Modulation of protein-ligand interactions in the presence of ZIF-8: Spectroscopy and molecular dynamics simulation

In this paper, we investigated the protein-ligand interactions in the presence of ZIF-8 using multi-spectroscopic approaches and molecular dynamics simulation. Fluorescence experiments and molecular docking results showed that ZIF-8 did not change the type of quenching and interaction force between ciprofloxacin (CIP) and human serum albumin (HSA), but made the binding constant of HSA-CIP to be smaller, suggesting that ZIF-8 maybe accelerate the dissociation of CIP from HSA-CIP complex. Moreover, the effect of ZIF-8 on the physiological function of HSA was explored. Multi-spectroscopic methods revealed that ZIF-8 did not significantly alter the microenvironment of amino acid groups, but cause a slight decrease in the content of α-helical conformation, and a sparse and flexible structure of the protein backbone. These peculiarities might lead to the diminution of HSA's ability to control drugs. In short, ZIF-8 might enhance drug effect due to affecting the binding of drugs to proteins. However, the present study is only a preliminary investigation of the suitability of ZIF-8 as a drug carrier in vitro, and subsequent in vivo experimental studies will be required to further confirm the idea.

Fluorine-18 prostate-specific membrane antigen-1007-avid indeterminate bone lesions in prostate cancer: clinical and PET/CT features to predict outcomes and prognosis

AIM

To determine clinical and fluorine-18 prostate-specific membrane antigen-1007 (18F-PSMA-1007) integrated positron-emission tomography (PET)/computed tomography (CT) features that could be used to interpret indeterminate bone lesions (IBLs) and assess the prognosis of prostate cancer (PCa) in patients with IBLs.

MATERIALS AND METHODS

Consecutive patients who underwent PSMA PET/CT were analysed retrospectively. IBLs were identified as benign or malignant based on follow-up imaging and clinical management. Lesion- and patient-based assessments were performed to define features predictive of bone lesion results and determine clinical risk. Patients' prognosis was analysed based on clinical characteristics, including prostate-specific antigen (PSA) and alkaline phosphatase (ALP), respectively.

RESULTS

A total of 105 patients (mean age ± SD, 72.1 ± 8 years) were evaluated and 158 IBLs were identified. Fifty-three (33.5%), 36 (22.8%), and 69 (43.7%) IBLs were benign, malignant, and equivocal, respectively. Variables including location, maximum standard uptake value (SUVmax), and lymph node metastases (LNM) were related to the benignancy or malignancy of IBLs (p=0.046, p<0.001 and p<0.001, respectively). Regression analysis indicated that LNM, SUVmax, and location of IBLs could be predictors of lesion interpretation (p<0.001, p=0.002 and p=0.035). Patients with benign IBLs experienced the most considerable decreases in PSA and ALP levels.

CONCLUSIONS

LNM, SUVmax, and location may contribute to IBL interpretation. A rapid decrease in PSA and ALP levels might suggest a better prognosis for patients with benign IBLs.

The value of T2-weighted MRI contrast ratio combined with DWI in evaluating the pathological grade of solid lung adenocarcinoma

AIM

To assess the predictive value of T2-weighted (T2W) magnetic resonance imaging (MRI) in combination with diffusion-weighted imaging (DWI) for determining the pathological grading of solid lung adenocarcinoma.

MATERIALS AND METHODS

The clinical and imaging data from 153 cases of solid lung adenocarcinoma (82 men, 71 women, mean age 63.2 years) confirmed at histopathology in The First Affiliated Hospital of Xi'an Jiaotong University from January 2017 to May 2022 were analysed retrospectively. Adenocarcinomas were classified into low-grade (G1 and G2) and high-grade (G3) groups following the 2020 pathological grading system proposed by the International Association for the Study of Lung Cancer. The T2-weighted contrast ratio (T2CR), calculated as the T2 signal intensity of the lung mass/nodule divided by the T2 signal intensity of the right rhomboid muscle was utilised. Two experienced radiologists reviewed the MRI images independently, measured the T2CR, and obtained apparent diffusion coefficient (ADC) values. The Mann-Whitney U-test was used to compare general characteristics (sex, age, maximum diameter), T2CR, and ADC values between the low-grade and high-grade groups. The non-parametric Kruskal-Wallis test determined differences in T2CR and ADC values among the five adenocarcinoma subtypes. Receiver characteristic curve (ROC) analysis, along with area under the curve (AUC) calculation, assessed the effectiveness of each parameter in distinguishing the pathological grade of lung adenocarcinoma. A Z-test was used to compare the AUC values.

RESULTS

Among the 153 patients with adenocarcinoma, 103 had low-grade adenocarcinoma, and 50 had high-grade adenocarcinoma. The agreement between T2CR and ADC observers was good (0.948 and 0.929, respectively). None of the parameters followed a normal distribution (p<0.05). The ADC value was lower in the high-grade adenocarcinoma group compared to the low-grade adenocarcinoma group (p=0.004), while the T2CR value was higher in the high-grade group (p=0.011). Statistically significant differences were observed in maximum diameter and gender between the two groups (p<0.001 and p=0.005, respectively), while no significant differences were noted in age (p=0.980). Among the five adenocarcinoma subtypes, only the lepidic and micropapillary subtypes displayed statistical differences in ADC values (p=0.047), with the remaining subtypes showing no statistical differences (p>0.05). The AUC values for distinguishing high-grade adenocarcinoma from low-grade adenocarcinoma were 0.645 for ADC and 0.627 for T2CR. Combining T2CR, ADC, sex, and maximum diameter resulted in an AUC of 0.778, sensitivity of 70%, and specificity of 75%. This combination significantly improved diagnostic efficiency compared to T2CR and ADC alone (p=0.008, z = 2.624; p=0.007, z = 2.679).

CONCLUSION

The MRI quantitative parameters are useful for distinguishing the pathological grades of solid lung adenocarcinoma, offering valuable insights for precise lung cancer treatment.

Linker Histone H1.4 Inhibits the Growth, Migration and EMT Process of Non-Small Cell Lung Cancer by Regulating ERK1/2 Expression

H1.4 is one of the 11 variants of linker histone H1, and is associated with tumorigenesis and development of various cancers. However, it is unclear for the role of histone H1.4 in non-small cell lung cancer (NSCLC). In this study, we found that overexpression of H1.4 significantly inhibited the cell viability, migration, invasion and epithelial-mesenchymal transition (EMT) processes, whereas silencing H1.4 by shRNA knockdown promoted these processes in NSCLC cell lines A549 and H1299. We further showed that H1.4 overexpression reduced ERK1/2 expression or its phosphorylation levels, while H1.4 knockdown increased ERK1/2 expression or phosphorylation levels in NSCLC. Furthermore, we demonstrated that H1.4 bound to the promoter of ERK1/2, and acted as a transcriptional suppressor to inhibit ERK1/2 expression in A549 or H1299 cells. Importantly, we found that ERK ecto-expression can largely recovered the inhibitory effects of H1.4 on cell viability, migration, invasion and EMT processes. In summary, our study reveals that the H1.4-ERK pathway is crucial for cell viability, migration, invasion and EMT of NSCLC and could be a therapeutic target for NSCLC.

