High indirect bilirubin levels as an independent predictor of postoperative myasthenic crisis: a single-center, retrospective study

Background

Thymectomy is an efficient and standard treatment strategy for patients with myasthenia gravis (MG), postoperative myasthenic crisis (POMC) is the major complication related to thymectomy and has a strongly life-threatening effect. As a biomarker, whether the bilirubin level is a risk factor for MG progression remains unclear. This study aimed to investigate the association between the preoperative bilirubin level and postoperative myasthenic crisis (POMC).

Methods

We analyzed 375 patients with MG who underwent thymectomy at Tangdu Hospital between January 2012 and September 2021. The primary outcome measurement was POMC. The association between POMC and bilirubin level was analyzed by restricted cubic spline (RCS). Indirect bilirubin (IBIL) was divided into two subgroups based on the normal upper limit of IBIL, 14 μmol/L.

Results

Compared with non-POMC group, IBIL levels were significantly higher in patients with POMC. Elevated IBIL levels were closely associated with an increased risk of POMC (p for trend = 0.002). There was a dose-response curve relationship between IBIL levels and POMC incidence (p for non-linearity = 0.93). However, DBIL levels showed a U-shaped association with POMC incidence. High IBIL level (≥14 μmol/L) was an independent predictive factor for POMC [odds ratio = 3.47, 95% confidence interval (CI): 1.56-7.8, p = 0.002]. The addition of high IBIL levels improved the prediction model performance (net reclassification index = 0.186, 95% CI: 0.039-0.334; integrated discrimination improvement = 0.0345, 95% CI: 0.005-0.065).

Conclusion

High preoperative IBIL levels, especially those exceeding the normal upper limit, could independently predict the incidence of POMC.

Relationship between visual impairment and school entrance age in rural China

CLINICAL RELEVANCE

Children with uncorrected visual impairment have lower scores on various motor and cognitive tests. Exploring the association between visual impairment and school entrance age among school children in rural China may assist in enhancing the visual health of early-entry school students.

BACKGROUND

Educational pressures may play a role in the visual health of students. School entrance age is associated with educational pressures. This study explored whether school entrance age can contribute to visual impairment among younger generations.

METHODS

A cross-sectional study was conducted with 17,510 students from 252 primary schools in two prefectures in western China. Information on the sampled students was collected through questionnaires and vision examinations. The relationship between visual impairment and school entrance age was further analysed by multiple regression. The school entrance age was classified as early-entry and late-entry, early-entry was defined as students entering school at the age 6 years.

RESULTS

The results showed that the myopia rate of early-entry students (26.92%) was higher than late-entry students (23.86%). Multiple regression showed that visual impairment increased with the earlier age of school entry (P = 0.044). The prevalence of myopia was also significantly higher in higher grades for children of the same age. The prevalence of myopia in 10-year-old and 11-year-old fourth- and fifth-grade students was 20.6% to 30.5%, 21.7% to 27.4% (P < 0.001). The near work with eyes was significantly different among children of the same age in different grades during this study (P < 0.001).

CONCLUSION

Myopia is related to the school entrance age of children. Children who start school earlier are more likely to suffer from myopia. Educational pressures and digital screens may play a role in the association. Changes in the current education mode by reducing the study burden in the early years of learning may be significant.

Neural adaption in midbrain GABAergic cells contributes to high-fat diet-induced obesity

Overeating disorders largely contribute to worldwide incidences of obesity. Available treatments are limited. Here, we discovered that long-term chemogenetic activation of ventrolateral periaqueductal gray (vlPAG) GABAergic cells rescue obesity of high-fat diet-induced obesity (DIO) mice. This was associated with the recovery of enhanced mIPSCs, decreased food intake, increased energy expenditure, and inguinal white adipose tissue (iWAT) browning. In vivo calcium imaging confirmed vlPAG GABAergic suppression for DIO mice, with corresponding reduction in intrinsic excitability. Single-nucleus RNA sequencing identified transcriptional expression changes in GABAergic cell subtypes in DIO mice, highlighting Cacna2d1 as of potential importance. Overexpressing CACNA2D1 in vlPAG GABAergic cells of DIO mice rescued enhanced mIPSCs and calcium response, reversed obesity, and therefore presented here as a potential target for obesity treatment.

Dissection of the bed nucleus of the stria terminalis neuronal subtypes in feeding regulation

The bed nucleus of the stria terminalis (BNST) plays an important role in feeding regulation through projections to other brain areas. However, whether functional distinctions exist within different BNST cells is not clear. Here, we found optogenetic activation of LH-projecting BNST neurons induced aversion and significantly reduced consumption of normal chow but not high-fat diets (HFD). In contrast, photoactivation of vlPAG-projecting BNST neurons induced place preference and promoted HFD intake, without affecting normal chow consumption. Moreover, optogenetic silencing of LH-projecting BNST neurons reduced the consumption of normal chow in fasted mice, while photoinhibition of vlPAG-projecting BNST neurons decreased the consumption of HFD in both fed and fasted mice. We then labeled the LH- and vlPAG-projecting BNST neurons using retroAAV-GFP and retroAAV-mCherry, respectively, and found these two populations of neurons have different anatomical distribution and electrophysiological properties. Taken together, we identified vlPAG-projecting and LH-projecting BNST neurons are two distinct populations of cells with significant differences in functional and anatomic characteristics.

Effects of remittances on life expectancy and under-five mortality in sub-Saharan Africa: Evidence using Generalized Method of Moments analysis

The study examined the relationship between financial remittances and health outcomes in 45 sub-Saharan African countries (SSA) using data obtained from the World Development Indicator (WDI) over the period 1990 to 2021. Because of the issue of endogeneity, the System Generalized Method of Moments (SGMM) was adopted to analyze the impact of remittances on life expectancy and infant mortality respectively. The results showed that contrary to expectations, remittances did not significantly improve life expectancy and infant mortality rate in SSA. The life expectancy in the previous year, has a statically significant impact on life expectancy at birth for the current year. Also, the lagged value of infant mortality rate significantly increased under five mortality. Therefore, the study recommends that governments in SSA sub-region should evolve policies aimed at guiding recipients of remittances towards effective utilization with a view to improving social welfare and health outcomes.

[Expression and clinical significance of plasma methylated SEPT 9 gene in patients with primary liver cancer]

Objective: To investigate the expression and clinical significance of plasma methylated SEPT9 (mSEPT9) gene in patients with primary liver cancer. Methods: 393 cases who visited our hospital from May 2016 to October 2018 were selected. Among them, 75 cases were in the primary liver cancer (PLC) group, 50 cases were in the liver cirrhosis (LC) group, and 268 cases were in the healthy control group (HC). The three groups' positive rates of mSEPT9 expression in the peripheral plasma were detected by the polymerase chain reaction (PCR) fluorescent probe method. The correlational clinical features of liver cancer were analyzed. At the same time, the electrochemiluminescence detection method was used to compare the AFP positive rate. Statistical analysis was conducted using chi-square tests or continuity-corrected chi-square tests. Results: 367 cases actually had valid samples. There were 64, 42, and 64 cases in the liver cancer group, cirrhosis group, and healthy control group, respectively. Among them, 34 cases of liver cancer were verified from pathological tissues. The positive rate of plasma mSEPT9 was significantly higher in the liver cancer group than that in the liver cirrhosis and healthy control groups [76.6% (49/64), 35.7% (15/42), and 3.8% (10/261), respectively], and the differences were statistically significant (χ (2) = 176.017, P < 0.001). The sensitivity of plasma mSEPT9 detection (76.6%) was significantly better in liver cancer (76.6%) than that of AFP patients (54.7%), and the difference was statistically significant (χ (2) = 6.788, P < 0.01). Compared with the single detection, the sensitivity and specificity of plasma mSEPT9 combined with AFP were significantly improved (89.7% vs. 96.3%, respectively). Patients with liver cancer aged≥50 years, with clinical stage II or above, and those with pathological signs of moderate to low differentiation had higher levels of plasma mSEPT9 positive expression, and the differences were statistically significant (χ (2) = 6.41, 9.279, 6.332, P < 0.05). During the follow-up period, the survival time of liver cancer patients with positive plasma mSEPT9 expression was significantly shorter than that of those with negative expression (310 ± 26 days vs. 487 ± 59 days, respectively), with statistically significant differences (Log Rank P = 0.039). Conclusion: In China, the positive rate of plasma mSEPT9 detection in liver cancer patients is higher than that of AFP in relation to age, clinical stage, and degree of tissue differentiation; additionally, it has certain survival predictive values. As a result, detecting this gene has important clinical significance and potential clinical application value in the non-invasive diagnosis and prognosis assessment of patients with primary liver cancer.

