[Epidemiological investigation of iron deficiency among preschool children in 10 provinces, autonomous regions, or municipalities in China]

Objective: To understand the current status of anemia, iron deficiency, and iron-deficiency anemia among preschool children in China. Methods: A cross-sectional study was conducted with a multi-stage stratified sampling method to select 150 streets or townships from 10 Chinese provinces, autonomous regions, or municipalities (East: Jiangsu, Zhejiang, Shandong, and Hainan; Central: Henan; West: Chongqing, Shaanxi, Guizhou, and Xinjiang; Northeast: Liaoning). From May 2022 to April 2023, a total of 21 470 children, including community-based children aged 0.5 to<3.0 years receiving child health care and kindergarten-based children aged 3.0 to<7.0 years, were surveyed. They were divided into 3 age groups: infants (0.5 to<1.0 year), toddlers (1.0 to<3.0 years), and preschoolers (3.0 to<7.0 years). Basic information such as sex and date of birth of the children was collected, and peripheral blood samples were obtained for routine blood tests and serum ferritin measurement. The prevalence rates of anemia, iron deficiency, and iron-deficiency anemia were analyzed, and the prevalence rate differences were compared among different ages, sex, urban and rural areas, and regions using the chi-square test. Results: A total of 21 460 valid responses were collected, including 10 780 boys (50.2%). The number of infants, toddlers, and preschoolers were 2 645 (12.3%), 6 244 (29.1%), and 12 571 (58.6%), respectively. The hemoglobin level was (126.7±14.8) g/L, and the serum ferritin level was 32.3 (18.5, 50.1) μg/L. The overall rates of anemia, iron deficiency, and iron-deficiency anemia were 10.4% (2 230/21 460), 28.3% (6 070/21 460), and 3.9% (845/21 460), respectively. The prevalence rate of anemia was higher for boys than for girls (10.9% (1 173/10 780) vs. 9.9% (1 057/10 680), χ2=5.58, P=0.018), with statistically significant differences in the rates for infants, toddlers and preschoolers (18.0% (475/2 645), 10.6% (662/6 244), and 8.7% (1 093/12 571), respectively, χ2=201.81, P<0.01), and the rate was significantly higher for children in rural than that in urban area (11.8% (1 516/12 883) vs. 8.3% (714/8 577), χ2=65.54, P<0.01), with statistically significant differences in the rates by region (χ2=126.60, P<0.01), with the highest rate of 15.8% (343/2 173) for children in Central region, and the lowest rate of 5.3% (108/2 053) in Northeastern region. The prevalence rates of iron deficiency were 33.8% (895/2 645), 32.2% (2 011/6 244), and 25.2% (3 164/12 571) in infants, toddlers, and preschoolers, respectively, and 30.0% (3 229/10 780) in boys vs. 26.6% (2 841/10 680) in girls, 21.7% (1 913/8 821), 40.0% (870/2 173), 27.1% (2 283/8 413), 48.9% (1 004/2 053) in Eastern, Central, Western, and Northeastern regions, respectively, and each between-group showed a significant statistical difference (χ2=147.71, 29.73, 773.02, all P<0.01). The prevalence rate of iron-deficiency anemia showed a significant statistical difference between urban and rural areas, 2.9% (251/8 577) vs. 4.6% (594/12 883) (χ2=38.62, P<0.01), while the difference in iron deficiency prevalence was not significant (χ2=0.51, P=0.476). Conclusions: There has been a notable improvement in iron deficiency and iron-deficiency anemia among preschool children in China, but the situation remains concerning. Particular attention should be paid to the prevention and control of iron deficiency and iron-deficiency anemia, especially among infants and children in the Central, Western, and Northeastern regions of China.

Integrated analysis of metabolome, transcriptome, and bioclimatic factors of Acer truncatum seeds reveals key candidate genes related to unsaturated fatty acid biosynthesis, and potentially optimal production area

BACKGROUND

Lipids found in plant seeds are essential for controlling seed dormancy, dispersal, and defenses against biotic and abiotic stress. Additionally, these lipids provide nutrition and energy and are therefore important to the human diet as edible oils. Acer truncatum, which belongs to the Aceaceae family, is widely cultivated around the world for its ornamental value. Further because its seed oil is rich in unsaturated fatty acids (UFAs)- i.e. α-linolenic acid (ALA) and nervonic acid (NA)- and because it has been validated as a new food resource in China, the importance of A. truncatum has greatly risen. However, it remains unknown how UFAs are biosynthesized during the growth season, to what extent environmental factors impact their content, and what areas are potentially optimal for their production.

RESULTS

In this study, transcriptome and metabolome of A. truncatum seeds at three representative developmental stages was used to find the accumulation patterns of all major FAs. Cumulatively, 966 metabolites and 87,343 unigenes were detected; the differential expressed unigenes and metabolites were compared between stages as follows: stage 1 vs. 2, stage 1 vs. 3, and stage 2 vs. 3 seeds, respectively. Moreover, 13 fatty acid desaturases (FADs) and 20 β-ketoacyl-CoA synthases (KCSs) were identified, among which the expression level of FAD3 (Cluster-7222.41455) and KCS20 (Cluster-7222.40643) were consistent with the metabolic results of ALA and NA, respectively. Upon analysis of the geographical origin-affected diversity from 17 various locations, we found significant variation in phenotypes and UFA content. Notably, in this study we found that 7 bioclimatic variables showed considerable influence on FAs contents in A. truncatum seeds oil, suggesting their significance as critical environmental parameters. Ultimately, we developed a model for potentially ecological suitable regions in China.

CONCLUSION

This study provides a comprehensive understanding of the relationship between metabolome and transcriptome in A. truncatum at various developmental stages of seeds and a new strategy to enhance seed FA content, especially ALA and NA. This is particularly significant in meeting the increasing demands for high-quality edible oil for human consumption. The study offers a scientific basis for A. truncatum's novel utilization as a woody vegetable oil rather than an ornamental plant, potentially expanding its cultivation worldwide.

Histology, physiology, and transcriptomic and metabolomic profiling reveal the developmental dynamics of annual shoots in tree peonies (Paeonia suffruticosa Andr.)

The development of tree peony annual shoots is characterized by "withering", which is related to whether there are bud points in the leaf axillaries of annual shoots. However, the mechanism of "withering" in tree peony is still unclear. In this study, Paeonia ostii 'Fengdan' and P. suffruticosa 'Luoyanghong' were used to investigate dynamic changes of annual shoots through anatomy, physiology, transcriptome, and metabolome. The results demonstrated that the developmental dynamics of annual shoots of the two cultivars were comparable. The withering degree of P. suffruticosa 'Luoyanghong' was higher than that of P. ostii 'Fengdan', and their upper internodes of annual flowering shoots had a lower degree of lignin deposition, cellulose, C/N ratio, showing no obvious sclerenchyma, than the bottom ones and the whole internodes of vegetative shoot, which resulted in the "withering" of upper internodes. A total of 36 phytohormone metabolites were detected, of which 33 and 31 were detected in P. ostii 'Fengdan' and P. suffruticosa 'Luoyanghong', respectively. In addition, 302 and 240 differentially expressed genes related to lignin biosynthesis, carbon and nitrogen metabolism, plant hormone signal transduction, and zeatin biosynthesis were screened from the two cultivars. Furtherly, 36 structural genes and 40 transcription factors associated with the development of annual shoots were highly co-expressed, and eight hub genes involved in this developmental process were identified. Consequently, this study explained the developmental dynamic on the varied annual shoots through multi-omics, providing a theoretical foundation for germplasm innovation and the mechanized harvesting of tree peony annual shoots.

Combined genome-wide association studies and expression quantitative trait locus analysis uncovers a genetic regulatory network of floral organ number in a tree peony (Paeonia suffruticosa Andrews) breeding population

Great progress has been made in our understanding of floral organ identity determination and its regulatory network in many species; however, the quantitative genetic basis of floral organ number variation is far less well understood for species-specific traits from the perspective of population variation. Here, using a tree peony (Paeonia suffruticosa Andrews, Paeoniaceae) cultivar population as a model, the phenotypic polymorphism and genetic variation based on genome-wide association studies (GWAS) and expression quantitative trait locus (eQTL) analysis were analyzed. Based on 24 phenotypic traits of 271 representative cultivars, the transcript profiles of 119 cultivars were obtained, which indicated abundant genetic variation in tree peony. In total, 86 GWAS-related cis-eQTLs and 3188 trans-eQTL gene pairs were found to be associated with the numbers of petals, stamens, and carpels. In addition, 19 floral organ number-related hub genes with 121 cis-eQTLs were obtained by weighted gene co-expression network analysis, among which five hub genes belonging to the ABCE genes of the MADS-box family and their spatial-temporal co-expression and regulatory network were constructed. These results not only help our understanding of the genetic basis of floral organ number variation during domestication, but also pave the way to studying the quantitative genetics and evolution of flower organ number and their regulatory network within populations.

