS patients who visited the rheumatology department of Peking University First Hospital, and 37 gender- and age-distribution matched healthy controls (HCs). (1) To compare the B cell subsets, expression of TACI and relevant receptors in pSS patients, peripheral blood mononuclear cells were separated to analyze the ratio of B subsets, TACI, and BAFF-R by flow cytometry; ELISA was applied to detect the serum BAFF and soluble TACI (sTACI) concentration. (2) As for functional research of TACI, CD19+ B cells separated by magnetic sorting were treated under in vitro culture circumstances with raw TACI, TACI knocked down by siRNA, and sTACI analog (telitacicept) intervention with varing doses. The apoptosis, proliferation, differentiation and regulatory capacity on T cells were analyzed by flow cytometry, inflammatory cytokines and immunoglobulin levels in the culture supernatants were detected by CBA. (3) As for TACI-associated signaling pathway exploration, based on our previous miRNA data and relevant report of high quality, miRNA associated with TACI with significantly biased expression was confirmed by RT-qPCR. Screening the target gene of the candidate miRNA, and miRNA overexpression and inhibition experiments were conducted to validate the targeted relationship in B cells. And TACI-associated signaling pathway was explored via overexpressing and inhibiting the target gene.

Results

(1) Compared to HC, peripheral blood B subsets of pSS patients exhibited a significant bias, manifesting as increased proportion of CD19+CD24hiCD38hi Breg and decreased ratio of CD19+CD24+CD38- memory B cells. The expression of TACI in all B subsets was down-regulated, while that of BAFF-R was up-regulated. Both the serum concentration of BAFF and sTACI in pSS patients increased significantly. (2) As for functional research of TACI, in the setting of raw TACI, B cells in the pSS group showed higher apoptosis rate than HC under culture in vitro, where the ligand of TACI (APRIL or BAFF) addition turned the rate comparable; more active proliferation, and impaired capacity of inducing Treg cells to secrete IL-10. When TACI was knocked down by 50%, B cells performed less late apoptosis, significantly increased proliferation, impaired differentiation, significant dysfunction of Breg itself and impaired induction of Treg cells to secrete IL-10. While telitacicept intervention increased early apoptosis rate of B cells, significantly inhibited proliferation in 500ng/mL group and impaired ability of Breg and Treg cells to secrete IL-10. Besides, increased TACI on B cells treated with telitacicept, decreased IgG and increased IgA in the culture supernatants were observed. (3) As for TACI-associated signaling pathway exploration, hsa-miR-30b-5p showed satisfactory correlation between both transmembrane and sTACI. Besides, the expression of hsa-miR-30b-5p was significantly down-regulated, and inhibition its expression in vitro could lead to differentiation retard, impaired secretion of IL-10 by Breg cells. SMAD1 was screened based on database and validated as its target gene by overexpressing and inhibiting hsa-miR-30b-5p in B cell. After targeted up- or down-regulating the transcription of SMAD1 further, the transcription of ID2 downstream the TGF-β/Hippo signaling pathway changed accordingly.

Conclusion

The expression of TACI on peripheral blood B cells was deficient in pSS patients. TACI deficiency was closely associated with the downregulation of hsa-miR-30b-5p, activating TGF-β/Hippo pathway mediated by its target gene SMAD1 and taking part in the pathogenesis of pSS.

Disclosure of Interests

None declared

Association Between Immunoglobulin G N-glycosylation and Vascular Cognitive Impairment in a Sample With Atherosclerosis: A Case-Control Study

Background

Atherosclerosis is considered a crucial component in the pathogenesis of decreased cognitive function, as occurs in vascular cognitive impairment (VCI). Inflammation and the immune response play a significant role in the development of many chronic diseases. Immunoglobulin G (IgG) N-glycosylation has been implicated in the development of a variety of diseases by affecting the anti-inflammatory and proinflammatory responses of IgG. This study aimed to investigate the association between IgG N-glycosylation and VCI in a sample of patients with atherosclerosis through a case-control study.

Method

We recruited a total of 330 patients with atherosclerosis to participate in this case-control study, including 165 VCI patients and 165 sex- and age-matched participants with normal cognitive function. The plasma IgG N-glycans of participants were separated by ultrahigh-performance liquid chromatography. An enzyme-linked immunosorbent assay (ELISA) kit was used to determine the corresponding serum inflammatory factors. Atherosclerosis was diagnosed by carotid ultrasound, and the diagnosis of VCI was based on the “Guidelines for the Diagnosis and Treatment of Vascular Cognitive Impairment in China (2019)”. A multivariate logistic regression model was used to explore the association between IgG N-glycans and VCI. We also analyzed the relationship between IgG N-glycans and the inflammatory state of VCI through canonical correlation analysis (CCA).

Results

Through the multivariate logistic regression analysis, 8 glycans and 13 derived traits reflecting decreased sialylation and galactosylation and increased bisecting GlcNAc significantly differed between the case and control groups after adjusting for confounding factors (P < 0.05, q < 0.05). Similarly, the differences in TNF-α, IL-6, and IL-10 were statistically significant between the case and control groups after adjusting for the effects of confounding factors (P < 0.05, q < 0.05). The CCA results showed that VCI-related initial N-glycans were significantly correlated with VCI-related inflammatory factors (r = 0.272, P = 0.004). The combined AUC value (AUC_combined = 0.885) of 7 initial glycans and inflammatory factors was higher than their respective values (AUC_{initial glycans} = 0.818, AUC_{inflammatory factors} = 0.773).

Conclusion

The findings indicate that decreased sialylation and galactosylation and increased bisecting GlcNAc reflected by IgG N-glycans might affect the occurrence of VCI in patients with atherosclerosis though promoting the proinflammatory function of IgG. IgG N-glycans may serve as potential biomarkers to distinguish VCI in individuals with atherosclerosis.

Regulating crystallization dynamics and crystal orientation of methylammonium tin iodide enables high-efficiency lead-free perovskite solar cells

Tin (Sn)-based perovskite solar cells (PSCs) have attracted much attention because they are more environmentally friendly than lead-based PSCs. However, the fast crystallization of Sn-based perovskite films and the easy oxidation of Sn²⁺ to Sn⁴⁺ hinder the improvement of their efficiency and stability. In this work, ethylammonium bromide (EABr) was added to methylammonium tin iodide (MASnI₃) perovskite precursor solution to regulate the crystallization dynamics and improve the film morphology. The results show that the large EA⁺ ions slow down the crystallization process of Sn-based perovskites and form a smooth perovskite film with high crystallinity, while the added Br^- anions further improved the crystallinity and orientation of the perovskite film. Under the combined action of EA⁺ and Br^- ions, the as-produced PSCs achieved a champion power conversion efficiency (PCE) of 9.59%. The EABr additive also retarded the oxidation of Sn²⁺, and the solar cell device maintained 93% of its initial efficiency after 30 days in a nitrogen-filled glove box without being encapsulated. This work provides a new strategy for the realization of high-efficiency Sn-based PSCs.