Landscape analysis of m6A modification regulators related biological functions and immune characteristics in myasthenia gravis

BACKGROUND

N6-methyladenosine (m6A) modification has been recognized to play fundamental roles in the development of autoimmune diseases. However, the implication of m6A modification in myasthenia gravis (MG) remains largely unknown. Thus, we aimed to systematically explore the potential functions and related immune characteristics of m6A regulators in MG.

METHODS

The GSE85452 dataset with MG and healthy samples was downloaded from Gene Expression Omnibus (GEO) database. m6A modification regulators were manually curated. The targets of m6A regulators were obtained from m6A2Target database. The differential expressed m6A regulators in GSE85452 dataset were identified by "limma" package and were validated by RT-PCR. Function enrichment analysis of dysregulated m6A regulators was performed using "clusterProfiler" package. Correlation analysis was applied for analyzing the relationships between m6A regulators and immune characteristics. Unsupervised clustering analysis was used to identify distinct m6A modification subtypes. The differences between subtypes were analyzed, including the expression level of all genes and the enrichment degree of immune characteristics. Weighted gene co-expression network analysis (WGCNA) was conducted to obtain modules associated with m6A modification subtypes.

RESULTS

We found that CBLL1, RBM15 and YTHDF1 were upregulated in MG samples of GSE85452 dataset, and the results were verified by RT-PCR in blood samples from19 MG patients and 19 controls. The targeted genes common modified by CBLL1, RBM15, and YTHDF1 were mainly enriched in histone modification and Wnt signaling pathway. Correlation analysis showed that three dysregulated m6A regulators were closely associated with immune characteristics. Among them, RBM15 possessed the strongest correlation with immune characteristics, including CD56dim natural killer cell (r = 0.77, P = 0.0023), T follicular helper cell (r = - 0.86, P = 0.0002), Interferon Receptor (r = 0.78, P = 0.0017), and HLA-DOA (r = 0.64, P = 0.0200). Further two distinct m6A modification patterns mediated by three dysregulated m6A regulators was identified. Bioinformatics analysis found that there were 3029 differentially expressed genes and different immune characteristics between two m6A modification patterns. Finally, WGCNA analysis obtained a total of 12 modules and yellow module was the most positively correlated to subtype-2.

CONCLUSION

Our findings suggested that m6A RNA modification had an important effect on immunity molecular mechanism of MG and provided a new perspective into understanding the pathogenesis of MG.

Effect of antioxidant procyanidin b2 (pcb2) on ovine oocyte developmental potential in response to in vitro maturation (ivm) and vitrification stress

BACKGROUND

It was demonstrated that external stress, such as in vitro maturation (IVM) and vitrification process can induce significantly reduced development capacity in oocytes. Previous studies indicated that antioxidants play a pivotal part in the acquisition of adaptation in changed conditions. At present, the role of the natural potent antioxidant PCB2 in response to IVM and vitrification during ovine oocyte manipulation has not been explored.

OBJECTIVE

To investigate whether PCB2 treatment could improve the developmental potential of ovine oocytes under IVM and vitrification stimuli.

MATERIALS AND METHODS

The experiment was divided into two parts. Firstly, the effect of PCB2 on the development of oocytes during IVM was evaluated. Un-supplemented and 5 ug per mL PCB2-supplemented in the IVM solution were considered as control and experimental groups (C + 5 ug per mL PCB2). The polar body extrusion (PBE) rate, mitochondrial membrane potential (MMP), ATP, reactive oxygen species (ROS) levels and early apoptosis of oocytes were measured after IVM. Secondly, we further determine whether PCB2 could improve oocyte quality under vitrification stress. The survival rate, PBE rate and early apoptosis of oocytes were compared between fresh group, vitrified group and 5 ug per mL PCB2-supplemented in the IVM solution after vitrification (V + 5 ug per mL PCB2).

RESULTS

Compared to the control group, adding PCB2 significantly increased PBE rate (79.4% vs. 62.8%, P < 0.01) and MMP level (1.9 +/- 0.08 vs. 1.3 +/- 0.04, P < 0.01), and decreased ROS level (47.1 +/- 6.3 vs. 145.3 +/- 8.9, P < 0.01). However, there was no significant difference in ATP content and early apoptosis. Compared to the fresh group, vitrification significantly reduced oocytes viability (43.0% vs. 90.8%, P < 0.01) as well as PBE rate (24.2% vs. 60.6%, P < 0.05). However, 5 ug per mL PCB2-supplemention during maturation had no effect on survival, PBE or early apoptosis in vitrified oocytes.

CONCLUSION

PCB2 could effectively antagonise the oxidative stress during IVM and promote oocyte development. DOI: 10.54680/fr23210110412.

Reanalysis of ribosome profiling datasets reveals a function of rocaglamide A in perturbing the dynamics of translation elongation via eIF4A

The quickly accumulating ribosome profiling data is an insightful resource for studying the critical details of translation regulation under various biological contexts. Rocaglamide A (RocA), an antitumor heterotricyclic natural compound, has been shown to inhibit translation initiation of a large group of mRNA species by clamping eIF4A onto poly-purine motifs in the 5' UTRs. However, reanalysis of previous ribosome profiling datasets reveals an unexpected shift of the ribosome occupancy pattern, upon RocA treatment in various types of cells, during early translation elongation for a specific group of mRNA transcripts without poly-purine motifs over-represented in their 5' UTRs. Such perturbation of translation elongation dynamics can be attributed to the blockage of translating ribosomes due to the binding of eIF4A to the poly-purine sequence in coding regions. In summary, our study presents the complete dual modes of RocA in blocking translation initiation and elongation, which underlie the potent antitumor effect of RocA.

Knowledge mapping of targeted immunotherapy for myasthenia gravis from 1998 to 2022: A bibliometric analysis

Background

The treatment of myasthenia gravis (MG) has advanced from steroids and traditional immunosuppressants to targeted immunotherapy. Targeted immunotherapy has been successfully employed in clinical practice in recent years. This study aimed to explore the emerging trend of targeted immunotherapy in MG and summarize the knowledge structure through bibliometric methods.

Methods

The Web of Science Core Collection database (WoSCC) was chosen to retrieve the literature on targeted immunotherapy for MG. Two bibliometric analysis software, VOSviewer and CiteSpace, and bibliometric online platform were mainly used to evaluate the contributions from countries/regions, institutions, journals, and authors through the construction and visualization of bibliometric networks. By systematically reviewing a knowledge domain, future research developments were determined. The R version 4.1.2 and Microsoft Excel 365 were used for statistical analysis.

Results

A total of 562 original articles and 262 reviews relevant to MG targeted immunotherapy were included. The number of publications on targeted immunotherapy for MG exhibited a two-phase advancement. The first stage showed a steady growth trend from 1998 to 2016, with an annual number of no more than 35 publications. The second stage revealed an explosive growth trend from 2017, reaching a peak number of publications in 2020. The United States ranked first in the number of publications, citations, and h-index. The author with the highest citation and h-index was Vincent A. And 28.03% of the articles were published in the top 10 journals. In addition to “myasthenia gravis”, the keyword with the highest consideration was “rituximab”, followed by “double-blind”, which indicate research hotspots gradually from basic research to clinical research over time, especially in the field of targeted immunotherapy. The MG treatment has entered a personalized precision treatment phase. Exploration into new target molecules and conducting high-quality randomized controlled trials on existing biological agents are the further research direction.

