Delayed-onset seizures after subthalamic nucleus deep brain stimulation surgery for Parkinson's disease

BACKGROUND

Delayed-onset seizures after deep brain stimulation (DBS) surgery were seldom reported. This study summarized the clinical characteristics of delayed-onset seizures after subthalamic nucleus (STN) DBS surgery for Parkinson's disease (PD) and analyzed risk factors.

METHODS

A single-center retrospective study containing consecutive STN-DBS PD patients from 2006 to 2021 was performed. Seizures occurred during the DBS surgery or within one month after DBS surgery were identified based on routine clinical records. Patients with postoperative magnetic resonance imaging (MRI) were included to further analyze the risk factors for postoperative seizures with univariate and multivariate statistical methods.

RESULTS

341 consecutive PD patients treated with bilateral STN-DBS surgery wereidentified, and five patients experienced seizures after DBS surgery with an incidence of 1.47 %. All seizures of the five cases were characterized as delayed onset with average 12 days post-operatively. All seizures presented as generalized tonic-clonic seizures and didn't recur after the first onset. In those seizures cases, peri-electrode edema was found in both hemispheres without hemorrhage and infarction. The average diameter of peri-electrode edema of patients with seizures was larger than those without seizures (3.15 ± 1.00 cm vs 1.57 ± 1.02 cm, p = 0.005). Multivariate risk factor analysis indicated that seizures were only associated with the diameter of peri-electrode edema (OR 4.144, 95 % CI 1.269-13.530, p = 0.019).

CONCLUSIONS

Delayed-onset seizures after STN-DBS surgery in PD patients were uncommon with an incidence of 1.47 % in this study. The seizures were transient and self-limiting, with no developing into chronic epilepsy. Peri-electrode edema was a risk factor for delayed-onset seizures after DBS surgery. Patients with an average peri-electrode edema diameter > 2.70 cm had a higher risk to develop seizures.

Postoperative use of steroids for peri-electrode edema after deep brain stimulation surgery: A retrospective cohort study

BACKGROUND

To review the incidence and extent of peri-electrode edema after DBS and to clarify the effect of postoperative use of steroids on the peri-electrode edema.

METHODS

This retrospective cohort study included 250 patients who underwent bilateral subthalamic nucleus (STN) DBS surgery with intact MRI within 1 month after DBS surgery. Patients were divided into steroid and non-steroid groups, based on postoperative steroids use. The occurrence and extent of peri-electrode edema were compared between the two groups, and other associated factors were analyzed using univariate and multivariate methods.

RESULTS

Peri-electrode edema >1 cm3 in at least one hemisphere was reported in 215 (86.00%) patients. The mean volume of peri-electrode edema observed in the steroid group was significantly smaller than in the non-steroid group (8.09 ± 8.47 cm3 vs 17.10 ± 16.90 cm3 , p < 0.001). In the steroid group, 104 (32.91%) of the 316 implanted electrodes present with edema less than 1 cm3 , whereas in the non-steroid group, only 27 (14.67%) of the 184 implanted electrodes present with edema less than 1 cm3 (p < 0.001). Multivariate analysis indicated that lesser peri-electrode edema was significantly associated with postoperative steroids use and general anesthesia.

CONCLUSIONS

Peri-electrode edema is common after DBS surgery, and postoperative steroids use reduces the occurrence and extent of peri-electrode edema.

The Effect of Surgical Positioning on Pneumocephalus in Subthalamic Nucleus Deep Brain Stimulation Surgery for Parkinson Disease

OBJECTIVES

This research analyzed the effect of surgical positioning on postoperative pneumocephalus and assessed additional potential risk factors of pneumocephalus in subthalamic nucleus (STN) deep brain stimulation (DBS) for Parkinson disease (PD).

MATERIALS AND METHODS

In this study, 255 consecutive patients with PD who received bilateral STN DBS under general anesthesia were retrospectively included. Of these, 180 patients underwent surgery with their heads in an elevated position, and 75 patients underwent surgery in a supine position. The postoperative pneumocephalus volume was compared between the two groups. Other potential risk factors for pneumocephalus also were analyzed.

RESULTS

The mean pneumocephalus volume for the group with elevated-head positioning (16.76 ± 15.23 cm3) was greater than for the supine group (3.25 ± 8.78 cm3) (p < 0.001). Multivariable analysis indicated that the pneumocephalus volume was related to surgical positioning, lateral trajectory angle, intraoperative mean arterial pressure (MAP), microelectrode recording (MER) passage number, brain atrophy degree, and the anterior trajectory angle. No correlation was found between pneumocephalus and age, sex, duration of PD, surgery length, or intracranial volume. In the subgroup analysis, the pneumocephalus volume exhibited a negative correlation with intraoperative MAP (r = -0.210, p = 0.005) and positive correlations with degree of brain atrophy (r = 0.242, p = 0.001) and MER passage number (r = 0.184, p = 0.014) in the elevated-head group. Specifically, an MER passage number > 3 was a significant risk factor for pneumocephalus in the elevated-head group. A positive correlation was observed between the pneumocephalus volume and the lateral trajectory angle in both groups (elevated-head positioning, r = 0.153, p = 0.041; supine positioning, r = 0.546, p < 0.001).

CONCLUSIONS

In patients with PD who were anesthetized and receiving STN DBS, supine positioning reduced pneumocephalus volume compared with patients with PD receiving STN DBS with their heads elevated. The pneumocephalus volume was negatively correlated with intraoperative MAP and positively correlated with the degree of brain atrophy, the lateral trajectory angle, and the MER passage number.

Optimal vaccination strategies for COVID-19 in population migration between two regions scenario

Population movements had a significant impact on the spread of COVID-19, and vaccination is considered the most effective means for humans to face viral infections. This study identifies the optimal control strategy for COVID-19 prevention and control, and explores the impact of short-term and long-term migration on the optimal proportion of vaccine allocation between two regions. We proposed to establish the SIR (Susceptible-Infectious-Recovered) model and determine the stability by calculating the disease free equilibrium and Jacobi matrix of the model. We then established the vaccine optimization model, solved the optimal vaccine distribution strategy by gradient descent method and explored the impact of short-term and long-term migration on the optimal vaccine allocation ratio. The stability analysis revealed that the virus could not be eliminated only by reducing the migration rates and infection rates. we introduced the vaccine methods and obtained the optimal vaccine allocation ratio in Shenzhen and Hong Kong as p1:p2=0.000341: 0.001739, and the daily vaccination rate we need to impose in each region as p1:p2=0.00068:0.001901. The presence or absence of short-term migration had no greater impact on the distribution of the vaccine, whereas Rv with long-term migration had a greater effect than no migration. We found that migration rates could not eliminate the outbreak in both regions and that adopting an effective vaccine distribution strategy could be more effective in eliminating the outbreak. And for different allocation scenarios with limited vaccine supply, we obtained the optimal allocation most favorable to control the epidemic.