Factors associated with early failure of the femoral neck system (FNS) in patients with femoral neck fractures

BACKGROUND

Femoral neck system (FNS) is a new type of internal fixation system which has been widely used for treating femoral neck fractures (FNFs).Compared with other internal fixation methods, FNS is minimally invasive and stable, and often achieves satisfactory short-term efficacy.Early failure of FNS (EFFNS) is not uncommon, however, there are few literatures and reports on factors associated with EFFNS.This study aimed to survey the prevalence and risk factors of EFFNS.

METHODS

We retrospectively analysed 62 patients with FNFs and underwent FNS fixation between 2019 and 2021. Demographic data, clinical characteristics, radiographic features and treatment process were described. Multifactor logistic regression analysis was used to analyse the different influencing factors.

RESULTS

Out of the 62 FNFs patients, 10 patients (16.1%) developed EFFNS, including 6 cases of severe femoral neck shortening, 2 cases of screw-out, 1 case of avascular necrosis of the femoral head and 1 case of nonunion. In the failure group, all patients were younger than 65 years old, which was significantly higher than 59.6% in the healing group (P = 0.012). There were no significant differences in sex(P = 0.490), BMI (P = 0.709), injured side (P = 0.312), injury mechanism (P = 0.617), reduction method(P = 0.570),femoral neck-shaft angle(P = 0.545), Pauwels classification (P = 0.564) and Garden classification (P = 0.195). Moreover, we not found that Garden classification (P = 0.464) and age (P = 0.128) were statistically significant risk factors for EFFNS at multivariate analysis.

CONCLUSION

In this study, sex, BMI, injury side, injury mechanism, reduction method, Pauwels angle, femoral neck-shift angle, Pauwels classification and Garden classification were excluded as EFFNS risk factors. Moreover, our study demonstrated that age and Garden classification were not significant risk factors at multivariate analysis.

TRIAL REGISTRATION

ChiCTR, ChiCTR2100051360. Registered on 21 September, 2021. https://www.chictr.org.cn/index.aspx .

Improving the visualisation of perforator arteries for anterolateral thigh flaps harvest in CT angiography via sublingual glyceryl trinitrate

AIM

To investigate the improvement of image quality and visualisation of the anterolateral thigh (ALT) flap perforators on computed tomography angiography (CTA) after administration of sublingual glyceryl trinitrate (GTN).

MATERIALS AND METHODS

Sixty patients with oral lesions received thigh CTA examinations were divided randomly into two groups after administration of sublingual GTN (GTN group) or without administration of sublingual GTN (non-GTN group). Two radiologists calculated the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and assessed the image quality of each vessel. Besides, the grade of thigh artery, the lumen diameter of deep femoral artery, lateral circumflex femoral artery (LCFA), the descending branch of LCFA and its proximal and distal perforators, and the number and type of visible perforators were evaluated quantitatively.

RESULTS

The SNR and CNR were not significantly different between the two groups (p>0.05). The image quality of CTA in the GTN group was significantly better than that in the non-GTN group (p<0.01). The lumen diameters of the deep femoral artery, LCFA, the descending branch of LCFA and its perforators were significantly larger in the GTN group than those in the non-GTN group (p<0.01). Compared with the non-GTN group, the number of visible perforators and the number of visible septocutaneous perforators were significantly more in the GTN group, and the qualitative grade of visible perforators was significantly higher (p<0.001).

CONCLUSIONS

The administration of sublingual GTN in preoperative thigh CTA can improve the image quality and visualisation of perforator vessels, thus could help surgeons to select the optimum ALT flaps.

Biomaterials / bioinks and extrusion bioprinting

Bioinks are formulations of biomaterials and living cells, sometimes with growth factors or other biomolecules, while extrusion bioprinting is an emerging technique to apply or deposit these bioinks or biomaterial solutions to create three-dimensional (3D) constructs with architectures and mechanical/biological properties that mimic those of native human tissue or organs. Printed constructs have found wide applications in tissue engineering for repairing or treating tissue/organ injuries, as well as in vitro tissue modelling for testing or validating newly developed therapeutics and vaccines prior to their use in humans. Successful printing of constructs and their subsequent applications rely on the properties of the formulated bioinks, including the rheological, mechanical, and biological properties, as well as the printing process. This article critically reviews the latest developments in bioinks and biomaterial solutions for extrusion bioprinting, focusing on bioink synthesis and characterization, as well as the influence of bioink properties on the printing process. Key issues and challenges are also discussed along with recommendations for future research.

[A method for sensitivity analysis of deviation factor for geometric correction of cone-beam CT system]

OBJECTIVE

To propose a sensitivity test method for geometric correction position deviation of cone-beam CT systems.

METHODS

We proposed the definition of center deviation and its derivation. We analyzed the influence of the variation of the three-dimensional spatial center of the steel ball point, the projection center and the size of the steel ball point on the deviation of geometric parameters and the reconstructed image results by calculating the geometric correction parameters based on the Noo analytical method using the FDK reconstruction algorithm for image reconstruction.

RESULTS

The radius of the steel ball point was within 3 mm. The deviation of the center of the calibration parameter was within the order of magnitude and negligible. A 10% Gaussian perturbation of a single pixel in the 3D spatial coordinates of the steel ball point produced a deviation of about 3 pixel sizes, while the same Gaussian perturbation of the 2D projection coordinates of the steel ball point produced a deviation of about 2 pixel sizes.

CONCLUSION

The geometric correction is more sensitive to the deviation generated by the three-dimensional spatial coordinates of the steel ball point with limited sensitivity to the deviation generated by the two-dimensional projection coordinates of the steel ball point. The deviation sensitivity of a small diameter steel ball point can be ignored.

Synthesis and Sonodynamic Antibacterial Activity Evaluation of Three Novel Fluoroquinolone Compounds

OBJECTIVE

Three ciprofloxacin derivatives (CPDs) were synthesized. Also, their sonodynamic antibacterial activities and possible mechanism under ultrasound (US) irradiation were preliminarily investigated.

METHODS

Staphylococcus aureus and Escherichia coli were selected as the research objects. The sonodynamic antibacterial effects of three CPDs and their structure-effective relationship were explored by the inhibition rate. The reactive oxygen species (ROS) produced under US irradiation were detected by oxidative extraction spectrophotometry and used to analyze the sonodynamic antibacterial mechanism of three CPDs.