[Characteristics of serum bile acids among healthy children in Zhejiang province]

Objective: To characterize the serum bile acid profiles of healthy children in Zhejiang Province. Methods: A cross-sectional study was conducted on 245 healthy children who underwent imaging and laboratory biochemical tests during routine physical examinations at the Children's Hospital of Zhejiang University School of Medicine from January 2020 to July 2022. Overnight fasting venous blood samples were collected, and the concentrations of 18 individual bile acids in the serum were accurately quantitated using tandem mass spectrometry. The concentration difference of bile acid were compared between different genders and to explore the correlation between age and bile acid levels. Used the Mann-Whitney U test for intergroup comparison and Spearman test to correlation analysis. Results: A total of 245 health children with a age of 10 (8, 12) years including 125 boys and 120 girls. There were no significant differences in levels of total bile acids, primary and secondary bile acids, free and conjugated bile acids between the two gender groups (all P>0.05). The serum concentrations of ursodeoxycholic acid and glycoursodeoxycholic acid in girls were significantly higher than those in boys (199.0 (66.9, 276.5) vs. 154.7 (49.3, 205.0) nmol/L, 274.0 (64.8, 308.0) vs. 181.0 (43.8, 209.3) nmol/L, Z=2.06, 2.71, both P<0.05). The serum taurolithocholic acid in both boys and girls were positively correlated with age (r=0.31, 0.32, both P<0.05). The serum chenodeoxycholic acid and glycochenodeoxycholic acid in the boys group were positively correlated with age (r=0.20, 0.23, both P<0.05), whereas the serum tauroursodeoxycholic acid in the girls group was negatively correlated with age (r=-0.27, P<0.05), and the serum cholic acid was positively correlated with age (r=0.34, P<0.05). Conclusions: The total bile acid levels are relatively stable in healthy children in Zhejiang province. However, individual bile acids showed gender differences and were correlated with age.

[Research progress of infrared light promoting wound healing]

At present, current stimulation, ultra-sound, and light therapy have become effective methods to promote wound healing. Among them, infrared light is the most widely used method and is one of the important methods to promote wound healing. The therapeutic effect of infrared light on wounds is related to the effect of photobiomodulation on cells and molecules on the skin surface, but the mechanism by which photobiomodulation of infrared light promotes wound healing has not been fully elucidated. Therefore, it is necessary to study the action characteristics and the mechanism of photo-biomodulation of infrared light in promoting wound healing. This article reviews the effect of different types of infrared light on wound healing and the mechanism of infrared light in promoting wound healing.

PhUGT78A22, a novel glycosyltransferase in Paeonia 'He Xie', can catalyze the transfer of glucose to glucosylated anthocyanins during petal blotch formation

BACKGROUND

Flower color patterns play an important role in the evolution and subsequent diversification of flowers by attracting animal pollinators. This interaction can drive the diversity observed in angiosperms today in many plant families such as Liliaceae, Paeoniaceae, and Orchidaceae, and increased their ornamental values. However, the molecular mechanism underlying the differential distribution of anthocyanins within petals remains unclear in Paeonia.

RESULTS

In this study, we used an intersectional hybrid between the section Moutan and Paeonia, hereafter named Paeonia 'He Xie', which has purple flowers with dark purple blotches. After Ultra-high performance liquid chromatography-diode array detector (UPLC-DAD) analysis of blotched and non-blotched parts of petals, we found the anthocyanin content in the blotched part was always higher than that in the non-blotched part. Four kinds of anthocyanins, namely cyanidin-3-O-glucoside (Cy3G), cyanidin-3,5-O-glucoside (Cy3G5G), peonidin-3-O-glucoside (Pn3G), and peonidin-3,5-O-glucoside (Pn3G5G) were detected in the blotched parts, while only Cy3G5G and Pn3G5G were detected in the non-blotched parts. This suggests that glucosyltransferases may play a vital role in the four kinds of glucosylated anthocyanins in the blotched parts. Moreover, 2433 differentially expressed genes (DEGs) were obtained from transcriptome analysis of blotched and non-blotched parts, and a key UDP-glycosyltransferase named PhUGT78A22 was identified, which could use Cy3G and Pn3G as substrates to produce Cy3G5G and Pn3G5G, respectively, in vitro. Furthermore, silencing of PhUGT78A22 reduced the content of anthocyanidin 3,5-O-diglucoside in P. 'He Xie'.

CONCLUSIONS

A UDP-glycosyltransferase, PhUGT78A22, was identified in P. 'He Xie', and the molecular mechanism underlying differential distribution of anthocyanins within petals was elucidated. This study provides new insights on the biosynthesis of different kinds of anthocyanins within colorful petals, and helps to explain petal blotch formation, which will facilitate the cultivar breeding with respect to increasing ornamental value. Additionally, it provides a reference for understanding the molecular mechanisms responsible for precise regulation of anthocyanin biosynthesis and distribution patterns.

Optimization technology and kinetic studies of Acer truncatum seed oil saponification and crystallization separation of nervonic acid

Acer truncatum seed oil (ATSO) contains abundant unsaturated fatty acids, with significant quantities of nervonic acid (NA, > 5%), which was authenticated as a new food resource in China. For the sake of minimizing animal consumption and the importance of NA for human health, extraction of NA from plants has become a research hotspot. In the present study, three extraction factors were determined to significantly influence the saponification reaction based on single-factor experiments: NaOH dosage, reaction time, and reaction temperature. These three factors were used to further optimize the saponification process through the response surface methodology, and the highest yield of mixed fatty acids was 83.12%. Moreover, the activation energy (40.8228 kJ/mol), the pre-exponential factor [2.568 × 10⁶ m³ /(kmol·min)], and the kinetic equation [r_A = kc_A c_B = 2.568 × 10⁶ ·exp(- 4970 . 1 T ) $\frac{{{\rm{4970}}{\rm{.1}}}}{{\rm{T}}})$ c_A c_B ] of the ATSO saponification reaction were determined by combining the chemical reaction rate equation of the elementary reaction, the Arrhenius equation, and the NaOH concentration in the substrate. Finally, the mixed fatty acids of ATSO were crystallized by triple-stage low-temperature crystallization, and we achieved 25.05% purity for NA. This study provides a technological basis and strategy for specific fatty acid production from ASTO, as well as other vegetable oils important in the field of food and health supplement products. PRACTICAL APPLICATION: Nervonic acid (NA) is an essential component of neural cells and neural tissue, and it is vital for maintaining the normal work of nerve tissues in organisms and promotes neurodevelopment. NA has traditionally been mainly obtained from shark hunting, which is now restricted due to an international ban on shark fishing. The alternative way to produce NA cheaply and in large quantities is from plant sources. The techniques utilized in this study provide an effective method of NA separation from Acer truncatum seed oil for industrial production.

POS0071 THE EFFICACY OF PIRFENIDONE COMBINED WITH IMMUNOSUPPRESSANT THERAPY IN THE CONNECTIVE TISSUE DISEASE-ASSOCIATED PULMONARY INTERSTITIAL DISEASE, A 24-WEEK PROSPECTIVE CONTROLLED COHORT STUDY

Background

Pulmonary interstitial disease(ILD)is very common in connective tissue disease (CTD). Different subtypes display significant differentiations in prognosis. Pirfenidone (PFD), the targeted anti-fibrosis and anti-inflammatory drug, started to apply in CTD-ILD, while its strategy of combination with immunotherapy, bridging time and service time are worth discussing.

Objectives

To evaluate the efficacy and safety of PFD combined with immunosuppressant (IS) in the treatment of several CTD- ILD.

Methods

111 CTD-ILD patients were involved from Aug 2019 to Dec 2021 (ClinicalTrials.gov Identifier NCT04928586), including systemic sclerosis (SSc, n=30), inflammatory myopathy (IIM, n=51), rheumatoid arthritis (RA, n=17) and other CTDs (such as systemic lupus erythematosus, sjogren’s syndrome, n=13). Patients were treated with relative stable dose of glucocorticoid (GC) and/or IS since screening.After the evaluation of HRCT, pulmonary function (FVC% and DLCo%) and basic disease activity, PFD was added or not and followed up regularly for 24 weeks. The changes of lung function and imaging were recorded in different subgroups.

Results

At baseline, The FVC% in the SSc-PFD (n=14), IIM-PFD (n=25) pts were lower than that of SSc-no-PFD (n=16), IIM-no-PFD (n=26) respectively, that was 81.06 vs 99.63(p = 0.014), 78.23 vs 91.12, (p= 0.010). And IIM-PFD group present a lower baseline DLCo% than IIM-no-PFD pts (64.25 vs 72.82, p =0.034). DLCo% in the other CTDs was lower than SSc, IIM, RA pts (54.58 vs 65.55, 68.71, 66.89, p=0.036), while there were no significant differences in baseline FVC% among these disease.

After 24 weeks of treatment, FVC% in SSc-PFD group was improved by 7.15%, while that was -0.91% in SSc-no-PFD pts (p=0.042). The elevation in FVC% was also significant between the IIM-PFD and IIM-no-PFD control (8.00 vs 1.40, p=0.016). On the other hand, DLCo% of RA-PFD obviously enhanced 7.40%, compared with RA-no-PFD decrease 5.50% from baseline(p=0.002) (Figure 1).

Figure 1.

The changes of FVC% and DLco% in PFD treated CTD-ILD for 24 weeks. (A) FVC% changes in SSc, IIM, RA and other CTD-ILD from baseline.; (B) DLco% changes in SSc, IIM, RA and other CTD-ILD from baseline. * p< 0.05, compared to no PFD treatment group.

When performing subgroup analysis with manifestations in HRCT, the change of FVC% in SSc-PFD pts with usual interstitial pueumonia tendency(SSc-PFD-UIP) was higher than SSc-PFD-non-UIP group (8.05 vs -3.20, p=0.014). However, the non-UIP tendency in IIM-PDF pts displayed superior therapeutic effects than IIM-PDF-UIP pts (10.50 vs 1.00, p=0.005). In addition, DLCo% improved significantly in RA-PDF-non-UIP subgroup, compared with RA-PDF-UIP pts (10.40 vs -4.45, p=0.017).