Exploring epidemic voluntary vaccinating behavior based on information-driven decisions and benefit-cost analysis

A complex dynamic interplay exists between epidemic transmission and vaccination, which is significantly influenced by human behavioral responses. We construct a research framework combining both the function modeling of the cumulative global COVID-19 information and limited individuals' information processing capacity employing the Gompertz model for growing processes. Meanwhile, we built a function representing the decision to get vaccinated following benefit-cost analysis considered the choices made by people in each scenario have an influence from altruism, free-riding and immunity escaping capacity. Through the mean-field calculation analysis and using a fourth-order Runge-Kutta method with constant step size, we obtain plots from numerical simulations. We found that only when the total number of infectious individuals proves sufficient to reach and exceed a certain level will the individuals face a better trade-off in determining whether to get vaccinated against the diseases based on that information. Besides, authoritative media have a higher decisive influence and efforts should be focused on extending the duration of vaccine protection, which is beneficial to inhibit the outbreaks of epidemics. Our work elucidates that reducing the negative payoff brought about by the free-riding behavior for individuals or improving the positive payoff from the altruistic motivation helps to control the disease in cultures that value social benefits, vaccination willingness is generally stronger. We also note that at a high risk of infection, the decision of vaccination is highly correlated with global epidemic information concerning COVID-19 infection, while at times of lower risk, it depends on the game theoretic vaccine strategy. The findings demonstrate that improving health literacy, ensuring open and transparent information on vaccine safety and efficacy as a public health priority can be an effective strategy for mitigating inequalities in health education, as well as alleviating the phenomenon that immunity escaping abilities is more likely to panic by populations with high levels of education. In addition, prosocial nudges are great ways to bridge these immunity gaps that can contribute to implementing government public health control measures, creating a positive feedback loop.

[A retrospective analysis of clinical characteristics and prognostic factors for 152 cases of Staphylococcus aureus bloodstream infection]

To understand the clinical characteristics of Staphylococcus aureus bloodstream infection and the main risk factors affecting clinical prognosis, providing a reference for clinical prevention and control of Staphylococcus aureus bloodstream infection. In this study, the clinical data of 152 patients with Staphylococcus aureus bloodstream infection admitted to Guangdong Provincial People's Hospital from January 2019 to December 2021 were retrospectively analyzed by reviewing the electronic medical record system, including underlying diseases, clinical characteristics, risk factors, and bacterial resistance. Statistical methods such as Chi-Squared Test and t Test were used to analyze the related risk factors that may affect the clinical characteristics and prognosis of patients with Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection, then the variables with P<0.05 in univariate analysis were included in the multivariate logistic regression model to analyze the independent risk factors of poor prognosis. The results showed among 152 patients with Staphylococcus aureus bloodstream infection, 50 patients (32.89%) were infected with MRSA. In comparison, 102 patients (67.11%) were infected with methicillin-sensitive Staphylococcus aureus (MSSA). Except for rifampicin, the resistance rate of MRSA to commonly used antibiotics was all higher than that of MSSA, and the difference was statistically significant (Chi-square values were 8.272, 11.972, 4.998, 4.776, respectively;all P-values are less than 0.05). Strains resistant to vancomycin, linezolid, and quinupristin/dalfopristin were not found. In the MRSA group, indwelling catheter and drainage tube, carbapenems, and β-lactamase inhibitor treatment were significantly higher than the MSSA group. The difference was statistically significant (P<0.05). The incidence of poor prognosis of bloodstream infection in the MRSA group was higher than that in the MSSA group (34.00% vs 13.73%), and the difference was statistically significant (χ²=8.495, P<0.05). No independent risk factors associated with poor prognosis were found in the included patients with MRSA bloodstream infection.Multivariate Logistic regression model analysis showed that solid malignant tumors (OR=13.576, 95%CI: 3.352-54.977, P<0.05), mechanical ventilation (OR=7.468, 95%CI: 1.398-39.884, P<0.05) were the most important independent risk factors for poor prognosis in patients with Staphylococcus aureus bloodstream infection. In summary, the poor prognosis rate of MRSA bloodstream infection is higher than that of MSSA. The clinical evaluation of related risk factors should be strengthened, targeted prevention and control interventions should be taken to improve the prognosis of patients with Staphylococcus aureus bloodstream infection, and the use of antibiotics should be rational and standardized, to control bacterial infection and drug resistance effectively.

Nirmatrelvir increases blood tacrolimus concentration in COVID-19 patients as determined by UHPLC-MS/MS method

OBJECTIVE

Transplant recipients have a higher risk of SARS-CoV-2 infection owing to the use of immunosuppressive drugs like tacrolimus (FK506). FK506 and nirmatrelvir (NMV) (an anti-SARS-CoV-2 drug) are metabolized by cytochrome P450 3A4 and may have potential drug-drug interactions. It is important to determine the effect of NMV on FK506 concentrations.

PATIENTS AND METHODS

Following protein precipitation from blood, FK506 and its internal standard (FK506-13C,2d4) were detected by ultra-high performance liquid chromatography/tandem mass spectrometry (UHPLC-MS/MS). Total 22 blood samples (valley concentrations) from two coronavirus disease 2019 (COVID-19) patients were collected and analyzed for FK506 concentrations.

RESULTS

Blood levels of FK506 (0.5-100 ng/mL) showed good linearity. The UHPLC-MS/MS method was validated with intra- and inter-batch accuracies of 104.55-107.85%, and 99.52-108.01%, respectively, and precisions of < 15%. Mean blood FK506 concentration was 12.01 ng/mL (range, 3.15-33.1 ng/mL). Five-day co-administration with NMV increased the FK506 concentrations from 3.15 ng/mL to 33.1 ng/mL, returning to 3.36 ng/mL after a 9-day-washout.

CONCLUSIONS

We developed a simple quantification method for therapeutic drug monitoring of FK506 in patients with COVID-19 using UHPLC-MS/MS with protein precipitation. We found that NMV increased FK506 blood concentration 10-fold. Therefore, it is necessary to re-consider co-administration of FK506 with NMV.

The efficacy and safety of asleep and awake subthalamic deep brain stimulation for Parkinson's disease patients: A 1-year follow-up

Introduction

Traditional DBS is usually conducted under local anesthesia (LA) which is intolerable to some patients, DBS under general anesthesia (GA) was opted to extended surgical indication. This study aimed to compare the efficacy and safety of bilateral subthalamic deep brain stimulation (STN-DBS) for Parkinson's disease (PD) under asleep and awake anesthesia state in 1-year postoperative follow-up.

Methods

Twenty-one PD patients were assigned to asleep group and 25 patients to awake group. Patients received bilateral STN-DBS under different anesthesia state. The PD participants were interviewed and assessed preoperatively and at 1-year postoperative follow-up.

Results

At 1-year follow-up, compared surgical coordinate in two groups, the left-side Y of asleep group showed more posterior than awake group (Y was-2.39 ± 0.23 in asleep group, -1.46 ± 0.22 in awake group, p = 0.007). Compared with preoperative OFF MED state, MDS-UPDRS III scores in OFF MED/OFF STIM state remained unchanged, while in OFF MED/ON STIM state were significantly improved in awake and asleep groups, yet without significant difference. Compared with preoperative ON MED state, MDS-UPDRS III scores in ON MED/OFF STIM, and ON MED/ON STIM state remained unchanged in both groups. In non-motor outcomes, PSQI, HAMD, and HAMA score significantly improved in asleep group compared to awake group at 1-year follow-up (PSQI, HAMD, and HAMA score in 1-year follow-up were 9.81 ± 4.43; 10.00 ± 5.80; 5.71 ± 4.75 in awake group, 6.64 ± 4.14; 5.32 ± 3.78; 3.76 ± 3.87 in asleep group, p = 0.009; 0.008; 0.015, respectively), while there was no significant difference in PDQ-39, NMSS, ESS, PDSS score, and cognitive function. Anesthesia methods was significantly associated with improvement of HAMA and HAMD score (p = 0.029; 0.002, respectively). No difference in LEDD, stimulation parameters and adverse events was observed between two groups.