Conclusion

The current study summarized the global research trends concerning targeted immunotherapy for MG. Research interests gradually advanced from basic research to clinical research. MG treatment has entered a personalized precision treatment phase. Further investigations into new target molecules and high-quality randomized controlled trials on existing biological agents are required urgently to direct future immunotherapy research.

Oxymatrine Alleviates Gentamicin-Induced Renal Injury in Rats

Gentamicin is an aminoglycoside antibiotic commonly used to treat Gram-negative bacterial infections that possesses considerable nephrotoxicity. Oxymatrine is a phytochemical with the ability to counter gentamicin toxicity. We investigated the effects and protective mechanism of oxymatrine in rats. The experimental groups were as follows: Control, Oxymatrine only group (100 mg/kg/d), Gentamicin only group (100 mg/kg/d), Gentamicin (100 mg/kg/d) plus Oxymatrine (100 mg/kg/d) group (n = 10). All rats were treated for seven continuous days. The results indicated that oxymatrine alleviated gentamicin-induced kidney injury, and decreased rats’ kidney indices and NAG (N-acetyl-beta-d-glucosaminidase), BUN (blood urea nitrogen) and CRE (creatine) serum levels. The oxymatrine-treated group sustained less histological damage. Oxymatrine also relived gentamicin-induced oxidative and nitrative stress, indicated by the increased SOD (superoxidase dismutase), GSH (glutathione) and CAT (catalase) activities and decreased MDA (malondialdehyde), iNOS (inducible nitric oxide synthase) and NO (nitric oxide) levels. Caspase-9 and -3 activities were also decreased in the oxymatrine-treated group. Oxymatrine exhibited a potent anti-inflammatory effect on gentamicin-induced kidney injury, down-regulated the Bcl-2ax and NF-κB mRNAs, and upregulated Bcl-2, HO-1 and Nrf2 mRNAs in the kidney tissue. Our investigation revealed the renal protective effect of oxymatrine in gentamicin-induced kidney injury for the first time. The effect was achieved through activation of the Nrf2/HO-1 pathways. The study underlines the potential clinical application of oxymatrine as a renal protectant agent for gentamicin therapy.

[Factors analysis of worsening renal function in patients with acute right ventricular myocardial infarction during hospitalization]

Objective: To analyze the related factors of worsening renal function (WRF) in patients with acute right ventricular myocardial infarction (RVMI) during hospitalization. Methods: A total of 98 patients with acute RVMI admitted to the emergency comprehensive ward of Beijing Anzhen Hospital from August 2011 to January 2020 were enrolled in this cross-sectional study. According to the situation of WRF, the patients were divided into non-WRF group (76 cases) and WRF group (22 cases). WRF was defined as ≥0.3 mg/dL increase in serum creatinine level from baseline on day 6 of hospitalization (if hospital stay<6 days, it was at discharge). Baseline data, intravenous fluid infusion, diuretic and significant positive balance of patients' intake and output volume [any 24 h intakes and outputs ≥1 000 ml or any consecutive 72 h intakes and outputs ≥2 000 ml within 6 d of hospitalization (if hospitalization<6 d, it was from admission to discharge)] were obtained, and the differences of above indicators between the two groups were analyzed. Multiple logistic regression model was used to analyze the related factors of WRF. Results: The ages of patients in WRF group and non-WRF group were 60 (50, 68) and 63 (52, 72) years, and the male proportions were 63.6% (14 cases) and 76.3% (58 cases), respectively, and there was no significant difference (all P>0.05). The proportion of positive balance was 31.8% (7 cases) in WRF group, which was higher than 14.5% (11 cases) in non-WRF group (P=0.034). The rate of loop diuretic use in WRF group was 4.5% (1 case), lower than that in non-WRF group 10.5% (8 cases) (P=0.027). After adjusting for age, sex, baseline estimated glomerular filtration rate (eGFR), preoperative isoproterenol/temporary pacemaker/atropine use, significant positive balance of intake and output volume, and loop diuretic use, it was found that eGFR≥60 ml·min^-1·1.73 m^-2 and significant positive balance were associated with WRF, the OR (95%CI) were 0.71 (0.62-0.86) and 1.21 (1.02-1.43) (both P<0.05); After eliminating the variable of significant positive balance in the above model, loop diuretic use was found to be a correlation factor for WRF, with an OR (95%CI) of 0.89 (0.72-0.97) (P<0.05). Conclusions: Significant positive balance of intake and output volume during hospitalization in patients with acute RVMI is a risk factor for WRF on day 6 or at discharge. In the presence of a significant positive balance, loop diuretic use is a protective factor for WRF.

[Clinical phenotype analysis of 6 cases of TTC21B gene related nephronophthisis]

Objective: To analyze the clinical characteristics of 6 children with TTC21B-related nephronophthisis to provide reference for early clinical diagnosis. Methods: The general condition, clinical manifestations, laboratory tests and other clinical data of 6 children from 4 families diagnosed with nephronophthisis by genetic testing in Shanghai Children's Hospital from January 2015 to December 2020 were analyzed retrospectively. Results: A total of 6 children (3 males and 3 females) developed proteinuria and progressive renal dysfunction in early infancy. The onset age of proteinuria was 18 (6, 25) months. The age at the onset of renal impairment was 22 (10, 36) months. All 6 children progressed to end-stage renal disease (ESRD) within 10 (4, 65) months of onset. Five children had hypertension, 3 children with abnormal liver function, 2 children with visceral translocation and 1 child with growth retardation. The genetic results suggested that all children carried variations TTC21B gene p.C518R. Conclusions: Children with TTC21B gene p.C518R nephronophthisis had proteinuria and progressed to ESRD at the early stage of life. These nephronophthisis patients commonly presented with liver and renal dysfunction.

Design of metalloenzyme mimics based on self-assembled peptides for organophosphorus pesticides detection

Organophosphorus pesticides (OPs) detection has attracted considerable attention because of the extensive application of OPs. In this research, non-toxic and high-performance metalloenzyme mimics of Zn²⁺-bonding peptides were developed by obtaining inspiration from phosphotriesterase (PTE) and nanofiber formation. Furthermore, based on the electrochemical activity of p-nitrophenol (PNP), the electrochemical sensor of metalloenzyme mimics was developed. By examining the effect of the active sites of peptides and fibril formation on the degradation of OPs, the optimal metalloenzyme mimic was selected. Furthermore, optimal metalloenzyme mimics were combined with NiCo₂O₄ to develop an electrochemical sensor of OPs. By monitoring square wave voltammetry (SWV) signals of PNP degraded from OPs, the amounts of OPs in actual samples could be determined in 15 min. We discovered that both the active sites of α metal and β metal were required for metalloenzyme mimics; Zn²⁺ promoted peptide fibrosis and especially acted as a cofactor for degrading OPs. Compared to traditional methods, the electrochemical sensor of metalloenzyme mimics was sensitive, reliable, and non-toxic; furthermore, the detection limit of methyl paraoxon was as low as 0.08 µM. The metalloenzyme mimics will be a promising material for detecting OPs in the food industry and environment fields.

Glycosides and Their Corresponding Small Molecules Inhibit Aggregation and Alleviate Cytotoxicity of Aβ40

Polyphenols are the class of naturally synthesized compounds in the secondary metabolism of plants, which are widely distributed in fruits and vegetables. Their potential health treatment strategies have attracted wide attention in the scientific community. The abnormal aggregation of Aβ to form mature fibrils is pathologically related to Alzheimer's disease (AD). Therefore, inhibiting Aβ40 fibrillogenesis was considered to be the major method for the intervention and therapy of AD. Glycosides, as a cluster of natural phenolic compounds, are widely distributed in Chinese herbs, fruits, and vegetables. The inhibitory effect of glycosides (phloridzin, salidroside, polydatin, geniposide, and gastrodin) and their corresponding small molecules (phloretin, 4-hydroxyphenyl ethanol, resveratrol, genipin, and 4-hydroxybenzyl alcohol) on Aβ40 aggregation and fibrils prolongation, disaggregation against mature fibrils, and the resulting cytotoxicity were studied by systematical biochemical, cell biology and molecular docking techniques, respectively. As a result, all inhibitors were observed against Aβ40 aggregation and fibrils prolongation and disaggregated mature Aβ40 fibrils in a dose-dependent manner. Besides, the cell validity experiments also showed that all inhibitors could effectively alleviate the cytotoxicity induced by Aβ40 aggregates, and the glycoside groups played important roles in this inhibiting process. Finally, molecular docking was performed to study the interactions between these inhibitors and Aβ40. Docking showed that all inhibitors were bound to the similar region of Aβ40, and glycoside group formed hydrogen bonds with the pivotal residues Lys16. These results indicated that the glycoside groups could increase the inhibitory effects and reduce cytotoxicity. Glycosides have tremendous potential to be developed as an innovative type of aggregation inhibitor to control and treat neurodegenerative diseases.