RESULTS

Research indicated that three CPDs, named compound 1 (C1), compound 2 (C2) and compound 3 (C3), separately all had strong sonodynamic antibacterial activities. In addition, C3 had the strongest effect relative to the other CPDs. The study also found that CPDs' concentration, US irradiation time, US solution temperature and US medium could disturb their sonodynamic antimicrobial effects. Moreover, ¹O₂ and ·OH were the main types of ROS produced by C1 and C3; the ROS produced by C2 included ¹O₂, among other types.

CONCLUSION

Results showed that all three CPDs could be activated to produce ROS after US irradiation. Among them, C3 displayed the highest ROS production and the utmost activity, which may be related to the introduction of the electron-giving group at the C-3 position of the quinoline backbone.

Risk factors analysis and establishment of predictive nomogram of extranodal B-cell lymphoma of mucosal-associated lymphoid tissue

PURPOSE

The role of radiation therapy in mucosa-associated lymphoid tissue (MALT) lymphoma is poorly defined. The objective of this study was to explore the factors associated with the performance of radiotherapy and to assess its prognostic impact in patients with MALT lymphoma.

PATIENTS AND METHODS

Patients with MALT lymphoma diagnosed between 1992 and 2017 were identified in the US Surveillance, Epidemiology, and End Results database (SEER). Factors associated with the delivery of radiotherapy were assessed by chi-square test. Overall survival (OS) and lymphoma-specific survival (LSS) were compared between patients with and without radiotherapy, using Cox proportional hazard regression models, in patients with early stage as well as those with advanced stage.

RESULTS

Of the 10,344 patients identified with a diagnosis of MALT lymphoma, 33.6% had received radiotherapy; this rate was 38.9% for stage I/II patients and 12.0% for stage III/IV patients, respectively. Older patients and those who already received primary surgery or chemotherapy had a significantly lower rate of receiving radiotherapy, regardless of lymphoma stage. After univariate and multivariate analysis, radiotherapy was associated with improved OS and LSS in patients with stage I/II (HR=0.71 [0.65-0.78]) and (HR=0.66 [0.59-0.74]), respectively, but not in patients with stage III/IV (HR=1.01 [0.80-1.26]) and (HR=0.93 [0.67-1.29]). The nomogram built from the significant prognostic factors associated with overall survival of stage I/II patients had a good concordance (C-index=0.749±0.002).

CONCLUSION

This cohort study shows that radiotherapy is significantly associated with a better prognosis in patients with early but not advanced MALT lymphoma. Prospective studies are needed to confirm the prognostic impact of radiotherapy in patients with MALT lymphoma.

Deep learning for predicting the risk of immune checkpoint inhibitor-related pneumonitis in lung cancer

AIM

To develop and validate a nomogram model that combines computed tomography (CT)-based radiological factors extracted from deep-learning and clinical factors for the early predictions of immune checkpoint inhibitor-related pneumonitis (ICI-P).

MATERIALS AND METHODS

Forty ICI-P patients and 101 patients without ICI-P were divided randomly into the training (n=113) and test (n=28) sets. The convolution neural network (CNN) algorithm was used to extract the CT-based radiological features of predictable ICI-P and calculated the CT score of each patient. A nomogram model to predict the risk of ICI-P was developed by logistic regression.

RESULTS

CT score was calculated from five radiological features extracted by the residual neural network-50-V2 with feature pyramid networks. Four predictors of ICI-P in the nomogram model included a clinical feature (pre-existing lung diseases), two serum markers (absolute lymphocyte count and lactate dehydrogenase), and a CT score. The area under curve of the nomogram model in the training (0.910 versus 0.871 versus 0.778) and test (0.900 versus 0.856 versus 0.869) sets was better than the radiological and clinical models. The nomogram model showed good consistency and better clinical practicability.

CONCLUSION

The nomogram model that combined CT-based radiological factors and clinical factors can be used as a new non-invasive tool for the early prediction of ICI-P in lung cancer patients after immunotherapy with low cost and low manual input.

The influence of several nutritional supplements on the rational use of cabozantinib

To promote the rational use of cabozantinib (CBZ), this paper studied the influence of several nutritional supplements on the interaction between CBZ and bovine serum albumin (BSA), an appropriate alternative model for human serum albumin (HSA) that is one of the important transporter proteins in plasma, by fluorescence spectroscopy and UV-vis spectroscopy. The results showed that CBZ could quench the fluorescence of BSA via a dynamic-static quenching process, and the six nutritional supplements did not change the quenching mode of BSA by CBZ. However, all of them could reduce the binding constant of the CBZ-BSA system at 293 K and increase the polarity around tryptophan residues. Among them, nicotinamide and vitamin B₁₂ (VB₁₂ ) had a greater effect on the binding constants of the CBZ-BSA system. In the meantime, the thermodynamic parameters of the CBZ-BSA system were examined, indicating that the interaction of CBZ with BSA was spontaneous and dominated by hydrophobic forces. Further research discovered that the combining of CBZ with BSA was primarily located within Site I of BSA, and the binding distance r was 2.48 nm. Consequently, while taking CBZ, patients should use VB₁₂ and nicotinamide carefully, which may interfere with the transport of drugs.

Wall Effects for Spheroidal Particle in Confined Bingham Plastic Fluids

The wall effects on the sedimentation motion of a single spheroidal particle in cylindrical tubes filled with Bingham plastic fluid are investigated with the fixed computational domain using the Computational Fluid Dynamic (CFD) model in steady-state mode. The CFD model is validated with literature in both bounded and unbounded mediums. The rheological model of the Bingham plastic fluid is regularized with a smoothly varying viscosity. The retardation effects of the tube wall are presented in functions of Reynolds number Re, radius ratio λ (the radius of the tube to the semiaxis of the particle normal to the flow λ = R/r), aspect ratio E (the ratio of the semiaxis of the particle along the flow to r, E = b/r), and Bingham number Bn. The simulation results demonstrate that the drag coefficient C _D declines with the rise in Reynolds number. The relative contribution to drag coefficient from the pressure force increases with larger Bingham number comparing with that from the friction force. The formation and size of the recirculation wake is suppressed by the yield stress. While Bn is approaching infinity, the limiting behavior is observed in the location of yield surface and the value of yield-gravity parameter. The values of critical yield-gravity parameter are explicitly given at different values of E, showing independence with Re and λ. For the flow with Bn ≥ 100, the influence of wall can be even ignored while λ is larger than 5.