Discussion

Asleep STN-DBS may be considered a good alternative method for PD patients. It is largely consistent with awake STN-DBS in motor symptoms and safety. Yet, it showed higher improvement in terms of mood and sleep compared to awake group at 1-year follow-up.

Characteristics of Electroencephalogram in the Prefrontal Cortex during Deep Brain Stimulation of Subthalamic Nucleus in Parkinson's Disease under Propofol General Anesthesia

BACKGROUND

Monitoring the depth of anesthesia by electroencephalogram (EEG) based on the prefrontal cortex is an important means to achieve accurate regulation of anesthesia for subthalamic nucleus (STN) deep brain stimulation (DBS) under general anesthesia in patients with Parkinson's disease (PD). However, no previous study has conducted an in-depth investigation into this monitoring data. Here, we aimed to analyze the characteristics of prefrontal cortex EEG during DBS with propofol general anesthesia in patients with PD and determine the reference range of parameters derived from the depth of anesthesia monitoring. Additionally, we attempted to explore whether the use of benzodiazepines in the 3 days during hospitalization before surgery impacted the interpretation of the EEG parameters.

MATERIALS AND METHODS

We included the data of 43 patients with PD who received STN DBS treatment and SedLine monitoring during the entire course of general anesthesia with propofol in a single center. Eighteen patients (41.86%) took benzodiazepines during hospitalization. We divided the anesthesia process into three stages: awake state before anesthesia, propofol anesthesia state, and shallow anesthesia state during microelectrode recording (MER). We analyzed the power spectral density (PSD) and derived parameters of the patients' prefrontal EEG, including the patient state index (PSI), spectral edge frequency (SEF) of the left and right sides, and the suppression ratio. The baseline characteristics, preoperative medication, preoperative frontal lobe image characteristics, preoperative motor and non-motor evaluation, intraoperative vital signs, internal environment and anesthetic information, and postoperative complications are listed. We also compared the groups according to whether they took benzodiazepines before surgery during hospitalization.

RESULTS

The average PSI of the awake state, propofol anesthesia state, and MER state were 89.86 ± 6.89, 48.68 ± 12.65, and 62.46 ± 13.08, respectively. The preoperative administration of benzodiazepines did not significantly affect the PSI or SEF, but did reduce the total time of suppression, maximum suppression ratio, and the PSD of beta and gamma during MER. Regarding the occurrence of postoperative delirium and mini-mental state examination (MMSE) scores, there was no significant difference between the two groups (chi-square test, p = 0.48; Mann-Whitney U test, p = 0.30).

CONCLUSION

For the first time, we demonstrate the reference range of the derived parameters of the depth of anesthesia monitoring and the characteristics of the prefrontal EEG of patients with PD in the awake state, propofol anesthesia state, and shallow anesthesia during MER. Taking benzodiazepines in the 3 days during hospitalization before surgery reduces suppression and the PSD of beta and gamma during MER, but does not significantly affect the observation of anesthesiologists on the depth of anesthesia, nor affect the postoperative delirium and MMSE scores.

Risk Factors for Hiccups after Deep Brain Stimulation of Subthalamic Nucleus for Parkinson's Disease

Background: After deep brain stimulation (DBS), hiccups as a complication may lead to extreme fatigue, sleep deprivation, or affected prognosis. Currently, the causes and risk factors of postoperative hiccups are unclear. In this study, we investigated the risk factors for hiccups after DBS of the subthalamic nucleus (STN) for Parkinson’s disease (PD) under general anesthesia. Methods: We retrospectively included patients who underwent STN DBS in the study, and collected data of demographic characteristics, clinical evaluations, and medications. According to the occurrence of hiccups within seven days after operation, the patients were divided into a hiccups group and non-hiccups group. The potentially involved risk factors for postoperative hiccups were statistically analyzed by logistic regression analysis. Results: A total of 191 patients were included in the study, of which 34 (17.80%) had postoperative transient persistent hiccups. Binary univariate logistic regression analysis showed that male, higher body mass index (BMI), smoker, Hoehn and Yahr stage (off), preoperative use of amantadine, hypnotic, Hamilton anxiety scale and Hamilton depression scale scores, and postoperative limited noninfectious peri-electrode edema in deep white matter were suspected risk factors for postoperative hiccups (p < 0.1). In binary multivariate logistic regression analysis, male (compared to female, OR 14.00; 95% CI, 1.74−112.43), postoperative limited noninfectious peri-electrode edema in deep white matter (OR, 7.63; 95% CI, 1.37−42.37), preoperative use of amantadine (OR, 3.64; 95% CI, 1.08−12.28), and higher BMI (OR, 3.50; 95% CI, 1.46−8.36) were independent risk factors for postoperative hiccups. Conclusions: This study is the first report about the risk factors of hiccups after STN DBS under general anesthesia for PD patients. The study suggests that male, higher BMI, preoperative use of amantadine, and postoperative limited noninfectious peri-electrode edema in deep white matter are independent risk factors for postoperative hiccups of STN-DBS for PD patients. Most hiccups after STN-DBS for PD patients were transient and self-limiting.

Assessing Vaccination Prioritization Strategies for COVID-19 in South Africa Based on Age-Specific Compartment Model

The vaccines are considered to be important for the prevention and control of coronavirus disease 2019 (COVID-19). However, considering the limited vaccine supply within an extended period of time in many countries where COVID-19 vaccine booster shot are taken and new vaccines are developed to suppress the mutation of virus, designing an effective vaccination strategy is extremely important to reduce the number of deaths and infections. Then, the simulations were implemented to study the relative reduction in morbidity and mortality of vaccine allocation strategies by using the proposed model and actual South Africa's epidemiological data. Our results indicated that in light of South Africa's demographics, vaccinating older age groups (>60 years) largely reduced the cumulative deaths and the "0-20 first" strategy was the most effective way to reduce confirmed cases. In addition, "21-30 first" and "31-40 first" strategies have also had a positive effect. Partial vaccination resulted in lower numbers of infections and deaths under different control measures compared with full vaccination in low-income countries. In addition, we analyzed the sensitivity of daily testing volume and infection rate, which are critical to optimize vaccine allocation. However, comprehensive reduction in infections was mainly affected by the vaccine proportion of the target age group. An increase in the proportion of vaccines given priority to "0-20" groups always had a favorable effect, and the prioritizing vaccine allocation among the "60+" age group with 60% of the total amount of vaccine consistently resulted in the greatest reduction in deaths. Meanwhile, we observed a significant distinction in the effect of COVID-19 vaccine allocation policies under varying priority strategies on relative reductions in the effective reproduction number. Our results could help evaluate to control measures performance and the improvement of vaccine allocation strategy for COVID-19 epidemic.

