Association between immune-related hub genes CD36, CXCL13, FGFR4, GABBR1, LAMP3, MMP12, and PPM1H and colorectal cancer prognosis

The present study aims to identify immune-related prognostic genes in colorectal cancer (CRC), and to explore potential mechanisms through which these genes regulate CRC progression. We first constructed a prognostic risk model based on seven gene signatures [cluster of differentiation-36 (CD36), chemokine (C-X-C-motif) ligand 13 (CXCL13), fibroblast growth factor receptor 4 (FGFR4), gamma-amino-butyric acid type B receptor 1 (GABBR1), lysosome-associated membrane glycoprotein 3 (LAMP3), recombinant matrix metalloproteinase 12 (MMP12), and protein phosphatase 1H (PPM1H)] using integrated bioinformatic analyses. FGFR4, GABBR1, and LAMP3 were highly expressed in CRC cell lines (in comparison with a normal colonic epithelial cell line), while CD36, CXCL13, MMP12, and PPM1H were weakly expressed. These in vitro expression results were largely consistent with our bioinformatic analysis. A prognostic model was generated to identify a high-risk group with worse survival outcome based on Kaplan-Meier analysis. Our prognostic model showed superior accuracy in both the training and test cohorts. In addition, we found that the low-risk subgroup exhibited greater infiltration by M1 macrophages, CD8+ T cells, CD4+ T cells, and activated NK cells. In conclusion, our findings provide evidence that seven immune-related hub genes can be considered as gene signatures to predict CRC prognosis and to differentiate CRC patient benefit, ultimately serving as a guide for individualized immunotherapy.

Diagnostic accuracy of the Copenhagen Index in ovarian malignancy: A meta-analysis

OBJECTIVE

To assess the diagnostic value of the Copenhagen index for ovarian malignancy.

METHODS

PubMed, Web of Science, the Cochrane Library, Embase, CBM, CNKI, and WanFang databases were searched throughout June 2021. Statistical analyses were performed using Stata 12, Meta-DiSc, and RevMan 5.3. The pooled sensitivity, specificity, and diagnostic odds ratio were calculated, the summary receiver operating characteristic curve was drawn, and the area under the curve was calculated.

RESULTS

Ten articles, including 11 studies with a total of 5266 patients, were included. The pooled sensitivity, specificity, and diagnostic odds ratio were 0.82 [95% CI (0.80-0.83)], 0.88 [95% CI (0.87-0.89)], and 57.31 [95% CI (32.84-100.02)], respectively. The area under the summary receiver operating characteristics curve and the Q index were 0.9545 and 0.8966, respectively.

CONCLUSION

Our systematic review shows that the sensitivity and specificity of the Copenhagen index are high enough for it to be used in a clinical setting to provide accurate ovarian cancer diagnosis without considering menopausal status.

[Clinicopathological features and HER2 expression of metaplastic squamous cell carcinoma of the breast]

Objective: To investigate the clinicopathological features and HER2 expression of metaplastic squamous cell carcinoma (MSCC) of the breast. Methods: A total of 47 MSCC cases diagnosed in the Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China from January 2010 to December 2021 were reviewed. The clinical information (including the follow-up data of HER2 positive patients) and pathological features were collected and analyzed. Results: All of the patients were female. Among the 47 cases, 25 were pure squamous cell carcinoma (PSCC) and 22 were mixed metaplastic carcinoma with squamous cell component (MMSC). The median age of the patients was 54 years (range, 29-84 years). The maximum diameter of the mass ranged from 0.8 to 10.0 cm, with a mean value of 3.3 cm, 85.7% (24/28) of the cases were smaller than 5 cm, and only 4 cases were larger than or equal to 5 cm. 89.5% of the MMSC presented with a solid mass. Cystic changes were more commonly found in the PSCC group (50%, P<0.05) than the MMSC group. 36.7% (11/30) of the patients had lymph node metastasis at the time of diagnosis. The squamous cell carcinoma component in all cases showed diffuse or patchy expression of p63, p40 and CK5/6. 55.3% (26/47) of the cases showed triple-negative phenotype. Among the 7 HER2-positive patients, 6 were MMSC group, which had a significantly higher rate of HER2-positivity than that in the PSCC group (1 case). In 1 MMSC case, immunohistochemistry showed HER2 2+in the invasive ductal carcinoma component and HER2 negativity (0) in the squamous cell carcinoma component, but HER2 FISH was negative in invasive ductal carcinoma and positive in squamous cell carcinoma component. Six HER2-positive MSCC patients received anti-HER2-targeted therapy, including two patients who received neoadjuvant chemotherapy combined with anti-HER2-targeted therapy before surgery. One patient achieved pathological complete remission, while the other achieved partial remission (the residual tumors were squamous cell carcinoma components). After 9-26 months of follow-up, four patients had no disease progression, two patients developed pulmonary metastases, and one patient showed local recurrence. Conclusions: MSCC is a group of heterogeneous diseases. PSCC and MMSC may be two different entities. Most of the MSCC are triple-negative and HER2 positivity is more commonly seen in MMSC with invasive ductal carcinoma component. Some HER2-positive MSCC patients can achieve complete remission or long-term progression-free survival after receiving anti-HER2 targeted therapy, but the squamous cell carcinoma component may be less sensitive to targeted therapy than the invasive ductal carcinoma component.

[Investigation on occupational hazard factors in teaching and research places of a university]

Objective: To investigate and monitor the occupational hazards in the Teaching and Research Laboratory (hereinafter referred to as the place) of a university, so as to provide basis for the occupational health work in the university. Methods: November 2014, 46 places in a university were selected by stratified random sampling, and the occupational health risk factors were investigated. Results: Indoor temperature, humidity, sulfur dioxide, nitrogen dioxide, carbon monoxide and carbon dioxide were detected in 21 sites, xylene and hydrofluoric acid were detected in 6 sites, and colony count was detected in 18 sites, the power frequency electric field intensity was measured in 23 places, and the x-ray radiation dose was measured in 4 places. Noise was measured at 21 sites, with 7 sites exceeding the standards accounting for 33.3% (7/21) ; 21 sites were detected for illumination and 10 sites for nonconformity accounting for 47.6% (10/21) ; 10 sites for Microwave Radiation and 3 sites exceeding the standards accounting for 30% (3/10) ; and 25 sites were detected for outdoor air volume and air velocity, the percentage of unqualified was 72% (18/25) in 18 sites, among which the wind velocity was statistically significant in teaching, research and experimental sites (P=0.010) . Conclusion: The occupational hazards in the teaching and research places of a university should be paid attention to, and the engineering protection and personal protection should be strengthened in the experiment.