Blast Resistance of 240 mm Building Wall Coated with Polyurea Elastomer

Enhancing the blast resistance of building walls is a research hotspot in the field of anti-terrorism and explosion protection. In this study, numerical simulation and experimental verification were combined to analyze the failure phenomenon of brick masonry wall and sprayed polyurea-reinforced brick wall under contact explosion and determine the failure response parameters of the wall. The failure limit, mode, and mechanism of a 240 mm wall without reinforcement and strengthened with polyurea elastomer under different strength loads were investigated. Under contact explosion, the increase in the size of the blasting pit of the 240 mm wall gradually slowed down after the dose was increased to higher than 0.5 kg. Thereafter, the energy of the explosive load was released by splashing wall fragments as well as by deflecting and movement of the wall. The results show that the 240 mm walls sprayed with polyurea elastomer had outstanding anti-explosion performance because it wraps the damaged area and fragments of masonry wall inside the polyurea layer. When the thickness of the polyurea layer increases to 8 mm, the damaged area of the masonry wall decreases by 55.6% compared with that without reinforcement. The numerical simulation results were in good agreement with the experimental results.

Zwitterion-Assisted Crystal Growth of 2D Perovskites with Unfavorable Phase Suppression for High-Performance Solar Cells

Despite two-dimensional (2D) Ruddlesden-Popper-phase layered perovskites (RPLPs) exhibiting excellent environmental stability, most solar cells based on 2D RPLP films are fabricated in a controlled inert atmosphere. Meanwhile, the poor charge transport of 2D RPLP films owing to the unfavorable phase arrangement and defects limits the efficiency of 2D RPLP solar cells. Here, we fabricate high-efficiency 2D RPLP solar cells in ambient air assisted by a zwitterion (ZW) additive. We show that the ZW additive suppresses the formation of the bottom 2D phases (n ≤ 2) and the top 3D-like phases in 2D RPLP films. These 2D phases usually grow parallel to the substrate and act as trap sites that inhibit charge transport in the vertical direction. The 3D-like phases, on the other hand, aggravate the long-term stability due to the intrinsic instability of MA⁺ cations. With improved phase distribution, crystal orientation, and reduced trap states in 2D RPLP films, efficient charge transport is obtained. Finally, a record-high open-circuit voltage (V_oc) of 1.19 V and a power conversion efficiency of 17.04% with an enhanced stability are achieved for (BA_0.9PEA_0.1)₂MA₃Pb₄I₁₃-based (n = 4) solar cells fabricated under high humidity (∼65% RH).

Digital intervention increases influenza vaccination rates for people with diabetes in a decentralized randomized trial

People with diabetes (PWD) have an increased risk of developing influenza-related complications, including pneumonia, abnormal glycemic events, and hospitalization. Annual influenza vaccination is recommended for PWD, but vaccination rates are suboptimal. The study aimed to increase influenza vaccination rate in people with self-reported diabetes. This study was a prospective, 1:1 randomized controlled trial of a 6-month Digital Diabetes Intervention in U.S. adults with diabetes. The intervention group received monthly messages through an online health platform. The control group received no intervention. Difference in self-reported vaccination rates was tested using multivariable logistic regression controlling for demographics and comorbidities. The study was registered at clinicaltrials.gov: NCT03870997. A total of 10,429 participants reported influenza vaccination status (5158 intervention, mean age (±SD) = 46.8 (11.1), 78.5% female; 5271 control, Mean age (±SD) = 46.7 (11.2), 79.4% female). After a 6-month intervention, 64.2% of the intervention arm reported influenza vaccination, vers us 61.1% in the control arm (diff = 3.1, RR = 1.05, 95% CI [1.02, 1.08], p = 0.0013, number needed to treat = 33 to obtain 1 additional vaccination). Completion of one or more intervention messages was associated with up to an 8% increase in vaccination rate (OR 1.27, 95% CI [1.17, 1.38], p < 0.0001). The intervention improved influenza vaccination rates in PWD, suggesting that leveraging new technology to deliver knowledge and information can improve influenza vaccination rates in high-risk populations to reduce public health burden of influenza. Rapid cycle innovation could maximize the effects of these digital interventions in the future with other populations and vaccines.

Simultaneous biogas upgrading, CO2 sequestration, and biogas slurry decrement using biomass ash

A novel system for simultaneous biogas upgrading, CO₂ sequestration, and biogas slurry decrement was established by adding biomass ash into biogas slurry to form a renewable CO₂ mixture absorbent. After CO₂ saturation, the CO₂-rich mixture absorbent could be applied for plant growth. When the mass ratio of liquid to solid was 4:1, CO₂ absorption capacity of this mixture absorbent reached up to 97.33 g-CO₂/kg-biomass-ash, which was about 135% higher than that of the biomass ash-water mixture. The highest value of 129.94 g-CO₂/kg-biomass-ash was obtained at a liquid-solid ratio of 99:1. When the TS concentration of anaerobic digestion feedstock was higher than 16 wt% and the water content of CO₂-rich absorbent was about 50 wt%, more than 80% of biogas slurry can be adsorbed by the biomass ash. If the biomass ash with a CO₂ absorption capacity of 100 g-CO₂/kg was adopted and its transportation distance was less than 45 km, the biogas upgrading cost could be lower than the global average level (about RMB¥ 0.7/Nm³-biogas) when using the novel system proposed in this study.

Association Between Gamma-Glutamyl Transferase, Total Bilirubin and Systemic Lupus Erythematosus in Chinese Women

Background

Systemic lupus erythematosus (SLE) affects many organs and systems of the human organism, at present, its specific pathogenesis is not completely clear, but inflammation is considered to be an important factor involved in the pathogenesis and progression of SLE. Gamma-glutamyl transpeptidase (GGT) and total bilirubin (TBIL) have different effects on inflammation: GGT has pro-inflammatory effects, on the contrary, TBIL has anti-inflammatory effects. Study has found that GGT and TBIL play opposite roles in metabolic diseases. However, the roles of them in SLE are unknown. Meanwhile, the relationship between GGT and SLE also remains unexplored.

Method

We recruited 341 SLE patients and 332 healthy individuals in Liaocheng People’s Hospital from August 2018 to May 2019. We diagnosed SLE using 2019 revised American College of Rheumatology (ACR) SLE criteria, and modeled the study outcomes using logistic regression to explore the respective relationship between GGT, TBIL and SLE. We also analyzed the interaction of GGT and TBIL in the progression of SLE.

Results

We found that the levels of CRP, IL-6 and TNF-α in the aggravated group were significantly higher than those in the unaggravated group, the levels of C3 and C4 in the aggravated group were significantly lower than those in the unaggravated group. According to Spearman correlation analysis, GGT is proportional to CRP (r_s=0.417) and IL-6 (r_s=0.412), inversely proportional to C3 (r_s=-0.177) and C4 (r_s=0.-132). TBIL was inversely proportional to CRP (r_s=-0.328) and TNF(r_s=-0.360), and positively proportional to C3 (r_s=0.174) and C4 (r_s=0.172). In the fully adjusted model, compared to the lowest quartile, the highest quartile of GGT exhibited a positive association with the risk of SLE aggravation (OR=2.99, 95% CI: 1.42–6.31, P<0.001). At the same time, compared to the highest quartile, the quartile lowest of TBIL exhibited a positive association with the risk of SLE aggravation (OR=2.66, 95% CI: 1.27–5.59, P<0.001) in the fully adjusted model. Through interaction analysis, we found that women with high GGT levels had an increased risk of SLE aggravation when they had a low level of TBIL (OR=3.68, 95% CI: 1.51–9.01, for women with Q1 TBIL and Q4 GGT compared to women with Q2-Q4 TBIL and Q1-Q3 GGT, P for interaction <0.001), the combined AUC value (AUC_COMBINED=0.711) of high GGT level and TBIL were higher than their respective values (AUC_GGT=0.612, AUC_TBIL=0.614).