[Analysis of liver function injury associated with 2019-nCoV Omicron mutant strains]

Objective: To investigate the clinical features and influencing factors of liver function injury in patients with 2019-nCoV/SARS-CoV-2 Omicron mutant strains. Methods: 1 183 confirmed imported cases of SARS-CoV-2 who were admitted at Shanghai Public Health Clinical Center (affiliated to Fudan University) from July 1, 2021 to January 15, 2022 were collected. Clinical data, viral genotyping and laboratory test results were collected to retrospectively analyze the basic condition and clinical characteristics of liver function injury. Statistical analysis was performed using t-test or Wilcoxon rank-sum test, χ² test or Fisher's exact test, Pearson correlation test and logistic regression analysis. Results: 125 (10.6%) cases had raised baseline ALT level and 60 (5.1%) cases had abnormal baseline AST level. Among them, 33 cases (2.8%) had received hepatoprotective drugs. Liver function injury was generally mild in SARS-CoV-2 infection and minimal in Omicron mutant strains. Leukocyte count was increased in patients with raised alanine aminotransferase (ALT) [(6.96±1.78)×10⁹/L vs. (6.41±1.96)×10⁹/L, P=0.005 2], CT scan showed the proportion of liver hypodensity was significantly increased (2.4% vs. 0.3%, P=0.018 0). High-sensitivity C-reactive protein [(7.83±22.36) mg/L vs. (2.68±6.21) mg/L, P=0.007 8] and D-dimer [(0.34±0.39) μg/ml vs. (0.31±0.75) μg/ml, P=0.047 5] levels were higher in patients with raised AST than normal group. 26 cases had normal liver function at hospital admission; however, abnormal liver function was occurred during the course of the disease. Another 8 patients had abnormal liver function at hospital admission, and reduced liver function further during the course of treatment. Recovery time and length of hospital stay was significantly affected in patients with worsened liver function. Baseline body mass index value [odds ratio (OR)]=1.80, P=0.047), non-Omicron strains (OR=12.63, P=0.046), D-dimer (OR=2.36, P=0.047) and interleukin-6 levels (OR=1.03, P=0.009), and those who used glucocorticoids and/or ulinastatin after hospital admission (OR=6.89, P=0.034) had a higher risk of worsening liver function. Conclusions: Liver dysfunction could be observed among COVID-19 patients. Patients infected with omicron variant generally showed mild liver injury. Dynamic monitoring of liver function is necessary, especially among those with baseline elevated IL-6, D-Dimer level and use of antiinflammation medication during treatment.

New approaches suggest term and preterm human fetal membranes may have distinct biomechanical properties

Preterm prelabour rupture of membranes is the leading cause of preterm birth and its associated infant mortality and morbidity. However, its underlying mechanism remains unknown. We utilized two novel biomechanical assessment techniques, ball indentation and Optical Coherence Elastography (OCE), to compare the mechanical properties and behaviours of term (≥ 37 weeks) and preterm (33-36 weeks) human fetal membranes from ruptured and non-ruptured regions. We defined the expression levels of collagen, sulfated glycosaminoglycans (sGAG), matrix metalloproteinase (MMP-9, MMP-13), fibronectin, and interleukin-1β (IL-1β) within membranes by biochemical analysis, immunohistochemical staining and Western blotting, both with and without simulated fetal movement forces on membrane rupture with a new loading system. Preterm membranes showed greater heterogeneity in mechanical properties/behaviours between ruptured and non-ruptured regions compared with their term counterparts (displacement rate: 36% vs. 15%; modulus: 125% vs. 34%; thickness: 93% vs. 30%; collagen content: 98% vs. 29%; sGAG: 85% vs 25%). Furthermore, simulated fetal movement forces triggered higher MMP-9, MMP-13 and IL-1β expression in preterm than term membranes, while nifedipine attenuated the observed increases in expression. In conclusion, the distinct biomechanical profiles of term and preterm membranes and the abnormal biochemical expression and activation by external forces in preterm membranes may provide insights into mechanisms of preterm rupture of membranes.

Analyzing the COVID-19 vaccination behavior based on epidemic model with awareness-information

Background

The widespread use of effective COVID-19 vaccines could prevent substantial morbidity and mortality. Individual decision behavior about whether or not to be vaccinated plays an important role in achieving adequate vaccination coverage and herd immunity.

Methods

This research proposes a new susceptible–vaccinated–exposed–infected–recovered with awareness-information (SEIR/V-AI) model to study the interaction between vaccination and information dissemination. Information creation rate and information sensitivity are introduced to understand the individual decision behavior of COVID-19 vaccination. We then analyze the dynamical evolution of the system and validate the analysis by numerical simulation.

Results

The decision behavior of COVID-19 vaccination in China and the United States are analyzed. The results showed the coefficient of information creation and the information sensitivity affect vaccination behavior of individuals.

Conclusions

The information-driven vaccination is an effective way to curb the COVID-19 spreading. Besides, to solve vaccine hesitancy and free-ride, the government needs to disseminate accurate information about vaccines safety to alleviate public concerns, and provide the widespread public educational campaigns and communication to guide individuals to act in group interests rather than self-interest and reduce the temptation to free-riding, which often results from individuals who are inadequately informed about vaccines and thus blindly imitate free-riding behavior.

Analyzing COVID-19 Vaccination Behavior Using an SEIRM/V Epidemic Model With Awareness Decay

Information awareness about COVID-19 spread through multiple channels can stimulate individuals to vaccinate to protect themselves and reduce the infection rate. However, the awareness individuals may lose competency over time due to the decreasing quality of the information and fading of awareness. This paper introduces awareness programs, which can not only change people from unaware to aware state, but also from aware to unaware state. Then an SEIRM/V mathematical model is derived to study the influence of awareness programs on individual vaccination behavior. We evaluate the dynamical evolution of the system model and perform the numerical simulation, and examine the effects of awareness transformation based on the COVID-19 vaccination case in China. The results show that awareness spread through various information sources is positively associated with epidemic containment while awareness fading negatively correlates with vaccination coverage.

Wernekinck Commissure Syndrome with Holmes Tremor: A Report of Two Cases and Review of Literature

Wernekinck commissure syndrome is a rare midbrain infarction, it consists of several symptoms including bilateral cerebellar ataxia, ophthalmoplegia, and palatal tremor. Holmes tremor is a rare clinical syndrome characterized by a combination of resting, postural, and action tremors. We describe two cases of Wernekinck commissure syndrome with Holmes tremor. To the best of our knowledge, it has been rarely reported in the literature to date. Both of the cases were presented with acute onset of bilateral cerebellar ataxia, dysarthria, and Holmes tremor. In the treatment, one patient was given "clonazepam and benheisol," the other was received acupuncture therapy, both of them showed a marked improvement in ataxia and tremor.

11-year follow-up outcomes of catheter ablation of para-hisian accessory pathways

Funding Acknowledgements

Type of funding sources: None.