MRI-based radiomics analysis in differentiating solid non-small-cell from small-cell lung carcinoma: a pilot study

AIM

To investigate the ability of a T2-weighted (W) magnetic resonance imaging (MRI)-based radiomics signature to differentiate solid non-small-cell lung carcinoma (NSCLC) from small-cell lung carcinoma (SCLC).

MATERIALS AND METHODS

The present retrospective study enrolled 152 eligible patients (NSCLC = 125, SCLC = 27). All patients underwent MRI using a 3 T scanner and radiomics features were extracted from T2W MRI. The least absolute shrinkage and selection operator (LASSO) logistic regression model was used to identify the optimal radiomics features for the construction of a radiomics model to differentiate solid NSCLC from SCLC. Threefold cross validation repeated 10 times was used for model training and evaluation. The conventional MRI morphology features of the lesions were also evaluated. The performance of the conventional MRI morphological features, and the radiomics signature model and nomogram model (combining radiomics signature with conventional MRI morphological features) was evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS

Five optimal features were chosen to build a radiomics signature. There was no significant difference in age, gender, and the largest diameter. The radiomics signature and conventional MRI morphological features (only pleural indentation and lymph node enlargement) were independent predictive factors for differentiating solid NSCLC from SCLC. The area under the ROC curves (AUCs) for MRI morphological features, and the radiomics model, and nomogram model was 0.69, 0.85, and 0.90 (ROC), respectively.

CONCLUSIONS

The T2W MRI-based radiomics signature is a potential non-invasive approach for distinguishing solid NSCLC from SCLC.

[Dynamic changes and influencing factors of HIV-1 DNA load in HIV-1 infected individuals under antiretroviral therapy]

Objective: To analyze the dynamic changes and influencing factors of HIV-1 DNA load in HIV-1 infected individuals under antiretroviral therapy (ART) in Dehong Dai and Jingpo autonomous prefecture, Yunnan province, and provide information support for the clinical use of HIV-1 DNA quantitative detection. Methods: The HIV infection cases in recent infection cohort from Dehong Center for Disease Control and Prevention during 2009-2018 were selected as study subjects. The dynamic curve of HIV-1 DNA load varrying with time was generated and logistic regression analysis was conducted to identify the risk factors for HIV-1 load in the recent follow up after ART and statistical analysis was performed by using SPSS 17.0. Results: Among the 113 HIV infection cases detected from the recent infection cohort, the recent HIV infection rate were 49.6%(56/113) males, sexual transmission cases and drug injection transmission cases accounted for 53.1% (60/113), 80.5% (91/113) and 19.5% (22/113), respectively. The dynamic changes curve showed that HIV-1 DNA load was relatively high (>800 copies /10⁶ PBMCs) before ART, and droped rapidly (<400 copies /10⁶ PBMCs) after ART for 1 year. However, HIV-1 DNA load decreased insignificantly from the second year of ART, and remained to be 269 copies/10⁶ PBMCs after ART for 6 years. Univariable logistic regression analysis indicated that OR (95%CI) of CD8, CD4/CD8 and HIV-1 DNA load were 1.00 (1.00-1.00), 0.30 (0.09-1.05) and 1.01 (1.00-1.01), respectively. Multivariable logistic regression analysis showed that OR value of HIV-1 DNA load base was 1.00 (1.00-1.01). Conclusions: HIV-1 DNA load decreased significantly in the first year of ART, then remained stable for years. HIV-1 DNA load base was the key factor associated with the decrease of HIV-1 DNA load, the lower the HIV-1 DNA load base, the lower HIV-1 DNA load. Therefore, earlier ART can contribute to the decrease of HIV-1 DNA load.

Diet preference of zebrafish (Danio rerio) for bio-based polylactic acid microplastics and induced intestinal damage and microbiota dysbiosis

The ingestion of petroleum-based microplastics (MPs) by aquatic animals and their toxicological effects are of wide concern. However, the ecological risks of bio-based MPs to aquatic animals remain largely unknown. In the present study, zebrafish (Danio rerio) were exposed to MPs of polylactic acid (PLA), the most widely used bio-based plastic, and polyethylene terephthalate (PET), a high-production volume petroleum-based plastic. PLA MPs were more actively ingested by fish than PET MPs. The abundance of PLA MPs in fish intestines was approximately 170 times greater than that of PET MPs after one day of exposure. The ingestion of PLA MPs caused gastrointestinal damage in zebrafish. In addition, the ingestion of PLA MPs induced specific changes in the diversity of intestinal microbiota and promoted species closely linked with energy metabolism, cellular processes, and fish diseases. This might have been related to the depolymerization of PLA in the digestive tract, which decreased the intestinal pH and changed the carbon source structure. Overall, bio-based MPs may have different ecological effects on aquatic animals than traditional petroleum-based MPs.

POS0754 DEVELOPMENT OF A RISK PREDICTION MODEL FOR VENOUS THROMBOEMBOLISM IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: THE SLE-VTE SCORE

Background:

Patients with systemic lupus erythematosus (SLE) have a substantially increased risk of venous thromboembolism (VTE). An individual VTE risk assessment is important to ensure that all patients are assessed and given adequate thromboprophylaxis.

Objectives:

We conducted this study to develop a risk score for VTE in patients with SLE.

Methods:

Patients with SLE who participated in the Chinese SLE Treatment and Research group were enrolled in this study. Patient baseline information and clinical laboratory indicators were obtained, and VTE events were recorded every 3-6 months during follow-up visits. The risk prediction model was created and internally validated using the bootstrap methods, and a scoring system was established (Figure 1).

Figure 1.

Flow chart of study design.

Results:

Out of 4,502 patients included in this study, 135 had a VTE event. After univariate analysis and Lasso regression, the following 11 variables were identified and included in the risk prediction model: male sex, age, BMI ≥25 kg/m2, hyperlipidemia, hypoalbuminemia, hsCRP>3 mg/L, renal involvement, nervous system involvement, anti-β2-glycoprotein I antibody positivity, lupus anticoagulant positivity, and no use of hydroxychloroquine. The AUC for the SLE-VTE score (Table 1) was 0.947 (95% CI, 0.9249-0.9694). The SLE-VTE score’s sensitivity and specificity with the optimal cutoff value of 13 were 0.919 and 0.881, respectively. The SLE-VTE score was superior to the GAPSS system in predicting the risk of VTE in patients with SLE (AUC= 0.947 vs. 0.680, P< 0.001; integrated discrimination improvement (IDI)= 0.6652, P< 0.001; net reclassification improvement (NRI)= 0.6652, P< 0.001).

Table 1.