Conclusion

We found that the effects of GGT and TBIL in the progression of SLE are opposite. High GGT level might be a risk factor for SLE aggravation, as GGT levels increased, so did the risk of SLE aggravation. At the same time, we found that low TBIL level might be a risk factor for SLE aggravation. Moreover, high GGT level and low TBIL level had a subadditive effect on the increased risk of SLE aggravation.

Sex-specific associations of serum insulin-like growth factor-1 with bone density and risk of fractures in Chinese patients with type 2 diabetes

We evaluated the associations of serum insulin-like growth factor-1 (IGF-1) with bone mineral density (BMD) and risk of fractures in Chinese patients with type 2 diabetes (T2D). We found positive associations between IGF-I and BMD and negative associations between IGF-I and all three modified 10-year probabilities of MOFs and HFs in men, but not in women.

INTRODUCTION

The objective was to investigate the associations of serum insulin-like growth factor-1 (IGF-1) with bone mineral density (BMD) and risk of fractures in Chinese patients with type 2 diabetes (T2D) in each gender.

METHODS

This was a cross-sectional, retrospective study that included men over 50 years and postmenopausal women with T2D without medical conditions or medications known to significantly affect BMD or serum IGF-I levels. Data of IGF-1, bone metabolism markers, lumbar spine (LS), femoral neck (FN), and total hip (TH) BMD were obtained; 10-year probability of major osteoporotic fractures (MOFs) and hip fractures (HFs) was calculated and modified with rheumatoid arthritis, femoral neck T-score, and age. Correlations of IGF-1 levels with bone metabolism and risk of fractures were statistically analyzed in men and women, respectively.

RESULTS

A total of 391 patients, including 226 men and 165 women, were included. The age, serum fasting C-peptide, glycosylated hemoglobin (HbA1c), bone formation marker, and all three modified 10-year probabilities of MOFs and HFs were higher in women than those in men (all p < 0.05). The levels of 25 hydroxyvitamin D (25OHD), IGF-1, and BMD were lower in women than those in men (all p < 0.05). In men, IGF-1 was positively correlated with FN and TH BMD (FN BMD: r = 0.267, p < 0.001; TH BMD: r = 0.235, p < 0.001) and negatively correlated with all three modified 10-year probabilities of MOFs (RA-modified MOFs: r = - 0.289, p < 0.001; age-modified MOFs: r = - 0.237, p < 0.001; FN T-score-modified MOFs: r = - 0.280, p < 0.001) and HFs (RA-modified HFs: r = - 0.291, p < 0.001; age-modified HFs: r = - 0.271, p < 0.001; FN T-score-modified HFs: r = - 0.270, p < 0.001), while no significant correlations were found between serum IGF-I and BMD and three modified 10-year probability in women.

CONCLUSIONS

According to this study, we found sex differences in the associations of serum IGF-1 with BMD and risk of fractures in Chinese patients with T2D. These results suggested that increasing serum IGF-1 might be a clinical target for protecting fractures in T2D, especially in men.

AB0280 THE INFLUENCE OF TARGET THERAPY AS WELL AS GLUCOCORTICOIDS TAPERING ON DISEASE FLARE IN SYSTEMIC LUPUS ERYTHEMATOSUS: RESULTS FROM A PROSPECTIVE CHINESE COHORT

Background:

Treat-to-target in systemic lupus erythematosus (SLE) has been proposed for 7 years and several recommendations were developed [1]. In these recommendations, prevention of flares should be a realistic target. Meanwhile, ‘remission’ or ‘low disease activity’ was recommended as the treatment target and minimizing glucocorticoids (GC) dose or withdrawal if possible was suggested in the maintenance treatment. However, would target therapy and GC tapering/withdrawal influence disease flare?

Objectives:

To investigate the frequency and determinants of disease flare, especially the influence of target therapy as well as GC tapering on flare in Chinese lupus patients.

Methods:

The baseline and follow-up data of all consecutive patients in a prospective longitudinal lupus cohort from January 2017 to June 2020 were collected. The lupus low disease activity state (LLDAS) was defined as in Golder et al., 2019[2]. The criteria for remission were from DORIS definitions [3]. Flare was assessed using the SELENA-SLEDAI flare index [4].

Results:

We enrolled 185 patients with disease duration at recruitment of 2.3 (0.8–7.7) years. During the 26.2 (12.5-34.5) months of follow-up, 73 (39.5%) patients experienced 95 flares, including 70 mild/moderate and 25 severe flares. The incidence of flare per patient-year was 0.27. Kaplan-Meier analyses showed that compared with those who never achieved LLDAS or DORIS, the patients who achieved the target at least once had a higher flare free survival rate; meanwhile, the patients with prednisone withdrawn had significantly lower flare free rate compared with those with small dose of GC maintained (≤7.5mg/d) (Figure 1A), but among the patients with different prednisone maintain doses (7.5~5mg, 5~2.5mg, and ≤2.5mg) there was not significant difference (Figure 1B). Cox regression analysis showed that younger age at disease onset and lower Complement 3 (C3) level at recruitment were independent risk factors for flare and achieving LLDAS or DORIS ≥50% of visits was independent protective factor (Table 1).

Conclusion:

In this Chinese prospective SLE cohort, age at disease onset, C3 level at recruitment and therapeutic target achieving influenced disease flare independently and significantly. GC tapering in appropriate patients and with appropriate pace did not increase the flare rate, but prednisone withdrawal may induce more disease exacerbation, which needs to be confirmed by large prospective studies.

References:

[1]Van Vollenhoven R F, et al. Treat-to-target in systemic lupus erythematosus: recommendations from an international task force. Ann Rheum Dis, 2014. 73(6): 958-967

[2]Golder, V., et al. Lupus low disease activity state as a treatment endpoint for systemic lupus erythematosus: a prospective validation study. The Lancet Rheumatology, 2019. 1(2): p. e95-e102.

[3]van Vollenhoven R, et al. A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS). Ann Rheum Dis. 2017. 76(3): 554–561.

[4]Petri M, et al. Classification and definition of major flares in SLE clinical trials. Lupus. 1999. 8(8): 685-691.

Table 1.

Determinants of disease flare by multivariate Cox regression analyses

Model 1(LLDAS) ΔModel 2(RONT) ΔModel 3(Complete RONT) ΔHR95%CIP valueHR95%CIP valueHR95%CIP valueAge at disease onset (years)†0.970.95-0.990.0040.970.95-0.990.0030.970.95-0.990.003Anti-dsDNA positive at recruitment1.340.82-2.180.2171.120.68-1.850.6491.190.73-1.960.486C3 (mg/L) at recruitment0.9980.997-0.9990.0040.9980.997-0.9990.0070.9980.997-1.0000.010Minimum prednisone dose during follow- up (mg/d)0.980.90-1.080.7161.010.94-1.080.7471.040.97-1.110.243Therapeutic target achieved≥50% of observationsΔ0.600.39-0.940.0010.540.34-0.870.0110.680.51-0.920.011

Δ In the three hazard models, the different target achievement status were included respectively.

RONT: Clinical remission on treatment; Complete RONT: Complete remission on treatment.