Background

Ablation of para-hisian accessory pathways (APs) remains challenging due to anatomic characteristics and few studies have focused on the causes for recurrence of radiofrequency ablation of para-hisian APs.

Objective

This retrospective single center study was aimed to explore the risk factors for recurrence of para-hisian APs.

Methods

113 patients who had a para-hisian AP with an acute success were enrolled in the study. In the 11-year follow-up, 15 cases had a recurrent para-hisian AP. Therefore 98 patients were classified into success group while 15 patients were classified into recurrence group. Demographic and ablation characteristics were analyzed.

Results

Gender difference was similar in two groups. The median age was 36.2 years old and was younger in recurrence group. Maximum ablation power was significantly higher in success group (29 ± 7.5 vs 22.9 ± 7.8, p &lt; 0.01). Ablation time of final target sites was found to be markedly higher in success group (123.4 ± 53.1 vs 86.7 ± 58.3, p &lt; 0.05). Ablation time less than 60 seconds was detected in 12 (12.2%) cases in success group and 7 (46.7%) cases in recurrence group (p &lt; 0.01). Occurrence of junctional rhythm was significantly higher in recurrence group (25.5% vs 53.3%, p &lt; 0.05). No severe conduction block, no pacemaker implantation and no stroke were reported. Junctional rhythm during ablation (OR = 3.833, 95%CI 1.083-13.572, p = 0.037) and ablation time &lt;60s (OR = 5.487, 95%CI 1.411-21.340, p = 0.014) were independent risk factors for the recurrence of para-hisian AP.

Conclusions

Considering the long-term safety of ablation of para-hisian AP, proper extension of ablation time and increase of ablation power could be applied during operation.

[Histopathological features of squamous cell carcinoma of lung neoadjuvant immunotherapy focusing on responses]

Objective: To analyze the pathologic features of responses to neoadjuvant immunotherapy of squamous cell carcinoma (SCC) of the lung. Methods: The study included 31 patients with resected lung SCC post neoadjuvant immunotherapy. All patients were recruited from the neoadjuvant anti-PD-1 (Sintilimab) phase Ⅰb clinical trial (ChiCTR-OIC-17013726). The histopathological morphology and different degrees of pathologic response to immunotherapy were evaluated basing on irPRC standard. Results: According to the percentage of residual viable tumor (% RVT), pathologic responses of complete pathologic response (cPR), major pathologic response (MPR) and non-MPR were noted in 19% (n=6), 29% (n=9), and 52% (n=16) of patients respectively. In addition, extensive immune activation phenomena (immune cell infiltration, including infiltration of lymphocytes, plasma cells, foamy macrophages, lymphocyte aggregation and tertiary lymphoid structures formation) and tissue repair features (giant cells, granuloma formation, proliferative fibrosis and neovascularization) were observed in tumor regression bed. Conclusions: Neoadjuvant immunotherapy has favorable effect on lung SCC. Pathologic assessment of resected lung cancer specimens after neoadjuvant immunotherapy shows unique histopathological features consistent with its mechanism.

Quantitative measurement of mechanical properties in wound healing processes in a corneal stroma model by using vibrational optical coherence elastography (OCE)

Corneal wound healing, caused by frequent traumatic injury to the cornea and increasing numbers of refractive surgeries, has become a vital clinical problem. In the cornea, wound healing is an extremely complicated process. However, little is known about how the biomechanical changes in wound healing response of the cornea. Collagen-based hydrogels incorporating corneal cells are suitable for replicating a three-dimensional (3D) equivalent of the cornea in-vitro. In this study, the mechanical properties of corneal stroma models were quantitatively monitored by a vibrational optical coherence elastography (OCE) system during continuous culture periods. Specifically, human corneal keratocytes were seeded at 5 × 10⁵ cells/mL in the hydrogels with a collagen concentration of 3.0 mg/mL. The elastic modulus of the unwounded constructs increased from 2.950 ± 0.2 kPa to 11.0 ± 1.4 kPa, and the maximum thickness decreased from 1.034 ± 0.1 mm to 0.464 ± 0.09 mm during a 15-day culture period. Furthermore, a traumatic wound in the construct was introduced with a size of 500 µm. The elastic modulus of the neo-tissue in the wound area increased from 1.488 ± 0.4 kPa to 6.639 ± 0.3 kPa over 13 days. This study demonstrates that the vibrational OCE system is capable of quantitative monitoring the changes in mechanical properties of a corneal stroma wound model during continuous culture periods and improves our understanding on corneal wound healing processes.

Assessment of Ischemic Volumes by Using Relative Filling Time Delay on CTP Source Image in Patients with Acute Stroke with Anterior Circulation Large Vessel Occlusions

BACKGROUND AND PURPOSE

Thrombectomy up to 24 hours after stroke onset in patients with specific ischemic brain volumes remains a challenge, because many stroke centers do not apply specialized software to calculate ischemic volumes at advanced imaging. We aimed to establish the association between relative filling time delay on CTP source imaging and ischemic volume parameters and the infarct penumbra to core volume mismatch in patients with acute ischemic stroke.

MATERIALS AND METHODS

Consecutive patients with acute ischemic stroke and with M1 segment MCA with or without terminal ICA occlusions on baseline CTA and CTP within 24 hours of stroke symptom onset were included. Ischemic volumes were analyzed with software based on CTP maps. Relative filling time delay was classified into 4 grades-grade 0: relative filling time delay = 0 seconds; grade 1: relative filling time delay >0 to ≤4 seconds; grade 2: relative filling time delay >4 to ≤8 seconds; and grade 3: relative filling time delay > 8 seconds. Differences in ischemic volume parameters among relative filling time delay grades were tested.

RESULTS

We recruited 138 patients (median age, 69 years; 62.3% male). Different median volumes of the infarct core (grade 0, 7.3 mL; grade 1, 23.3 mL; grade 2, 45.7 mL; grade 3, 135 mL [P < .001]) and the penumbra (grade 0, 47.6 mL; grade 1, 90 mL; grade 2, 110 mL; grade 3, 92 mL [P = .043]) were observed among relative filling time delay grades. Target mismatch (defined by the criteria of the DEFUSE 3 trial) was identified in 71.7% of the patients (99/138). A relative filling time delay grade ≤ 1 independently predicted target mismatch, with a sensitivity of 0.79 (95% CI, 0.7-0.87) and a specificity of 0.66 (95% CI, 0.49-0.8).

CONCLUSIONS

Relative filling time delay grade based on CTP source imaging is a simple and effective parameter for evaluating ischemic volumes and target mismatch in patients with acute ischemic stroke. Further studies that compare relative filling time delay grade with clinical functional outcomes are necessary.

MiR-24 alleviates cardiomyocyte apoptosis after myocardial infarction via targeting BIM

Since this article has been suspected of research misconduct and the corresponding authors did not respond to our request to prove originality of data and figures, "MiR-24 alleviates cardiomyocyte apoptosis after myocardial infarction via targeting BIM, by L.-J. Pan, X. Wang, Y. Ling, H. Gong, published in Eur Rev Med Pharmacol Sci 2017; 21 (13): 3088-3097-PMID: 28742197" has been withdrawn. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/13100.