[Application of bionics in spinal surgery]

Spinal bionic therapy is the application of bionics concept, by imitating the natural anatomical structure and physiological function of the spine, to treat spinal diseases using various modern technology, materials and equipment .How to repair or preserve the anatomical structure and function of spine to the maximum extent while treating spinal diseases is an important content of spinal bionic therapy.Firstly, the use of movable spinal implants not only preserves the spinal mobility function to a certain extent, reduces the degeneration of adjacent segments, but also reduces the incidence of internal fixation fracture and improves the long-term efficacy.Secondly, with the help of the development of three dimensional printing technology, personalized artificial prostheses can be made to fill the spinal structure with complex defects, and biological scaffolds and functional prostheses with anti-tumor drugs can not only realize the biomimetic and functional spine anatomy, but also become a multiplier of the efficacy of anti-tumor drugs.Thirdly, in the design and manufacture of spinal orthopaedic braces, computer aided design and manufacturing technology can make spinal orthopaedic braces more comfortable with better orthopaedic effect and ergonomic characteristics.How to apply bionics concepts and relate technologies to spinal surgery have not been determined yet, and no relevant diagnosis and treatment guidelines have been formulated.It is foreseeable that with the continuous development of medical technology, the content of spinal bionic therapy will be gradually enriched and improved, and become a powerful measure to overcome difficulties in the diagnosis and treatment of spinal surgery diseases.

BiTE secretion from in situ-programmed myeloid cells results in tumor-retained pharmacology

Bispecific T-Cell Engagers (BiTEs) are effective at inducing remission in hematologic cancers, but their use in solid tumors has been challenging due to their extreme potency and on-target, off-tumor toxicities in healthy tissue. Their deployment against solid tumors is further complicated by insufficient drug penetration, a hostile tumor microenvironment, and immune escape. To address these challenges, we developed targeted nanocarriers that can deliver in vitro-transcribed mRNA encoding BiTEs to host myeloid cells – a cell type that is actively recruited into the tumor microenvironment. We demonstrate in an immunocompetent mouse model of ovarian cancer, that infusion of these nanoparticles directs BiTE expression to tumor sites, which reshapes the microenvironment from suppressive to permissive and triggers disease regression without systemic toxicity. In contrast, conventional injections of recombinant BiTE protein at doses required to achieve anti-tumor activity, induced systemic inflammatory responses and severe tissue damage in all treated animals. Implemented in the clinic, this in situ gene therapy could enable physicians – with a single therapeutic – to safely target tumor antigen that would otherwise not be druggable due to the risks of on-target toxicity and, at the same time, reset the tumor milieu to boost key mediators of antitumor immune responses.

[Analysis of the factors influencing the elimination strategies with the current status of diagnosis and treatment of hepatitis C in hospital]

Objective: To understand the current status of screening, diagnosis, and treatment and analyze the factors influencing micro-elimination strategy, so as to achieve hepatitis C elimination in hospital. Methods: Anti-HCV and HCV RNA test results of patients from October 2017 to September 2020 were retrospectively analyzed. Anti-HCV positive rates and factors influencing different genders, ages, places of residence and departments were analyzed. After comparing anti-HCV-positive patients with HCV RNA-positive patients with duplicate entries in "Name" and "Date of birth", the data were divided into three categories: anti-HCV positive without HCV RNA test, HCV RNA positive in single test, and HCV RNA positive many times in multiple tests. The above three types of patients were followed-up by telephone. According to the hospital follow-up results, current status of diagnosis and treatment and the factors influencing the micro-elimination strategy of hepatitis C were studied and analyzed. The comparison of data between groups were performed using χ(2) or χ(2) continuity-correction test. Results: Anti-HCV positive detection rate was 1.34% (899/66 866). The positive rate of male patients aged 40 and over residing in cities was significantly higher than female patients under 40 years old residing in rural areas, and the difference was statistically significant (χ(2) = 55.178, 264.11, 36, 351, P < 0.05). There were 90 (10.02%) and 809 cases (89.98%) in outpatient and inpatient departments, respectively, with no statistically significant difference between the two (χ(2) = 0.002, P > 0.05). The total number of anti-HCV positive cases were 196 in Gastroenterology (22.0%), 75 in Respiratory and Critical Care Medicine (8.3%), 74 in Neurology (8.2%), 63 in Orthopedics (7.0%) and 55 in Endocrinology departments (6.1%), and the difference in the positive rate among different departments were also statistically significant (χ(2) = 271.585, P < 0.05). Among the 480 cases who were followed-up, 215 (44.79%) were lost to follow-up, 84 cases (39.07%) were unregistered, 77 cases (16.04%) were untreated, 15 cases (19.48%) were unaware of their state of illness, 46 cases (59.74%) were diagnosed without concern, 16 cases (20.78%) were diagnosed but did not take medicine, 60 cases were under treatment, and 29 cases were mostly on counterfeit drugs (48.33%). Conclusion: Comprehensive diagnosis and treatment education to non-specialist clinicians and timely manner regular follow-up of patients is a key factor and an important link to formulate a simple, easy and sustainable model to improve the efficiency of screening, diagnosis, and treatment of hepatitis C micro-elimination strategy in hospital. In addition, it will also play an important role in achieving the strategic goal of "eliminating hepatitis C as a public health threat by 2030".

Genetic in situ engineering of myeloid regulatory cells controls inflammation in autoimmunity

The ability of myeloid regulatory cells (MRCs) to control immune responses and to promote tolerance has prompted enormous interest in exploiting them therapeutically to treat inflammation, autoimmunity, or to improve outcomes in transplantation. While immunomodulatory small-molecule compounds and antibodies have provided relief for some patients, the dosing entails high systemic drug exposures and thus increased risk of off-target adverse effects. More recently, MRC-based cell-therapy products have entered clinical testing for tolerance induction. However, the elaborate and expensive protocols currently required to manufacture engineered MRCs ex vivo put this approach beyond the reach of many patients who might benefit. A solution could be to directly program MRCs in vivo. Here we describe a targeted nanocarrier that delivers in vitro-transcribed mRNA encoding a key anti-inflammatory mediator. We demonstrate in models of systemic lupus erythematosus that infusions of nanoparticles formulated with mRNA encoding glucocorticoid-induced leucine zipper (GILZ) effectively control the disease. We further establish that these nanoreagents are safe for repeated dosing. Implemented in the clinic, this new therapy could enable physicians to treat autoimmune disease while avoiding systemic treatments that disrupt immune homeostasis.