Final multivariable analysis for venous thromboembolism risk in patients with SLE

β coefficientsOdds ratio* (95% CI)P-valuePoints in scoring systemMale0.6211.86(0.953-3.503)0.0612Age at study entry(≥50)0.8372.308(1.339-3.915)0.0023BMI02(kg/m20.7922.209(1.333-3.627)0.0023Hyperlipemia0.8382.313(1.246-4.166)0.0063Hypoalbuminemia2.1638.697(5.185-14.794)< 0.0017hsCRP>3 mg/L1.4524.272(2.618-6.968)< 0.0015Anti β2GPI1.0132.754(1.543-4.853)0.0013LA1.5594.752(2.799-8.072)< 0.0015Nervous system2.38210.832(6.163-18.998)< 0.0018Lupus nephritis0.8352.305(1.414-3.756)0.0013No use of hydroxychloroquine1.7715.876(3.722-9.401)< 0.0016

BMI: body mass index; hsCRP: Hypersensitive c-reactive protein; ACL: anticardiolipin, antiβ2GPI: anti-β2-glycoprotein I, LA: lupus anticoagulantm;

Values in bold are statistically significant at p <0.05.

Conclusion:

Various factors are related to the occurrence of VTE in patients with SLE. The proposed SLE-VTE risk score can accurately predict the risk of VTE and help identify SLE patients with a high risk of VTE who may benefit from thromboprophylaxis.

References:

[1]Ramirez GA, Efthymiou M, Isenberg DA, Cohen H. Under crossfire: thromboembolic risk in systemic lupus erythematosus. Rheumatology. 2018;58:940-952.

[2]Chung WS, Lin CL, Chang SN, Lu CC, Kao CH. Systemic lupus erythematosus increases the risks of deep vein thrombosis and pulmonary embolism: a nationwide cohort study. J Thromb Haemost. 2014;12:452-458.

[3]Liew NC, Alemany GV, Angchaisuksiri P, et al. Asian venous thromboembolism guidelines: updated recommendations for the prevention of venous thromboembolism. Int Angiol. 2017;36:1.

[4]Savino S, Giovanni S, Veronica M, Dario R, Khamashta MA, Laura BM. GAPSS: the Global Anti-Phospholipid Syndrome Score. Rheumatology. 2013:8.

[5]Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41:543-603.

[6]Moghadamyeghaneh Z, Hanna MH, Carmichael JC, Nguyen NT, Stamos MJ. A Nationwide Analysis of Postoperative Deep Vein Thrombosis and Pulmonary Embolism in Colon and Rectal Surgery. J Gastrointest Surg. 2014;18:2169-2177.

Disclosure of Interests:

None declared

Effect of radiomics from different virtual monochromatic images in dual-energy spectral CT on the WHO/ISUP classification of clear cell renal cell carcinoma

AIM

To investigate the effect of radiomics obtained from different virtual monochromatic images (VMIs) in dual-energy spectral computed tomography (CT) on the World Health Organization/International Association for Urological Pathology (WHO/ISUP) classification of clear cell renal cell carcinoma (ccRCC).

MATERIALS AND METHODS

A retrospective study of 99 ccRCC patients who underwent contrast-enhanced dual-energy CT was undertaken. ccRCC was confirmed at surgery or biopsy and graded according to the WHO/ISUP pathological grading criteria as low grade (n=68, grade I and II) or high grade (n=31, grade III and IV). Radiomics risk scores (RRSs) for differentiating high and low grades of ccRCC were constructed from 11 sets of VMI in (40-140 keV, 10 keV interval) the cortical phase. Receiver operating characteristic (ROC) curves were drawn and the area under the curves (AUCs) was calculated to evaluate the discriminatory power of RRS for each VMI. The Hosmer-Lemeshow test was used to evaluate the goodness-of-fit of each model and the decision curve was used to analyse its net benefit to patients.

RESULTS

The AUC values for distinguishing low-from high-grade ccRCC with RRS of 40-140 keV VMIs were all >0.920. The Hosmer-Lemeshow test showed that the p-values of RRS of VMIs were >0.05, suggesting good fits. In the decision curve analysis, RRS from the 40-140 keV VMIs had similar decision curves and provided better net benefits than considering all patients either as high-grade or low-grade.

CONCLUSIONS

The RRS obtained from multiple VMIs in dual-energy spectral CT have high diagnostic efficiencies for distinguishing between low- and high-grade ccRCC with no significant differences between different VMIs.

Toxicities of microplastic fibers and granules on the development of zebrafish embryos and their combined effects with cadmium

Toxicity of microplastics (MPs) in granular form to aquatic animals has been frequently tested, whereas the effects of fibrous MPs remain further explored. In this study, the effects of polyethylene terephthalate granular particles (p-PET, approximately 150 μm in diameter) and fibers (f-PET, approximately 3-5 mm in length and 20 μm in diameter) on the development of zebrafish embryos and their joint effects with cadmium (Cd) were compared. p-PET and f-PET accelerated the velocities of blood flow and heart rate and inhibited hatching in zebrafish embryos because of their barrier effects on the channels in the embryonic chorion and enhanced the mechanical strength of the chorion. The Cd content in the chorion increased by p-PET due to the adsorption of p-PET on the chorion. By contrast, more f-PET dissociated in culture medium and resulted in low Cd content in the chorion. Given that chorion can effectively block p-PET and f-PET, the Cd accumulation in eggs significantly decreased (p < 0.05) under p-PET/f-PET and Cd combined treatment because of the reduction in the bioavailability of Cd. Therefore, p-PET and f-PET decreased the toxicities of Cd on all the target endpoints in this study, and the detoxification effect of f-PET at 72 hpf was more significant than that of p-PET. These results suggest that the toxicity induced by MPs might be form-related.

Troxerutin Improves Dextran Sulfate Sodium-Induced Ulcerative Colitis in Mice

Screening potential compounds for improving ulcerative colitis (UC) from clinical medication is an effective strategy for drug repurposing. We applied bioinformatics and network pharmacology to the drug screening process in this study, which helped us to screen out troxerutin that could improve UC. Troxerutin belongs to flavonoids and is used clinically as an anticoagulant and thrombolytic agent. This study found a new pharmacological activity of troxerutin, that is, it had a significant improvement effect on UC in mice. Experimental results of in vitro and in vivo levels showed that troxerutin could effectively reduce the level of oxidative stress that caused damages in intestinal epithelial cells and colonic tissue, maintain the distribution and expression of tight junction-related proteins, and protect the barrier function of colon tissue. In addition to the oxidative stress, severe inflammatory response is also an important pathological factor that aggravates UC. However, troxerutin could reduce the infiltration of inflammatory cells in the colon tissue and decrease the expression of inflammation-related proteins and proinflammatory cytokines. Due to its antioxidant and anti-inflammatory effects, troxerutin inhibited the process of cell apoptosis in the colon tissue and relieved the degree of colonic fibrosis. Bioinformatics analysis showed that the ameliorating effect of troxerutin on UC was probably related to its network regulation of signaling pathways. In summary, we discovered a new pharmacological activity of the flavonoid troxerutin against UC, which is conducive to the expansion and application of flavonoids in the treatment of human diseases.