[Analysis of baseline liver biochemical parameters in 324 cases with novel coronavirus pneumonia in Shanghai area]

Objective: To summarize the clinical characteristics and liver biochemical parameters of 324 cases admitted with novel coronavirus pneumonia in Shanghai area. Methods: Clinical data and baseline liver biochemical parameters of 324 cases with novel coronavirus pneumonia admitted to the Shanghai Public Health Clinical Center from January 20, 2020 to February 24, 2020 were retrospectively analyzed. Patients were divided into two groups based on the status of illness: mild type (mild and typical) and severe type (severe and critical).The differences in clinical data and baseline liver biochemical parameters of the two groups were described and compared. The t-test and Wilcoxon rank-sum test were used for measurement data. The enumeration data were expressed by frequency and rate, and chi-square test was used. Results: Of the 324 cases with novel coronavirus pneumonia, 26 were severe cases (8%), with median onset of 5 days, 20 cases were HBsAg positive (6.2%), and 70 cases (21.6%) with fatty liver, diagnosed with X-ray computed tomography. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyl transferase (GGT), total bilirubin (TBil), albumin(ALB) and international normalized ratio (INR) of 324 cases at baseline were 27.86 ± 20.02 U/L, 29.33 ± 21.02 U/L, 59.93 ± 18.96 U / L, 39.00 ± 54.44 U/L, 9.46 ± 4.58 μmol / L, 40.64 ± 4.13 g / L and 1.02 ± 0.10. Of which, ALT was > than the upper limit of normal (> ULN), accounting for 15.7% (51/324). ALT and AST > ULN, accounting for 10.5% (34/324). ALP > ULN, accounting for 1.2% (4/324). ALP and GGT > ULN, accounting for 0.9% (3/324). INR > ULN was lowest, accounting for 0.6% (2/324). There were no statistically significant differences (P > 0.05) in ALT [(21.5 vs. 26) U / L, P = 0.093], ALP [(57 vs.59) U/L, P = 0.674], and GGT [(24 vs.28) U/L, P = 0.101] between the severe group and the mild group. There were statistically significant differences in AST (23 U/L vs. 34 U/L, P < 0.01), TBil (10.75 vs. 8.05 μmol / L, P < 0.01), ALB (35.79 ± 4.75 vs. 41.07 ± 3.80 g/L, P < 0.01), and INR (1.00 vs. 1.04, P < 0.01). Conclusion: The baseline liver biochemical parameters of 324 cases with novel coronavirus pneumonia in Shanghai area was comparatively lower and the liverinjury degree was mild, and the bile duct cell damage was rare.

Determination of Glyphosate and Aminomethylphosphonic Acid in Crops by Capillary Gas Chromatography with Mass-Selective Detection: Collaborative Study

A collaborative study was conducted to validate a method for the determination of glyphosate and aminomethylphosphonic acid (AMPA) in crops. The analytes are extracted from crops with water, and the crude extracts are then subjected to a cation exchange cleanup. The analytes are derivatized by the direct addition of the aqueous extract into a mixture of heptafluorobutanol and trifluoroacetic anhydride. The derivatized analytes are quantitated by capillary gas chromatography with mass-selective detection (MSD). The collaborative study involved 13 laboratories located in 5 countries 12 laboratories returned valid data sets. The crops tested were field corn grain, soya forage, and walnut nutmeat at concentrations of 0.050, 0.40, and 2.0 mg/kg. The study used a split-level pair replication scheme with blindly coded laboratory samples. Twelve materials were analyzed, including 1 control and 3 split-level pairs for each matrix, 1 pair at each nominal concentration. For glyphosate, the mean recovery was 91%, the average intralaboratory variance, the repeatability relative standard deviation (RSDr), was 11%, and the interlaboratory variance, the reproducibility relative standard deviation (RSDR), was 16%. For AMPA, the mean recovery was 87%, the RSDr was 16%, and the RSDR was 25% at mg/kg levels.

Stromal fibroblast-derived MFAP5 promotes the invasion and migration of breast cancer cells via Notch1/slug signaling

BACKGROUND

The tumor microenvironment (TME) regulates tumor progression, and cancer-associated fibroblasts (CAFs) are the primary stromal components of the TME, with the potential to drive tumor metastasis via the secretion of paracrine factors, but the specific mechanisms driving this process have not been defined.

METHODS

Proteins secreted from CAFs and normal fibroblasts (NFs) were analyzed via proteomic analysis (fold change > 2, p < 0.05) to identify tumor-promoting proteins secreted by CAFs.

RESULTS

Proteomic analysis revealed that microfibrillar-associated protein 5 (MFAP5) is preferentially expressed and secreted by CAFs relative to NFs, which was confirmed by Western blotting and RT-qPCR. Transwell and wound healing assays confirmed that MFAP5 is secreted by CAFs, and drives the invasion and migration of MCF7 breast cancer cells. We further found that in MCF7 cells MFAP5 promoted epithelial-mesenchymal transition, activating Notch1 signaling and consequently upregulating NICD1 and slug. When Notch1 was knocked down in MCF7 cells, the ability of MFAP5 to promote invasion and migration decreased.

CONCLUSION

CAFs promote cancer cells invasion and migration via MFAP5 secretion and activation of the Notch1/slug signaling. These data highlight this pathway as a therapeutic target to disrupt tumor progression through the interference of CAF-tumor crosstalk.

Abstract P6-09-07: Expression of miR-106b in circulating tumor cells is associated with EMT and prognosis in metastatic breast cancer patients

# Co-first author: W.T., G.L., X.X.

* Co-Correspondence: C.G. and W.G.J.

Abstract

Background: Circulating tumor cells (CTCs) display changes in epithelial-mesenchymal transition (EMT) markers and miRNAs regulate EMT in breast cancer cells. The association between EMT characteristics and miRNA expression in CTCs of metastatic breast cancer (MBC) patients and their clinical implications remain unknown.

Methods: CTC-specific miRNAs were screened based on comparison of the miRNA profile between CTC and primary tumor. RT-PCR was used to quantity the expression levels of EMT makers and miRNA candidates. We enrolled 219 MBC patients with CTCs ≥ 5/7.5mL blood from 2 cohorts and CTCs were detected and enriched by CellSearch. Overall survival (OS) and radiological response were analyzed. CTCs were divided into epithelial- (E-CTCs) and mesenchymal-like CTC (M-CTCs) phenotypes based on a cut-off value derived from suspended breast cancer cells recovered from PBMCs.

Results: MiR-106b displayed upregulation in CTCs, with a higher level in M-CTCs than E-CTCs. Patients with E-CTCs showed better OS than those with M-CTCs (HR 1.77, 95% CI 1.14-2.78, P =0.012). CTCs from chemo-resistant MBC patients exhibited higher miR-106b. CTC-specific miR-106b was negatively associated with therapy response and OS (HR 1.73, 95% CI 1.06-2.84, P = 0.029).

Conclusions: CTC-specific miR-106b was associated with EMT phenotypes of CTCs and may predict prognosis in MBC patients.

Citation Format: Tan W, Liang G, Xie X, Tan L, Sanders AJ, Liu Z, Ling Y, Zhong W, Jiang WG, Gong C. Expression of miR-106b in circulating tumor cells is associated with EMT and prognosis in metastatic breast cancer patients [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-09-07.