According to whether the baseline FVC% and DLCo% value was less than 70%, the improvement of FVC% was significantly higher in PFD treatment group than no-PFD pts of SSc and IIM with baseline High-FVC%(6.60 vs 0.10, p=0.047),(6.30 vs 1.10, p= 0.089).In RA-PFD pts, DLCo% showed a significant increase in baseline DLCo% less than 70% subgroup, compared to RA-no-PDF (7.40% vs -6.60%, p=0.011).The basic IS were considerable between PFD andno-PFD pts throughout the study and no differences of GS and IS dosages at baseline and follow up among all subgroups.

Multiple linear regression analysis found that baseline FVC%<70%(HR=4.56,6.81) and prescription of PFD(HR=4.56,4.37) could positively affect the changes of FVC% and DLCo% (all p<0.05).

Conclusion

The response of pulmonary function to PFD were varied in different CTD-ILD subsets. SSc and IIM pts acquired obviously improvement on FVC%, especially with high baseline FVC group. DLco% elevated in RA-PFD, highlight those baseline Low-DLco and No-UIP pts.

Acknowledgements

Funded by ECCM Program of Clinical Research Center of Shandong University (No. 2021SDUCRCB010)

Disclosure of Interests

None declared

POS0558 A INFLAMMATORY FACTOR-BASED NOMOGRAM PREDICTS FIRST REMISSION TIME OF RHEUMATOID ARTHRITIS PATIENTS WITH BASELINE GALECTIN-9

Background

Rheumatoid arthritis (RA) is an autoimmune disease. The core treatment principle of RA is to achieve remission or low disease activity as soon as possible to ensure optimal outcomes. Predicting the first remission time according to the patient’s risk factors is very important for the choice of treatment scheme.

Objectives

We aimed to verify the prognostic value of inflammatory factors in RA and establish a nomogram based on Human Interleukin-6(IL-6), Galectin-9(Gal-9)and disease activity to predict the first remission time after conventional synthetic DMARDstreatment.

Methods

184 RA active patients(DAS28-ESR> 3.2, ACR 1987 criteria or EULAR 2010 criteria) were enrolled in the rheumatology department of Qilu Hospital of Shandong University from June 2014 to June 2020.129 patients were assigned to the development cohort and 55 patients were assigned to the validation cohort randomly. Baseline clinical data and plasma were collected. The expressions of Tumour Necrosis Factor α (TNF-α), Vascular Endothelial Growth Factor (VEGF), IL-6 and Gal-9 in plasma of RA patients were detected by ELISA. All patients were treated with csDMARDs and we recorded activity of each follow-up visit until 36 months. Lasso regression and Cox regression analysis were used to screen the 14 variables (including activity indices and cytokines) at baseline, and the prediction model was established to draw the nomogram.

Results

Patient age, CRP, IL-6, Gal-9, HAQ and DAS28-ESR were the significant prognostic factors in the lasso and Cox regression analyses, especially Gal-9. The multivariate analysis revealed that IL-6≤ 9.04 pg/ml(HR =0.54, 95% CI:0.31–0.95), Gal-9≤ 4490 pg/ml(HR =0.43, 95% CI:0.21–0.89) were independent protective factors (Table 1). Above-mentioned six factors were included in our model as predictors (Figure 1). The resulting model containing six factors had good discrimination ability in both the development cohort (C-index, 0.729) and the validation cohort (C-index, 0.710). Time-dependent ROC curve (Figure 2), calibration analysis (Figure 3) and decision curve analysis (DCA) show that the nomogram has significant discriminant power, stability and clinical practicability in predicting the first remission time.

Conclusion

We constructed and validated a nomogram with baseline activity indices and cytokines that can predict first remission time in RA patients after csDMARDs treatment. Using this simple-to-use model with plasma Gal-9 at baseline, the remission rate can be determined for an individual patient and could be useful for the early identification of high-risk patients.

References

[1]SUN J, SUI Y, WANG Y, et al. Galectin-9 expression correlates with therapeutic effect in rheumatoid arthritis [J]. Scientific reports, 2021, 11(1): 5562.

[2]ZHANG L, CHEN F, GENG S, et al. Methotrexate (MTX) Plus Hydroxychloroquine versus MTX Plus Leflunomide in Patients with MTX-Resistant Active Rheumatoid Arthritis: A 2-Year Cohort Study in Real World [J]. Journal of inflammation research, 2020, 13: 1141-50.

[3]FORNARO M, CACCIAPAGLIA F, LOPALCO G, et al. Predictors of long-term clinical remission in rheumatoid arthritis [J]. European journal of clinical investigation, 2021, 51(2): e13363.

Acknowledgements

Funded by ECCM Program of Clinical Research Center of Shandong University (No. 2021SDUCRCB010)

Disclosure of Interests

None declared.

POS0555 THE NON-APOPTOTIC PROGRAMMED-CELL-DEATH-RELATED SIGNATURE PREDICTS ANTI-TNF THERAPY NONRESPONSE IN PATIENTS WITH RHEUMATOID ARTHRITIS

Background

EULAR guideline in rheumatoid arthritis (RA) recommended the primary failure of the first-line conventional synthetic modifying anti-rheumatic drugs (csDMARDs) patients switching to tumor necrosis factor alpha inhibitors (TNFi) [1]. Nevertheless, approximately 30-40% csDMARDs-IR patients also experience inefficacy of TNFi [2]. There is still no index to predict whether TNFi would be responded or not. Moreover, only few studies had focused on the relationship between TNFi nonresponse and other cell programmed deaths except apoptosis.

Objectives

To predict the possibility of TNFi response prior to prescript in RA patients with the biomarkers of non-apoptotic programmed cell death in synovial cells.

Methods

The datasets of 22 TNFi treated RA synovial samples were enrolled from the Gene Expression Omnibus (GEO) database (GSE140036 and GSE15602). And the differentially expressed genes (DEGs) and modules related to TNFi treatment through weight gene correlation network analysis (WGCNA) were identified with the R packages “limma” and “WGCNA”. Then the enrichment analysis among the shared genes was performed through the R.4.1.2, Metascape website, and WebGestalt website. Following with the confirmation of the non-apoptotic programmed cell death (NAPCD) genes in the shared genes with Student’s T-Test. Furthermore, the TNFi treatment cohort was clustered based on the hub genes, making the receiver operating characteristic (ROC) curve analysis. Moreover, the least absolute shrinkage and selection operator (LASSO) model was constructed to identify the predictive genes.

Results

2624 DEGs were identified significantly, including 161 upregulated genes and 2463 downregulated genes. One module with TNFi treatment was constructed in WGCNA, significant in both response and nonresponse. Then the gene signatures for TNFi nonresponse were collected from overlaps 2260 genes in above. And we found 38 NAPCD genes might play role in TNFi nonresponse, but reserved 33 genes which statistically significant with T-Test. 22 TNFi treated synovial samples in GEO database could be classified into response or nonresponse subgroups. The ROC curve showed that the AUC for 32 genes in these samples ranged from 0.7 to 0.9, expected for CD46. At last, the LASSO model indicated that CASP5, CAPN10, ITGB4, NLRP2, and SLC2A8 could predict the TNFi nonresponse, as the risk score = CASP5 × 0.028 + CAPN10 × 0.064 + ITGB4× 0.080+ NLRP2 × 0.317+ SLC2A8 × 0.090 (Figure 1).

Figure 1.

Predictive model of TNFi nonresponse based on NAPCD genes. (A) Volcano map of differential expressed genes; (B) Correlation heat map of gene modules and phenotypes, the red is positively correlated with the phenotype, blue is negatively correlated with the phenotype; (C) The shared 38 genes of TNFi response & nonresponse DEGs, among the WGCNA turquoise module and cell programmed death genes; (D) Consensus clustering matrix for k = 2; (E) The ROC curve of 33 genes; (F) LASSO regression of the 32 genes,except for CD46; (G) Nomogram for predicting TNFi nonresponse in TNFi treatment RA cohort, indicated five possible indicators (CASP5, CAPN10, ITGB4, NLRP2, and SLC2A8) were closely related to TNFi nonresponse.

Conclusion

Our study firstly screened out the 38 NAPCD candidate genes signatures in RA synovial tissues which took part in TNFi nonresponse through WGCNA and DEGs. Further analysis confirmed that five possible indicators (CASP5, CAPN10, ITGB4, NLRP2, and SLC2A8) were closely related to TNFi nonresponse.

References

[1]van Delft MAM, Huizinga TWJ: An overview of autoantibodies in rheumatoid arthritis. Journal of autoimmunity 2020, 110:102392.

[2]Aletaha D: Precision medicine and management of rheumatoid arthritis. Journal of autoimmunity 2020, 110:102405.

Acknowledgements

Funded by ECCM Program of Clinical Research Center of Shandong University.

Disclosure of Interests

None declared.

AB0407 EFFICACY AND SAFETY OF 144-WEEK TREATMENT WITH TACROLIMUS AS THE FIRST-LINE CONVENTIONAL SYNTHETIC DISEASE-MODIFYING ANTIRHEUMATIC DRUG (csDMARD) FOR PATIENTS WITH ACTIVE REFRACTORY RHEUMATOID ARTHRITIS： A PROSPECTIVE, COHORT STUDY

Background

The T2T guideline in RA recommended the normal csDMARDs irresponsive patients (pts) switching to other treatment target. Tacrolimus (TAC), the inhibitor of T cell activation, is candidate for these pts, especially with extrarticular complications (EC).

Objectives

To observe the efficacy and safety of TAC-based csDMARDS regimen refractory RA (RRA) pts and the characteristics of TAC combined treatment.