Nociceptor Neurons Magnify Host Responses to Aggravate Periodontitis

Periodontitis is a highly prevalent chronic inflammatory disease that progressively destroys the structures supporting teeth, leading to tooth loss. Periodontal tissue is innervated by abundant pain-sensing primary afferents expressing neuropeptides and transient receptor potential vanilloid 1 (TRPV1). However, the roles of nociceptive nerves in periodontitis and bone destruction are controversial. The placement of ligature around the maxillary second molar or the oral inoculation of pathogenic bacteria induced alveolar bone destruction in mice. Chemical ablation of nociceptive neurons in the trigeminal ganglia achieved by intraganglionic injection of resiniferatoxin decreased bone loss in mouse models of experimental periodontitis. Consistently, ablation of nociceptive neurons decreased the number of osteoclasts in alveolar bone under periodontitis. The roles of nociceptors were also determined by the functional inhibition of TRPV1-expressing trigeminal afferents using an inhibitory designer receptor exclusively activated by designer drugs (DREADD) receptor. Noninvasive chemogenetic functional silencing of TRPV1-expressing trigeminal afferents not only decreased induction but also reduced the progression of bone loss in periodontitis. The infiltration of leukocytes and neutrophils to the periodontium increased at the site of ligature, which was accompanied by increased amount of proinflammatory cytokines, such as receptor activator of nuclear factor κΒ ligand, tumor necrosis factor, and interleukin 1β. The extents of increase in immune cell infiltration and cytokines were significantly lower in mice with nociceptor ablation. In contrast, the ablation of nociceptors did not alter the periodontal microbiome under the conditions of control and periodontitis. Altogether, these results indicate that TRPV1-expressing afferents increase bone destruction in periodontitis by promoting hyperactive host responses in the periodontium. We suggest that specific targeting of neuroimmune and neuroskeletal regulation can offer promising therapeutic targets for periodontitis supplementing conventional treatments.

Prognostic signature of ovarian cancer based on 14 tumor microenvironment-related genes

BACKGROUND

Ovarian cancer is one of the lethal gynecological diseases in women. However, using tumor microenvironment related genes to identify prognostic signature of ovarian cancer has not been discussed in detail.

METHODS

The mRNA profiles of 386 ovarian cancer patients were retrieved from The Cancer Genome Atlas. Univariate Cox regression and LASSO Cox regression analyses were performed and 14 optimized prognostic genes related to tumor microenvironment were identified.

RESULTS

The multivariate Cox hazards regression showed risk score was an independent prognostic signature for ovarian cancer. Nomogram model could reliably predict the patients' survival. Furthermore, M1 macrophages, M2 macrophages, and follicular helper T cells, differentially expressed between the high- and low-risk groups, were found to be associated with the risk score.

CONCLUSION

CTL-associated antigen 4 (CTLA4) and indoleamine 2,3-Dioxygenase 1 (IDO1), which were previously shown to be important immune checkpoints, probably contribute to the immunosuppressive microenvironment aberration. This study may shed light on the prognosis of ovarian cancer.

Totally endoscopic sublay (TES) repair for lateral abdominal wall hernias: technique and first results

BACKGROUND

The optimal surgical treatment for lateral hernias of the abdominal wall remains unclear. The presented prospective study assesses for the first time in detail the clinical value of a totally endoscopic sublay (TES) technique for the repair of these hernias.

METHODS

Twenty-four consecutive patients with a lateral abdominal wall hernia underwent TES repair. This technique is naturally combined with a transversus abdominis release maneuver to create a sufficient retromuscular/preperitoneal space that can accommodate, if necessary, a giant prosthetic mesh.

RESULTS

The operations were successful in all but one patient who required open conversion because of dense intestinal adhesion. The mean defect width was 6.7 ± 3.9 cm. The mean defect area was 78.0 ± 102.4 cm² (range 4-500 cm²). The mean mesh size used was 330.2 ± 165.4 cm² (range 108-900 cm²). The mean operative time was 170.2 ± 73.8 min (range, 60-360 min). The mean visual analog scale score for pain at rest on the first day was 2.5 (range 1-4). The average postoperative stay was 3.4 days (range 2-7 days). No serious complications (Dindo-Clavien Grade 2-4) were seen within a mean follow-up period of 13.3 months.

CONCLUSIONS

A totally endoscopic technique (TES) for the treatment of lateral hernias is described. The technique revealed to be reliable, safe and cost-effective. The first results are promising, but larger studies with longer follow-up periods are recommended to determine the real clinical value.

Retroperitoneal totally endoscopic prosthetic repair of primary lumbar hernia

PURPOSE

A primary lumbar hernia is a rare entity that requires surgical management, but the preferred technique has not been established. We herein describe a standardized and reproducible retroperitoneal totally endoscopic prosthetic (TEP) repair technique for primary lumbar hernias.

METHODS

Ten adult patients with primary lumbar hernias underwent retroperitoneal TEP repair from February 2019 to July 2020. A sufficient retroperitoneal space was established to accommodate a non-coated polypropylene mesh to reinforce the weakened flank area, and hernia content reduction and defect closure were then performed. The patients' clinical data were prospectively collected and analyzed.

RESULTS

Nine patients had a primary superior lumbar hernia and one patient had a primary diffuse lumbar hernia. All operations were successfully performed without serious intraoperative complications. The mean defect area was 6.4 ± 2.8 cm² (range 4-12 cm²), and the mean mesh area was 144.6 cm² (range 130-180 cm²). The average operative time (skin to skin) was 49.0 ± 5.7 min (range 40-60 min), and intraoperative bleeding was minimal. The mean visual analog pain scale score at rest on the first postoperative day was 2.2 (range 2-3). The average length of postoperative stay was 1.5 days (range 1-2 days). No serious postoperative complications occurred. No recurrence, chronic pain, or mesh infection occurred during a mean follow-up period of 7.5 months.