Disclosure of Interests:

None declared

A new approach for biogas slurry disposal by adopting CO2-rich biogas slurry as the flower fertilizer of Spathiphyllum: Feasibility, cost and environmental pollution potential

A new approach for biogas slurry disposal was put forward in this study through converting biogas slurry to the organic fertilizer of Spathiphyllum. The biogas slurry was firstly concentrated by vacuum distillation to reduce its volume by 80% who is called 5CBS, and then CO₂ saturated to reduce its pH to about 6.50 ± 0.20. With or without adding the exogenetic Ca, Mg and P nutrients, CO₂-rich 5CBS (i.e., CR-5CBS) was adopted as the root or foliar fertilizer to cultivate Spathiphyllum. Additionally, the commercial Spathiphyllum fertilizer was also experimented as a control. Results showed that the cases adopting CR-5CBS as the root or foliar fertilizer can obtain the agronomic traits and ornamental values of Spathiphyllum better those irrigated by the commercial fertilizer. Exogenetic nutrients added into CR-5CBS can lead to a decreased dead leaf number of Spathiphyllum, an enhanced N assimilation performance, however only a slightly improved assimilation performance of Ca, Mg and P. In terms of the fertilizer economy, CR-5CBS without exogenetic nutrient addition may be a promising for replacing the commercial Spathiphyllum fertilizer in the future. Economic and environmental pollution potential (EPP) analyses indicated that treating biogas slurry as the organic flower fertilizer can achieve a high net profit with about $ 28.89/m³-biogas slurry and a negative EPP value (-3.9), showing its profitability and environmental friendliness.

Efficient Stabilization and Passivation for Low-Temperature-Processed γ-CsPbI3 Solar Cells

The inorganic CsPbI₃ perovskite has attracted tremendous attention in the photovoltaic fields for its chemical stability and suitable band gap. Generally, CsPbI₃ solar cells with decent performances adopted high annealing temperature to form high-quality black-phase perovskite films. The high-temperature process hinders its practical application and further development. Hence, fabricating stable black-phase CsPbI₃ at low temperature is imperative and necessary. In this work, a new additive p-xylilenediamine bromide (PhDMADBr) is reported to facilitate the synthesis of solution-processed, high-quality, and stable γ-CsPbI₃ films at a surprisingly low temperature of 60 °C. The additive with an appropriate content can effectively improve both the film morphology and crystallinity of γ-CsPbI₃ perovskite films. PhDMADBr anchors to the perovskite surface or grain boundaries as a protection through hydrogen bonding between its ammonium cations and CsPbI₃. In addition, the Br element introduced by the additive passivates I^- vacancies in perovskite films, resulting in the improvement of both phase stability and devices' performance. Finally, the PSCs based on the modified γ-CsPbI₃ perovskite film achieve a champion efficiency of 12.71%. Moreover, the device retains 85% of its original efficiency after being kept for 1000 h.

The role of Dock2 on macrophage migration and functions during Citrobacter rodentium infection

Dedicator of cytokinesis 2 (Dock2), an atypical guanine exchange factor, is specifically expressed on immune cells and mediates cell adhesion and migration by activating Rac and regulates actin cytoskeleton remodeling. It plays a crucial role in the migration, formation of immune synapses, cell proliferation, activation of T and B lymphocytes and chemotaxis of pDCs and neutrophils. However, in-vivo physiological functions of Dock2 have been relatively seldom studied. Our previous studies showed that Dock2^-/- mice were highly susceptible to colitis induced by Citrobacter rodentium infection, and in early infection, Dock2^-/- mice had defects in macrophage migration. However, the specific roles of Dock2 in the migration and functions of macrophages are not clear. In this study, we found that the expression of chemokines such as chemokine (C-C motif) ligand (CCL)4 and CCL5 and chemokine receptors such as chemokine (C-C motif) receptor (CCR)4 and CCR5 in bone marrow-derived macrophages (BMDM) of Dock2^-/- mice decreased after infection, which were supported by the in-vivo infection experimental results; the Transwell experiment results showed that Dock2^-/- BMDM had a defect in chemotaxis. The bacterial phagocytic and bactericidal experiment results also showed that Dock2^-/- BMDM had the defects of bacterial phagocytosis and killing. Furthermore, the adoptive transfer of wild-type BMDM alleviated the susceptibility of Dock2^-/- mice to C. rodentium infection. Our results show that Dock2 affects migration and phagocytic and bactericidal ability of macrophages by regulating the expression of chemokines, chemokine receptors and their responses to chemokine stimulation, thus playing an essential role in the host defense against enteric bacterial infection.

Relationship between inflammatory factors and arrhythmia and heart rate variability in OSAS patients

OBJECTIVE

Obstructive Sleep Apnea Syndrome (OSAS) is a disorder characterized by recurrent upper airway obstruction, apnea, and hypopnea, associated with decreased oxygen saturation and disturbed sleep structure during sleep. It was found that OSAS was associated with a variety of arrhythmia and conduction disorders, but the relationship between multiple types of arrhythmia and the severity of OSAS, and its possible mechanism remain unclear. The purpose of this study was to observe the main types of arrhythmia and the condition of heart rate variability (HRV) in patients with OSAS, to detect the levels of multiple inflammatory factors in serum of OSAS patients, and to observe the correlation between polysomnographic parameters or inflammatory factors, and arrhythmia or HRV, as well as its possible mechanisms.

PATIENTS AND METHODS

141 patients with suspected OSAS were collected in the Second Affiliated Hospital of Soochow University and Xinghua People's Hospital from February 2016 to February 2018. According to the sleep apnea hypopnea index (AHI), they were divided into control group (AHI <5, n = 34), mild-moderate OSAS group (5≤ AHI <30, n = 48), and severe OSAS group (AHI ≥30, n = 59). Clinical data such as gender and age were collected. All patients completed polysomnography (PSG), 24-hour Holter monitoring and blood routine, biochemical indexes and serum hs-CRP, TNF-α, IL-6, and IL-1β testing. The indicators in the three groups were compared, and the correlation between PSG parameters, HRV and inflammatory biomarkers was investigated.

RESULTS

Compared with control group, there were significant differences in age, sex ratio, BMI, uric acid, TC, and TG in the mild-moderate OSAS group (p<0.05), and in age, sex ratio, BMI, red blood cell count, hemoglobin, hematocrit, uric acid, FBS, TC, TG, LDL, and HDL in severe OSAS group (p<0.05). There were significant differences in gender ratio, BMI, red blood cell count, hemoglobin, hematocrit, uric acid, FBS, TC, TG, LDL, and HDL between mild-moderate OSAS group and severe OSAS group (p<0.05). Heart rate variability (HRV) parameters include SDNN, SDNN index, RMSSD, PNN50, LF, HF, and LF/HF. SDNN, PNN50, and HF in severe OSAS group and mild-moderate OSAS group were significantly lower than those in control group (p<0.05). LF/HF was significantly higher than that of control group (p<0.05). There was a significant difference in PNN50, HF, and LF/HF between severe OSAS group and mild-moderate OSAS group (p<0.05). In terms of inflammation, serum hs-CRP was significantly higher in mild-moderate OSAS group and severe OSAS group than that in control group (p<0.05). Serum IL-1β was significantly higher in mild-moderate OSAS group than that in severe OSAS group (p<0.05). There was no significant difference in other indicators (p>0.05). There was a significant positive correlation between hs-CRP and oxygen reduction index (ODI) (r=0.209, p=0.013) and a significant negative correlation with PNN50 (r=-0.188, p=0.025). There is no significant correlation between other indicators.