Methods

This prospective cohort study (ClinicalTrials.gov Identifier NCT02837978) was conducted in China. According to baseline DAS28-ESR, RRA pts (ACR 1987 criteria [1]) were classified to severe (>5.1, S) or moderate (> 3.2,≦5.1, M) groups. The efficacy indicators and AE were recorded untill 144w.

The combined medicine with TAC was based on the past history of csDMARD prescription and EC, including TAC with/wo MTX (T+M or T group), Pred, HCQ.

Results

150 pts (52±14y) were involved, 15 finished 144w observation, 50 still following up and 85 lost.

As shown with GEE analysis, DAS28-ESR, CRP, HAQ were decreased significantly in all pts within 24ws, and maintained stable in later period (Figure 1). The REM or LDA, achieved ACR20, good or moderate EULAR response (G+M) proportion of 103 pts completed the 24w were 41.75%, 56.31%, 76.70%.

Figure 1.

Disease activity index of 150 RRA pts decreased in 144weeks

Similar to the Japanese study [2], DAS28-ESR, CRP and HAQ typically declined rapidly in S group, but still higher than M (Figure 2A-C). According to GBTM analysis, S group, longer disease course or higher HAQ had a higher ACR20 remission rate (Figure 2D).

Figure 2.

Disease activity index of 103 pts declined rapidly in 24weeks.

(A). DAS28-ESR; (B) CRP; (C). HAQ declined significantly in S (n=53) than M (n=50) during 24ws. (D).higher increased ACR20 remission group (90.6%), compared with low-stable (0%) in 24ws. *p< 0.05, compared to M; #p< 0.05, compared to baseline.

A total of 69 RA pts (46.0%) had 177 times (23.07%) AE, including 2 SAEs. Infection was the dominating AE (30%) due to asymptomatic positive urinary leucocyte and cold were classified, higher than (3.4%) Japanese study [3]. AEs were mainly happened in pts with higher TAC blood concentration 4.55(3-14.5) ng/ml, compared to No AE group 3.8(2.4-7.8) ng/ml, p=0.048, extremely in those abnormal glucose tolerance and hypertensive pts, p=0.002, 0.022.

The most common reasons of lost were drug ineffective (32.94%), economic reasons (29.1%). There was no difference in efficacy of TAC combined treatment. Combination MTX reduce AE, decrease the usage rate and dosage of Pred. Combination Pred increased AE.

Pts that achieved REM+LDA, G+M, had better TAC survival rate (Figure 3A-B). The combination of MTX, HCQ reduce lost rate (Figure 3C-D).

Figure 3.

TAC survival ratio were compared in different response and csDMARDs combination groups.

(A).The pts acquired remission (n= 31) or LDA (n= 18) had higher TAC survival rate than high (n=28) & moderate (n=73) group, * p < 0.05, compared to group High; # p < 0.05, compared to Moderate; & p < 0.05, compared to Low; (B). The pts G+M (n=95) had better TAC survival rate, compared with no response (N, n=55), ** p < 0.01; (C). Combine MTX reduced lost rate, ** p < 0.01, compared to T; (D). Combine MTX and HCQ reduced lost rate, * p < 0.05 compared to MTX-HCQ-; # p < 0.05 compared to MTX+HCQ-.

The Logistic regression showed baseline DAS28-ESR was an independent protective factor for poor response. Baseline DAS28-ESR and previous Perd use were independent protective factors for ACR20 remission.　

Conclusion

TAC-based combined therapies are effective and tolerable for RRA, especially to the higher disease activity pts. TAC blood concentration related to AE. The lower disease activity index and better respond, the higher TAC survival ratio. MTX is recommended as TAC combined treatment.

References

[1]Levin RW, et al. Scand J Rheumatol 1996, 25(5):277-281.

[2]Kanzaki T,et al., Rheumatology International,2013. 33(4):871-877.

[3]Takeuchi T, et al. Mod Rheumatology 2018,28(1): 48-57.

Acknowledgements

Acknowledgements: Funded by ECCM Program of Clinical Research Center of Shandong University (No. 2021SDUCRCB010)

Disclosure of Interests

None declared

Modulating Effect of Paeonol on Piglets With Ulcerative Colitis

Piglet enteritis is a major problem that needs to be solved urgently in modern pig production. Paeonol (Pae) has been used as a novel treatment option due to its good medicinal value. This study purported to elucidate the regulatory mechanism of Pae on dextran sodium sulfate (DSS)-induced ulcerative colitis (UC) in weaned piglets. A total of 36 crossbred (Duroc × Landrace × Yorkshire) weaned piglets were stochastically split into six groups: the control group, DSS group, 0.2% Pae group, 0.4% Pae group, 0.8% Pae group, and mesalazine group. The control and DSS groups were fed with a basic diet, the three Pae and mesalazine groups were fed with 0.2, 0.4, 0.8%, and 2 g mesalazine per kilogram of basic diet throughout the study. On the 15th day of the test period, the control group was gavaged with 10 ml of normal saline, while the remaining five groups were gavaged with 10 ml 5% DSS solution for 13 days. The study lasted for 27 days. The results showed that the 0.8% Pae group significantly increased the average daily feed intake (ADFI) and Occludin mRNA expression in the colon of piglets (P &lt; 0.05). The 0.2% Pae group markedly increased the average daily gain (ADG) and zonula occludens-1 (ZO-1) mRNA expression (P &lt; 0.05). In the 0.2% and 0.4% Pae groups, the feed-to-gain ratio (F/G) was significantly reduced and the mRNA expression levels of Caspase-8, respectively, markedly enhanced the mRNA expression levels of transforming growth factor-β (TGF-β) and interleukins-4 (IL-4) (P &lt; 0.05). In the 0.8% Pae group, the relative abundance of Campilobacterota was significantly reduced (P &lt; 0.05). In the 0.4% Pae group, the relative abundance of Firmicutes was notably increased (P &lt; 0.05). In the 0.2 and 0.8% Pae groups, the relative abundance of Prevotella was markedly increased (P &lt; 0.05). In the 0.2% Pae group, the contents of propionic acid, butyric acid, and valerate acid were markedly higher (P &lt; 0.05). Thus, it is speculated that Pae may regulate the balance of anti-inflammatory/pro-inflammatory factors, improve intestinal tight junction expression, reduce apoptosis, and improve intestinal microflora structure and growth performance of piglets, thereby restoring intestinal barrier function and alleviating DSS-induced UC in piglets.

ABSCISIC ACID-INSENSITIVE 5-ω3 FATTY ACID DESATURASE3 module regulates unsaturated fatty acids biosynthesis in Paeonia ostii

Paeonia ostii is an authorized novel vegetable oil crop due to its seeds rich in unsaturated fatty acids (UFAs) especially α-linolenic acid (ALA), which overweight the current available edible oil. However, little is known on the regulation mechanism of UFAs biosynthesis during its seed development. Here, we used transcriptome and proteome data combining phytochemistry means to uncover the relationship between abscisic acid (ABA) signaling and UFAs biosynthesis during P. ostii seed development. Based on transcriptome and proteome analysis, two desaturases of omega-6 and omega-3 fatty acid, named as PoFAD2 and PoFAD3 responsible for ALA biosynthesis were identified. Then, an ABSCISIC ACID-INSENSITIVE 5 (ABI5) proteins was identified as an upstream transcriptional factor, which activated the expression of PoFAD3 instead of PoFAD2. Moreover, silencing of PoABI5 repressed the response of PoFAD3 to ABA. This study provides the first view on the connection between the function of ABA signaling factors and ALA biosynthesis in the P. ostii seed, which lays the foundation for studies on the regulatory mechanism of ABA signaling involved in the UFAs synthesis during seeds development, meanwhile, it will shed light on manipulation of ALA content for satisfying human demands on high quality of edible oil or healthy supplement.

Inhibitory Effect of Acer truncatum Bunge Seed Coat Extract on Fatty Acid Synthase, Differentiation and Lipid Accumulation in 3T3-L1 Adipocytes

Acer truncatum Bunge is now widely cultivated throughout the world. Fatty acid synthase (FAS) is a potential target in the treatment of both obesity and cancer. Only a few FAS inhibitors have been reported. In this study, the inhibitory effect of A. truncatum seed coat (ESA) on FAS and the inhibition mechanisms were investigated using a FAS activity assay and an enzyme kinetics study. The main chemicals of ESA were analyzed with UPLC-MS/MS. The effects of ESA on 3T3-L1 adipocyte differentiation and lipid accumulation were investigated using Oil red O staining. We first identified seven main compounds (quinic acid, malic acid, gentisic acid, procyanidin dimer, procyanidin trimer, catechin, and quercetin) from 50% ethanol extracts of seed coats of A. truncatum (ESAs), which were then found to inhibit 3T3-L1 adipocyte differentiation at the concentration of 50 μg/mL. ESA obviously reduced the visible triglyceride droplets accumulation, and dramatically decreased the number of the adipocytes at a comparatively high concentration. It is suggested that the effects are due to the inhibition of FAS by ESA; FAS activity is inhibited by ESA at a half inhibition concentration (IC₅₀) of 0.57 μg/mL, which is lower than that of classically known FAS inhibitors. Meanwhile, ESA displayed different inhibition kinetics and reacting sites for FAS. These results provide new clues for the development of novel products for obesity treatment and a scientific basis for the full use of byproducts for future industrial production of vegetable oil.