Effect of macro-calcification on the failure mechanics of intracranial aneurysmal wall tissue

BACKGROUND

Calcification was recently found to be present in the majority of cerebral aneurysms, though how calcification and the presence or absence of co-localized lipid pools affect failure properties is still unknown.

OBJECTIVE

The primary objective is to quantify the biomechanical effect of a macro-calcification with surrounding Near-Calcification Region (NCR) of varying mechanical properties on tissue failure behavior.

METHODS

We utilized a structurally informed finite element model to simulate pre-failure and failure behavior of a human cerebral tissue specimen modeled as a composite containing a macro-calcification and surrounding NCR, embedded in a fiber matrix composite. Data from multiple imaging modalities was combined to quantify the collagen organization and calcification geometry. An idealized parametric model utilizing the calibrated model was used to explore the impact of NCR properties on tissue failure.

RESULTS

Compared to tissue without calcification, peak stress was reduced by 82% and 49% for low modulus (representing lipid pool) and high modulus (simulating increase in calcification size) of the NCR, respectively. Failure process strongly depended on NCR properties with lipid pools blunting the onset of complete failure. When the NCR was calcified, the sample was able to sustain larger overall stress, however the failure process was abrupt with nearly simultaneous failure of the loaded fibers.

CONCLUSIONS

Failure of calcified vascular tissue is strongly influenced by the ultrastructure in the vicinity of the calcification. Computational modeling of failure in fibrous soft tissues can be used to understand how pathological changes impact the tissue failure process, with potentially important clinical implications.

Effect of dietary l-arginine of broiler breeder hens on embryonic development, apparent metabolism, and immunity of offspring

This study investigated the effects of supplemented l-arginine (l-Arg) in broiler breeder hens' diets on the embryonic development and physiological changes of offspring during the hatching period. A total of 480 35-wk-old healthy female Arbor Acres broiler breeders were randomly divided into 6 groups and fed a corn and soybean meal diet with 6 digestible Arg levels (0.96%, 1.16%, 1.35%, 1.55%, 1.74%, and 1.93%). After a 10-wk experiment, eggs were collected for incubation. At embryonic day (E) 11 to E21, eggs, embryos, and organs (liver, breast muscle, and thigh muscle) were weighed. Total protein, urea nitrogen, creatinine, cholesterol, and triglyceride in plasma, were measured. Plasma level of immunoglobulin G (IgG), immunoglobulin M (IgM), and nitric oxide synthase (NOS) were measured at E13, E17, and E21. Messenger RNA expression of carbamoyl phosphate synthase I (CPS1), ornithine transcarbamylase (OTC), and argininosuccinate synthase (ASS) in liver and breast muscle tissues was assessed at E13, E17, and E21. The results showed that 1.16% Arg in maternal diet increased egg weight (P < 0.05). The level of Arg in maternal diet has a significant effect on organ index and embryo weight of multiple embryonic days (P < 0.05). Embryonic plasma total protein concentration was significantly affected by maternal dietary Arg level (P < 0.05) and exhibited quadratic responses at E11, E15, E17, and E21 (P < 0.01). Plasma urea nitrogen, creatinine, triglyceride, and cholesterol level were also significantly affected by the level of maternal Arg at different embryonic ages (P < 0.05). Dietary digestible Arg levels quadratically influenced plasma urea nitrogen level at E21 (P < 0.05) and cholesterol concentration at E17 and E19 (P < 0.01). L-Arg supplementation in maternal diet significantly improved the IgG level at E17 and E21 (1.16%, 1.35%, 1.55%, and 1.74%; P < 0.05), the IgM level at E13 (1.35%, 1.55%, 1.74%, and 1.93%) and E17 (P < 0.05) and the NOS level at E13, E17, and E21 (P < 0.05). Maternal dietary L-Arg supplementation significantly improved the expression of CPS1 gene, OTC gene (1.16%, 1.35%, and 1.55%), and ASS gene (1.35% and 1.55%) in the liver (P < 0.05), and also enhanced the CPS1 gene (except 1.35%) and OTC gene (1.55% and 1.74%) expression in the breast muscle (P < 0.05). In conclusion, maternal Arg level affected the embryonic development of offspring and regulated the apparent metabolic programming and immunity state of the embryo. Arginine level of 1.55% in hens' diet was beneficial to the protein synthesis and immunity of the offspring in the embryonic period, and it was recommended to obtain healthy offspring.

p53 coordinates glucose and choline metabolism during the mesendoderm differentiation of human embryonic stem cells

Metabolism plays crucial roles in the fate decision of human embryonic stem cells (hESCs). Here, we show that the depletion of p53 in hESCs enhances glycolysis and reduces oxidative phosphorylation, and delays mesendoderm differentiation of hESCs. More intriguingly, the disruption of p53 in hESCs leads to dramatic upregulation of phosphatidylcholine and decrease of total choline in both pluripotent and differentiated state of hESCs, suggesting abnormal choline metabolism in the absence of p53. Collectively, our study reveals the indispensable role of p53 in orchestrating both glucose and lipid metabolism to maintain proper hESC identity.

Convolutional neural network based proton stopping-power-ratio estimation with dual-energy CT: a feasibility study

Dual-energy computed tomography (DECT) has shown a great potential for lowering range uncertainties, which is necessary for truly leveraging the Bragg peak in proton therapy. However, analytical stopping-power-ratio (SPR) estimation methods have limitations in resolving the influence from the beam-hardening artifact, i.e. CT number variation of the same object scanned under different imaging conditions, such as different patient size and location in the field-of-view (FOV). We present a convolutional neural network (CNN)-based framework to estimate proton SPR that accounts for patient geometry variation and addresses CT number variation. The proposed framework was tested on both prostate and head-and-neck (HN) patient datasets. Simulated CT images were used in order to have a well-defined ground-truth SPR for evaluation. Two training scenarios were evaluated: training with patient CT images (ideal scenario) and training with computational phantoms (realistic scenario). For the training in ideal scenario, computational phantoms were created based on 120 kVp patient CT images using a custom-defined density and material translation curve. Then, 80 kVp and 150 kVp Sn DECT image pairs were obtained using ray-tracing simulation, and their corresponding SPR was calculated from the known density and elemental compositions. For the training in realistic scenario, computational phantoms were created based on the geometry of calibration phantoms. For both scenarios, evaluation was performed on the phantoms created from patient CT images. Compared to a conventional parametric model, U-net trained with computational phantoms (realistic scenario) reduced the SPR estimation uncertainty (95th percentile) of the prostate patient from 1.10% to 0.71%, and HN patient from 2.11% to 1.20%. With the U-net trained with patient images (ideal scenario) uncertainty values were 0.32% and 0.42% for prostate and HN patients, respectively. These results suggest that CNN has great potential to improve the accuracy of SPR estimation in proton therapy by incorporating individual patient geometry information.