CONCLUSIONS

The retroperitoneal TEP repair for primary lumbar hernias is safe, efficient, and reproducible. Anti-adhesive coated meshes and fixation tackers are not required, making this a cost-effective procedure that is worthy of recommendation.

Quasi-oracle estimation of heterogeneous treatment effects

Flexible estimation of heterogeneous treatment effects lies at the heart of many statistical applications, such as personalized medicine and optimal resource allocation. In this article we develop a general class of two-step algorithms for heterogeneous treatment effect estimation in observational studies. First, we estimate marginal effects and treatment propensities to form an objective function that isolates the causal component of the signal. Then, we optimize this data-adaptive objective function. The proposed approach has several advantages over existing methods. From a practical perspective, our method is flexible and easy to use: in both steps, any loss-minimization method can be employed, such as penalized regression, deep neural networks, or boosting; moreover, these methods can be fine-tuned by cross-validation. Meanwhile, in the case of penalized kernel regression, we show that our method has a quasi-oracle property. Even when the pilot estimates for marginal effects and treatment propensities are not particularly accurate, we achieve the same error bounds as an oracle with prior knowledge of these two nuisance components. We implement variants of our approach based on penalized regression, kernel ridge regression, and boosting in a variety of simulation set-ups, and observe promising performance relative to existing baselines.

[Pathological changes of the spleen in ten patients with coronavirus disease 2019(COVID-19) by postmortem needle autopsy]

Objective: To study the pathological changes of the spleen in patients with COVID-19 and to analyze the relationship between the weakened immune system and splenic lesions. Methods: Postmortem needle autopsies from the spleen were carried out on 10 patients who died from COVID-19 in Wuhan. Routine hematoxylin and eosin (HE) staining was used to observe the pathological changes. The changes of lymphocytes were studied further with immunohistochemistry.RT-PCR was used to detect 2019-nCoV RNA in the spleen. In addition,the Epstein-Barr virus (EBV) was detected by in situ hybridization, and coronavirus particles were detected by transmission electron microscopy in 2 cases. Results: There were 7 males and 3 females, with an average age of 68.3 years.Of the 10 cases, 4 had cancer history and another 4 had other underlying diseases respectively.Cough, fever, malaise and dyspnea were the main clinical symptoms.The time from onset to death was 15-45 days.Ten cases patients had normal or slight increase in peripheral blood leukocyte count in the early stage of the disease, 6 cases had significant increase before death. Five patients' peripheral blood lymphocyte count decreased in the early stage of the disease, and 10 patients' peripheral blood lymphocyte count decreased significantly before the disease progressed or died. Seven cases were treated with corticosteroid (methylprednisolone ≤40 mg/d, not more than 5 days). Histopathological examination showed that the cell composition of the spleen decreased, white pulp atrophied at different levels, meanwhile lymphoid follicles decreased or absent;in addition, the ratio of red pulp to white pulp increased with varying degrees. In 7 cases, more neutrophil infiltration was found, and in 5 cases, scattered plasma cell infiltration was found. Macrophage proliferation and hemophagocytic phenomena in a few cells were found in a case. Meanwhile, necrosis and lymphocyte apoptosis were detected in 2 cases, small artery thrombosis and spleen infarction in 1 case, and fungal infection in 1 case. The results of immunohistochemistry showed that the T and B lymphocyte components of the spleen in all cases decreased in varying degrees. CD20(+) B cells were found to accumulate in the lymphoid sheath around the splenic artery in 8 cases. However, CD20 and CD21 immunostaining in 2 cases showed that the number of white pulp was almost normal, and splenic nodules were atrophic. CD3(+), CD4(+) and CD8(+)T cells were decreased. In 9 cases,CD68(+) macrophages were no significant changes in the distribution and quantity. While more CD68(+) cells were found in the medullary sinuses of 1 case (related to fungal infection). Few CD56(+) cells were found. EBV was negative by in situ hybridization. RT-PCR was used to detect the nucleic acid of 2019-nCoV. One of 10 cases was positive, 39 years old,who was the youngest patient in this group, and the other 9 cases were negative. Coronavirus particles were found in the cytoplasm of macrophage under electron microscope in 2 cases. Conclusions: The death of COVID-19 occurs mainly in the elderly, and some cases have no underlying diseases. Spleen may be one of the organs directly attacked by the virus in some patients who died from COVID-19. T and B lymphocyte in the spleen decrease in varying degrees, lymphoid follicles are atrophied, decreased or absent, and the number of NK cells do not change significantly. And the pathological changes of the spleen are not related to the use of low dose corticosteroid, which may be related to the direct attack of virus and the attack of immune system on its own tissues.

OP0246 MIR-214-3P PROTECTS AGAINST OSTEOARTHRITIS BY DIRECTLY TARGETING NF-ĸB PATHWAY

Background:

Osteoarthritis (OA) is a degenerative disease associated with changes in the articular cartilage and bone, severely affecting patients’ mobility and quality of life. Multiple factors including mechanical stress, metabolic alteration and inflammatory mediators are involved in the complex pathogenesis of OA[1]. Interventions targeting these pathogenic factors may contribute to the treatment of OA. MiRNAs are single strand non-coding small RNAs, which are regulated in chondrogenesis and OA[2,3]. Recent studies demonstrated that miRNAs are involved in the regulation of NF-κB signaling pathway by different mechanisms[4]. These interactions suggest that NF-κB related miRNAs may be used as potential biomarkers and drug therapeutic targets in clinical treatment of OA. However, the relationship between miR-214-3p and NF-κB pathway remains poorly understood in OA.

Objectives:

This study aimed to test the expression and biological function of miR-214-3p in OA, and explore its mechanism in osteoarthritic chondrocytes.