Quantitative analysis of resveratrol derivatives in the seed coats of tree peonies and their hypoglycemic activities in vitro/vivo

Tree peonies are well-known horticultural and medicinal plants. The tree peony seeds, as emerging woody oil crops, recently have attracted great attention for their metabolites and bioactivities. In this study, the phytochemicals isolated from tree peony seed coats were systematically investigated. Seven polyphenolics were separated and prepared, mainly belonging to resveratrol derivatives. There was a great variation in the seed coat polyphenolic content among eight Paeonia species, and the contents of the resveratrol trimers and dimers were significantly higher in the seed coats of Paeonia ostii than other species. Based on the HPLC fingerprint characteristics and chemometric analysis, a clear discrimination among Paeonia plants was found, including the composition patterns and contents of the constituents. Moreover, the characteristic phytochemicals (vateriferol and trans-ε-viniferin) could significantly reduce the starch-mediated levels of postprandial blood glucose in diabetic/normal mice. In addition, in vitro enzyme tests showed that the two compounds could effectively and competitively inhibit α-glucosidase, with the IC₅₀ values of 3.01 and 7.75 μM, respectively, indicating that vateriferol and trans-ε-viniferin could be therapeutic potential agents for hyperglycemia and diabetes mellitus.

Phytochemical profiles and the hypoglycemic effects of tree peony seed coats

As emerging woody oil crops, the tree peony seeds recently have been attracting great attention for their metabolites and bioactivities. In this research, the phytochemical profiles of the seed coats of tree peonies from different production regions were investigated systematically. Twelve phytochemicals were separated and prepared, mainly belonging to stilbenes. A great variation in stilbene content was detected in the three Paeonia plants, and Paeonia ostii seed coats (POSC) had significantly higher contents of the stilbene compounds than other species. There were nineteen significant correlations between ecogeographical factors and the predominant compounds. A clear discrimination among the species was observed in their HPLC fingerprint and chemometric analysis. Furthermore, POSC extracts could significantly reduce the starch mediated PBG (postprandial blood glucose) levels in normal/diabetic mice. Meanwhile, in vitro enzyme tests revealed that the predominant compounds, suffruticosol B and ampelopsin D, could effectively and competitively inhibit α-glucosidase, indicating that POSC could be a natural source of hypoglycemics in the food and drug fields.

Dietary Moutan Cortex Radicis Improves Serum Antioxidant Capacity and Intestinal Immunity and Alters Colonic Microbiota in Weaned Piglets

Background:Moutan cortex radicis (MCR), as a common traditional Chinese medicine, has been widely used as an antipyretic, antiseptic, and anti-inflammatory agent in China.

Objectives: This study aimed to investigate the effects of dietary MCR supplementation on the antioxidant capacity and intestinal health of the pigs and to explore whether MCR exerts positive effects on intestinal health via regulating nuclear factor kappa-B (NF-κB) signaling pathway and intestinal microbiota.

Methods: MCR powder was identified by LC-MS analysis. Selected 32 weaned piglets (21 d of age, 6.37 ± 0.10 kg average BW) were assigned (8 pens/diet, 1 pig/pen) to 4 groups and fed with a corn-soybean basal diet supplemented with 0, 2,000, 4,000, and 8,000 mg/kg MCR for 21 d. After the piglets were sacrificed, antioxidant indices, histomorphology examination, and inflammatory signaling pathway expression were assessed. The 16s RNA sequencing was used to analyze the effects of MCR on the intestinal microbiota structure of piglets.

Results: Supplemental 4,000 mg/kg MCR significantly increased (P < 0.05) the average daily weight gain (ADG), average daily feed intake (ADFI), total antioxidative capability, colonic short-chain fatty acids (SCFA) concentrations, and the crypt depth in the jejunum but decreased (P < 0.05) the mRNA expression levels of interferon γ, tumor necrosis factor-α, interleukin-1β, inhibiting kappa-B kinase β (IKKβ), inhibiting nuclear factor kappa-B (IκBα), and NF-κB in the jejunum and ileum. Microbiota sequencing identified that MCR supplementation significantly increased the microbial richness indices (Chao1, ACE, and observed species, P < 0.05) and the relative abundances of Firmicutes and Lactobacillus (P < 0.05), decreased the relative abundances of Bacteroides, Parabacteroides, unidentified_Lachnospiraceae, and Enterococcus (P < 0.05) and had no significant effects on the diversity indices (Shannon and Simpson, P > 0.05). Microbial metabolic phenotypes analysis also showed that the richness of aerobic bacteria and facultative anaerobic bacteria, oxidative stress tolerance, and biofilm forming were significantly increased (P < 0.05), and the richness of anaerobic bacteria and pathogenic potential of gut microbiota were reduced (P < 0.05) by MCR treatment. Regression analysis showed that the optimal MCR supplemental level for growth performance, serum antioxidant capacity, and intestinal health of weaned piglets was 3,420 ~ 4,237 mg/kg.

Conclusions: MCR supplementation improved growth performance and serum antioxidant capacity, and alleviated intestinal inflammation by inhibiting the IKKβ/IκBα/NF-κB signaling pathway and affecting intestinal microbiota in weaned piglets.

POS0647 EFFICACY, SAFETY AND CHARACTERISTICS OF IGURATIMOD-BASED THERAPY IN THE TREATMENT OF UA, ERA AND RA PATIENTS FOR 24 WEEKS: A PROSPECTIVE COHORT STUDY

Background:

Experts emphasize early diagnosis and treatment in RA, but the widely used diagnostic criterias fail to meet the accurate judgment of early rheumatoid arthritis. In 2012, Professor Zhanguo Li took the lead in establishing ERA “Chinese standard”, and its sensitivity and accuracy have been recognized by peers. However, the optimal first-line treatment of patients (pts) with undifferentiated arthritis (UA), early rheumatoid arthritis (ERA), and rheumatoid arthritis (RA) are yet to be established.

Objectives:

To evaluate the efficacy and safety of Iguratimod-based (IGU-based) Strategy in the above three types of pts, and to explore the characteristics of the effects of IGU monotherapy and combined treatment.

Methods:

This prospective cohort study (ClinicalTrials.gov Identifier NCT01548001) was conducted in China. In this phase 4 study pts with RA (ACR 1987 criteria[1]), ERA (not match ACR 1987 criteria[1] but match ACR/EULAR 2010 criteria[2] or 2014 ERA criteria[3]), UA (not match classification criteria for ERA and RA but imaging suggests synovitis) were recruited. We applied different treatments according to the patient’s disease activity at baseline, including IGU monotherapy and combination therapies with methotrexate, hydroxychloroquine, and prednisone. Specifically, pts with LDA and fewer poor prognostic factors were entered the IGU monotherapy group (25 mg bid), and pts with high disease activity were assigned to combination groups. A Chi-square test was applied for comparison. The primary outcomes were the proportion of pts in remission (REM)or low disease activity (LDA) that is DAS28-ESR<2.6 or 3.2 at 24 weeks, as well as the proportion of pts, achieved ACR20, Boolean remission, and good or moderate EULAR response (G+M).

Results:

A total of 313 pts (26 pts with UA, 59 pts with ERA, and 228 pts with RA) were included in this study. Of these, 227/313 (72.5%) pts completed the 24-week follow-up. The results showed that 115/227 (50.7%), 174/227 (76.7%), 77/227 (33.9%), 179/227 (78.9%) pts achieved DAS28-ESR defined REM and LDA, ACR20, Boolean remission, G+M response, respectively. All parameters continued to decrease in all pts after treatment (Fig 1).

Compared with baseline, the three highest decline indexes of disease activity at week 24 were SW28, CDAI, and T28, with an average decline rate of 73.8%, 61.4%, 58.7%, respectively. Results were similar in three cohorts.

We performed a stratified analysis of which IGU treatment should be used in different cohorts. The study found that the proportion of pts with UA and ERA who used IGU monotherapy were significantly higher than those in the RA cohort. While the proportion of triple and quadruple combined use of IGU in RA pts was significantly higher than that of ERA and UA at baseline and whole-course (Fig 2).

A total of 81/313 (25.8%) pts in this study had adverse events (AE) with no serious adverse events. The main adverse events were infection(25/313, 7.99%), gastrointestinal disorders(13/313, 4.15%), liver dysfunction(12/313, 3.83%) which were lower than 259/2666 (9.71%) in the previous Japanese phase IV study[4].

The most common reasons of lost follow-up were: 1) discontinued after remission 25/86 (29.1%); 2) lost 22/86 (25.6%); 3) drug ineffective 19/86 (22.1%).

Conclusion:

Both IGU-based monotherapy and combined therapies are tolerant and effective for treating UA, ERA, and RA, while the decline in joint symptoms was most significant. Overall, IGU combination treatments were most used in RA pts, while monotherapy was predominant in ERA and UA pts.

References:

[1]Levin RW, et al. Scand J Rheumatol 1996, 25(5):277-281.

[2]Kay J, et al. Rheumatology 2012, 51(Suppl 6):vi5-9.

[3]Zhao J, et al. Clin Exp Rheumatol 2014, 32(5):667-673.

[4]Mimori T, et al. Mod Rheumatol 2019, 29(2):314-323.