CONCLUSIONS

Systemic inflammatory reactions existed in patients with OSAS. With the increase of OSAS, inflammation was aggravated, especially serum hs-CRP. Hs-CRP was significantly and negatively correlated with PNN50 and positively correlated with ODI. The results suggested that the inflammatory response was involved in the occurrence of heart rate variability in OSAS patients.

The association of metabolic syndrome and cognitive impairment in Jidong of China: a cross-sectional study

BACKGROUND

Metabolic syndrome (Mets) is prevalent in the general population and has been reported to be an independent risk factor for cognitive impairment. This study aimed to investigate the association of Mets with the risk of cognitive impairment.

METHODS

We studied 5854 participants from the Jidong community. Cognitive function was assessed by the Mini-Mental State of Examination (MMSE) scale. Mets was diagnosed according to the International Diabetes Federation criteria. We used logistic regression analysis to investigate the association of metabolic syndrome with the risk of cognitive impairment.

RESULT

Among the 5854 adults included in the study, the age mean (SD) of age was 44 (13.57) years, and 2916 (50.34%) were male. There was a higher (56.03%) cognitive impairment incidence rate among participants with Mets than among those without Mets. In addition, there was a significant association between Mets and cognitive impairment (OR: 2.39, 95% CI: 2.00-2.86, P < 0.05) after adjusting for potential confounders, including age, gender, education level, marital status, smoking and alcohol consumption status. Regarding the 5 Mets components, abdominal obesity and elevated blood pressure were associated with the risk of Mets (OR: 1.36, 95% CI: 1.09-1.70, P < 0.001; OR: 1.32, 95% CI: 1.07-1.63, P < 0.05). Moreover, the strongest statistical correlation (adjusted OR: 1.86, 95% CI: 1.22-2.83, P < 0.05) was found when the number of Mets components was three.

CONCLUSION

Our study suggested that Mets was associated with cognitive impairment and that abdominal obesity and hypertension were associated with an increased risk of cognitive impairment.

Association Between Gamma-Glutamyl Transferase and Mild Cognitive Impairment in Chinese Women

Background: Dementia, as a global public health problem, is becoming increasingly serious. As a precursor of dementia, mild cognitive impairment (MCI) plays an important role in the diagnosis and prevention of dementia. Recent studies have found a correlation between gamma-glutamyl transferase (GGT) levels and cognitive function in men. The relationship between GGT levels and cognitive function in women remains unclear because GGT activity and expression differ between the sexes. Method: We recruited a total of 2,943 Chinese women from Jidong and Taian in 2019. We grouped the participants according to GGT levels, diagnosed MCI using the Montreal Cognitive Assessment (MOCA) scale, and modeled the study outcomes using logistic regression to explore the relationship between GGT level and MCI. We also analyzed the interaction of obesity, sleep duration, and hyperuricemia with GGT in the development of MCI. Results: The prevalence of MCI increased with increasing GGT level, from the lowest quartile to the highest quartile of GGT: 8.4% (66/786), 14.2% (119/840), 17.6% (108/613), and 21.4% (151/704), respectively. At the same time, as GGT levels increased, so did the risk of MCI. In the fully adjusted model, compared with those for participants in the lowest GGT quartiles, the odds ratios (ORs), and 95% confidence intervals (CIs) for MCI for participants in the second, third, and fourth GGT quartiles were 1.49 (1.04-2.12), 1.53(1.06-2.21), and 1.88 (1.33-2.65), respectively. The risk of developing MCI was further increased in people with high GGT levels who were obese (OR = 1.96, 95% CI: 1.39-2.76, P < 0.001), slept less (OR = 1.91, 95% CI: 1.35-2.71, P < 0.001), had high levels of uric acid (OR = 1.55, 95% CI: 1.03-2.32, P < 0.001), or after menopause (OR = 2.92, 95% CI: 2.07-4.12, P < 0.001). Conclusion: We found that MCI is more common in women with elevated GGT levels, so GGT could be a potential diagnostic marker for MCI. Meanwhile, our findings indicated that women with high GGT levels had an increased risk of MCI when they were obese, sleep deprived, had high serum uric acid (SUA) levels or underwent menopause.

[Abnormalities of white matter differentiate the Parkinson variant of multiple system atrophy from Parkinson's disease]

Objective: To identify objective markers between the Parkinson variant of multiple system atrophy (MSA-P) and Parkinson's disease (PD). Methods: Retrospective analysis was performed on 10 patients with MSA-P, 15 patients with PD, and 15 healthy control group during the period from August 2016 to February 2019 in Baoshan Branch of Shanghai First People's Hospital.We combined the novel tract based spatial statistics (TBSS) and region of interest (ROI) analyses for the first time to investigate three groups with diffusion tensor imaging. By TBSS, we performed pairwise comparisons of mean diffusivity and fractional anisotropy (FA) maps. The clusters with significant differences between MSA-P and PD were used as ROIs for further analyses. Results: FA values in the left anterior thalamic radiation(ATR) (ROI values were 0.371(0.287-0.535), 0.472(0.390-0.594), 0.473(0.388-0.555); P values were 0.008, 0.008) and left superior longitudinal fasciculus (SLF)(ROI values were 0.397(0.291-0.469), 0.456(0.338-0.560), 0.473(0.427-0.530); P values were 0.013,<0.001) were significantly decreased in MSA-P compared with PD or controls, and significantly correlated with clinical data((r =-0.807, P =0.005),(r =-0.455, P =0.022)). Conclusion: Our findings indicate the abnormalities of left ATR and left SLF as specific biomarkers for differential diagnosis.

Relationship between country income, socioeconomic factors and control of cardiovascular disease risk factors in patients with type 2 Diabetes: insights from the global DISCOVER registry

Background

In patients with type 2 diabetes (T2D), optimal management of cardiovascular (CV) risk factors is critical for primary prevention of CV disease.

Purpose

To describe the association of country income and patient socioeconomic factors with risk factor control in patients with T2D.

Methods

DISCOVER is a 37-country, prospective, observational study of 15,983 patients with T2D enrolled between January 2016 and December 2018 at initiation of 2nd-line glucose-lowering therapy and followed for 3 years. In patients without known CV disease with sub-optimally controlled risk factors at baseline, we examined achievement of risk factor control (HbA1c &lt;7%, BP &lt;140/90 mmHg, appropriate statin) at the 3 year follow-up. Countries were stratified by gross national income (GNI)/capita, per World Bank report. We explored variability across countries in risk factor control achievement using hierarchical logistic regression models and examined the association of country- and patient-level economic factors with risk factor control.

Results

Among 9,613 patients with T2D but without CV disease (mean age 57.2 years, 47.9% women), 83.1%, 37.5%, and 66.3% did not have optimal control of glucose, BP, and statins, respectively, at baseline. Of these, 40.8%, 55.5%, and 28.6% achieved optimal control at 3 years of follow-up. There was substantial variability in achievement of risk factor control across countries (Figure) but no association of country GNI/capita on achievement of risk factor control (Table). Insurance status, which differed substantially by GNI group, was strongly associated with glycemic control, with no insurance and public insurance associated with lower odds of patients achieving HbA1c &lt;7%.

Conclusions

In a global cohort of patients with T2D, a substantial proportion do not achieve risk factor control even after 3 years of follow-up. The variability across countries in risk factor control is not explained by the GNI/capita of the country.