Methods:

Articular primary chondrocytes were isolated from human cartilage samples, which were acquired from patients with end-stage knee OA at the time of total knee replacement surgery (n = 27), according to protocols approved by the Ethic Committee of Zhujiang Hospital. Real time PCR (RT-PCR) and in situ hybridization (ISH) were used to detect the expression of miR-214-3p in OA and non-OA cartilage tissues. Interference of miR-214-3p was conducted using inhibitor, while overexpression of miR-214-3p was performed with mimics. Metabolism of extracellular matrix was detected by RT-PCR, western blotting and immunofluorescence in vitro. Flow cytometry were conducted to determine cell apoptosis. A luciferase reporter assay, was used to evaluate the interaction between miR-214-3p and its downstream target. Human chondrocytes were cotransfected with miR-214-3p and the IKBKB-overexpressing plasmid to confirm the interaction between miR-214-3p and NF-ĸB pathway. For in vivo studies, experimental OA was induced in 12-week-old male C57BL/6J mice by destabilization of the medial meniscus (DMM) surgery with miR-214-3p agomir intra-articular (IA) injection (once weekly for 12 days) or by IA injection (once weekly for 12 days) of miR-214-3p antiagomir. Mice were sacrificed 10 weeks after the first IA injection, and subjected to histological analyses.

Results:

MiR-214-3p was significantly reduced in human OA cartilage. The decreased expression of miR-214-3p in the OA cartilage tissues was directly associated with excessive apoptosis and imbalance between anabolic and catabolic factors of ECM. Mechanistically, we determined that miR-214-3p directly targeted IKBKB/IKK-b and thereby suppressed the activation of NF-ĸB pathway. IKBKB overexpression attenuated the inhibitory effect of miR-214-3p on NF-ĸB pathway. Furthermore, inhibition of miR-214-3p in mice joints triggered spontaneous cartilage loss and OA development, while IA injection of miRNA-214-3p agomir alleviated OA in the DMM mouse model.

Conclusion:

Our results reveal an important role of miR-214-3p in OA progression. MiR-214-3p was down-regulated while IKBKB was upregulated in OA. MiR-214-3p inhibits the NF-kB signaling pathway and suppresses the progression of OA through targeting IKBKB. Thus, miR-214-3p maybe a therapeutic target for OA.

References:

[1]Glyn-Jones S, Palmer AJR, Agricola R, Price AJ, Vincent TL, Weinans H, Carr AJ:Osteoarthritis.The Lancet2015,386(9991):376-387.

[2]Nugent M:MicroRNAs: exploring new horizons in osteoarthritis.Osteoarthritis and cartilage2016,24(4):573-580.

[3]Vicente R, Noel D, Pers YM, Apparailly F, Jorgensen C:Deregulation and therapeutic potential of microRNAs in arthritic diseases.Nature reviews Rheumatology2016,12(4):211-220.

[4]Xu B, Li YY, Ma J, Pei FX:Roles of microRNA and signaling pathway in osteoarthritis pathogenesis.Journal of Zhejiang University Science B2016,17(3):200-208.

Disclosure of Interests:

None declared

Single-site laparoscopic percutaneous extraperitoneal closure (SLPEC) of hernia sac high ligation using an ordinary taper needle: a novel technique for pediatric inguinal hernia

PURPOSE

Laparoscopic high ligation of the internal inguinal ring is an alternative procedure for treatment of pediatric inguinal hernia (PIH), with a major trend toward increasing use of extracorporeal knotting and decreasing use of working ports. We have utilized this laparoscopic technique to treat the entire spectrum of PIH (including incarcerated cases) for more than 17 years, and the technique continues to evolve and improve. We herein report our latest modification of this minimally invasive technique, namely single-site laparoscopic percutaneous extraperitoneal closure (SLPEC) of hernia sac high ligation using an ordinary taper needle, and evaluate its safety and efficacy.

METHODS

From July 2016 to July 2019, 790 children with indirect PIH were treated by laparoscopic surgery. All patients underwent high ligation surgery with a modified single-site laparoscopic technique mainly performed by extracorporeal suturing with an ordinary closed-eye taper needle (1/2 arc 11 × 34). The clinical data were retrospectively analyzed.

RESULTS

All surgeries were successful without serious complications. A contralateral patent processus vaginalis (CPPV) was found intraoperatively and subsequently repaired in 190 patients (25.4%). The mean operative time was 15 min (8-25 min) for 557 unilateral hernias and 21 min (14-36 min) for 233 bilateral hernias. The mean postoperative stay was 20 h. Minor complications occurred in five patients (0.63%) and were managed properly, with no major impact on the final outcomes. No recurrence was noted in the patients who were followed up for 6-42 months. No obvious scar was present postoperatively.

CONCLUSION

Modified SLPEC of hernia sac high ligation using an ordinary taper needle for repair of indirect PIH is a safe, reliable, and minimally invasive procedure with satisfactory outcome, with no special device being needed. It is easy to learn and perform and is worthy of popularization in the clinical setting.

Association of Fruit and Vegetable Intake and Frailty among Chinese Elders: A Cross-Sectional Study in Three Cities

OBJECTIVES

To examine the association of FVI and frailty in Chinese elders.

DESIGN

A sectional study was conducted in three cities (Shanghai, Zhengzhou, and Baoji) in China from June 2017 to June 2018.

PARTICIPANTS

A total of 5699 participants from 49 districts were included in the current study by two-stage sampling methods.

MEASUREMENTS

Frailty was measured by a validated Chinese version of the FRAIL scale. FVI per day was measured by two single questions.

RESULTS

The sample proportion with sufficient fruit intake was 36.7%, and 44.7% reported sufficient vegetable intake. The sample proportions that were robust, pre-frail, and frail were 43.6%, 38.3%, and 18.1%, respectively. Compared with low FVI, after including covariates, the odds ratio (OR) of frailty was 0.84 (95% CI: 0.73-0.97) for moderate fruit intake and 0.81 (95% CI: 0.70-0.94) for enough fruit intake; the OR of frailty was 0.83 (95% CI: 0.68-0.91) for moderate vegetable intake and 0.77 (95% CI: 0.64-0.93) for enough vegetable intake.