[Looking for the roots of Wa Na Qi]

Wa Na Qi(), is a traditional-curing male impotence medicinal. We have made several conclusions through a field investigation to Antarctica, material medica literature research, and current market investigation. Throughout history, Wa Na Qi (also known ashaigou shen) was a word of vague connotation which was not the meaning of a specific product. However, the most common meaning of Wa Na Qi was the penises of several different species of seals. The name Wa Na Qi was adapted from a foreign word, and it is believed to sound like walrus, which has also been credited as a source for Wa Na Qi. In Chinese, Wa Na was a reference to the roundness of the walrus but eventually became a general description of heaviness. Later, it became a name for fur seals. The Song Dynasty Materia Medica Bencao Tujing(, Illustration of Materia Medica) and the Ming Dynasty Materia Medica Bencao Pinhui Jingyao(, Collected Essentials of Species of Materia Medica) both had animal illustrations resembling fur seals. The illustrations in the Compendium of Materia Medica, or Bencao Gangmu, Jinling edition also had characteristics of a fur seal. However, in the Buyi Leigong Paozhi Bianlan(, Lei Gong's Guide to Drug Preparation with Addenda) and later materia medica works, the animal illustrations became distorted and almost myth-like. After a field investigation in Antarctica, we learned that historically, name Wa Na Qi probably originated from seals, such as fur seals. This information matches the current medicines available on the market.

Barrier function of zebrafish embryonic chorions against microplastics and nanoplastics and its impact on embryo development

Embryonic stage is important for the development of aquatic animals, and embryonic chorion is an efficient barrier against exogenous pollutants. The efficient barrier function of zebrafish (Danio rerio) embryonic chorions against micro- and nano- polystyrene (PS) particles was observed. Embryonic chorions presented high affinity to PS particles. The covering layer of PS particles on the outer surface of chorions affected the patency of pores in chorions, and the nano- PS particles exerted a considerable effect. The accelerated heart rate and blood flow velocity in the embryos indicated that the PS particles adhering to embryonic chorions might cause an internal hypoxic microenvironment in the embryos. The coating of PS particles on embryonic chorions also resulted in delayed hatching of the embryos. The observed development toxicity induced by the nano- and micro-PS particles was confirmed via the expressions of metabolic pathways related to antioxidant system. The pathways of biosynthesis of unsaturated fatty acid, linoleic acid metabolism and alanine, and aspartate and glutamate metabolism extensively altered when the embryos were exposed to PS particles, especially to the nano- PS particles. Although micro- and nano- plastic particles can be efficiently blocked by embryonic chorions, they can still affect the early development of aquatic organisms.

SAT0326 SYSTEMIC SCLEROSIS WITHOUT ANTINUCLEAR ANTIBODIES: A MULTI-CENTER STUDY OF EUSTAR COHORT IN CHINA

Background:

The presence of circulating antinuclear antibodies (ANAs) is a hallmark of immune dysregulation and malfunction in patients with systemic sclerosis (SSc)[1]. A variety of ANAs[2], including anti-centromere antibody, anti-topoisomerase I antibody, and anti-RNA polymerase III antibody, are associated with unique sets of disease manifestations and widely used in routine clinical practice for diagnosis, clinical subgrouping, risk stratification and prediction of future organ involvements and prognosis in SSc patients[3,4].

Objectives:

This study aimed to investigate the clinical features of SSc patients with negative ANAs in a European League Against Rheumatism Scleroderma Trials and Research Group (EUSTAR) and Chinese Rheumatism Data Center (CRDC) multi-center cohort in China.

Methods:

Patients were prospectively recruited between April 2008 and June 2019 based on the EUSTAR database and CRDC multi-center cohort from 154 clinical centers nationwide, all of whom fulfilled the 2013 ACR/EULAR classification criteria for systemic sclerosis. Antinuclear antibody testing result was intensively collected. Demographic, clinical, and laboratory data were compared between ANA-positive SSc patients and those with negative ANAs. T-test and chi-square analysis were performed in the comparisons.

Results:

Antinuclear antibodies were detected in 2129 out of 2809 systemic sclerosis patients enrolled in the multi-center cohort and 4.2% of them were negative. There was significant difference between patients with negative and positive ANAs based on gender (29/60 vs 294/1746, p<0.001). The presence of Raynaud’s phenomenon is less common (71.8% vs 99.8%, p<0.001) in the ANA-negative patients. In addition, compared with ANA-positive patients, the incidence of certain critical organ involvements, including gastroesophageal reflux (5.6% vs 18.5%, p=0.002), interstitial lung disease (65.2% vs 77.9%, p=0.015) and pulmonary arterial hypertension (11.5% vs 29.0%, p=0.006) were significantly lower in ANA-negative patients than in the positive group. The proportion of IgG elevation, an indicator of disease activity and severity of inflammation, was significantly lower in the ANA-negative patients than that in the positive group (14.3% vs 41.2%, p<0.001), while no significant differences were found in other inflammatory indicators and skin scores.

Conclusion:

This study describes the clinical features of SSc patients with negative ANAs, which have been rarely mentioned or focused in existing studies. Antinuclear antibody is proved to be strongly associated with the clinical manifestations of systemic sclerosis patients and ANA-negative SSc patients tend to be in relatively milder conditions, including a less common involvement of critical organs and a more temperate inflammatory severity.

References:

[1]Seri, Jeong, Dahae, et al. Diagnostic value of screening enzyme immunoassays compared to indirect immunofluorescence for anti-nuclear antibodies in patients with systemic rheumatic diseases: A systematic review and meta-analysis. [J]. Seminars in arthritis and rheumatism, 2018.

[2]Hesselstrand, R. The association of antinuclear antibodies with organ involvement and survival in systemic sclerosis[J]. Rheumatology, 2003, 42(4):534-540.

[3]Behmanesh F, Amin R, Khajedaluee M, et al. Autoantibody Profile in Systemic Sclerosis[J]. Acta Medica Iranica, 2010, 48(1):12-20.

[4]Hachulla E, Dubucquoi S. Nuclear auto-antibodies: a useful tool for the diagnosis, the classification and the prognosis of systemic sclerosis. [J]. La Revue de Médecine Interne, 2004, 25(6):442-447.