Proportion of patients at goal

Funding Acknowledgement

Type of funding source: Private company. Main funding source(s): The DISCOVER study is funded by AstraZeneca

COVID-19 in people living with diabetes: An international consensus

The COVID-19 pandemic has added an enormous toll to the existing challenge of diabetes care world-wide. A large proportion of patients with COVID-19 requiring hospitalization and/or succumbing to the disease have had diabetes and other chronic conditions as underlying risk factors. In particular, individuals belonging to racial/ethnic minorities in the U.S. and other countries have been significantly and disproportionately impacted. Multiple and complex socioeconomic factors have long played a role in increasing the risk for diabetes and now for COVID-19. Since the pandemic began, the global healthcare community has accumulated invaluable clinical experience on providing diabetes care in the setting of COVID-19. In addition, understanding of the pathophysiological mechanisms that link these two diseases is being developed. The current clinical management of diabetes is a work in progress, requiring a shift in patient-provider interaction beyond the walls of clinics and hospitals: the use of tele-medicine when feasible, innovative patient education programs, strategies to ensure medication and glucose testing availability and affordability, as well as numerous ideas on how to improve meal plans and physical activity. Notably, this worldwide experience offers us the possibility to not only prepare better for future disasters but also transform diabetes care beyond the COVID-19 era.

MiR-127-3p targets KIF3B to inhibit the development of oral squamous cell carcinoma

OBJECTIVE

Recently, increased microRNAs have been shown to play an important role in the pathogenesis and progression of human cancers, including oral squamous cell carcinoma (OSCC). In this study, we focused on the function of microRNA-127-3p (miR-127-3p) associated with OSCC carcinogenesis.

PATIENTS AND METHODS

MiR-127-3p and KIF3B expressions were observed via quantitative Real-time polymerase chain reaction (qRT-PCR) or Western blot in OSCC. The functions of mR-127-3p and KIF3B were investigated through MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) and transwell assays. And luciferase reporter assay was performed to confirm the relationship between mR-127-3p and KIF3B.

RESULTS

First, down-regulation of miR-127-3p was identified in OSCC, which was associated with malignant clinicopathological features and poor prognosis in OSCC patients. Functionally, overexpression of miR-127-3p led to inhibition of cell proliferation and metastasis in OSCC. Further, KIF3B was confirmed to be a direct target of miR-127-3p. Moreover, upregulation of KIF3B was also observed in OSCC, which promoted tumorigenesis of OSCC. In particular, the upregulation of KIF3B partially attenuated the inhibitory effect of miR-127-3p on the development of OSCC.

CONCLUSIONS

MiR-127-3p targeted KIF3B to inhibit the development of OSCC through suppressing cell proliferation, migration and invasion.

Curcumin exerts protective effect on PC12 cells against lidocaine-induced cytotoxicity by suppressing the formation of NLRP3 inflammasome

OBJECTIVE

To explore the protective effect of curcumin on lidocaine-insulted PC12 cells.

MATERIALS AND METHODS

We first treated PC12 cells with different doses of lidocaine, and then treated the cells with curcumin or Nod-like receptor pyrin domain3 (NLRP3) inhibitor (MCC950). Subsequently, the cell viability, apoptosis, reactive oxygen species (ROS) production and NLRP3 inflammasome were detected by cell counting kit-8 (CCK8), Annexin V/PI staining, FCM and Western blot analysis, respectively, and the level of IL-1β in PC12 cells was determined by an enzyme-linked immunosorbent assay (ELISA) kit.

RESULTS

Lidocaine inhibited the viability of PC12 cells, and it induced cell apoptosis, promoted ROS release and activated NLRP3 inflammasome in PC12 cells, but its effects were reversed by the treatment of curcumin. Moreover, NLRP3 over-expression also induced cytotoxicity in PC12 cells, which was also rescued by the treatment of curcumin.

CONCLUSIONS

Our study indicates that curcumin exerts protective effect against lidocaine-induced cytotoxicity on PC12 cells by suppressing the activity of NLRP3 inflammasome, which provides new ideas on screening natural product for neurological damage therapy.

Relationships between menstrual status and obesity phenotypes in women: a cross-sectional study in northern China

BACKGROUND

One of most important concerns of postmenopausal women is obesity. The relationships between menstruation status and obesity phenotypes are unclear. This study aimed to assess the associations between menstrual status and different obesity phenotypes in women.

METHODS

In total, 5373 women aged ≥40 years were recruited from the Jidong and Kailuan communities. Basic information was collected via clinical examination, laboratory testing and standardized questionnaires. The women were stratified into the following three groups: menstrual period, menopausal transition period and postmenopausal period. General obesity was defined as a body mass index (BMI) of ≥28 kg/m². Central obesity was defined as a waist-to-hip ratio (WHR) of > 0.85. Visceral obesity was defined as the presence of nonalcoholic fatty liver disease (NAFLD) and increased pericardial fat volume (PFV).

RESULTS

The numbers of women in the menstrual, menopausal transition, and postmenopausal periods were 2807 (52.2%), 675 (12.6%) and 1891 (35.2%), respectively. The adjusted odds ratio (OR) and 95% confidence interval (CI) for central obesity among women in the menopausal transition and postmenopausal periods compared with women in the menstrual period were 0.99 (0.82-1.19) and 1.52 (1.26-1.84), respectively. The OR for NAFLD among postmenopausal women was 1.78 (1.44-2.20). The adjusted β-coefficient (standard error, SE) for PFV among postmenopausal women was 41.25 (7.49). The adjusted OR for general obesity among postmenopausal women was 1.01 (0.77-1.34).

CONCLUSIONS

This study demonstrated that menopause is an independent risk factor for central and visceral obesity but not general obesity.

OP0093 FREQUENCIES AND PREDICTORS OF THE LUPUS LOW DISEASE ACTIVITY STATE AND REMISSION IN TREATMENT-NAÏVE PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS -- A REAL-WORLD COHORT STUDY

Background:

After the introduction of treat-to-target strategy in systemic lupus erythematosus (SLE), Lupus Low Disease Activity State (LLDAS) and definitions of remission in SLE (DORIS) were developed and validated. Several studies had demonstrated that the achievement and maintenance of LLDAS or DORIS was associated with good prognosis.

Objectives:

To evaluate the attainability of LLDAS and DORIS in a treatment-naïve cohort of SLE.

Methods:

LDAS5 was defined as LLDAS with a prednisone dose ≤5 mg/d. There were 4 definitions in DORIS: clinical remission on treatment (RONT), complete RONT, clinical remission off treatment (ROFT) and complete ROFT. The treatment-naïve patients from Peking University First Hospital SLE cohort were enrolled. The time to each state and their annual cumulative probabilities were estimated by Kaplan-Meier approach. The frequencies of patients who achieved each component of LLDAS or DORIS during follow-up were determined.

Results:

A total of 218 treatment-naïve patients were included, with a median follow-up of 4.48 years. Respectively, 190 (87.2%), 160 (73.4%), 148 (67.9%), 94 (43.1%), 23 (10.6%) and 18 (8.3%) patients achieved LLDAS, LLDAS5, clinical RONT, complete RONT, clinical ROFT and complete ROFT at least once during the follow-up time. The median time to LLDAS, LLDAS5, clinical RONT and complete RONT were 1.4, 2.3, 2.6 and 4.7 years, respectively.

Table 1.