Disclosure of Interests:

None declared

In Vitro Evaluation of a Fluorescent Microemulsion as an Oral Delivery Carrier and its Potential Application in Tracking Bioactive Compounds Label-Free

In this work, a microemulsion emitting fluorescence was fabricated as a potential oral delivery system for bioactive compounds. In simulated oral administration, the microemulsion was characterized for its microstructure by ¹hydrogen-nuclear magnetic resonance (¹H-NMR). Results showed that microemulsions not only have good resistance to oral and gastric phases, but also lay a solid foundation for the release of bioactive compounds in the intestine. Fluorescence stability tests showed that microemulsions exhibit a remarkable fluorescence intensity in the digestive environment, indicating feasibility as a label-free delivery carrier. Moreover, in vitro release tests of bioactive compounds confirmed that an α-linolenic acid (ALA)-loaded microemulsion mainly released in the intestine, thereby achieving the aim of controlling the release of bioactive compounds. These results suggest that the synthesized fluorescent microemulsion, combining the favorable features of nontoxicity, antidigestive stability, remarkable fluorescence intensity, and controllable release, can be regarded as a promising label-free delivery carrier for oral administration.

Childhood COVID-19: a multicentre retrospective study

Objectives

To investigate the clinical and epidemiological characteristics of paediatric patients with coronavirus disease-19 (COVID-19).

Methods

Paediatric patients diagnosed with COVID-19 between January 15 and March 15, 2020, from seven hospitals in Zhejiang Province, China, were collected retrospectively and analysed.

Results

Thirty-two children with COVID-19, ranging in age from 3 months to 18 years, were enrolled. Family aggregation occurred in 87.5% of infant and preschool-aged children (7/8), and also school-aged children (14/16), but in only 12.5% (1/8) of adolescents (p < 0.05, p < 0.001). Most of these patients had mild symptoms: mainly fever (20/32) followed by cough (10/32) and fatigue (4/32). The average durations of viral RNA in respiratory samples and gastrointestinal samples were 15.8 d and 28.9 d, respectively. Detox duration in faeces decreased with age: 39.8 d, 27.5 d and 20.4 d in infants and preschool children, school children, and adolescents respectively (p_{0–6, –18} <0.01, p_{0–6, –14} <0.05). Pneumonia was found in 14 children, but there was no statistical significance in the incidence of pneumonia between different age groups. Thirty patients were treated with antiviral drugs, and all patients were stable and gradually improved after admission.

Conclusions

Most children with COVID-19 had a mild process and a good prognosis. More attention should be paid to investigation of household contact history in the diagnosis of COVID-19 in young children. Viral RNA lasts longer in the gastrointestinal system than in the respiratory tract, especially in younger children.

THU0252 CORRELATION BETWEEN DISEASE ACTIVITY AND MENTAL HEALTH IN SLE PATIENTS: A CROSS-SECTION STUDY WITH SELF-ASSESSMENTS BASED ON SMART SYSTEM OF DISEASE MANAGEMENT (SSDM) MOBILE TOOLS

Background:

WHO survey showed that the prevalence of anxiety and depression in Chinese population and Chinese patients with chronic diseases were between 3.1% - 4.2% and 3.1% - 7.3%, respectively. SLEDAI-2K and Hospital Anxiety and Depression Scale (HADS) are commonly used to evaluate SLE patients’ disease activity and mental health. All the Assessments were mainly performed by health professionals (HCPs) with paper questionnaire previously. SSDM is a novel smart disease management tool that allows patients to do self-assessments on SLEDAI-2K and HADS by mobile App.

Objectives:

To investigate the prevalence of anxiety and depression in Chinese patients with SLE and to analyze the potential association between disease activity of SLE and mental health.

Methods:

Under the guidance and training by HCPs, SLE patients downloaded SSDM and performed self-assessments bundle of SLEDAI-2K and HADS with SSDM. SLEDAI-2K <=4, 5-9, 10-14 and >=15 are defined SLE inactive, low (LDA), moderate (MDA) and high (HDA) disease activity, respectively. SLEDAI-2K score <= 4 is set as the main criteria for Lupus Low Disease Activity State (LLDAS) and achievement of T2T. HADS score >=8 can be diagnosed with anxiety or depression.

Results:

From June 2016 to Jan 2020, 3,332 SLE patients (199 male, 3,133 female) with a mean age of 36.34 ± 12.80 (10-91) years and the median disease duration of 3.43 years from 216 hospitals performed bundle self-assessments for 4,967 times in total. According to the HADS and SLEDAI-2K Assessment results, the prevalence of anxiety and depression in all patients was 36.7% and 39.3% respectively, which was significantly higher than that in the WHO survey in Chinese population and chronic disease patients. The proportion of patients achieved and failed on LLDAS was 53% and 47%, respectively. The prevalence of anxiety (A) and depression (D) was 19% and 27% among LLDAS achievers; 41% and 47% among LLDAS failures, respectively (pA<0.01, pD<0.01).

According to SLEDAI-2K, in LLDAS, LDA, MDA and HDA subgroups, the prevalence of anxiety and depression was 19%, 30%, 37%, 54% and 27%, 36%, 44%, 61%, respectively. The correlation coefficients of anxiety (A) and depression (D) with SLEDAI-2K were rA=0.9957 and rD=0.9819. It suggested that with the increase of disease activity, the proportion of SLE patients with anxiety and depression increased significantly. (Figure 1)

Conclusion:

Conclusion: Higher prevalence of anxiety and depression were Associated with higher levels of disease activity in SLE patients. SSDM is an effective mobile interface to monitor and study entanglement of disease activity and mental health in SLE patients, which build a foundation for proactive interventions physically and mentally in future.

References:

Acknowledgments:

SSDM was developed by Shanghai Gothic Internet Technology Co., Ltd.

Disclosure of Interests:

None declared

Chalcone synthase is ubiquitinated and degraded via interactions with a RING-H2 protein in petals of Paeonia 'He Xie'

Flavonoids are secondary metabolites widely distributed among angiosperms, where they play diverse roles in plant growth, development, and evolution. The regulation of flavonoid biosynthesis in plants has been extensively studied at the transcriptional level, but post-transcriptional, translational, and post-translational control of flavonoid biosynthesis remain poorly understood. In this study, we analysed post-translational regulation of flavonoid biosynthesis in the ornamental plant Paeonia, using proteome and ubiquitylome profiling, in conjunction with transcriptome data. Three enzymes involved in flavonoid biosynthesis were identified as being putative targets of ubiquitin-mediated degradation. Among these, chalcone synthase (PhCHS) was shown to have the greatest number of ubiquitination sites. We examined PhCHS abundance in petals using PhCHS-specific antibody and found that its accumulation decreased at later developmental stages, resulting from 26S proteasome-mediated degradation. We further identified a ring domain-containing protein (PhRING-H2) that physically interacts with PhCHS and demonstrated that PhRING-H2 is required for PhCHS ubiquitination. Taken together, our results suggest that PhRING-H2-mediates PhCHS ubiquitination and degradation is an important mechanism of post-translational regulation of flavonoid biosynthesis in Paeonia, providing a theoretical basis for the manipulation of flavonoid biosynthesis in plants.

3.7 kW monolithic narrow linewidth single mode fiber laser through simultaneously suppressing nonlinear effects and mode instability

In this paper, we report a 3.7 kW all fiber narrow linewidth single mode fiber laser. The full width at half-maximum is about 0.30 nm, and the beam quality is Mx2=1.358, My2=1.202 at maximum output power. The laser is achieved by simultaneously suppressing nonlinear effects and mode instability (MI). Different seeds are injected into the main amplifier to study stimulated Raman scattering (SRS) effect. The results show that the phase modulated single frequency seed is benefit to suppress the SRS effect. For the phase modulated single frequency seed, inserting a filter in preamplifier will suppress amplified spontaneous emission (ASE) and decrease the backward power. By optimizing the coiling of active fiber, the MI effect is suppressed.

A Novel R2R3-MYB Transcription Factor Contributes to Petal Blotch Formation by Regulating Organ-Specific Expression of PsCHS in Tree Peony (Paeonia suffruticosa)

Flower color patterns play critical roles in plant-pollinator interactions and represent one of the most common adaptations during angiosperm evolution. However, the molecular mechanisms underlying flower color pattern formation are less understood in non-model organisms. The aim of this study was to identify genes involved in the formation of petal blotches in tree peony (Paeonia suffruticosa) through transcriptome profiling and functional experiments. We identified an R2R3-MYB gene, PsMYB12, representing a distinct R2R3-MYB subgroup, with a spatiotemporal expression pattern tightly associated with petal blotch development. We further demonstrated that PsMYB12 interacts with a basic helix-loop-helix (bHLH) and a WD40 protein in a regulatory complex that directly activates PsCHS expression, which is also specific to the petal blotches. Together, these findings advance our understanding of the molecular mechanisms of pigment pattern formation beyond model plants. They also benefit molecular breeding of tree peony cultivars with novel color patterns and promote germplasm innovation.

Long-term effects: Galectin-1 and specific immunotherapy for allergic responses in the intestine

BACKGROUND AND AIMS

Mast cell activation interferes with the effects of allergen-specific immunotherapy (SIT). Galectin-1 (Gal-1) is capable of regulating immune cells' functions. This study tests the hypothesis that administration of Gal-1 promotes and prolongs the efficacy of SIT via suppressing mast cell activation.

METHODS

An intestinal allergy mouse model was developed. The coadministration of SIT and Gal-1 on suppression of the allergic responses, prevention of mast cell activation, and generation of antigen-specific regulatory T cells (Treg) in the intestine was observed in sensitized mice.

RESULTS

The coadministration of Gal-1 and SIT markedly suppressed the allergic responses in the mouse intestine vs the use of either SIT alone or Gal-1 alone. The Gal-1 binds to the IgE/FcɛRI complexes on the surface of mast cells to prevent mast cell activation during SIT. Gal-1 promoted the SIT-generated allergen-specific Tregs in the intestine of sensitized mice. Coadministration of Gal-1 and SIT significantly enhanced the efficacy of immunotherapy in suppressing allergic responses in the intestine, which lasted for at least for 12 months.