Disclosure of Interests:

None declared

Molecular analysis and clinical diversity of distal hereditary motor neuropathy

BACKGROUND AND PURPOSE

Distal hereditary motor neuropathies (dHMNs) are a clinically and genetically heterogeneous group of disorders. The purpose of this study was to identify the genetic distribution of dHMNs in a large cohort of Chinese patients and provide insight into the underlying common pathophysiology of dHMNs.

METHODS

Multi-gene panel testing or whole-exome sequencing was performed in 70 index patients with clinically diagnosed dHMN between January 2007 and December 2018. The clinical features, Charcot-Marie-Tooth (CMT) neuropathy scores and electrophysiological data at diagnosis were recorded.

RESULTS

Twenty-four causative mutations were identified in 70 index patients with dHMN (34.3%). Mutation in the HSPB1 gene was the most common cause of dHMN. Some CMT genes (MPZ, SH3TC2, GDAP1) were found to be related to dHMN with minor sensory involvement. Patients with a dHMN-plus phenotype (distal motor neuropathy and additional neurological deficits) carried variants in genes related to hereditary spastic paraplegia, amyotrophic lateral sclerosis and spinal muscular atrophy (FUS, KIF5A, KIF1B, ZFYVE26, DNAJB2).

CONCLUSIONS

Comprehensive genetic testing of dHMN patients allows for identification of the pathogenic mutation in one-third of cases. Pure motor neuropathies and motor neuropathies with minor sensory involvement share many genes with CMT disease. Causes for dHMN-plus phenotypes overlap with motor neuron disease.

Microplastics in Yellow River Delta wetland: Occurrence, characteristics, human influences, and marker

Microplastics (MPs) are widespread in the environment including coastal wetlands. The influence of different types and intensities of human activities on the occurrence of MPs in coastal wetlands is still unknown. The aim of this study was to investigate the distribution of MPs and the contribution of human activities in different areas of Yellow River Delta wetland. MPs were widely detected in different areas of the wetland even in the protection area with little human activities. Direct human activities resulted in more severe MPs contamination in the protection area than the tourism area. In the soil of different areas, the MPs abundances ranged from 136 to 2060 items/kg. The concentrations of polyethylene terephthalate (PET) ranged from 536 to 660 μg/kg, and the concentrations of polycarbonate (PC) ranged from 83.9 to 196 μg/kg. The MP abundances of the three areas had significant correlations with PET concentrations. These results indicate that the direct influence of human activities has much greater contribution than indirect influence. These results also suggest that PET concentration can be used as a potential marker of MPs contamination in wetland soils.

5033Effect of intraoperative hybrid surgery on incidence of CPB-AKI in children Congenital heart disease patients: a propensity score matched study

Objective

Cardiopulmonary bypass-associated acute kidney injury (CPB-AKI) is a frequent complication after cardiac surgery in children patients. Intraoperative hybrid cardiac surgery (IPH) is a new technique which needed contrast administration. Contrast was also reported to induce AKI. Therefore, we hypothesized that the IPH would increase the occurrence of CPB-AKI in children Congenital heart disease patients.

Methods

A total of 1509 consecutive patients (age≤3 year) undergoing on-pump cardiac surgery were enrolled in this study from November, 2017 to May, 2018. Multivariate logistic regression was performed in this retrospective study. Propensity score matched analysis was applied for confounding factors. Perioperative and interoperative characteristics and outcomes in IHP group with or without AKI are compared. CPB-AKI was determined by serum Creatinine (SCr) increased twice as much as preoperative or need dialysis within 7 days postoperatively.

Result

IPH was found to be an independent risks factor in the development of CPB-AKI development (OR 2.798, 95% CI 1.823–4.296, p<0.001). Other independent risk factors for CSA-AKI were: CPB time >100 min (OR 2.068, 95% CI 1.521–2.811, P<0.001), weight≤5 kg (OR 3.409, 95% CI 2.192–5.302, P<0.001). Cohort analysis revealed that AKI occurred more frequently in the IPH group before and after matching (30.4% vs. 12.97%, P<0.001; 32.2% vs. 18.3% %, P=0.015, respectively). IPH group also had higher prolonged length of postoperative stay in the hospital (11 vs 7.5, P<0.001; 10.9 vs 7.7, p=0.01), and higher length of mechanical ventilation support (27 vs 10, P<0.001; 26 vs 16, <0.001) before and after matching. Perioperative and interoperative characteristics and outcomes of patients with or without AKI are compared. Only CPB duration was an independent factor for AKI in IPH group.

Comparison of outcomes Variablesa Without PSM PSM IPH group (n=128) No IPH group (n=1381) P IPH group (n=117) No IHP group (n=117) P Median LOSPHOS (days) 11 (8.0, 13.0) 7.4 (6.5, 10.6) <0.001d 11.0 (8.0, 13.0) 7.5 (6.5, 14.7) <0.001d Median LOSMV (hours) 27 (19.0, 71.0) 10 (5, 24) <0.001d 27.0 (18.0, 71.0) 17 (3.0, 49.0) <0.001d Overall mortality n (%) 0 (0%) 14 (1.0%) 0.252c 0 (0%) 2 (1.7%) 0.156c Dialysis, n (%) 3 (2.4%) 23 (1.6%) 0.573c 3 (2.6%) 6 (2.6%) 1.000c AKI, n (%) 39 (30.4%) 176 (12.7%) <0.001b 37 (31.6%) 21 (17.9%) 0.015b aLOSPOHOS: length of postoperative stay in hospital; LOSMV: length of mechanical ventilation; CPB: cardiopulmonary bypass. bχ2 test. cFisher's exact test. dRank sum test.

Study flow

Conclusion

IPH was associated with a higher incidence of CPB-AKI.

Flotillin 1 is differentially expressed in human epithelial ovarian tumors

Although Flotillin 1 (FLOT1) is highly expressed in various human cancers, its relationship with ovarian cancer (OC) remains unknown. This study determines FLOT1 expression in human ovarian tumors and examines its effect on OC   cell proliferation. FLOT1 protein expression was assessed in a tissue microarray by immunohistochemical staining. We found that 81.48% malignant and 50% borderline tumors were FLOT1 protein-positive, whereas benign tumors and normal ovarian tissues were negative. The staining was strongest in serous malignant tumor and transitional cell carcinoma and weakest in mucinous tumor. Differentially expressed FLOT1 in freshly isolated serous tumors was confirmed by Western blot and we then evaluated FLOT1 expression association with OC patients' clinical characteristics. Histological typing established that FLOT1 protein expression was significantly associated with serous tumor (P Keywords: cell proliferation, epithelial ovarian cancer, FLOT1, miRNA, therapeutic target, tumorigenesis.