Frequencies, time to achieve and annual cumulative probabilities of each state by Kaplan-Meier approach

StatesAchieved patientsNumber (%)Time to achieve(years)Cumulative probabilities of achievement (%)Year 1Year 2Year 3Year 4Year 5LLDAS190 (87.2)1.418.869.786.789.192.6LLDAS5160 (73.4)2.36.940.763.376.082.3Clinical RONT148 (67.9)2.65.536.156.168.876.6Complete RONT94 (43.1)4.74.122.637.545.350.4Clinical ROFT23 (10.6)NA1.42.95.46.710.6Complete ROFT18 (8.3)NA0.92.54.84.88.8Table 2.

Patients who achieved each component of LLDAS or DORIS during follow-up

ComponentsNumber (%)SLEDAI-2K ≤4, with no activity in major organ systems (renal, central nervous system, cardiopulmonary, vasculitis, fever), and no haemolytic anaemia or gastrointestinal active213 (97.7)Clinical SLEDAI-2K =0210 (96.3)PGA ≤1217 (99.5)PGA <0.5199 (91.3)Serology (anti-dsDNA and complement) negative148 (67.9)Prednisone dose ≤7.5 mg/day201 (92.2)Prednisone dose ≤5 mg/day171 (78.4)No prednisone dose40 (18.3)No prednisone dose and Immunosuppressants32 (14.7)

Conclusion:

Our data confirmed that LLDAS is an attainable early treatment target for SLE. Though with more difficulty, RONT can be achieved in two-thirds of our patients. ROFT may not be an ideal treatment target at present as it is only attained in few patients.

References:

[1]Franklyn, K. et al. Ann Rheum Dis. 2016 Sep;75(9):1615-21.

[2]van Vollenhoven, R. et al. Ann Rheum Dis. 2017 Mar;76(3):554-561.

Disclosure of Interests:

None declared

AB0376 DETERMINANTS AND PROTECTIVE EFFECTS OF A LOW DISEASE ACTIVITY STATE IN SYSTEMIC LUPUS ERYTHEMATOSUS: RESULTS FROM A PROSPECTIVE CHINESE COHORT

Background:

The concept of treat to target in systemic lupus erythematosus has moved forward in recent years. The Lupus low disease activity state (LLDAS) defined by the Asia-Pacific Lupus Collaboration (APLC) in 2016 has been validated prospectively in the APLC cohort itself and retrospectively in multiple other cohorts.

Objectives:

The concept of treat to target in systemic lupus erythematosus has moved forward in recent years. The Lupus low disease activity state (LLDAS) defined by the Asia-Pacific Lupus Collaboration (APLC) in 2016 has been validated prospectively in the APLC cohort itself and retrospectively in multiple other cohorts. The aim of this study was to investigate the frequency and determinants of achieving LLDAS, and the influence of LLDAS on short term outcomes including disease flare and damage accrual in Chinese lupus patients.

Methods:

The baseline and follow-up data of all consecutive patients in a longitudinal lupus cohort from January 2017 to December 2018 were collected prospectively. SLEDAI-2K, PGA and disease flare were assessed at each follow-up visit, and further compared to the previous routine clinical visits. Irreversible disease damage was captured using the SLICC damage index and the short form (36) health survey for health-related quality of life was completed annually.

Results:

One hundred and forty-nine patients were enrolled, with the median disease duration at recruitment of 2.4 (0.9–8.2) years, and median follow-up of 15.4 (10.1-18.2) months. By the end of the study, 104 (69.8%) patients achieved LLDAS at least once; 59 patients achieved LLDAS for≥50% of observations. Multivariate logistic regression analysis showed that age at disease onset< 30 years (OR=0.05, 95%CI [0.01-0.59], p=0.017), 24-hour urine total protein (UTP) level at recruitment (OR=0.9992, 95%CI [0.9987-0.9998], p=0.007), and C3 level (OR=1.004, 95%CI [1.001-1.008], p=0.024) had independent associations with achieving LLDAS for≥50% of all observations (Table 1). During follow-up, 56 (37.6%) patients experienced disease flare including 14 (9.4%) patients with severe flare. Kaplan-Meier analyses showed significant differences in flare rates according to whether LLDAS was achieved and the percentage follow-up time in LLDAS (Figure 1). Multivariate cox analysis revealed that the percentage time of time in LLDAS was an independent negative determinant of disease flare (HR=0.18, 95% CI [0.07-0.48], p=0.001) (Table 2). There were 16 (15.0%)/107 patients who had damage accrual after one year of follow-up. Multivariate logistic analysis showed a tendency for achieving LLDAS during follow-up being protective for damage accrual (OR=0.27, 95%CI [0.07-1.00], p=0.050).

Conclusion:

In this Chinese early disease cohort, LLDAS was an attainable goal in clinical practice. Age at onset, UTP and C3 level at recruitment influenced achievement of LLDAS. LLDAS was negatively associated with disease flare and damage accrual; this needs to be confirmed by future longer follow-up.

Acknowledgments:

The data in this cohort was collected and recorded using the framework of the lupus low disease activity status (LLDAS) study from the Asia-Pacific Lupus Collaboration (APLC).

Disclosure of Interests:

Yanjie Hao: None declared, Lanlan Ji: None declared, Dai Gao: None declared, Yong Fan: None declared, Eric F. Morand Grant/research support from: AstraZeneca, Consultant of: AstraZeneca, Speakers bureau: AstraZeneca, Mandana Nikpour: None declared, Zhuoli Zhang: None declared

SAT0096 DISCORDANCE BETWEEN SUBJECTIVE AND OBJECTIVE INDEX OF THE DISEASE ACTIVITY SCORE MAY REDUCE THE CORRELATION BETWEEN CLINICAL AND ULTRASOUND ASSESSMENT IN RHEUMATOID ARTHRITIS

Background:

There was discordance between subjective and objective index of the disease activity score, or between clinical parameters and ultrasound findings in some RA patients. Therefore, we set out to determine whether the discordance between subjective and objective index of the composite score could reduce the correlation between clinical and ultrasound parameters in RA.

Objectives:

To investigate whether the discordance between tender and swollen joint count (TJC and SJC) as well as patient’s and evaluator’s global assessment (PGA and EGA) influences the correlation between clinical and US parameters in RA.

Methods:

RA patients with available ultrasonography of 28 joints from Jan 2014 to Jan 2018 were enrolled in the study. Gray-scale (GS) synovial hypertrophy and Power Doppler (PD) synovitis were measured and semi-quantitatively graded. The total GS/PD score was the sum score of 28 joints. SJC and TJC based on 28 joints, PGA and EGA of all the patients were evaluated by one rheumatologist. The numeric difference between TJC and SJC (ΔTSJ) and that between PGA and EGA (ΔPEG) were calculated. The correlation between clinical and ultrasound parameters in different ΔTSJ and ΔPEG subgroups was explored.

Results:

Totally 163 patients were enrolled in the study. Clinical composite disease activity scores and all the components were significantly correlated with the total GS and PD scores (p<0.01 for all). But the relevance between the clinical disease parameters and total PD score became weak, with the increase of ΔTSJ. For the patients with ΔTSJ > 5, the total PD score was only correlated with CRP, EGA and PGA, while the total GS score was only correlated with CRP. Similarly, no correlation between total PD score and clinical parameters, except for SJC, was observed in patients with ΔPEG < 0 (p < 0.05).

Conclusion:

Total PD/GS score was correlated well with the clinical parameters of disease activity, including both the subjective and objective indexes. But for patients with ΔTSJ > 5,there was no correlation between total GS/PD scores and clinical composite disease activity scores, except that only the objective index (CRP, SJC and EGA) were more likely to correlate with total GS/PD scores.