CONCLUSIONS

Long-term effects of specific immunotherapy on intestinal allergy can be achieved with Gal-1/SIT therapy by inhibiting mast cell activation and facilitating Treg development.

[The role and significance of digital reconstruction technique in liver segments based on portal vein structure]

Objective: To study the segment of liver according to the large amount of three-dimensional(3D) reconstructive images of normal human livers and the vascular system, and to recognize the basic functional liver unit based on the anatomic features of the intrahepatic portal veins. Methods: The enhanced CT primitive DICOM files of 1 260 normal human livers from different age groups who treated from October 2013 to February 2017 provided by 16 hospitals were analyzed using the computer-aided surgery system.The 3D liver and liver vascular system were reconstructed, and the digital liver 3D model was established.The vascular morphology, anatomical features, and anatomical distributions of intrahepatic portal veins were statistically analyzed. Results: The digital liver model obtained from the 3D reconstruction of CAS displayed clear intrahepatic portal vein vessels of level four.Perform a digital liver segments study based on the analysis of level four vascular distribution areas.As the less anatomical variation of left hepatic portal vein, the liver was classified into four types of liver segmentation mainly based on right hepatic portal vein.Type A was similar to Couinaud or Cho's segmentation, containing 8 segments(537 cases, 42.62%). Type B contained 9 segments as there are three ramifications of right-anterior portal vein(464 cases, 36.82%). The main difference for Type C was the variation of right-posterior portal vein which was sector shape(102 cases, 8.10%). Type D contained the cases with special portal vein variations, which needs three-dimensional simulation to design individualized liver resection plan(157 cases, 12.46%). These results showed that there was no significant difference in liver segmental typing between genders(χ(2)=2.179, P=0.536) and did not reveal any significant difference in liver segmental typing among the different age groups(χ(2)=0.357, P=0.949). Conclusions: The 3D digital liver model can demonstrate the true 3D anatomical structures, and its spatial vascular variations.The observation of anatomic features, distribution areas of intrahepatic portal veins and individualized liver segmentation achieved via digital medical 3D visualization technology is of great value for understand the complexity of liver anatomy and to guide the precise hepatectomy.

Promoter polymorphisms of the TIM-4 gene are correlated with disease activity in patients with systemic lupus erythematosus

Although the TIM gene family plays important roles in immune responses, little is known about TIM regulation in the development of systemic lupus erythematosus (SLE). This study aimed to investigate the association of two TIM-4 single nucleotide polymorphisms (SNPs) rs6874202 (-1419G>A) and rs62382402 (-1609G>A) with SLE susceptibility in a Chinese Han population. The results showed no significant differences between patients with SLE and control group for rs6874202 and rs62382402 (p = .72, .53 respectively). However, the anti-dsDNA levels in serum from SLE patients with GG genotype of TIM-4 gene at -1419 site were significantly higher than those with GA and AA genotype (p = .0335), and C3 levels of SLE patients with GG and GA genotype were much lower than those with AA genotypes (p = .0187). Moreover, the apoptotic cell levels of SLE patients with AA and GG genotypes were significantly higher than those with GA genotypes in patients with SLE (p = .0393). In addition, the C3 concentration of SLE patients with the GG genotype of TIM-4 gene at -1609 site was found to be significantly higher than those with the GA genotype (p = .0129). The results imply that GG genotype of the TIM-4 gene at -1419 site might be associated with the disease activity of SLE.

Overexpression of PSK1, a SKP1-like gene homologue, from Paeonia suffruticosa, confers salinity tolerance in Arabidopsis

Our study is the first to demonstrate that PSK1 , a SKP1 -like gene homologue, is involved in salinity tolerance. Our functional characterization of PSK1 provides new insights into tree peony development. A homologous gene of S-phase kinase-associated protein1 (SKP1) was cloned from tree peony (Paeonia suffruticosa) and denoted as PSK1. The 462-bp open reading frame of PSK1 was predicted to encode a protein comprising 153 amino acids, with a molecular mass of 17 kDa. The full-length gene was 1,634 bp long and included a large 904-bp intron. PSK1 transcription was detected in all tissues, with the highest level observed in sepals, followed by leaves. Under salinity stress, overexpression of PSK1 in Arabidopsis resulted in increased germination percentages, cotyledon greening, and fresh weights relative to wild-type plants. Furthermore, transgenic Arabidopsis lines containing 35S::PSK1 displayed increased expression of genes that would be essential for reproduction and growth under salinity stress: ASK1, LEAFY, FT, and CO involved in flower development and flowering time as well as P5CS, RAB18, DREB, and SOD1-3 contributing to salinity tolerance. Our functional characterization of PSK1 adds to global knowledge of the multiple functions of previously explored SKP1-like genes in plants and sheds light on the molecular mechanism underlying its role in salinity tolerance. Our findings also provide information on the function and molecular mechanism of PSK1 in tree peony flower development, thereby revealing a theoretical basis for regulation of flowering and conferral of salinity tolerance in tree peony.

[Extracorporeal membrane oxygenation for rescuing 12 children with acute fulminant myocarditis]

Objective: To summarize clinical experience of using extracorporeal membrane oxygenation (ECMO) in rescuing children with acute fulminant myocarditis (AFM). Method: Data of 12 children with acute fulminate myocarditis (6 boys and 6 girls, median age 8.3 (0.6, 13.0) years, median weight 33.1 (6, 61) kg) who were rescued with ECMO in Children's Hospital, Zhejiang University from September 2009 to August 2015 were analyzed retrospectively. The analysis focused on the intervene timing of ECMO for the cardiogenic shock and hypoperfusion caused by heart failure and(or) lethal arrhythmia and the essentials of ECMO cardiopulmonary resuscitation(ECPR) for cardiac arrest in pediatric AFM were summarized. Result: The median ECMO duration was 110(22, 240) h. Ten cases survived and 2 were dead of the total of 12 patients. Six ECPR patients survived and 2 were dead in the total of 8 ECPR patients. The complication of 10 survivors were cannula site bleeding (3 cases), hypernatremia and intracranial hemorrhage (1 case), limping (1 case), hoarse voice (1 case), and cerebral injury (1 case). Conclusion: The key points of improving ECMO rescuing outcome for the AFM children are grasping the ECMO intervene timing and training skilled ECMO team. For ECPR patients, keeping effective chest compressions resuscitation is the key to achieve survival and improve the quality of life.

A smoking cessation intervention among tuberculosis patients in rural China

OBJECTIVE

To assess the integration of a smoking cessation intervention into routine tuberculosis (TB) services.

METHOD

Consecutive TB patients registered from 1 March to 31 August 2010 were enrolled in an intervention for self-reported smoking to promote tobacco cessation during treatment for TB. Information on the harmful health effects of tobacco smoke and smoking and TB were provided to TB patients who self-reported as current smokers. Smoking status was reassessed at every follow-up visit during anti-tuberculosis treatment with reinforced health messages and advice to quit.

RESULTS

Of 800 TB patients enrolled, 572 (71.5%) were male and 244 (30.5%) were current smokers. Females were more likely to be non-smokers (100% vs. 35.8%, P < 0.001). Of the 244 current smokers, 144 (59.0%) started smoking at <20 years, 197 (80.7%) consumed ⩾20 cigarettes per day, 211 (86.5%) had perceived smoking dependence and 199 (81.6%) had made no attempt to quit before the diagnosis of TB. Of the 244 current smokers, 234 (95.9%) were willing to quit, and 156 (66.7%) reported abstinence at month 6. Challenges to implementing smoking cessation intervention were identified.

CONCLUSION

The majority of current smokers among TB patients were willing to quit and remained abstinent at the end of anti-tuberculosis treatment. This intervention should be scaled up nationwide.

Rapid microsatellite development for tree peony and its implications

BACKGROUND

Microsatellites are ubiquitous in genomes of various organisms. With the realization that they play roles in developmental and physiological processes, rather than exist as 'junk' DNA, microsatellites are receiving increasing attention. Next-generation sequencing allows acquisition of large-scale microsatellite information, and is especially useful for plants without reference genome sequences.

RESULTS

In this study, enriched DNA libraries of tree peony, a well-known ornamental woody shrub, were used for high-throughput microsatellite development by 454 GS-FLX Titanium pyrosequencing. We obtained 675,221 reads with an average length of 356 bp. The total size of examined sequences was 240,672,018 bp, from which 237,134 SSRs were identified. Of these sequences, 164,043 contained SSRs, with 27% featuring more than one SSR. Interestingly, a high proportion of SSRs (43%) were present in compound formation. SSRs with repeat motifs of 1-4 bp (mono-, di-, tri-, and tetra-nucleotide repeats) accounted for 99.8% of SSRs. Di-nucleotide repeats were the most abundant. As in most plants, the predominant motif in tree peony was (A/T)n, with (G/C)n less common. The lengths of SSRs were classified into 11 groups. The shortest SSRs (10 bp) represented 1% of the total number, whereas SSRs 21-30 and 101-110 bp long accounted for 26% and 29%, respectively, of all SSRs. Many sequences (42,111) were mapped to CDS (coding domain sequence) regions using Arabidopsis as a reference. GO annotation analysis predicted that CDSs with SSRs performed various functions associated with cellular components, molecular functions, and biological processes. Of 100 validated primer pairs, 24 were selected for polymorphism analysis among 23 genotypes; cluster analysis of the resulting data grouped genotypes according to known relationships, confirming the usefulness of the developed SSR markers.