CONCLUSION

High FVI was negatively associated with the OR of frailty in Chinese elders. This finding implies it is important to promote FVI among adults to prevent frailty.

[HER2 status in gastric adenocarcinoma of Chinese: a multicenter study of 40 842 patients]

Objective: To investigation HER2 status in gastric adenocarcinoma of Chinese and contributing factors to the HER2 expression. Methods: HER2 status of 40 842 gastric adenocarcinomas and clinical data were retrospectively collected from 23 hospitals dated from 2013 to 2016. The association between HER2 positivity and clinicopathologic features was analyzed. Results: Of the 40 842 patients the median age was 62 years, the male female ratio was 2.6∶1.0. The rate of HER2 positivity was 8.8% (3 577/40 842). HER2 expression was related to the tissue type, tumor location, Lauren classification and tumor differentiation (P values: 0.009, 0.001, <0.01 and <0.01, respectively). Different HER2 expression status was observed between primary and recurrent tumors in 7.6% (48/635) cases. The rates of HER2 positivity ranged from 2% to 10% among different institutions. The rates of HER2 FISH amplification were dramatically different among the 23 hospitals (0-100%) with an average rate of 10% (810/8 156) in patients with HER2 IHC 2+ . Conclusions: HER2 expression is associated with clinicopathologic characteristics. HER2 re-assessment of tumor tissue and use of in situ hybridization techniques increase HER2 positivity. The current retrospective study should reflect the HER2 status in gastric adenocarcinoma of Chinese patients.

Epithelial Cdc42 Deletion Induced Enamel Organ Defects and Cystogenesis

Cdc42, a Rho family small GTPase, regulates cytoskeleton organization, vesicle trafficking, and other cellular processes in development and homeostasis. However, Cdc42's roles in prenatal tooth development remain elusive. Here, we investigated Cdc42 functions in mouse enamel organ. Cdc42 showed highly dynamic temporospatial patterns in the developing enamel organ, with robust expression in the outer enamel epithelium, stellate reticulum (SR), and stratum intermedium layers. Strikingly, epithelium-specific Cdc42 deletion resulted in cystic lesions in the enamel organ. Cystic lesions were first noted at embryonic day 15.5 and progressively enlarged during gestation. At birth, cystic lesions occupied the bulk of the entire enamel organ, with intracystic erythrocyte accumulation. Ameloblast differentiation was retarded upon epithelial Cdc42 deletion. Apoptosis occurred in the Cdc42 mutant enamel organ prior to and synchronously with cystogenesis. Transmission electron microscopy examination showed disrupted actin assemblies, aberrant desmosomes, and significantly fewer cell junctions in the SR cells of Cdc42 mutants than littermate controls. Autophagosomes were present in the SR cells of Cdc42 mutants relative to the virtual absence of autophagosome in the SR cells of littermate controls. Epithelium-specific Cdc42 deletion attenuated Wnt/β-catenin and Shh signaling in dental epithelium and induced aberrant Sox2 expression in the secondary enamel knot. These findings suggest that excessive cell death and disrupted cell-cell connections may be among multiple factors responsible for the observed cystic lesions in Cdc42 mutant enamel organs. Taken together, Cdc42 exerts multidimensional and pivotal roles in enamel organ development and is particularly required for cell survival and tooth morphogenesis.

Abdominal wall reconstruction following resection of large abdominal aggressive neoplasms using tensor fascia lata flap with or without mesh reinforcement

PURPOSE

Abdominal wall defects caused by neoplasms with large extended resection defects remain a challenging problem. Autologous flaps, meshes, and component separation techniques are effective in reconstructing these defects. We retrospectively reviewed and assessed the success of reconstruction using tensor fascia lata flap with or without meshes.

METHODS

18 patients with abdominal wall neoplasms were identified during the period from 2007 to 2016. A retrospective review of office charts and hospital records was performed.

RESULTS

A total of 18 patients received corresponding treatment according to the degree of defects, with a mean age of 53.89 ± 14.56 years old, a mean body mass index (BMI) of 22.89 ± 4.09 kg/m², and a mean American Society of Anesthesiologist (ASA) score of 2.18 ± 0.75. Operative details included the mean defect size (303.44 ± 175.67 cm²), the mean mesh size (265.92 ± 227.99 cm²), and the mean operative time (382.33 ± 180.38 min). Postoperative wound complications were identified in 7 (39%) patients, including incisional infection, edema and thrombus. Neoplasm recurrence was observed in 2 (13%) primary neoplasms patients. No hernias were present in any patient.

CONCLUSIONS

Abdominal wall defects caused by neoplasms should be repaired by autologous flaps combined with or without mesh reinforcement. Most type I defects should be primary sutured; type II or III defects should be repaired well by flaps, with or without mesh; if the incision is infected or contaminated, biological mesh or flaps are the best choice.

Sequence identification, serological reactivity and family genetics of a novel HLA allele, HLA-A*26:82

HLA-A*26:82 was identified by sequence-based typing and showed the serological specificity of A26.

Evaluation of attenuation correction in cardiac PET using PET/MR

BACKGROUND

Simultaneous acquisition Positron emission tomography/magnetic resonance (PET/MR) is a new technology that has potential as a tool both in research and clinical diagnosis. However, cardiac PET acquisition has not yet been validated using MR imaging for attenuation correction (AC). The goal of this study is to evaluate the feasibility of PET imaging using a standard 2-point Dixon volume interpolated breathhold examination (VIBE) MR sequence for AC.

METHODS AND RESULTS

Evaluation was performed in both phantom and patient data. A chest phantom containing heart, lungs, and a lesion insert was scanned by both PET/MR and PET/CT. In addition, 30 patients underwent whole-body 18F-fluorodeoxyglucose PET/CT followed by simultaneous cardiac PET/MR. Phantom study showed 3% reduction of activity values in the myocardium due to the non-inclusion of the phased array coil in the AC. In patient scans, average standardized uptake values (SUVs) obtained by PET/CT and PET/MR showed no significant difference (n = 30, 4.6 ± 3.5 vs 4.7 ± 2.8, P = 0.47). There was excellent per patient correlation between the values acquired by PET/CT and PET/MR (R 2 = 0.97).