Disclosure of Interests:

None declared

THU0247 FREQUENCY AND PREDICTORS OF THE LUPUS LOW DISEASE ACTIVITY STATE IN CHINESE PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: AN OBSERVATIONAL COHORT STUDY

Background:

As a consensus-based definition of minimally acceptable disease activity in systemic lupus erythematosus (SLE), Lupus Low Disease Activity State (LLDAS) has been well-validated and widely accepted. However, no data about the time to LLDAS in Asian ethnicity has been reported so far.

Objectives:

To estimate the time to LLDAS and the predictors of time to LLDAS in our prospective observational cohort of Chinese patients with SLE.

Methods:

Patients were from Peking University First Hospital SLE cohort and those having not fulfilled LLDAS at enrolment were included in this study. The time to LLDAS and annual cumulative probabilities of LLDAS achievement were estimated by the Kaplan-Meier approach. The predictors of time to LLDAS were identified by univariate and multivariable Cox proportional hazards.

Results:

A total of 574 patients with SLE were included and 435 (75.8%) of them achieved LLDAS during a median 4.2 years of follow-up. The median time to LLDAS was 19.0 months and the cumulative probabilities at 1, 2, 3, 5 and 10 years were 19.8%, 57.6%, 72.0%, 85.1% and 98.0%, respectively. In multivariable Cox models, older age at disease onset, treatment-naïve and hydroxychloroquine prescription were found to be independent predictors of shorter time to LLDAS, after adjusted by daily prednisone dose, SLE Disease Activity Index 2000 and physician’s global assessment. Finally, we developed a matrix model based on the identified independent predictors to present the time to LLDAS in patients with respective characteristics.

Conclusion:

Our study proved that LLDAS is attainable as an early treatment target for SLE in Chinese patients. The older age at disease onset, treatment-naïve and hydroxychloroquine prescription were independent predictors of shorter time to LLDAS.

References:

[1]Franklyn K, Lau CS, Navarra SV, Louthrenoo W, Lateef A, Hamijoyo L, Wahono CS, Chen SL, Jin O, Morton S, Hoi A, Huq M, Nikpour M, Morand EF; Asia-Pacific Lupus Collaboration. Ann Rheum Dis. 2016 Sep;75(9):1615-21.

Table 1

Baseline variables associated with LLDAS achievement based on multivariable Cox models

CharacteristicsModel 1Model 2Model 3HR (95% CI)pvalueHR (95% CI)pvalueHR (95% CI)pvalueAge at disease onset, years1.010 (1.003-1.016)0.0051.009 (1.002-1.016)0.0101.010 (1.003-1.017)0.004Treatment-naïve1.346 (1.105-1.641)0.0031.425 (1.161-1.749)0.0011.484 (1.204-1.830)<0.001Nephritis0.776 (0.641-0.939)0.0091.066 (0.820-1.385)0.6340.925 (0.737-1.160)0.498SLEDAI0.968 (0.950-0.987)0.001PGA0.685 (0.551-0.853)0.001Daily prednisone (or equivalent) dose, mg/d1.003 (0.998-1.007)0.2661.005 (0.999-1.010)0.093HCQ1.638 (1.263-2.123)<0.0011.713 (1.318-2.225)<0.0011.664 (1.284-2.157)<0.001

Disclosure of Interests:

None declared

Controllable Two-dimensional Perovskite Crystallization via Water Additive for High-performance Solar Cells

Steering the crystallization of two-dimensional (2D) perovskite film is an important strategy to improve the power conversion efficiency (PCE) of 2D perovskite solar cells (PVSCs). In this paper, the deionized water (H₂O) additive is introduced into the perovskite precursor solution to prepare high-quality 2D perovskite films. The 2D perovskite film treated with 3% H₂O shows a good surface morphology, increased crystal size, enhanced crystallinity, preferred orientation, and low defect density. The fabricated 2D PVSC with 3% H₂O exhibits a higher PCE compared with that without H₂O (12.15% vs 2.29%). Furthermore, the shelf stability of unsealed devices with 3% H₂O under ambient environment is significantly improved. This work provides a simple method to prepare high-quality 2D perovskite films for efficient and stable 2D PVSCs.

Effect of GATA4 gene methylation on proliferation and apoptosis of SGC-7901 gastric cancer cells

Gastric cancer (GC) remains a major cause of cancer-related deaths worldwide. GATA4 has been previously reported to exhibit functions in GC. In this study, we aimed to investigate the effect of GATA4 gene methylation on GC progression. Methylation-Sensitive High-Resolution Melting was used to detect the methylation of GATA4 promoter region in GC tissues and adjacent normal tissues, GC cell lines and GES-1 cells. The relationship between GATA4 methylation level and clinical characteristics of GC patients was analyzed. GATA4 levels in GC tissues and adjacent normal tissues, GC cell lines and GES-1 cell lines were detected, and gain-of-function was performed to investigate the role of GATA4 in GC. si-GATA4 was transfected into GES-1 cells to observe the changes of various indicators. RNA-seq detected the differentially expressed genes in SGC-7901 cells overexpressing GATA4, and western blot analysis verified their expression. GATA4 methylation rate was increased in GC tissues, and GATA4 promoter was abnormally methylated in GC cells. GATA4 methylation rate in GC tissues was related to lymph node metastasis, differentiation degree and clinical stage of GC patients. Lower expressed GATA4 was observed in GC tissues and cells. Cell proliferation rate decreased and cell apoptosis rate increased in SGC-7901 cells overexpressing GATA4. Transfecting si-GATA4 into GES-1 cells led to increased proliferation, inhibited apoptosis, and restoration of GATA4 led to decreased APC and GSK3β levels. In conclusion, restoration of GATA4 caused by 5-Aza treatment can inhibit the proliferation and promote apoptosis of GC cells possibly via Wnt/β-catenin signaling pathway. This study may offer new sight for GC treatment.

Factors associated with resistance to complications in long-standing type 1 diabetes in China

OBJECTIVE

Type 1 diabetes (T1DM) is associated with a higher risk of premature death, but there are factors in certain patients with T1DM that protect them from complications and premature death. These factors had not been identified in non-Caucasian populations, so we aimed to identify factors that protect against the development of diabetic nephropathy (DN) and diabetic retinopathy (DR) in long-standing T1DM in China

METHODS

Ninety-five T1DM patients with >30 years’ duration of diabetes were enrolled in this nationwide study. Differences between groups of patients with and without complications were compared, and multivariable regression analysis was used to evaluate the relationships between candidate protective factors and the development of DN or DR.

RESULTS

Thirty of the participants did not have DN and the same amount did not have DR. 6/52 of participants without DN were from a rural area, whereas 11/28 of participants with DN had been born in a rural area (P = 0.005). Systolic blood pressure (SBP) was higher in participants with DN (135 ± 26 mmHg vs 121 ± 13 mmHg; P = 0.002). In participants without DR, 27/30 were married or cohabitating, and only 3/30 were single, never married, or widowed, but for those with proliferative DR (PDR), 13/26 had been married (P = 0.003). A rural or urban origin and SBP were associated with DN in the multivariable analysis.

CONCLUSION

we have shown that higher socioeconomic status, indicated by birth in an urban area, and being married or cohabitating, are accompanied by better blood pressure control and a lower risk of microvascular complications in Chinese patients with long-standing T1DM. These findings illustrate the importance of improving care for patients with T1DM in China.