Abstract P2-08-56: Effects of young age on prognosis in patients with node-negative tumors 2 cm or smaller breast cancer

Background It is still controversial to consider age as a prognostic factor into the treatment strategy of patients with T1N0M0 breast cancer.

Aim The main purpose of this study was to evaluate the effect of age on recurrence risk in patients diagnosed with T1N0M0 breast cancer as well as compare the prognosis of young aged patients(YA,≤40 years old) to non-young aged patients(non-YA,&gt;40 years old) by using a propensity score matching(PSM) analysis.

Methods 365 patients with T1N0M0 breast cancer diagnosed between 2003 and 2016 who received surgery in Sun Yat-sen Memorial Hospital Breast Cancer Center were included.The recurrence free survival (RFS) and risk factors for recurrence were identified by using Kaplan-Meier method and Cox proportional hazards models. PSM was then used to reduce the confounding effect of known risk factors on prognosis and then to compare 5-year RFS rates in patients between two age groups.

Results After a median follow up of 79 months, 54 patients developed recurrences and 5-year RFS was 87.6%. YA patients had lower RFS estimates (80.6%), compared to patients diagnosed in a later age (89.1% if older than 40-years old; P = 0.049). YA patients tended to have Her-2 positive, TNBC tumors, higher rate of Ki-67 expression and nuclear grade tumor. At multivariate analysis, Her-2 positive (HR 2.115; 95% CI 1.103-4.055, p=0.024) and TNBC (HR 2.963; 95% CI 1.485-5.914, p=0.002) resulted independent prognostic factors of patient with T1N0M0 breast cancer. In the subgroup analysis, we found significant poor RFS for YA patients with Her-2 positive breast cancer compared to the older counterparts(p=0.006) and YA patients were associated with significantly higher rates of the locoregional recurrence rather than metastasis(p=0.004), especially in first 5 years after diagnosis. After PSM, the baseline level and treatment status including tumor size, grade, HR status, Her-2 status, Ki67 expression breast surgery type and systemic adjuvant treatment(AST) of patients in the two age groups tended to be equal. As result, we found significant difference in the 5-year RFS between two age groups(p=0.008).

Conclusion Based on equal treatment condition, young age at presentation conferred a worse prognosis in patients with T1N0M0 breast cancer is independent on other pathological features.

Citation Format: Zhong W, Tan L, You N, Wang Y, Liang G, Liu Z, Ling Y, Tian Z, Gong C. Effects of young age on prognosis in patients with node-negative tumors 2 cm or smaller breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-56.

Abstract P2-07-12: A prognostic prediction nomogram (PDIDC) for breast Paget's disease with infiltrating ductal carcinoma patients: A SEER cohort analysis

Purpose

The aim of the study was to develop a specific nomogram for prediction of prognosis for breast Paget's disease with infiltrating ductal carcinoma (PD-IDC) patients.

Patients and Methods

Patients data were obtained by the Surveillance, Epidemiology, and End Results (SEER) program (N=2502). Study outcome was Breast Cancer Specific Survival (BCSS). Cox proportional hazards model was applied to identify risk factors and develop predictive model. For internal validation, discrimination was calculated with the concordance index (C-index) using the bootstrap method and calibration assessed.

Results

NPI classification, skin symptom, tumor site and age showed significant association with BCSS(table.1)and were used to build the PDIDC nomogram and to calculate risk score. PDIDC nomogram's C-index (0.791, 95%CI 0.783-0.818) showed better discrimination power than NPI classification (0.691, 95%CI, 0.650-0.735, P= 0.000) and AJCC staging (0.718, 95%CI, 0.695-0.741, P=0.000). Patients were divided into high-risk (1882/2502, 75.21%) and low-risk (620/2502, 24.78%) subgroups with the optimal cut-off of risk scores (4.28). The total BCSS of low-risk subgroup was 77.8% (95%CI 74.4%-81.4%) vs. 31.1% (95%CI 19.4-49.8) of high-risk group (P=0.000). Bootstrap internal validation demonstrated an average C-index of 0.739 (95% CI, 0.692-0.746). The nomogram calibration was validated to be accurate in predicting 5-year and 10-year survival.

Variable finally selected for risk predicted model.PredictorHazard RatioP Value95% CINPI classification Good1 Moderate2.170.0001.51-3.14Poor7.260.0004.96-10.63Skin symptom Without1 With1.760.0001.34-2.32Tumor site Centrally located1 Non-centrally located1.250.0421.07-1.56Age*1.010.0001.01-1.03* Continuous variable.

Conclusion

Utilizing NPI classification, skin symptom, tumor site and age, we developed the PDIDC nomogram to predict the 5-year and 10-year BCSS of breast PD-IDC patients.

Citation Format: Tan L, Chen K, Jiang WG, You N, Wang Y, Sanders A, Liang G, Liu Z, Ling Y, Zhong W, Tian Z, Gong C. A prognostic prediction nomogram (PDIDC) for breast Paget's disease with infiltrating ductal carcinoma patients: A SEER cohort analysis [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-07-12.

Semi-dominant mutation in the cysteine-rich receptor-like kinase gene, ALS1, conducts constitutive defence response in rice

Plants have evolved a sophisticated two-branch defence system to prevent the growth and spread of pathogen infection. The novel Cys-rich repeat (CRR) containing receptor-like kinases, known as CRKs, were reported to mediate defence resistance in plants. For rice, there are only two reports of CRKs. A semi-dominant lesion mimic mutant als1 (apoptosis leaf and sheath 1) in rice was identified to demonstrate spontaneous lesions on the leaf blade and sheath. A map-based cloning strategy was used for fine mapping and cloning of ALS1, which was confirmed to be a typical CRK in rice. Functional studies of ALS1 were conducted, including phylogenetic analysis, expression analysis, subcellular location and blast resistance identification. Most pathogenesis-related (PR) genes and other defence-related genes were activated and up-regulated to a high degree. ALS1 was expressed mainly in the leaf blade and sheath, in which further study revealed that ALS1 was present in the vascular bundles. ALS1 was located in the cell membrane of rice protoplasts, and its mutation did not change its subcellular location. Jasmonic acid (JA) and salicylic acid (SA) accumulation were observed in als1, and enhanced blast resistance was also observed. The mutation of ALS1 caused a constitutively activated defence response in als1. The results of our study imply that ALS1 participates in a defence response resembling the common SA-, JA- and NH1-mediated defence responses in rice.

Reduced fibre size, capillary supply and mitochondrial activity in constitutional thinness' skeletal muscle

AIM

Constitutional thinness (CT) is a rare condition of natural low body weight, with no psychological issues, no marker of undernutrition and a resistance to weight gain. This study evaluated the skeletal muscle phenotype of CT women by comparison with a normal BMI control group.

METHODS

Ten CT women (BMI < 17.5 kg/m² ) and 10 female controls (BMI: 18.5-25 kg/m² ) underwent metabolic and hormonal assessment along with muscle biopsies to analyse the skeletal muscular fibres pattern, capillarity, enzymes activities and transcriptomics.