CONCLUSIONS

The results of our large-scale SSR marker development using tree peony are valuable for investigating plant genomic structural evolution and elucidating phenotypic variation in this species during its evolution and artificial selection. The newly identified SSRs should be useful for genetic linkage map construction, QTL mapping, gene location and cloning, and molecular marker-assisted breeding. In addition, the genome-wide marker resources generated in this study should aid genomic studies of tree peony and related species.

Analysis of 15 patients with systemic lupus erythematosus manifesting with negative immunofluorescence anti-nuclear antibodies after treatment

The purpose of this study was to investigate the clinical and laboratorial characteristics of patients with systemic lupus erythematosus (SLE) manifesting with negative immunofluorescence anti-nuclear antibodies (IFANA) after treatment for the better understanding of negative conversion of IFANA. Demographic characteristics, clinical and laboratory data of hospitalized SLE patients between March 2006 and May 2011 were retrospectively reviewed. Fifteen cases with negative IFANA were identified in 960 patients. All of the 15 patients were severe, 11 patients manifested with nephritic range proteinuria and hypoalbuminemia, 8 patients were complicated with severe infection and all of the patients had been treated with glucocorticoid and immunosuppressant. Anti-ENA antibodies were positive in 4 of 15 patients. Eight patients died after average 1-year follow-up. Collectively, negative IFANA is mainly attributed to nephritic-range proteinuria; and large-dose glucocorticoid, immunosuppressant and severe infection are also important factors for negative IFANA. Antinuclear antibody can be detected in some SLE patients with negative IFANA by changing the detection method and titer. Negative conversion of IFANA often indicates unfavorable prognosis for severe patients.

Relationship between the composition of flavonoids and flower colors variation in tropical water lily (Nymphaea) cultivars

Water lily, the member of the Nymphaeaceae family, is the symbol of Buddhism and Brahmanism in India. Despite its limited researches on flower color variations and formation mechanism, water lily has background of blue flowers and displays an exceptionally wide diversity of flower colors from purple, red, blue to yellow, in nature. In this study, 34 flavonoids were identified among 35 tropical cultivars by high-performance liquid chromatography (HPLC) with photodiode array detection (DAD) and electrospray ionization mass spectrometry (ESI-MS). Among them, four anthocyanins: delphinidin 3-O-rhamnosyl-5-O-galactoside (Dp3Rh5Ga), delphinidin 3-O-(2"-O-galloyl-6"-O-oxalyl-rhamnoside) (Dp3galloyl-oxalylRh), delphinidin 3-O-(6"-O-acetyl-β-glucopyranoside) (Dp3acetylG) and cyanidin 3- O-(2"-O-galloyl-galactopyranoside)-5-O-rhamnoside (Cy3galloylGa5Rh), one chalcone: chalcononaringenin 2'-O-galactoside (Chal2'Ga) and twelve flavonols: myricetin 7-O-rhamnosyl-(1 → 2)-rhamnoside (My7RhRh), quercetin 7-O-galactosyl-(1 → 2)-rhamnoside (Qu7GaRh), quercetin 7-O-galactoside (Qu7Ga), kaempferol 7-O-galactosyl-(1 → 2)-rhamnoside (Km7GaRh), myricetin 3-O-galactoside (My3Ga), kaempferol 7-O-galloylgalactosyl-(1 → 2)-rhamnoside (Km7galloylGaRh), myricetin 3-O-galloylrhamnoside (My3galloylRh), kaempferol 3-O-galactoside (Km3Ga), isorhamnetin 7-O-galactoside (Is7Ga), isorhamnetin 7-O-xyloside (Is7Xy), kaempferol 3-O-(3"-acetylrhamnoside) (Km3-3"acetylRh) and quercetin 3-O-acetylgalactoside (Qu3acetylGa) were identified in the petals of tropic water lily for the first time. Meanwhile a multivariate analysis was used to explore the relationship between pigments and flower color. By comparing, the cultivars which were detected delphinidin 3-galactoside (Dp3Ga) presented amaranth, and detected delphinidin 3'-galactoside (Dp3'Ga) presented blue. However, the derivatives of delphinidin and cyanidin were more complicated in red group. No anthocyanins were detected within white and yellow group. At the same time a possible flavonoid biosynthesis pathway of tropical water lily was presumed putatively. These studies will help to elucidate the evolution mechanism on the formation of flower colors and provide theoretical basis for outcross breeding and developing health care products from this plant.

Analysis of the formation of flower shapes in wild species and cultivars of tree peony using the MADS-box subfamily gene

Tree peony (Paeonia suffricotisa) cultivars have a unique character compared with wild species; the stamen petalody results in increased whorls of petals and generates different flower forms, which are one of the most important traits for cultivar classification. In order to investigate how petaloid stamens are formed, we obtained the coding sequence (666 bp) and genomic DNA sequence of the PsTM6 genes (belongs to B subfamily of MADS-box gene family) from 23 tree peony samples, Five introns and six exons consisted of the genomic DNA sequence. The analysis of cis-acting regulatory elements in the third and fourth intron indicated that they were highly conserved in all samples. Partial putative amino acids were analyzed and the results suggested that functional differentiation of PsTM6 paralogs apparently affected stamen petalody and flower shape formation due to due to amino acid substitution caused by differences in polarity and electronic charge. Sliding window analysis indicated that the different regions of PsTM6 were subjected to different selection forces, especially in the K domain. This is the first attempt to investigate genetic control of the stamen petalody based on the PsTM6 sequence. This will provide a basis for understanding the evolution of PsTM6 and its the function of in determining stamen morphology of tree peony.

Viability and delivery of immobilised Lactobacillus reuteri DPC16 within calcium alginate gel systems during sequential passage through simulated gastrointestinal fluids

The objective of the study was to design and produce calcium alginate beads that can deliver immobilised Lactobacillus reuteri DPC16 to a target site of the colon in the gastrointestinal (GI) tract. In this study, several factors that might affect the effectiveness of calcium alginate gel beads entrapping L. reuteri DPC16 cells were investigated. An in vitro GI tract model was used to simulate the pH variation and the existence of enzymes. Firstly, by varying the concentration of alginate at a constant concentration of CaCl2 the survival of immobilised DPC16 cells in simulated gastric fluid (SGF) was observed; secondly, the physical stability of calcium alginate beads containing skim milk during sequential incubation in the GI fluids was observed using optimal concentrations of alginate; finally, the survival of DPC16 cells immobilised within alginate beads containing skim milk were compared when the beads were incubated for different times during sequential exposure to the simulated fluids. The results demonstrated that non-encapsulated DPC16 cells were sensitive to an acidic environment, and no viable cells were detected after 90 min exposure in SGF (pH 1.2). With the protection of calcium alginate gel, the survival rate of immobilised DPC16 cells was slightly improved. An alginate concentration of 4% (w/v) was the most effective of those tested, but due to the irregular shape it formed, an alginate concentration of 3% (w/v) was used in further investigations. When skim milk (8% (w/v)) was added to the alginate solution, the cell survival was improved markedly. The optimal concentration of calcium chloride was 0.3 M, because the beads maintained their integrity in SGF and simulated intestinal fluid while disintegrating in simulated colonic fluid. The beads made from 3% alginate, 8% skim milk and 0.3 M CaCl2 proved to be an effective delivery and release system for DPC16 cells.

Flavonoid composition and antioxidant activity of tree peony (Paeonia section moutan) yellow flowers

Tree peony flowers are edible and traditional Chinese medicine materials. In the present study, 26 flavonoids were identified and quantified in yellow flowers of tree peony by high-performance liquid chromatography with diode array detector (HPLC-DAD) and by HPLC-electrospray ionization-mass spectrometry (HPLC-ESI-MS). Seventeen of them were first reported in flowers of tree peony, and glycosides of kaempferol, luteolin, and apigenin as well as isosalipurposide were the main flavonoids investigated. Furthermore, the petal extracts showed high antioxidant activity according to DPPH*, ABTS*(+), and OH* scavenging assays and ferric reducing antioxidant power assay. There were significant correlations between antioxidant activity and both the total polyphenol content (determined by Folin-Ciocalteu method) and the total content of quercetin, kaempferol, and luteolin glycosides. This work is valuable for elucidation of phenolic composition in tree peony flowers and for further utilization of them as functional food and medicine materials.

GMCHI, cloned from soybean [Glycine max (L.) Meer.], enhances survival in transgenic Arabidopsis under abiotic stress

Plants respond to cold stress by modifying the expression of a battery of cold-responsive genes. Using cDNA-AFLP techniques, GMCHI (G lycine m ax chilling-inducible) (accession no. EU699765) was isolated from the embryonic axis of a chilling-resistant cultivar of soybean seed imbibed at 4 degrees C for 24 h. The full-length GMCHI cDNA which consisted of a single open reading frame (ORF) encoded a putative polypeptide of 129 amino acids. Sequence analysis revealed neither significant similarity of GMCHI to known proteins, nor any conserved domains found. Soybean seed imbibed at 4 degrees C dramatically enhanced transcript level of GMCHI after 1 h, and reached a maximum at 18 h, while the expression was only detected in the embryonic axis. GMCHI expression was strongly induced by treatment with ABA and PEG, but weakly by 250 mM NaCl which suggests that GMCHI is probably regulated by ABA-dependent signal transduction pathway during cold acclimation. Overexpression of GMCHI in Arabidopsis under the control of CaMV35S promoter enhanced the tolerance to cold, drought and NaCl stresses. Therefore, GMCHI may play an important role in the adaptation of chilling-resistant soybean seed to chilling imbibition.