CONCLUSIONS

Myocardial SUVs PET imaging using MR for AC shows excellent correlation with myocardial SUVs obtained by standard PET/CT imaging. The 2-point Dixon VIBE MR technique can be used for AC in simultaneous PET/MR data acquisition.

Pioglitazone Enhances the Beneficial Effects of Glucocorticoids in Experimental Nephrotic Syndrome

Glucocorticoids are the primary therapy for nephrotic syndrome (NS), but have serious side effects and are ineffective in ~20-50% of patients. Thiazolidinediones have recently been suggested to be renoprotective, and to modulate podocyte glucocorticoid-mediated nuclear receptor signaling. We hypothesized that thiazolidinediones could enhance glucocorticoid efficacy in NS. We found that puromycin aminonucleoside-induced proteinuria in rats was significantly reduced by both high-dose glucocorticoids (79%) and pioglitazone (61%), but not low-dose glucocorticoids (25%). Remarkably, pioglitazone + low-dose glucocorticoids also reduced proteinuria (63%) comparably to high-dose glucocorticoids, whereas pioglitazone + high-dose glucocorticoids reduced proteinuria to almost control levels (97%). Molecular analysis revealed that both glucocorticoids and pioglitazone enhanced glomerular synaptopodin and nephrin expression, and reduced COX-2 expression, after injury. Furthermore, the glomerular phosphorylation of glucocorticoid receptor and Akt, but not PPARγ, correlated with treatment-induced reductions in proteinuria. Notably, clinical translation of these findings to a child with refractory NS by the addition of pioglitazone to the treatment correlated with marked reductions in both proteinuria (80%) and overall immunosuppression (64%). These findings together suggest that repurposing pioglitazone could potentially enhance the proteinuria-reducing effects of glucocorticoids during NS treatment.

Effects of pulsed Nd:YAG laser on tensile bond strength and caries resistance of human enamel

This study aims to evaluate the effects of pulsed Nd:YAG laser on the tensile bond strength (TBS) of resin to human enamel and caries resistance of human enamel. A total of 201 human premolars were used in this in vitro study. A flat enamel surface greater than 4 × 4 mm in area was prepared on each specimen using a low-speed cutting machine under a water coolant. Twenty-one specimens were divided into seven groups for morphology observations with no treatment, 35% phosphoric acid etching (30 seconds), and laser irradiation (30 seconds) of pulsed Nd:YAG laser with five different laser-parameter combinations. Another 100 specimens were used for TBS testing. They were embedded in self-cured acrylic resin and randomly divided into 10 groups. After enamel surface pretreatments according to the group design, resin was applied. The TBS values were tested using a universal testing machine. The other 80 specimens were randomly divided into eight groups for acid resistance evaluation. Scanning electron microscope (SEM) results showed that the enamel surfaces treated with 1.5 W/20 Hz and 2.0 W/20 Hz showed more etching-like appearance than those with other laser-parameter combinations. The laser-parameter combinations of 1.5 W/15 Hz and 1.5 W/20 Hz were found to be efficient for the TBS test. The mean TBS value of 14.45 ± 1.67 MPa in the laser irradiated group was significantly higher than that in the untreated group (3.48 ± 0.35 MPa) but lower than that in the 35% phosphoric acid group (21.50 ± 3.02 MPa). The highest mean TBS value of 26.64 ± 5.22 MPa was identified in the combination group (laser irradiation and then acid etching). Acid resistance evaluation showed that the pulsed Nd:YAG laser was efficient in preventing enamel demineralization. The SEM results of the fractured enamel surfaces, resin/enamel interfaces, and demineralization depths were consistent with those of the TBS test and the acid resistance evaluation. Pulsed Nd:YAG laser as an enamel surface pretreatment method presents a potential clinical application, especially for the caries-susceptible population or individuals with recently bleached teeth.

Role of mitogen-activated protein kinase cascades in 2,3,7,8-tetrachlorodibenzo-p-dioxin-induced apoptosis in neuronal pheochromocytoma cells

Mitogen-activated protein kinases (MAPKs) are involved in neuronal death caused by many cytotoxins. Conventional MAPKs consist of three family members: extracellular signal-regulated kinase-1/2 (ERK1/2), c-Jun N-terminal kinase (JNK) and p38. It has been originally shown that ERK1/2 is important for cell survival, whereas JNK and p38 are deemed stress responsive and thus involved in apoptosis. However, information describing the role of MAPKs in 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-induced neurotoxicity is insufficient. The aim of this study was to identify the role of MAPK cascades in TCDD-induced neurotoxicity using differentiated pheochromocytoma (PC12) cells as a model for neuronal cells. Cell viability assay, terminal deoxynucleotidyl transferase dUTP nick-end labeling assay and flow cytometry analysis showed that TCDD attenuated cell viability with a dose- and time-dependent manner and significantly induced apoptosis in primary cortical neurons and PC12 cells. Western blot analysis indicated that TCDD markedly activated the expression of ERK1/2, JNK and p38 in TCDD-treated PC12 cells. Furthermore, PD98059 (ERK1/2 inhibitor), SP600125 (JNK inhibitor) and SB202190 (p38 inhibitor) notably blocked the effect of TCDD on cell apoptosis. Based on the findings above, it is concluded that the activation of MAPK signaling pathways may be associated with TCDD-mediated neuronal apoptosis.

In-silico prediction of blood-brain barrier permeability

The ability of penetration of the blood-brain barrier is one of the significant properties of a drug or drug-like compound for the central nervous system (CNS), which is commonly expressed by log BB (log BB = log (C (brain)/C (blood))). In this work, a dataset of 320 compounds with log BB values was split into a training set including 198 compounds and a test set including 122 compounds according to their structure properties by a Kohonen's self-organizing map (SOM). Each molecule was represented by global and shape descriptors, 2D autocorrelation descriptors and RDF descriptors calculated by ADRIANA.Code. Several quantitative models for prediction of log BB were built by a multilinear regression (MLR), a support vector machine (SVM) and an artificial neural network (ANN) analysis. The models show good prediction performance on the test set compounds.