RESULTS

Constitutional thinness displayed similar energy balance metabolic and hormonal profile to controls. Constitutional thinness presented with lower mean area of all the skeletal muscular fibres (-24%, P = .01) and percentage of slow-twitch type I fibres (-25%, P = .02, respectively). Significant downregulation of the mRNA expression of several mitochondrial-related genes and triglycerides metabolism was found along with low cytochrome c oxidase (COX) activity and capillary network in type I fibres. Pre- and post-mitochondrial respiratory chain enzymes levels were found similar to controls. Transcriptomics also revealed downregulation of cytoskeletal-related genes.

CONCLUSION

Diminished type I fibres, decreased mitochondrial and metabolic activity suggested by these results are discordant with normal resting metabolic rate of CT subjects. Downregulated genes related to cytoskeletal proteins and myocyte differentiation could account for CT's resistance to weight gain.

Methylation pattern variation between goats and rats during the onset of puberty

Puberty is initiated by increased pulsatile gonadotropin-releasing hormone (GnRH) release from the hypothalamus. Epigenetic repression is thought to play a crucial role in the initiation of puberty, although the existence of analogous changes in methylation patterns across species is unclear. We analysed mRNA expression of DNA methyltransferases (DNMTs) and methyl-binding proteins (MBPs) in goats and rats by quantitative real-time PCR (qRT-PCR). DNA methylation profiles of hypothalamic were determined at the pre-pubertal and pubertal stages by bisulphite sequencing. In this study, expression of DNMTs and MBPs mRNA showed different patterns in goats and rats. Global methylation variation was low in goats and rats, and the profile remained stable during puberty. Gene ontology (GO) and Kyoto Encyclopedia of Gene and Genomes (KEGG) pathway analysis revealed the involvement of 62 pathways in puberty in goats and rats including reproduction, type I diabetes mellitus and GnRH signalling pathways and found that Edn3, PTPRN2 and GRID1 showed different methylation patterns during puberty in goats and rats and similar variation patterns for Edn3 and PTPRN2 were showed. These indicated that Edn3 and PTPRN2 would play a role in the timing of puberty. This study provides evidence of the epigenetic control of puberty.

Microscale characterization of prostate biopsies tissues using optical coherence elastography and second harmonic generation imaging

Photonics, especially optical coherence elastography (OCE) and second harmonic generation (SHG) imaging are novel high-resolution imaging modalities for characterization of biological tissues. Following our preliminary experience, we hypothesized that OCE and SHG imaging would delineate the microstructure of prostate tissue and aid in distinguishing cancer from the normal benign prostatic tissue. Furthermore, these approaches may assist in characterization of the grade of cancer, as well. In this study, we confirmed a high diagnostic accuracy of OCE and SHG imaging in the detection and characterization of prostate cancer for a large set of biopsy tissues obtained from men suspected to have prostate cancer using transrectal ultrasound (TRUS). The two techniques and methods described here are complementary, one depicts the stiffness of tissues and the other illustrates the orientation of collagen structure around the cancerous lesions. The results showed that stiffness of cancer tissue was ~57.63% higher than that of benign tissue (Young's modulus of 698.43±125.29 kPa for cancerous tissue vs 443.07±88.95 kPa for benign tissue with OCE. Using histology as a reference standard and 600 kPa as a cut-off threshold, the data analysis showed sensitivity and specificity of 89.6 and 99.8%, respectively. Corresponding positive and negative predictive values were 99.5 and 94.6%, respectively. There was a significant difference noticed in terms of Young's modulus for different Gleason scores estimated by OCE (P-value<0.05). For SHG, distinct patterns of collagen distribution were seen for different Gleason grade disease with computed quantification employing a ratio of anisotropic to isotropic (A:I ratio) and this correlated with disease aggressiveness.

The early repigmentation pattern of vitiligo is related to the source of melanocytes and by the choice of therapy: a retrospective cohort study

BACKGROUND

Patients with vitiligo present with different repigmentation patterns in the early recovery stage.

OBJECTIVES

To analyze the relationships between early repigmentation patterns in vitiliginous patches, their clinical characteristics, and therapeutic choices.

METHODS

Patients with vitiligo seen in the Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University from 2010 to 2015, were included, and their clinical records, especially photographs and medical treatments, were reviewed.

RESULTS

One hundred and sixteen patients were included in this study, and 326 lesions with different degrees of depigmentation, locations, stages, distributions, therapies, and repigmentation patterns were included and analyzed. Perifollicular repigmentation occurred more frequently in lesions with complete depigmentation (P = 0.005), in non-sun exposed areas (P < 0.001), a stable stage (P = 0.008), and lesions treated with narrow band ultraviolet B (NB-UVB) (P < 0.001, despite lesion distributions). Marginal repigmentation is more frequent in lesions with complete depigmentation (P = 0.016), lesions treated without NB-UVB (P = 0.002), and facial lesions treated with topical vitamin D analogs (TVDAs) monotherapy (P = 0.022). Diffuse repigmentation is the predominant pattern in lesions with incomplete depigmentation (P < 0.001), in sun-exposed areas (P < 0.001), progressive stage (P = 0.044), and truncal lesions treated with TVDAs (P < 0.001).

CONCLUSIONS

The different repigmentation patterns of vitiligo lesions depend on the different source and status of melanocytes and their abilities to produce melanin on the choice of therapy.

MiR-24 alleviates cardiomyocyte apoptosis after myocardial infarction via targeting BIM

OBJECTIVE

Ischemia hypoxia induces cardiomyocyte (CM) apoptosis in the process of acute myocardial infarction (AMI). It was showed that pro-apoptosis factor BIM participates in regulating tumor cell apoptosis under ischemia or hypoxia condition, while its role in CM apoptosis after AMI is still unclear. It was revealed that miR-24 expression was significantly reduced in myocardial tissue after AMI. Bioinformatics analysis exhibits that miR-24 is targeted to the 3'-UTR of BIM. This study aims to investigate the role of miR-24 in mediating BIM expression and CM apoptosis.

PATIENTS AND METHODS

Dual-luciferase assay was used to confirm the targeted regulation between miR-24 and BIM. Cells were cultured under ischemia hypoxia for 12 h after transfection for 48 h. Cell apoptosis was tested by using flow cytometry. The caspase activity was detected by using spectrophotometry. Wistar rats were divided into four groups, including Sham, AMI, AMI + agomir-control, and AMI + agomir-24 groups. Cardiac function was evaluated by using echocardiography. CM apoptosis was determined by using TUNEL. Infarction area was measured by using evans blue staining. MiR-24 targeted suppressed BIM expression.

RESULTS

MiR-24 mimic and/or si-BIM transfection significantly declined the BIM expression, inhibited caspase-9 and caspase-3 activities, and reduced cell apoptosis in H9C2 cells. MiR-24 expression was decreased, while BIM levels were up-regulated in myocardium after AMI. Agomir-24 injection down-regulated the BIM expression in myocardium, reduced CM apoptosis, narrowed infarction area, and improved cardiac function in rats.

CONCLUSIONS

MiR-24 was reduced, whereas BIM was enhanced in the CM after AMI. MiR-24 up-regulation plays a critical role in decreasing BIM expression, reducing CM apoptosis, and improving cardiac function after AMI.