The correlated effects of polyetheramine-functionalized graphene oxide loading on the curing reaction and the mechanical properties of epoxy composites

In this study, the effects of polyetheramine (D230) functionalized graphene oxide loading on the curing reaction, thermal and mechanical properties of epoxy composites were studied and the correlation between structure and property of epoxy composite was established. In the functionalization of graphene oxide (GO), the effect of the mass ratio of D230 to GO on chemical properties of the functionalized GO was investigated. Results showed that D230 were successfully covalently grafted onto surface of two-dimensional functionalized GO sheet. The functionalized GO sheets prepared under optimal condition of D230/GO ratio of 1:1 dispersed evenly in epoxy composites, indicating the possibility of the epoxy composite fabrication by the solvent-free technique. The analysis of qualitative Cure Index suggested that epoxy composites were subjected to excellent curing. The quantitative evaluation of curing kinetics demonstrated that the functionalized GO exhibited a chemical facilitation on the curing reaction. However, the functionalized GO simultaneously physically restricted the curing reactivity, especially at high loading. These contributed to the improved interfacial properties and high toughness of the epoxy composites. Compared to neat epoxy, the epoxy composites showed effective tensile strength improvement of ∼10.0% (77.0 MPa), tensile modulus enhancement of ∼7.7% (3.34 GPa), flexural modulus increment of ∼12.1% (3.43 GPa), and flexural strength increment of ∼10.6% (124.3 MPa). This study demonstrated an effective and environment-friendly strategy to design GO reinforced epoxy composites with favorable dispersion and interfacial bonding, and it further clarified the relationship between the crosslinking network/interfacial structure and the mechanical properties of epoxy composites.

Enzyme mimics based membrane reactor for di(2-ethylhexyl) phthalate degradation

Di(2-ethylhexyl) phthalate (DEHP), the most abundantly used plasticizer, was considered to be a hazardous chemical that was difficult to be degraded naturally. In this study, inspired by the "catalytic triad'' in serine proteases, an enzyme mimic material was developed by combining the proteases's active sites of serine, histidine and aspartate (S-H-D) with the self-assembling sequence of LKLKLKL and the aromatic group of fluorenylmethyloxycarbonyl (Fmoc). By mixing the monomer of peptides containing separate S, H and D residues with a ratio of 2:1:1, the enzyme mimics were found to co- assemble into nanofibers (Co-HSD) and showed the highest activity towards DEHP degradation because of the synergistic effects of active sites, orderly secondary structure and stable molecular conformation. To further improve ability and applicability, the high active mimetic enzyme was immobilized onto regenerated cellulose (RC) membranes for DEHP degradation in a continuous recycling mode. The RC membranes were first functionalized by the NaIO₄ oxidation method to form aldehyde groups and then conjugated with the enzyme mimics via Schiff-base reaction. As a biocatalytic membrane, this membrane could not only effectively degrade DEHP, but also showed good stability, thus establishing a promising biomaterial for large scale biodegradation of DEHP in water decontamination and liquid food depollution.

Digital PCR is a sensitive new technique for SARS-CoV-2 detection in clinical applications

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Digital PCR is a sensitive new technique for SARS-CoV-2 detection in clinical applications.

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Digital PCR would substantially reduce the rates of false-negative COVID-19 test results, in particular those pertaining to asymptomatic carriers.

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Real-time reverse-transcriptase (RT)-PCR is a fast and convenient method for viral nucleic acid detection, but it’s results can be compromised by numerous factors and can yield false-negative results.

The global coronavirus disease 2019 (COVID-19) pandemic has posed great challenges in people’s daily lives. Highly sensitive laboratory techniques played a critical role in clinical COVID-19 diagnosis and management. In this study the feasibility of using a new digital PCR-based detection assay for clinical COVID-19 diagnosis was investigated by comparing its performance with that of RT-PCR. Clinical patient samples and samples obtained from potentially contaminated environments were analyzed. The study included 10 patients with confirmed COVID-19 diagnoses, 32 validated samples of various types derived from different clinical timepoints and sites, and 148 environmentally derived samples. SARS-CoV-2 nucleic acids were more readily detected in respiratory tract samples (35.0%). In analyses of environmentally derived samples, the positivity rate of air samples was higher than that of surface samples, probably due to differences in virus concentrations. Digital PCR detected SARS–CoV–2 in several samples that had previously been deemed negative, including 3 patient-derived samples and 5 environmentally derived samples. In this study digital PCR exhibited higher sensitivity than conventional RT-PCR, suggesting that it may be a useful new method for clinical SARS-CoV-2 detection. Improvement of SARS-CoV-2 detection would substantially reduce the rates of false-negative COVID-19 test results, in particular those pertaining to asymptomatic carriers.

Transfemoral-venous transcatheter access to left ventricle through the created communication of inter-ventricular septum with the assistance of arterio-venous circuit

Background

During transcatheter aortic/mitral valve replacement (TA/MVR), current available routes are limited due to unfavorable entry-angle, vessel-anatomy or mini-thoracotomy. Through created communication of inter-ventricular septum (C-IVS), transfemoral venous transcatheter access to left ventricle becomes feasible with the assistance of arterio-venous circuit.

Purpose

The study was conducted to investigate the feasibility and safety of transfemoral-venous transcatheter access to left ventricle through the created C-IVS in a swine model.

Methods

Via femoral artery, transcatheter puncture of mid-IVS was performed with the custom-made nickel-titanium needle (0.038-inch, needle-tip bent 60 degrees automatically associated with increased hardness when temperature was above 30°C) and 6F-sheath in 20 healthy Chinese mini-swine. Then femoral arterio-venous circuit was established through created C-IVS with hydrophilic guidewire in all swine, and femoral veno-venous circuit was further created through C-IVS and atrial septum in 4 swine. After pre-dilation of C-IVS, a 20F-sheath was introduced into left ventricle transvenously over the guidewire. Furthermore, transfemoral-venous TAVR was attempted with this approach in one swine. C-IVS was evaluated postoperatively and was further confirmed pathologically 2 months later.

Results

All transcatheter puncture of IVS was performed successfully in left ventricle and the thickness of mid-IVS was 7.67±0.98 mm. During the puncture, ventricular fibrillation occurred in one swine (successfully defibrillation) and only isolated ventricular premature beats/non-sustained ventricular tachycardia were observed in other swine. In all swine, femoral arterio-venous/veno-venous circuit was established via C-IVS, and the 20F-sheath was introduced into left ventricle safely through femoral vein and C-IVS. With the aid of vessel circuit, the 20F-sheath was further advanced into aorta in 16 swine (the entry-angle was 145.3±12.2 degrees) and into left atrium in 4 swine. After the procedure, there was one swine with moderate tricuspid regurgitation and 5 swine with mild residual shunt (2.6±0.7 mm). In addition, epicardial coronary arteries were normal in all swine. Two months later, residual shunt was still detected in 3 swine and the communication was confirmed pathologically. In other swine, there was no defect of IVS and mild replacement-scar was identified along C-IVS. In the swine underwent transfemoral-venous TAVR, prosthetic valve was deployed successfully with good function.

Conclusions

With the aid of vessel circuit, transfemoral-venous transcatheter access to left ventricle is feasible and safe via C-IVS, and transfemoral-venous TAVR was achieved successfully using this novel approach with favorable entry-angle.

Figure 1

Funding Acknowledgement

Type of funding source: Other. Main funding source(s): National Natural Science Foundation of China

Fluorescent methylammonium lead halide perovskite quantum dots as a sensing material for the detection of polar organochlorine pesticide residues

Methylammonium lead halide perovskite quantum dots (MAPB-QDs) have been widely used for photovoltaic devices due to their special electronic structures. In this work, MAPB-QDs were used for the first time to detect polar organochlorine pesticides (OCPs) based on the phenomenon that the fluorescence spectra of MAPB-QDs were blue-shifted in the presence of polar OCPs. Furthermore, ¹H NMR, FTIR, XPS and XRD were performed first to illustrate the sensing mechanism. In the presence of polar OCPs, the MAPB-QDs' capping ligands, oleic acid (OA) and oleylamine (OAm), were replaced with OCPs and then the chlorine element was adequately doped into QDs, resulting in the increase of the MAPB-QDs' bandgap. As result of the insufficient stability of MAPB-QDs in the presence of moisture, MAPB-QDs were mixed with PDMS and used as the colorimetric cards for fast detection of OCPs in real samples.