A new approach for the identification of aphid vectors (Hemiptera: Aphididae) of potato virus Y

Potato virus Y (PVY) is one of the most economically important viruses affecting potato crops worldwide. PVY can be transmitted from potato to potato by several aphid species, most of which do not colonize the potato crop. New methods including preservation of viral RNA on stylets of aphids collected from yellow pan trap samples, polymerase chain reaction detection of PVY from the stylets of one aphid, and aphid identification using DNA barcoding were used to identify possible PVY vectors from field samples. In total, 65 aphid taxa were identified from the samples that tested positive for PVY. Among those, 45 taxa had never been evaluated for their ability to transmit PVY, and 7 were previously labeled as nonvectors. These results demonstrated that the list of PVY vectors is likely longer than previously reported and that most (if not all) species of aphids could be considered as potential vectors. This premise has important implications in the management of PVY in seed potato production.

Aphid feeding behavior in relation to potato virus Y (PVY) acquisition

Potato virus Y (PVY) is transmitted by aphids in a nonpersistent manner and aphid species differ in their ability to transmit PVY. During host selection, aphids will land and probe on nonhost plant species and this behavior is an important component of the epidemiology of many aphid-transmitted viruses. In this study, we hypothesized that host selection behavior varies between aphid species and the host or nonhost status of the plant and this behavior will modulate their ability to acquire PVY. Three potato colonizers, Myzus persicae (Sulzer), Macrosiphum euphorbiae (Thomas), and Aphis nasturtii (Kaltenbach) and three casual visitors to potato fields, Myzus cerasi (F.), Rhopalosiphum padi (L.), and Sitobion avenae (F.) were evaluated using two acquisition assays. In one assay, the normal host selection and feeding behavior of aphid species were eliminated using an artificial diet while the other considered the normal host selection and feeding behavior of aphid species on potato plants. PVY acquisition rates of aphid species widely differed between the two assays indicating the impact of host selection and feeding behavior on PVY acquisition. This behavior varied greatly between potato colonizers and noncolonizers. We recommend that laboratory evaluations of PVY vector efficiency consider the normal host selection and feeding behavior of aphid species on potatoes.

Association of KIR genotypes and haplotypes with syphilis in a Chinese Han population

Killer immunoglobulin-like receptors (KIRs) can regulate the activation of NK and T cells in response to infection. Syphilis is a sexually transmitted infection caused by the Treponema pallidum subspecies pallidum spirochete bacterium. The objective of this study was to explore whether KIR genotypes and haplotypes were associated with syphilis in a Chinese Han population. Polymerase chain reaction with sequence-specific primers (PCR-SSP) was used to identify the KIR genotypes in 190 patients with syphilis and 192 healthy controls. The frequency of genotype P was higher in healthy controls than that in patients with syphilis (P = 0.002), and its OR was 0.304, while the frequencies of genotypes AE and AG were higher in patients with syphilis than those in healthy controls. The frequency of haplotype 17 was lower, and its OR was 0.321, whereas the frequencies of haplotype 1 and 6 were higher in patients with syphilis than those in healthy controls. KIR haplotypes A and B have distinctive centromeric (Cen) and telomeric (Tel) gene content motifs. The frequency of Tel-B/B was higher in patients with syphilis than that in healthy controls (P = 0.024). Based on these findings, it seems that individuals with the genotype AE, AG or Tel-B/B, or haplotypes 1 and 6 are susceptible to syphilis, whereas individuals with genotype P or haplotype 17 are protective from syphilis in the Chinese Han population.

SU-E-J-202: Treatment Dose Assessment with the Consideration of Radiation Dose Inducible Organ Shrinkage/Deformation

PURPOSE

For asymmetric organ shrinkage caused by heterogeneity dose distribution, tissue elasticity based deformable organ registration cannot be directly applied to the treatment image to construct the treatment dose. A novel approach is proposed to include radiation dose inducible organ shrinkage/deformation in the consideration of treatment dose assessment.

METHODS

A model and algorithm were developed to include dose inducible organ shrinkage in the deformable image registration. In the model, we assume that the logarithm of tissue-element volume shrinkage ratio is proportional to the LQ survival function, and the tissue-element displacement field is the gradient of a scalar potential function. The derived Poisson equation of the potential was solved using a finite element method. Two steps registration was implemented to determine the tissue-element volume and displacement. The first is the conventional deformable image registration to determine the organ surface. The second is to map the element volume/position in the shrinking organ with using the dose inducible shrinkage model. Treatment dose was constructed by applying both the conventional deformable registration and the shrinkage model on CBCT images obtained from h&n treatment. The dose distribution in the patient parotid was evaluated.

RESULTS

Treatment dose-volume, V30, constructed including the dose inducible parotid shrinkage was 11% higher than the one from the conventional deformable image registration and dose construction. Tissue elements in the high dose region shrink more than those in a low dose region which results in extra tissue elements in the organ move into the high dose area during the treatment course and an unfavorable dose-volume relationship in the organ.

CONCLUSIONS

Without including dose inducible organ shrinkage, treatment dose in a shrinking organ could be underestimated. On the other hand, including this effect in the treatment evaluation and adaptive planning optimization will minimize the potential detriment of the effect.

Inertia effects on characterization of dynamic response of brain tissue

Modeling and simulation of traumatic brain injury (TBI) resulted from collision or blast loading requires characterization of mechanical response over a wide range of loading rates under valid testing conditions. In this study, mechanical response of fresh bovine brain tissue was studied using the two modified Kolsky bar techniques. Radial deformation behavior of annular specimens, which are typically used to characterize the dynamic uniaxial compressive response of biological tissues, was examined using a modified Kolsky bar and a high speed camera to collect images while the specimen deforms at an axial strain rate of 2000s(-1). The high-speed images revealed inhomogeneous specimen deformation possibly brought about by radial inertia and causing a multi-axial stress state. To acquire valid stress-strain results that can be used to produce constitutive behavior of the soft materials, a novel torsion technique was developed to obtain pure shear response at dynamic loading rates. Experimental results show clear differences in the material response using the two methods. These results indicate that the previously demonstrated annular specimen geometry aimed at reducing inertia induced stress components for high rate soft materials uniaxial-compressive testing may still possess a significant component of radial inertia induced radial stress which consequently caused the observed inhomogeneous deformation in brain tissue test samples.