The Lateral Hypothalamic and BNST GABAergic Projections to the Anterior Ventrolateral Periaqueductal Gray Regulate Feeding

Overeating is a serious issue in modern society, causing many health problems, including obesity. Although the hypothalamus has been previously identified as the key brain structure that regulates body weight homeostasis, the downstream pathways and non-canonical neural circuitry involved in feeding behavior remain largely uncharacterized. Here, we discover that suppressing the activity of GABAergic cells in the anterior ventrolateral periaqueductal gray (vlPAG), whether directly or through long-projection GABAergic inputs from either the bed nucleus of the stria terminalis (BNST) or the lateral hypothalamus (LH), is sufficient to promptly induce feeding behavior in well-fed mice. In contrast, optogenetic activation of these cells interrupts food intake in starved mice. Long-term chemogenetic manipulation of vlPAG GABAergic cell activity elicits a corresponding change in mouse body weight. Our studies reveal distinct midbrain GABAergic pathways and highlight an important role of GABAergic cells in the anterior vlPAG in feeding behavior.

Hydroxycinnamic Acid from Corncob and Its Structural Analogues Inhibit Aβ40 Fibrillation and Attenuate Aβ40-Induced Cytotoxicity

The aggregation of amyloid-β protein (Aβ) is deemed a vital pathological feature of Alzheimer's disease (AD). Hence, inhibiting Aβ aggregation is noticed as a major tactic for the prevention and therapy of AD. Hydroxycinnamic acid, as a natural phenolic compound, is widely present in plant foods and has several biological activities including anti-inflammation, antioxidation, and neuroprotective effects. Here, it was found that hydroxycinnamic acid and its structural analogues (3-hydroxycinnamic acid, 2-hydroxycinnamic acid, cinnamic acid, 3,4-dihydroxycinnamic acid, 2,4-dihydroxycinnamic acid, and 3,4,5-trihydroxycinnamic acid) could inhibit Aβ40 fibrillogenesis and reduce Aβ40-induced cytotoxicity in a dose-dependent manner. Among these small molecules investigated, 3,4,5-trihydroxycinnamic acid is considered to be the most effective inhibitor, which reduces the ThT fluorescence intensity to 30.79% and increases cell viability from 49.47 to 84.78% at 200 μM. Also, the results with Caenorhabditis elegans verified that these small molecules can ameliorate AD-like symptoms of worm paralysis. Moreover, molecular docking studies showed that these small molecules interact with the Aβ40 mainly via hydrogen bonding. These results suggest that hydroxycinnamic acid and its structural analogues could inhibit Aβ40 fibrillogenesis and the inhibition activity is enhanced with the increase of phenolic hydroxyl groups of inhibitors. These small molecules have huge potential to be developed into novel aggregation inhibitors in neurodegenerative disorders.

Covalent polymer functionalized graphene oxide/poly(ether ether ketone) composites for fused deposition modeling: improved mechanical and tribological performance

This paper presents a novel method using poly(aryl ether ketone) containing pendant carboxyl groups to covalently functionalize graphene oxide. The functionalized graphene oxide (LFG) was used to prepare poly(ether ether ketone) (PEEK) composites through melt blending. It is found that LFG has great interface adhesion to the PEEK matrix, and just a small amount of it can simultaneously improve the strength and toughness of the composites, while unmodified graphene oxide could enhance strength but cause toughness damage. The tensile and impact strength of composite with 0.1 wt% LFG are 5.7% and 20.5% higher than that of neat PEEK, respectively. In addition, 0.5 wt% LFG composite shows great friction and wear performance with friction coefficient and specific wear rate 27.3% and 18.3% lower than that of PEEK. Furthermore, the composites can be used as practical high-performance additive manufacturing materials because LFG is able to improve the mechanical performance of the fused deposition modeling (FDM) composite samples significantly.

A polymer “bridge” was designed to connect graphene oxide and poly(ether ether ketone), making stronger and tougher composites.

OP0095 A DECISION MODEL OF LABIAL GLAND BIOPSY BASED ON B-MODE ULTRASONOGRAPHY WITH SHEAR-WAVE ELASTOGRAPHY IN PATIENTS WITH SUSPECTED SJÖGREN’S SYNDROME

Background:

Focal lymphocytic sialadenitis defined as focus score (FS) ≥1 on labial gland (LG) biopsy plays an integral role in various classification criteria of Sjögren’s syndrome (SS). However, suspected patients often hesitate to receive a biopsy; and rheumatologists hope a decision for biopsy based on a high predicted incidence of FS≥1, or against biopsy based on an absolutely low predicted incidence.

Objectives:

To build a decision model of LG biopsy based on B-mode ultrasonography (US) with shear-wave elastography (SWE) in patients with suspected SS.

Methods:

Patients who had at least one symptom of oral dryness (based on AECG questions) or had anti-SSA positive were recruited and signed a written informed consent. Bilateral parotid (PG) and submandibular glands (SMG) were examined with B-mode US which graded the echostructure of each gland on a scoring system scaled 0 to 4 (US score), and SWE which described the elasticity of glands. Then LG biopsy was performed.

Results:

(1)Ninety-one patients whose mean age was 43±15 years were enrolled and 93% of them were female. Anti-SSA was detected in 77 patients (85%) and 28 patients (31%) showed unstimulated whole saliva flow rate (USFR)≤0.1mL/mim. There were 57 patients (63%) showing FS≥1 on LG biopsy. Sixty-three patients (69%) were classified as primary SS, 10 patients (10%) were secondary SS, 18 patients (20%) were uCTD and one patient was RA without SS.

(2)US scores were equal between PG and SMG in 59 patients (65%), while the rest patients showed different US scores between two glands: 7 patients (8%) showed higher US scores in PG and 25 patients (27%) showed higher scores in SMG. In each pair of glands US scores were equal. SWE values in PG or SMG of US score 1, 2 or 3 were significantly higher than those of US score 0, while SWE values in glands of US score 4 became declined and showed no significant difference from those with US score 0 (Figure 1A).

(3)Heatmap showed US scores in either major salivary gland of patients with FS≥1 on LG biopsy were significantly higher than those with FS<1 (all p<0.001, Figure 1B). ROC curve showed a total US score (including bilateral PG and SMG) ≥9 and a total SWE value (including bilateral PG and SMG)≥30 could significantly recognize patients with FS≥1, respectively with specificity of 100% and 93% (Figure 1C). In this cohort, among 51 patients with a total US score ≥9 and/or a total SWE value≥30, 49 patients (96%) showed FS≥1 on LG biopsy; while two outliers showed total US scores were both 8 although combined SWE values≥30. Other 29 patients showed total US scores≤6 with total SWE values <30 and only one patient (3%) showed FS≥1 on LG biopsy. The remaining 11 patients showed total US scores were 8 with total SWE values <30 and 64% of them (n=7) showed FS≥1.

Conclusion:

A preliminary decision model of LG biopsy based on B-mode US with SWE in patients with suspected SS were built in Table 1. For example, rheumatologists should reassess the need for biopsy if the incidence of FS≥1 would be <5%. Another cohort of patients with suspected SS is needed for further validation.

Table 1.

A preliminary decision model of LG biopsy based on B-mode US with SWE in patients with suspected SS

Algorithm*Comments on the decision of LG biopsyA total US score≥9 and/or a total SWE≥30The specificity of FS≥1 on biopsy is >93%. Biopsy is recommended. In some special cases (e.g. contraindicated to biopsy), this item is a potential alternative to LG biopsy.A total US score 7~8 with a total SWE <30It is hard to predict the result of FS, so biopsy is strongly recommended.A total US score≤6 with a total SWE <30The incidence of FS≥1 would be <5%. Rheumatologists should reassess the need for biopsy.

References:

None

Disclosure of Interests:

None declared

Core Fucosylation of Intestinal Epithelial Cells Protects Against Salmonella Typhi Infection via Up-Regulating the Biological Antagonism of Intestinal Microbiota

The fucosylated carbohydrate moieties on intestinal epithelial cells (IECs) are involved in the creation of an environmental niche for commensal and pathogenic bacteria. Core fucosylation catalyzed by fucosyltransferase 8 (Fut8) is the major fucosylation pattern on the N-glycans of the surface glycoproteins on IECs, however, the role of IECs core fucosylation during infection remains unclear. This study was conducted to investigate the interaction between IECs core fucosylation and gut microbiota, and the effects of this interaction on protecting Salmonella enterica subsp. enterica serovar Typhi (S. Typhi) infection. Firstly, the Fut8^+/+ and Fut8^+/– mice were infected with S. Typhi. The level of IECs core fucosylation and protein expression of intestinal mucosa were then detected by LCA blot and Western blot, respectively. The gut microbiota of Fut8^+/+ and Fut8^+/– mice before and after S. Typhi infection was assessed by 16S rRNA sequencing. Our results showed that core fucosylation was ubiquitous expressed on the intestinal mucosa of mice and had significant effects on their gut microbiota. Fut8^+/– mice was more susceptive to S. Typhi infection than Fut8^+/+ mice. Interestingly, infection of S. Typhi upregulated the core fucosylation level of IECs and increased the abundances of beneficial microorganisms such as Lactobacillus and Akkermansia spp. Further in vitro and in vivo studies demonstrated that Wnt/β-catenin signaling pathway mediated the elevation of IECs core fucosylation level upon infection of S. Typhi. Taken together, our data in this study revealed that the IECs core fucosylation plays an important role in protecting against S. Typhi infection via up-regulating the biological antagonism of intestinal microbiota.

HPV genotypic spectrum in Jilin province, China, where non-vaccine-covered HPV53 and 51 are prevalent, exhibits a bimodal age-specific pattern

Background

Human papillomavirus (HPV), the most common sexually transmitted disease, is involved in a series of other diseases. The persistent infection of high-risk HPVs (HR-HPVs) is considered to be the causative agent of cervical cancer, and it is related to noncervical cancers. The present study aims to estimate the HPV prevalence and genotype distribution in Jilin province, China, to guide HPV-related cervical cancer screening and HPV vaccination.

Methods

From October 2017 to September 2019, 21,282 samples (634 male and 20,648 female) were collected for HPV infection detection using an HPV genotyping panel. The age-related HPV prevalence and morbidity of HPV-based disease and HPV prevalence associated with specific diseases were analyzed.

Results

A total of 7095 (34.4%) positive for HPV infection of 20648 women, and 164 (25.8%) positive of 634 men. The HPV prevalence among women exhibited a bimodal pattern, with a peak in young group and a second peak in old group, with increased severity of cervical lesions. HPV16 (7.8%), HPV52 (5.8%), HPV58 (5.0%), HPV53 (3.4%), and HPV51 (3.0%) were the most prevalent genotypes among women, and HPV6 (6.0%), HPV11 (5.7%), HPV16 (3.6%), HPV18 (2.7%), and HPV51 (3.0%) were prevalent among men. Non-vaccine-covered HPV53 and 51 were found in 6.3% of HPV infection and 8.9% of cervical cancer in Jilin province. Furthermore, 45.5% of females and 28.6% of males with genital warts were infected with HR-HPV genotypes.

Conclusion

The HPV genotypic spectrum in Jilin province, where non-vaccine-covered HPV53 and 51 were prevalent, exhibited an age- and cervical lesion-specific pattern, which provides guidance for HPV vaccination and cervical cancer screening. HPV infection in men and benign hyper-proliferative lesions should not be neglected.

Enzyme mimics based on self-assembled peptides for di(2-ethylhexyl)phthalate degradation

Enzyme mimics inspired by serine proteases are developed through self-assembled peptides to degrade di(2-ethylhexyl)phthalate (DEHP).

CLVFFA-Functionalized Gold Nanoclusters Inhibit Aβ40 Fibrillation, Fibrils' Prolongation, and Mature Fibrils' Disaggregation

The abnormal aggregation of amyloid beta (Aβ or A beta) from monomeric proteins into amyloid fibrils is an important pathological contact to Alzheimer's disease (AD). Amyloid beta 40 (Aβ40), the pivotal biomarker of AD, aggregates to form amyloid plaques. For this reason, inhibition of amyloid fibrillation had become a crucial prevention and therapeutic strategy. Usually, LVFFA is the central hydrophobic fragment of Aβ and can inhibit the aggregation of Aβ40. In this work, in order to improve the inhibitory ability of LVFFA, hexapeptide CLVFFA were conjugated at the surface of Au clusters (AuNCs) to manufacture a nanosized inhibitor, AuNCs-CLVFFA. Thioflavin T fluorescence and transmission electron microscope results showed that AuNCs-CLVFFA inhibited Aβ40 fibrillogenesis, fibrils' prolongation, and mature fibrils' disaggregation. Furthermore, AuNCs as the backbone of the inhibitor showed extraordinary inhibition ability for Aβ40 aggregation at a low AuNCs-CLVFFA concentration. Free hexapeptide CLVFFA, at the same concentration, showed almost no inhibition. Additionally, the inhibitor could maintain the optical properties of nanoclusters, and the cell viability demonstrated that the inhibitor had good biocompatibility and may potentially be applied into AD therapy or treatment.

Brain-wide Mapping of Mono-synaptic Afferents to Different Cell Types in the Laterodorsal Tegmentum

The laterodorsal tegmentum (LDT) is a brain structure involved in distinct behaviors including arousal, reward, and innate fear. How environmental stimuli and top-down control from high-order sensory and limbic cortical areas converge and coordinate in this region to modulate diverse behavioral outputs remains unclear. Using a modified rabies virus, we applied monosynaptic retrograde tracing to the whole brain to examine the LDT cell type specific upstream nuclei. The LDT received very strong midbrain and hindbrain afferents and moderate cortical and hypothalamic innervation but weak connections to the thalamus. The main projection neurons from cortical areas were restricted to the limbic lobe, including the ventral orbital cortex (VO), prelimbic, and cingulate cortices. Although different cell populations received qualitatively similar inputs, primarily via afferents from the periaqueductal gray area, superior colliculus, and the LDT itself, parvalbumin-positive (PV⁺) GABAergic cells received preferential projections from local LDT neurons. With regard to the different subtypes of GABAergic cells, a considerable number of nuclei, including those of the ventral tegmental area, central amygdaloid nucleus, and VO, made significantly greater inputs to somatostatin-positive cells than to PV⁺ cells. Diverse inputs to the LDT on a system-wide level were revealed.

[The role and mechanism of 2-deoxyglucose in reversing osimertinib-acquired resistance of non-small cell lung cancer cell line]

Objective: To explore the role and mechanism of 2-deoxyglucose (2-dg) in reversing osimertinib- acquired resistance of non-small cell lung cancer(NSCLC)cell line. Methods: The NSCLC line H1975 (purchased from the American Type Culture Collection) was conducted by induction method in vitro to construct the osimertinib-resistance NSCLC cell line H1975-OR. The osimertinib-resistance of H1975-OR cell line was examined by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, colony-formation assay, Ki67 incorporation assay and the expression of apoptosis-related protein. The glycolysis level was assayed by the lactic acid production measured in the culture medium supernatant of H1975 and H1975-OR. The expression of glycolysis key enzymes (HK2, GLUT1, P-PKM2) and apoptosis-related protein (BIM, Bcl-2) were detected by Western blot. The cells were divided into control group, 2-deoxyglucose (4 mmol/L) monotherapy group, osimertinib (3 μmol/L) monotherapy group and 2-deoxyglucose (4 mmol/L)+ osimertinib (3 μmol/L) combination therapy group, then the apoptosis rate of cells was measured by flow cytometry to evaluate the pro-apoptotic ability of drugs. Date were analyzed by Independent-Samples t-test using SPSS 16.0 statistical software. Results: The glycolysis level of osimertinib-sensitive cell line H1975 was lower than that of osimertinib-resistance cell line H1975-OR [the yield of lactic acid, respectively, was (21.0±0.9) and (26.5±2.8) mmol·L(-1)·10(4)cells(-1), P<0.05]. The osimertinib- acquired resistance of H1975-OR could be reversed by 4 mmol/L 2-deoxyglucose(the IC(50) value of osimertinib in H1975-OR cell line decreased from (7.0±1.9) μmol/L to (1.4±0.1) μmol/L, which was close to the IC(50) value of osimertinib in H1975 cell line (1.0±0.2) μmol/L. The apoptosis rate of H1975-OR was significantly higher in 2-deoxyglucose + osimertinib combination therapy group (26.7±2.4)%, compared to control group (5.1±0.7)%, 2-deoxyglucose monotherapy group (6.1±2.5)% and osimertinib monotherapy group (11.4±2.7)%(all P<0.05). The expression of pro-apoptotic protein BIM in H1975-OR was significantly higher in 2-deoxyglucose+ osimertinib combination therapy group (177.8±28.1)% and the expression of anti-apoptotic protein Bcl-2 in H1975-OR was significantly lower in 2-deoxyglucose+ osimertinib combination therapy group (24.6±5.2)%, compared to control group (100±0)%, all P<0.05. Conclusion: 2-deoxyglucose can reverse the acquired resistance of NSCLC cell line to osimertinib, which may be related to the inhibition of cell glycolysis and the induction of apoptosis.