Diagnosis and surgical treatment of carotid body tumors: 25 years' experience in China

Carotid body tumors (CBT) are rare neoplasms arising from the small chemoreceptor organ in the adventitia of the common carotid bifurcation. A retrospective survey was conducted in 33 patients, treated by curative resection of the neoplasm, from 1980 to 2005, to investigate clinical features, preoperative treatment and surgical approach, and determine the optimum management for CBT. The demographic characteristics, clinical features, surgical approach and complications were documented and analyzed. Accurate diagnosis and effective preoperative training were associated with a good surgical outcome. Carotid arteriography accurately diagnoses and evaluates the brain's collateral circulation in the circle of Willis. Ultrasonography is useful. Carotid blood flow obstruction (Matas' training) is effective. Complete excision of the carotid system without a vascular replacement is possible only after reliable Matas' training and objective observation of the establishment of circulation in the circle of Willis. Correct treatment of the internal and common carotid artery is important to reduce postoperative complications. The continuity of the common and internal carotid artery should be retained if possible, and carotid artery repair is recommended. Minor complications occurred in five (15%) patients and one patient died from a cause not related to the CBT at follow-up.

A novel HLA-B*40 allele, B*4086, was identified by sequence-based typing in a Chinese donor

We report the identification of a novel HLA-B*40 allele, B*4086, which was detected during our routine sequence-specific oligonucleotide (SSO) HLA typing of a sample from a bone marrow donor and confirmed with sequence-based typing. The name HLA-B*4086 was officially assigned by the WHO Nomenclature Committee in February 2008.

Behavior of bird cherry-oat aphid and green peach aphid in relation to potato virus Y transmission

Potato virus Y is transmitted to potato in a nonpersistent manner by many aphid species, some of which do not colonize this crop. The behavior of bird cherry-oat aphid, Rhopalosiphum padi (L.) on potato, Solanum tuberosum L., a plant species that is not colonized by this aphid, was described and compared with that of the potato-colonizing green peach aphid, Myzuspersicae (Sulzer). A higher proportion of winged morph of R. padi than M. persicae left the plant, but aphids that stayed in contact with the plant took the same mean time to initiate the first probe and it lasted the same mean time compared with M. persicae. Electronic penetration graph technique was used to study the probing behavior of the aphids during Potato virus Y (family Potyviridae, genus Potyvirus, PVY) transmission tests. Transmission rate decreased from 29 to 8% when the acquisition time increased from 5 min of continuous probing to 1 h with M. persicae, but it remained low (2 and 1%) with R. padi. Most of the difference in transmission rate between acquisition time with M. persicae and between aphid species was related to the change in the time and behavior taking place between the last cell puncture of the acquisition phase to the first cell puncture of the inoculation phase. Results presented here clearly demonstrated the importance of host plant selection and probing behavior in the transmission of nonpersistent plant viruses. They also stress the need to consider the behavior of the aphid in the design of laboratory tests of virus vector efficacy.

Successful application of tissue-engineered skin to refractory ulcers

In this study, the effectiveness of a tissue-engineered skin (Activskin; Aierfu, Xi'an, China) was evaluated for the treatment of various refractory ulcers. These ulcers were treated with Activskin after debridement and irrigation with saline. A second application of Activskin was essential if the first application failed to persist on the wounds. Clinical efficacy and safety were assessed at regular clinic visits during 6 months of follow-up. All 11 treated patients improved with Activskin. The ulcers healed by inward migration from the wound edge. The average healing time was 27.8 days. No recurrent ulceration or other adverse events were observed during follow-up. These results provide preliminary evidence that Activskin is safe and effective in the management of refractory ulcers.

Improvement of peripheral nerve regeneration by a tissue-engineered nerve filled with ectomesenchymal stem cells

Ectomesenchymal stem cells (EMSCs) originate from the cranial neural crest. They are a potential source of neuronal and Schwann cells (SCs) of the peripheral nervous system (PNS) during embryonic development. The third passage of EMSCs enzymatically isolated from the mandibular processes of Sprague-Dawley rats were cultured in forskolin and bovine pituitary extract for 6 days to generate functional Schwann cell phenotypes. Next, 10-mm defects in the sciatic nerves were bridged with an autograft, tissue-engineered nerve filled with differentiated cells in collagen, or a PLGA conduit alone in 18 rats, and the nerve defects of another four rats were left untreated. The regenerated nerves were evaluated by the sciatic functional index (SFI) monthly and by histological analysis 4 months after grafting. The recovery index of the sciatic nerve improved significantly in the autograft and tissue-engineered nerve groups, both of which were superior to the PLGA group. In animals transplanted with the EMSCs, there was greater regeneration than with conduit alone during the same period of implantation. These results show that when EMSCs are transplanted to a peripheral nerve defect they differentiate into supportive cells that contribute to the promotion of axonal regeneration.

FGF signalling in craniofacial development and developmental disorders

The Fgf signalling pathway is highly conserved in evolution and plays crucial roles in development. In the craniofacial region, it is involved in almost all structure development from early patterning to growth regulation. In craniofacial skeletogenesis, the Fgf signal pathway plays important roles in suture and synchondrosis regulation. Mutations of FGF receptors relate to syndromatic and non-syndromatic craniosynostosis. The Fgf10/Fgfr2b signal loop is critical for palatogenesis and submandibular gland formation. Perturbation of the Fgf signal is a possible mechanism of palatal cleft. Fgf10 haploinsufficiency has been identified as the cause of autosomal dominant aplasia of lacrimal and salivary glands. The Fgf signal is also a key regulator of tooth formation: in the absence of Fgfr2b tooth development is arrested at the bud stage. Fgfr4 has recently been identified as the key signal mediator in myogenesis. In this review, these aspects are discussed in detail with a focus on the most recent advances.