Abstract P4-08-14: Invasive micropapillary carcinoma had no difference in prognosis compared with invasive ductal carcinoma: A propensity-matched analysis

Background: Invasive micropapillary carcinoma (IMPC) is a rare histopathological variant of breast carcinoma and usually performs poor clinical characteristics, such as high tendency of lymph nodes metastases. But whether it has worse prognosis than invasive ductal carcinoma (IDC) is still controversial nowadays. We conducted this retrospective study to figure out the prognostic difference between IMPC and IDC, then guide therapy of IMPC ultimately.

Methods: In this study, we analyzed 327 cases of IMPC patients and 4979 cases of IDC who underwent primary resection in our institution during 2008 to 2012. By using propensity score matching, two groups were matched at a ratio of 1:1 by age, tumor size, nodal status, hormone and HER2 status to demonstrate the difference of prognosis assessed by Kaplan-Meier estimates and Cox regression analysis.

Result: After a mean follow-up of 52 months, we established the IMPC group and figured out 324 IDC patients from the control group by propensity score matching (3 IMPC patients were canceled because of data missing). The result of survival analysis indicated that women diagnosed with IMPC had no significant reduced overall survival (OS) (p = 0.752) and disease-free survival (DFS) (p = 0.578) compared with women with IDC. Multivariate Cox regression analysis revealed that IMPC was not found as an independent prognostic factor for DFS (hazard ratio [HR] = 0.858; 95% confidential interval [CI], 0.419-1.757) or OS (HR = 0.720; 95%CI, 0.353-1.469).

Conclusion: The consequence of survival analysis manifested that there was no statistically significant difference between 2 groups, and elucidated proactive or radical clinical therapy was unnecessary.

Citation Format: Hao S, Zhao Y-Y, Peng J-J, Yang W-T, Ren F, Yu K-D, Shao Z-M. Invasive micropapillary carcinoma had no difference in prognosis compared with invasive ductal carcinoma: A propensity-matched analysis [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 P4-08-14.

Asymmetric bismaleimide-based high-performance resins with improved processability and high Tg over 400 °C

Asymmetric 2-(4′-maleimido)phenyl-2-(4′-maleimidophenoxyl)phenylbutane (EBA-BMI) was successfully mixed with N, N′-(4,4′-diphenylmethane)bismaleimide (DDM-BMI) to prepare the matrix resins for high-temperature fiber-reinforced polymeric composites (glass transition temperature ( Tg) > 400°C). Experimental results imply that DDM-BMI/EBA-BMI (DE-BMIs) show excellent melting performance with wide processing temperature window and low molten viscosity, suggesting excellent compatibility between DDM-BMI and EBA-BMI. For example, the viscosity of DE-BMI41 (DDM-BMI/EBA-BMI, 4/1) is about 474–51 mPa·s in the temperature range of 148–180 °C. In addition, cured DE-BMIs represent remarkable thermal properties with Tg over 400°C, under which the storage modulus could still reach as high as 3.2 GPa. Meanwhile, the coefficient of thermal expansion of these cured resins is about 36–40 ppm °C−1 at 50–250°C, and the 5% weight loss temperature is about 470°C.

Degradation of phthalic acid esters (PAEs) by an enzyme mimic and its application in the degradation of intracellular DEHP

An enzyme mimic inspired by serine proteases was developed for the degradation of PAEs and applied in the hydrolysis of intracellular DEHP.

Intracellular Fenton reaction based on mitochondria-targeted copper(ii)–peptide complex for induced apoptosis

Intracellular Fenton reaction-based mitochondria-targeted copper(ii)–peptide complex and Asc is developed for cancer cell treatment.

[Retrospective analysis of cuffed-tunneled catheters in pediatric patients receiving maintenance hemodialysis]

Objective: To summarize the characteristics of cuffed-tunneled catheters insertion and investigate the values of cuffed-tunneled catheters in pediatric patients. Methods: Between March 2015 and July 2017, all the pediatric patients who received maintenance hemodialysis at least 3 consecutive months in our center were included. Sixteen cuffed-tunneled hemodialysis catheters were inserted in patients for long-term hemodialysis access. The clinical manifestations and complications were retrospectively reviewed. Results: Fifteen pediatric patients with end stage ranal disease (ESRD) were included in this study and they received 16 cuffed-tunneled catheters for long-term vascular access, including 10 males and 5 females; median age at start of catheter insertion was 11.5 (4.2-14.5) years. Body weight was (27.8±8.0)kg (16.0-39.4 kg) . The size and the length of the catheters were based on the height of patients as follows: 28 cm for (115.6±10.6) cm (102.0-130.0 cm) ,36 cm for (148.6±9.9)cm (140.0-167.0 cm) . Cuffed-tunneled catheters outcome: 10 cuffed-tunneled catheters were still functional at the end of the study; 5 catheters were removed after successful kidney transplantation. Catheter failure occurred in 1 out of 16 cuffed-tunneled catheters due to catheter-related infections. The median catheter survival time was 11.9 months (range 3.5-21.3 months). Complications of cuffed-tunneled catheters: Catheter placements operation was successful in 15 cases using ultrasound guidance. No serious complications were observed in any patients receiving catheter inserting operation. The overall rate of catheter-related infections and thrombosis/malposition was 6.3% and 18.7%, respectively. Conclusions: Ultrasound guidance is suggested in pediatric patients during the catheters insertion. The size and the length of the catheters should be based on the height of patients. Cuffed-tunneled hemodialysis catheters could be effectively used for maintenance of hemodialysis vascular access for pediatric patients with ESRD.

Adverse impact of intermittent portal clamping on long-term postoperative outcomes in hepatocellular carcinoma

Introduction To evaluate the impact of intermittent portal clamping (IPC) on long-term postoperative outcomes in patients with hepatocellular carcinoma (HCC). Methods Clinical records of 355 patients underwent curative liver resection for HCC in January 2007 to December 2010 were retrospectively reviewed. According to how portal clamping was performed, patients were grouped as: IPC, n=113; other portal clamping (OPC), n=190; and no portal clamping (NPC), n=52. Results Median recurrence-free survival (RFS) was statistically significantly shorter in the IPC (39.4 months) than OPC (47.3 months, p=0.010) and NPC groups (51.4 months, p=0.008). Median overall survival (OS) was also significantly shorter with IPC (46.3 months), versus 52.9 months with OPC (p=0.022) and 56.2 months with NPC (p=0.015). Kaplan-Meier survival analysis revealed that 5-year cumulative RFS was much lower in the IPC (42.5%) than OPC (50.9%, p=0.014) and NPC groups (49.6%, p=0.013). Five-year cumulative OS was also much lower in the IPC (44.9%) than OPC (58.0%, p=0.020) and NPC groups (57.7%, p=0.025). On univariate analysis, tumour grade, size and number, TNM stage, blood transfusion, vascular invasion and IPC were significantly inversely correlated with RFS and OS. On multivariate analysis, tumour size and number, blood transfusion, vascular invasion and IPC remained significant. Conclusions Our study suggests that IPC is an independent risk factor for poor long-term postoperative outcomes in patients with HCC.